The document discusses blood film examination and abnormalities seen in red blood cells. Key points include:
Blood films are prepared manually or automatically and stained using Romanowsky stains like Giemsa or Leishman's. Films are examined under low then high power microscopy to assess cell morphology and identify abnormalities.
Abnormal red blood cell morphology seen in various anemias includes microcytosis in iron deficiency, macrocytosis in megaloblastic anemia, poikilocytosis in thalassemia, and hypochromia in iron deficiency. Specific abnormalities include target cells, sickle cells, spherocytes, and nucleated red blood cells. The differential diagnosis is considered based on the
An absolute eosinophil count is a blood test that measures the number of one type of white blood cells called eosinophils.
Eosinophils become active when you have certain allergic diseases, infections, and other medical conditions.
to download this presentation from this link
https://mohmmed-ink.blogspot.com/2020/11/evaluation-of-peripheral-blood-smear.html
Evaluation of the Peripheral Blood Smear
An absolute eosinophil count is a blood test that measures the number of one type of white blood cells called eosinophils.
Eosinophils become active when you have certain allergic diseases, infections, and other medical conditions.
to download this presentation from this link
https://mohmmed-ink.blogspot.com/2020/11/evaluation-of-peripheral-blood-smear.html
Evaluation of the Peripheral Blood Smear
anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia, also referred to as low hemoglobin, can make you feel tired and weak. There are many forms of anemia, each with its
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. BLOOD FILM PREPARATION
made on clean glass slides
Films may be spread by hand or by
means of an automated slide spreader
Manual Method
3. • Hemogram:
measured and
calculated
parameters
• Histograms:
size distribution of
WBC, RBC and Plt
• Cytogram: WBC
differential
CBC on automated analyzers
Flagging for abnormalities
necessitates a manual
PBS review
4. STAINING BLOOD AND BONE MARROW
FILMS
Romanowsky stains are used universally for
routine stainingof blood films
Giemsa’s Stain
Leishman’s Stain
Automatic staining machines are available that
enable large batches of slides to be handled
5. EXAMINATION OF BLOOD FILMS
examined systematically
starting with macroscopic observation of the
stained film assess whether the spreading
technique was satisfactoryand to judge its
staining characteristics and either any
abnormal particles present
6. EXAMINATION OF BLOOD FILMS
Microscopic examination- progressing from low-
power to high-power
Under low magnification to:
(a) get an idea of the quality of the preparation
(b) assess whether red cell agglutination, excessive
rouleaux formation or platelet aggregation is present
(c) assess the number, distribution and staining
of the leucocytes
(d) find an area where the red cells are evenly distributed
and are not distorted
7. EXAMINATION OF BLOOD FILMS
Having selected a suitable area,
Inspection under high-power magnification
for the final examination of unusual cells and for
looking at fine details
9. RED CELL MORPHOLOGY
NORMAL
SHAPE - round, smooth contours
SIZE- range of 7–8 μm (about the same as that of the nucleus
of a small lymphocyte on the dried film)
STAIN - Central pallor 1/3 of total area
stain quite deeply with the eosin component of
Romanowsky dyes, particularly at the periphery of
the cell as a result of the cell’s normal biconcavity
10. Biconcave disc
Diameter : 7 - 8 μm
Central pallor occupy 1/3
rd of total
Size : approx. same as
nucleus of mature
lymphocyte
NORMAL RED CELL MORPHOLOGY
12. ABNORMAL ERYTHROPOIESIS
Anisocytosis- variation in size of RBC
result of the presence of cells larger than normal
(macrocytosis), cells smaller than normal
(microcytosis) or both; frequently both
macrocytes and microcytes are present
13. Microcytes
results from a defect in haemoglobin
formation
characteristic of iron deficiency anaemia
various types of thalassaemia and severe
cases of anaemia of chronic disease.
Anisocytosis
14. Anisocytosis
Macrocytes
classically found in megaloblastic anaemias
also present in some cases of aplastic anaemia,
myelodysplastic syndromes ,other
dyserythropoietic states, in patients being
treated with hydroxyurea, chronic alcoholic &
chronic liver disease
15. Poikilocytosis –variation in shape of RBC
produced in many types of abnormal
erythropoiesis
for example
- megaloblastic anaemia
- iron deficiency anaemia
- Thalassaemia
- Myelofibrosis
ABNORMAL ERYTHROPOIESIS
16. Poikilocytosis
Elliptocytes and ovalocytes
present when there is dyserythropoiesis
in megaloblastic anaemia (macro-ovalocytes)
in iron deficiency anaemia (‘pencil cells’)
17. Target Cells
refers to a cell in which there is a central round
stained area and a peripheral rim of
haemoglobinized cytoplasm separated by non-
staining or more lightly staining cytoplasm
result from cells having a surface that is
disproportionately large compared with their
volume
are seen in films in chronic liver diseases, iron
deficiency anaemia and thalassaemia
Poikilocytosis
18. Sickle Cells - vary in shape between boat-shaped forms
and sickles
SPICULATED CELLS AND RED CELL FRAGMENTATION
- Schistocytosis – Fragmented red cells
- Acanthocytosis- abnormality of the red cell in which
there are a small number of spicules of inconstant length,
thickness
-Stomatocytosis ,
Red cell inclusion bodies- Howell–Jolly Bodies
Pappenheimer Bodies
Basophilic stippling or punctate basophilia
Poikilocytosis
20. seen when there is extramedullary erythropoiesis
Tear drop cells / dacrocytes
• Osteopetrosis
• Myelofibrosis
• Bone marrow infiltrated with
hematological or
non-hematological
malignancies
• Iron deficiency anemia
• Pernicious anemia
22. Hyperchromasia (Hyperchromia)
deep staining of the red cells with a lack of
central pallor
seen in two circumstances
- in the presence of macrocytes
- cells are abnormally rounded
Abnormally rounded cells may be either
spherocytes or irregularly contracted cells
23. Spherocytosis
cells that are more spheroidal (i.e. less disc like)
than normal red cells but maintain a regular
outline
diameter is less and thickness is greater than
normal
result from genetic defects of the red cell
membrane as in hereditary spherocytosis,
haemolytic anaemia
24. Anisochromasia-
Dimorphic Red Cell Population
abnormal variability in staining of red with two
distinct populations
is characteristic of a changing situation
It can occur during the development or resolution
of iron deficiency anaemia
25. Polychromasia
Blue-gray coloration of RBCS.
Due RNA remnants
Increased - Increased erythropoietic
activity. Decreased - Hypoproliferative
states.
Hemolytic anemias
•Blood loss anemias
•Recovering anemia
30. Examination of peripheral blood film
RBC shows Hypochromic Microcytic anaemia with
moderate anisocytosis & poikilocytosis with the
presence of elliptical forms, elongated pencil
shaped cells
WBC - white cell count and differential are normal
Platelet - normal
Comment: Hypochromic Microcytic anaemia
Differential diagnosis: Iron deficiency anaemia
Thalasaemia
32. Microcytosis Macrocytosis Target cells Spherocytes Red cell
fragments
Nucleated
red blood Howell-Jolly body
Basophilic stippling
Polychromasia
abnormal ribosom
al RNA appears as
blue dots
33. Shows marked anisocytosis, marked poikilocytosis,
one unusually large macrocyte and one severely
hypochromic cell
34. Blood film showing macrocytes, oval macrocytes & a
hypersegmented neutrophil
