This document provides information about a complete blood count (CBC) analysis. It discusses the components of a CBC and blood analysis that are measured, including hemoglobin, red blood cell count, hematocrit, and others. It also summarizes common red blood cell disorders like anemia, explaining causes such as blood loss, impaired production, and increased destruction. Specific types of anemia like iron deficiency and thalassemia are described. The white blood cell differential count and platelet count are also overviewed.

1. Topic :- Complete blood count analysis
Dr Rahul JainDr Sharda Jain
for Gynaecologist & Surgery Specialist

2. Over 400 ppts are available on
slideshare.net ***for use of public/Doctors
www.slideshare.net / Lifecarecentre

3. HAEMOGRAM AND CBC ARE THEY
DIFFT?
• HAEMOGRAM=CBC+ESR
• ALWAYS GET A PERIPHERAL SMEAR!

4. BLOOD ANALYSIS
• HAEMOGLOBIN
• RBC COUNT
• HAEMATOCRIT
• MEAN CORPUSCULAR VOLUME
• MEAN CORPUSCULAR HAEMOGLOBIN
• MEAN CORPUSCULAR HAEMOGLOBIN CONCENTERATION
• RED CELL DISTRIBUTION WIDTH
• RETICULOCYTE COUNT
• TOTAL LEUCOCYTE COUNT
• DLC(N/L/M/E/B)
• PLATELET COUNT
• ESR
• PERIPHERAL SMEAR

5. RED BLOOD CELL DISORDERS-

6. ANAEMIA-
• DUE TO BLOOD LOSS-POST HAEMORRHAGE,CHRONIC
BLOOD LOSS
• DUE TO IMPAIRED PRODUCTION-
1. B12,FOLIC ACID,IRON,NUTRITIONAL DEFICIENCY
2. APLSTIC ANAEMIA
3. ANAEMIA OF CHRONIC DISEASES-
TB,INFECTIONS,RENAL DISEASES,LIVER DISEASE
4. BONE MARROW INFILTRATION-
LEUKEMIA,LYMPHOMAS,MULTIPLE MYELOMA
5. CONGENITAL ANAEMIAS-SIDEOBLASTIC ANAEMIA

7. ANAEMIA-
• ANAEMIA DUE TO INCREASED RED CELL
DESTRUCTION-
(HAEMOLYTIC ANAEMIA’S)

8. haemoglobin
• OXYGEN CARRYING PIGMENT IN RBC
• NORMAL LEVELS-MALE=14-18 GM/DL
FEMALES=12-15.5GM/DL
• DECREASED IN ANAEMIA
• INCREASED IN CHRONIC
SMOKERS,POLYCYTHEMIA,DEHYDRAT.
• ANAEMIA SEVERITY(WHO)-
1. MILD ANAEMIA-9-11 GM/DL
2. MODERATE ANAEMIA-7-9 GM/DL
3. SEVERE ANAEMIA-<7 GM/DL

9. RBC COUNT
• NO. OF RBC PER MICROLITRE OF BLOOD
• NORMAL-MALES=5-6 MILLION/MM3
FEMALES=4.5-5.5 MILLION/MM3
• DECREASED IN ANAEMIA
• INCREASED IN CHRONIC
SMOKERS,DEHYDRATION,CHRONIC
HYPOXIA,POLYCYTHEMIA

10. HAEMATOCRIT
• VOLUME OF RBC PER LITRE OF WHOLE BLOOD
• EXPRESSED IN PERCENTAGE
• NORMAL LEVELS-MALES 40-54%
FEMALES 37-47%
• DECREASED IN ANAEMIA
• INCREASED IN CHRONIC
SMOKERS,DEHYDRATION,CHRONIC
HYPOXIA,POLYCYTHEMIA,SHOCK
• HELPS TO CALCULATE MCH,MCHC,MCV

11. MEAN CORPUSCULAR VOLUME
• AVERAGE VOLUME OF ONE RBC (FEMTOLITRE)
• NORMAL VALUES-77-93 FEMTOLITRES
• NORMAL VOLUME-NORMOCYTES
• DECREASED VOLUME-MICROCYTES(IRON
DEFICIENCY,THALASSEMIA,SIDEROBLASTIC

12. MEAN CORPUSCULAR
HAEMOGLOBIN
• AVERAGE AMT OF HAEMOGLOBIN IN SINGLE
RBC IN PICOGRAM
• Normal values-27-32 PICOGRAMS
• NORMAL AMOUNT-NORMOCHROMASIA

13. MEAN CORPUSCULAR
HAEMOGLOBIN CONCENTERATION
• HAEMOGLOBIN CONCENTERATION IN SINGLE
RBC(PERCENTAGE OF HAEMOGLOBIN
OCCUPIED IN SINGLE RBC)
• NORMAL 32-37%

14. RED CELL DISTRIBUTION WIDTH
• VARIATION BETWEEN SMALLEST RBC AND
LARGEST RBC
• NORMAL LEVELS(11.6-14%)
• VARIATION IN SIZE(ANISOCYTOSIS)-2 TYPES-
MICRO AND MACROCYTES
• VARIATION IN SHAPE(POIKILOCYTOSIS)-SEEN
IN IDA,MEGALOBLASTIC

16. Reticulocyte count
• INDICATES MARROW ERYTHROPOEITIC
ACTIVITY
• NORMAL 0.5-2.5%
• HIGH RETIC COUNT-HAEMOLYTIC
ANAEMIA,ACUTE HG,THALASSEMIA,RESPONSE
TO IRON THERAPY
• LOW RETIC COUNT-IDA,B12,FOLIC ACID
DEFICIENCY,ACD

17. ERYTHROCYTE SEDIMENTATION
RATE-
• USED AS AN INDEX FOR PRESENCE OF ACTIVE
DISEASE.
• NORMAL VALUES AT END OF 1ST HOUR MALES-
0-7MM
FEMALES 0-
15MM

18. PERIPHERAL SMEAR-

19. PERIPHERAL SMEAR
• RBC MORPHOLOGY
1. SIZE(MICRO,NORMO,MACROCYTE)
2. PIGMENT(HYPO,NORMO,HYPERCHROMIA)
3. POIKILOCYTOSIS(VARIATION IN SHAPE)
4. SPECIAL APPEARANCES-SICKLE CELLS,TEAR
DROP
CELLS,SPHEROCYTES,SCHISTOCYTES,HOWELL
JOLLY BODIES,HEINZ BODIES)

20. IDA PS-
• MICROCYTES
• HYPOCHROMIA
• INCREASED CENTRAL
PALLOR
• POIKILOCYTOSIS
• NORMAL WBC

21. MEGALOBLASTIC ANAEMIA PS-
• MACROCYTES
• NORMOCHROMIC
• TEAR DROP CELLS
• ANISOPOIKILOCYTOSIS
• LESS PLATELETS
• HYPERSEGMENTED
NEUTROPHILS

22. (QUALITATIVE)Sickle cell anaemia-
• RED CELLS DEVELOP SICKLING WHEN
EXPOSED TO LOW OXYGEN
TENSION(HYPOXIA,ACIDOSIS)
• DEFECTIVE BETA CHAIN IN
GLOBIN(ALPHA2,BETA2)
• HAEMOLYSIS HISTORY
• ANAEMIA IN CBC(Hb 6-9 GM/DL)
• PERIPHERAL SMEAR-SICKLE CELLS,TARGET
CELLS,HOWELL JOLLY BODIES

23. (QUANTITATIVE D/S)THALASSEMIA-
• SYNTHESIS OF GLOBIN CHAIN AFFECTED,ALPHA
OR BETA
• MORE COMMONLY BETA,REDUCED
FORMATION OF NORMAL HAEMOGLOBIN
• H/O MULTIPLE BLOOD
TRANSFUSION,JAUNDICE,IRON CHEL.
• RBC WITH LESS HB ARE PRODUCED(SMALL AND
PALE RBC’S)

25. FEATURES IRON DEFICIENCY ANAEMIA THALASSEMIA
BLOOD PICTURE MICROCYTIC HYPOCHROMIC MICROCYTIC HYPOCHROMIC
ANISOCYTOSIS(SIZE
VARIATION)
++ --(UNIFORM SIZE)
RDW WIDE NARROW
RETIC COUNT LOW SLIGHTLY HIGH
RBC COUNT LOW(LOW IRON) HIGH(COMPENSATORY)
(INEFF ERYTHOPOIESIS)
MENTZER’S INDEX(MCV/RBC) MORE THAN 14
(MCV↓/RBC COUNT↓↓)
LESS THAN 12
(MCV↓/RBC COUNT ↑↑)
)IRON PROFILE SERUM FERRITIN LOW,SERUM
IRON LOW
NORMAL

26. TOTAL LEUCOCYTE COUNT
• TOTAL NO. OF WBC/MICROLITRE OF BLOOD
• NORMAL LEVELS-4000-11000/MICROLITRE
• LEUCOCYTOSIS(INC)-
1. NEWBORN
2. EXERCISE
3. STRESS
4. ANY INFECTIONS OF BODY(CHRONIC
INFECTIONS,PUS FORMING
INFECTIONS,FEVER PRODUCING INFECTIONS)

27. TLC
• LEUKOPENIA-
1. STARVATION
2. DENGUE FEVER(VIRAL FEVER)
3. BONE MARROW DEPRESSION
4. STARVATION
• PSEUDOLEUKOPENIA-ACUTE MIGRATION OF
WBC AT INFECTION SITE WILL CAUSE FALSE
LEUKOPENIA IN PERIPERAL BLOOD

28. DIFFERENTIAL LEUKOCYTE COUNT
• NEUTROPHILS>LYMPHOCYTES>MONOCYTES>E
OSINOPHILS>BASOPHILS(NEVER LET
MONKEYS EAT BANANAS)
• N:L:M:E:B—50-70%:20-30%:2-6%:2-4%:0-1%
• NEUTROPHILS-BACTERIAL INFECTIONS,BURNS
• LYMPHOCYTES-CHRONIC
INFECTIONS(TB),VIRAL
INFECTIONS,LYMPHATIC LEUKEMIA
• MONOCYTES-
SYPHILIS,LEUKEMIAS,MALARIA,KALA AZAR

29. PLATELET COUNT-
• NO. OF PLATELETS PER MICROLITRE OF BLOOD
• NORMAL-1.5 LAKH-4.0 LAKHS/MM3
• THROBOCYTOPENIA-
1. IMPAIRED PRODUCTION-BONE MARROW
FAILURE,B12 DEFICIENCY
2. ACC PLATELET DESTRUCTION-
• IMMUNOLOGIC-ITP,POST
TRANSFUSION,VIRAL(DENGUE)
• INCREASED CONSUMPTION-DIC,TTP

30. • THANK YOU
• ANY QUESTIONS?