Pharm-D 4th-year Clinical pharmacy 4th unit 1 topic

1. H A EM A TO LO GIC A L TEST
B Y M O H A M M E D SA LA H U D DIN
18S91T0 0 18
P J H A R M -D

2. LET' S GET
STA RTED
MD SALAHUDDIN

3. COMPLETE BLOOD
PICTURE(CBP):
A COMPLETE BLOOD PICTURE IS A SERIES OF TESTS USED TO
EVALUATE THE COMPOSITION & CONCENTRATION OF THE BLOOD
IT IS A BASIC TEST
THE FOLLOWING PARAMETERS ARE EVALUATED IN CBP
1.HAEMOGLOBIN(Hb):
NR F: 12.0 - 16.0 g/dl
M: 13.5 - 17.5 g/dl
2.RED BLOOD CELL(RBC):
NR F: 4.2 - 5.4 mill/cum
M: 4.5 - 6.5 mill/cum
MD SALAHUDDIN

4. HIGH RBC/HB CELLVOUNT CAN BESEENIN PATIENTS
WITH ALSO CALLED AS POLYCETHEMIA
DEHYDRATION
LUNG
DISEASES
SMOOKING
EXCESSIVE ERYTHROPOETIN PRODUCTION
GENETIC CAUSES
LOW RBC/HB LEVELCAN BESEEN IN PATIENT WITH
ANAEMIA
ACUTE CHRONIC BLEEDING
NUTRITIONAL DEFICIENCIES
BONE MARROW DISORDER
CHRONIC INFLAMMATORY DISEASE
C.K.D MD SALAHUDDIN

5. WHITE BLOOD CELLS(WBC):
NR 4000 - 11000 cells/cumm
HIGH WBC COUNT ALSO CALLED AS LEUKOCYTOSIS
& IT CAN BE SEEN IN PATIENT WITH
INFECTIONS
INFLAMMATORY DISORDERS
LEUKAMIA
MYELO PROLIFERATIVE
DISORDERS ALLERGIES/ASTHAMA
LOW LEVEL OF WBC IALSO CALLED LEUKOPENIA ALSO
SEEN IN PATIENT WITH
APLASTIC ANAEMIA
BONR MARROW DISORDER
AUTOIMMUNE DISORDER/CONTIDTION
LYMPHOMA
MD SALAHUDDIN

6. TECHNIQUE USED IN RBC& WBCCOUNT
AUTOMATED
COULTER-
COUNTER
MANUAL
HEMOCYTOMETER
HEMATOCRIT(PCV
) NR 35 - 50%
- IT IS A MEASURE OF THE RATIO OF VOLUME OCCUPIED BY RED
BLOOD
CELLS TO THE VOLUME OF WHOLE BLOOD
-THE BLOOD SAMPLE IS DRAWN INTO CAPILLARY & CENTRIFUGATED
& THEN THE RATIO CAN BE MEASURED AS DECIMAL OR
PERCENTAGE FRACTION
MD SALAHUDDIN

7. HIGH LEVEL OF PCV IS SEEN IN PATIENT
WITH
DEHYDRATION POLYCETHEMI
A
LOW LEVEL OF PCV IS SEEN IN PATIENTS
WITHANAEMIA BLOOD
LOSS
MD SALAHUDDIN
TECHNIQUE INVOLVED: MICROHAEMATOCRIT

8. NEUTROPHILLS
DEPRESSIO
N
- HIGH LEVELS OF NEUTROPHILLS ALSO CALLED AS
NEUTROPHILIA SEEN IN PATIENT WITH
ACUTE BACTERIAL
INFECTIONS INFLAMMATION
BURNS , TRAUMA, HEART ATTACK, STRESS,
LEUKAMIA
-LOW LEVEL OF N
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SEEN IN PATIENTS WITH
APLASTIC ANAEMIA, AUTIIMMUNE DISORDER, DRUG
REACTIONS
CHEMOTHERAPY, MYELODYSPLASIA, BONE
MARROW
TECHNIQUE
:
FLOW CYTOMETRIC METHOD FOR DETERMINATION OF
NEUTROPHILLS CONCENTRATION IS IN AGREEMENT WITH
MICROSCOPIC ENUMERATION MD SALAHUDDIN

9. EOSINOPHILLS
NR 1 - 6%
- HIGH EOSINOPHILLS COUNT IS SEEN IN PATIENTS WITH
ASTHMA, ALLERGIES
ADDISON DISEASE, DRUG REACTIONS
PARASITIC REACTION, CANCER,
INFLAMMATORY DISORDERS
- LOW LEVELS OF EOSINOPHILLS SEEN IN PATIENTS
WITH ALCOHOL ABUSE, CUSHING DISEASE
TECHNIQUE
A FLOW CYTOMETRIC METHOD FOR DETERMINATION OF
BLOOD NEUTROPHILLS
MD SALAHUDDIN

10. LYMPHOCYTES
NR 20 - 40%
- HIGH LYMPHOCYTE COUNT CAN BE SEEN IN PATIENTS
WITH ACUTE VIRAL INFECTIONS
TB, LYMPHOCYTIC LEUKAMIA
- LOW LYMPHOCYTE COUNT CAN BE SEEN IN PATIENT
WITH BONE MARROW DAMAGE, APLASTIC
ANAEMIA AUTO-IMMUNE DISORDER,
CORTICOSTEROID USE
TECHNIQUE
DETECTION OF LYMPHOCYTES IN BLOOD SAMPLES USING
FLOW CYTOMETRY
MD SALAHUDDIN

11. MONOCYTES
NR 2 - 10%
- HIGH MONOCYTE COUNT CAN BE SEEN IN PATIENTS WITH
TB, BACTERIAL ENDOCARDITIS
COLLAGEN VASCULAR DISORDER
INFLAMMATORY BOWEL
DISEASES
- LOW MONNOCYTE COUNT CAN BE SEEN IN PATIENTS WITH
BONE MARROW DAMAGE, APLASTIC ANEMIA
HAIRY CELL LEUKAMIA
TECHNIQUE
AN IDEAL METHOD FOR EXAMINING ALTERATION TO MONOCYTE IS
WHOLE BLOOD FLOW CYTOMETRY
MD SALAHUDDIN

12. BASOPHILS
NR 0 - 1%
HIGH BASOPHILS COUNT CAN BE SEEN IN PATIENTS
WITH CHRONIC MYELOID LEUKAMIA
LEUKAMIA
RARE ALLERGIC RECTIONS
LOW EOSINOPHILS COUNT IS RARE &
MEDICALLY INSIGNIFICANT
TECHNIQUE
FLOW CYTOMETRIC ANALYSIS
MD SALAHUDDIN

13. PLATELET COUNT
NR 1.5 - 4.5 laks/cumm
HIGH PLATELET COUNT IS KNOWN AS THROMBOCYTOSIS
& SEEN IN PATIENTS WITH
CHRONIC INFECTION OR INFLAMMATORY DISEASES
REMOVAL OF SPLEEN
BLOOD LOSS FROM RECENT SURGERY OR INJURY
RA, IBD, LUPUS
LOW PLATELET COUNT IS KNOWN AS
THROMBOCYTOPENIA & SEEN IN
PATIENTS WITH
DENGUE FEVER
BLEEDING OR PLATELET DISORDER
VIRAL INFECTIONS, CIRRHOSIS, SEPSIS
CANCER, CHEMOTHERAPY & RADIATION
THERAPY MYELODYSPLASIA MD SALAHUDDIN

14. TECHNIQUE
S:
1.MANUAL COUNTING USING PHASE-CONTRAST
MICROSCOPY
2.IMPEDANCE ANALYSIS
3.OPTICAL LIGHT SCATTER/FLUORESCENCE ANALYSIS
4.IMMUNOPLATELET COUNTING BY FLOW CYTOMETRY
BLOOD UREA
N 7 - 20 mg/dl
HIGH VALUES SEEN IN PATIENTS WITH
KIDNEY INJURIES, INFLAMMATION
CHRONIC KIDNEY DAMAGE CAUSED BY HIGH
BLOOD PRESSURE
MD SALAHUDDIN

15. LOW VALUES IS SEEN IN PATIENT WITH
MALNUTRITION (LOW PROTEIN DIET)
SEVERE LIVER DAMAGE
ANABOLIC STERIODS & PREGNENCY
GENETIC DEFFECIENCY OF UREA
CYCLE
TECHNIQUES:
1.THE DIACETYL MONOXIME METHOD USED WITH A CONTINUOUS
FLOW ANALYSER.
2.THE DIACETYL MONOXIME METHOD USED WITH AN OLDER
CONTINUOUS FLOW ANALYSER.
3.UREASE- CONDUCTIVITY METHOD.
4.UREASE- GLUTAMATE DEHYDROGENASE METHOD WITH
CENTRI FUNGAL ANALYZER.
MD SALAHUDDIN

16. CREATININE
NR 1 - 5 mg/dl MALE
1 - 2 mg/dl FEMALE
HIGH LEVELS OF CREATININE SEEN IN PATIENTS
WITH GLOMERULONEPHRITIS
BACTERIAL INFECTION
PROSTATE DISEASES
REDUCED BLOOD FLOW TO KIDNEY
LOW LEVELS OF CREATININE SEEN IN PATIENTS
WITH NOT MEDICALLY SIGNIFICANT
TECHNIQUES:
CREATININE IS MEASURED BY THE COLORIMETRIC METHOD
IN BLOOD & URINE
MD SALAHUDDIN

17. WHAT IS A COMPLETE BLOOD COUNT TEST
A COMPLETE BLOOD COUNT/PICTURE PROVIDES
INFORMATION ABOUT BLOOD CELLS LIKE
RED BLOOD
CELLS WHITE
BLOOD CELS
PLATELETS
IT IS ROUTINELY PERFORMED TO PROVIDE AN OVERVIEW OF
PATIENTS GENERAL HEALTH STATES
WHY COMPLETE BLOOD COUNT TESTDONE
TO MONITOR OVERALL HEALTH AS PART OF ROUTINE CHECK-
UP TO DETECT ANY SUSPECTED INFECTIONS, ANAEMIA,
DISEASE OF THE IMMUNE SYSTEM, OR BLOOD CANCER
TO MONITOR TREATMENT THAT IS KNOWN TO AFFECT
BLOOD CELLS SUCH AS CHEMOTHERAPY OR
RADIOTHERAPY
TO MONITOR AN EXISTING BLOOD DISORDER
MD SALAHUDDIN

18. HOW IS COMPLETE BLOOD
COUNT/PICTURE IS DONE
CBP TESTIS DONE ON A SAMPLE OF
BLOOD.
A SYRINGE ATTACHED TO A NEEDLE IS
USED TO WITHDRAW THE BLOOD FROM A
VEIN OF YOUR ARM.
MANY OTHER FACTORS LIKE DIET, MEDICINE, PHYSICAL ACTIVITY
& OTHER STRESS CONDITIONS CAN AFFECT THE TEST
RESULTS.
MD SALAHUDDIN

19. THANK YOU
MD SALAHUDDIN