This document provides information on interpreting a complete blood count (CBC). It defines various CBC parameters such as anisopokilocytosis, cytometry, and Coulter principle. The importance of the CBC is discussed as it can provide information about the blood, bone marrow, and health of other organs. The CBC evaluates components of the blood including red blood cell count, hemoglobin, hematocrit, and red cell indices. Abnormalities in these values can indicate conditions like anemia, bone marrow aplasia, and malignancies. Peripheral blood smear examination is also important for identifying red blood cell morphologies.
A presentation made by Dr Gauhar Mahmood Azeem on the interpretations of a simple CBC and the information it can give us, Various conditions which may cause derangement are mentioned,
This presentation is focused on diagnostic utility of Red blood cell indices which will be very useful for undergraduate and postgraduate of medical field.
A presentation made by Dr Gauhar Mahmood Azeem on the interpretations of a simple CBC and the information it can give us, Various conditions which may cause derangement are mentioned,
This presentation is focused on diagnostic utility of Red blood cell indices which will be very useful for undergraduate and postgraduate of medical field.
causes of macrocytic anemia pathopysiology, sign and symptoms and the difference between macrocytic anemia megaloblastIc anemia. causes of hypersegmented neutrophils and its association between them. investigation and medical management plus pictures illustration.
Hereditary spherocytosis is an inherited condition related to RBC destruction. its diagnosis is require to differentiate immune hemolytic anemia and G-6-P-D deficiency anemia
causes of macrocytic anemia pathopysiology, sign and symptoms and the difference between macrocytic anemia megaloblastIc anemia. causes of hypersegmented neutrophils and its association between them. investigation and medical management plus pictures illustration.
Hereditary spherocytosis is an inherited condition related to RBC destruction. its diagnosis is require to differentiate immune hemolytic anemia and G-6-P-D deficiency anemia
Seven Basic Tools of Quality
A designation given to a fixed set of graphical techniques identified as being most helpful in troubleshooting issues related to quality.
CBC interpretation in routine clinical practice.pptxDibyajyoti Prusty
CBC: Basic haematologic and systemic evaluation
-It offers a comprehensive assessment of the cellular components that circulate within the bloodstream revealing wide range of medical conditions
We will discuss :
Blood, Blood components, Blood cells, Haematopoiesis
CBC parameters and clinical significance
Use in Clinical Practice
CBC analyser, Technical aspects
What next after analysing a CBC report
Futuristic aspects
Blood is a specialized body fluid
Transporting oxygen and nutrients to the lungs and tissues: RBCs
Forming blood clots to prevent excess blood loss: Platelets
Carrying cells (WBCs) and antibodies (Plasma) that fight infection
Bringing waste products to the kidneys and liver, which filter and clean the blood
Regulating body temperature
Plasma : a mixture of water, sugar, fat, protein, and salts. Transport blood cells throughout body along with nutrients, waste products, antibodies, clotting proteins, hormones, and proteins that help maintain the body's fluid balance.
Red blood cells (Erythrocytes): Controlled by erythropoietin. No nucleus and can easily change shape. Contain a special protein called haemoglobin. The percentage of whole blood volume that is made up of red blood cells is called the haematocrit.
White blood cells (Leukocytes): White blood cells protect the body from infection
Platelets (Thrombocytes): Platelets are not actually cells but rather small fragments of cells. Helps in blood clotting process
An overview about approach to diagnosis of anemia for new learners. It is not all about approach to anemia, approach to anemia really needs a lot of knowledge about each groups of anemia such as microcytic, normocytic and macrocytic anemia.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. TERMS
Anisopokilocytosis: variation in size and shape
Cytometry: measurment of the cell either visual or automated
Cluster analysis: analysis that is based upon the instrument‟s ability to cluster
different populations, together based upon size, staining, absorption or other
parameter
Contour grating: analysis where information is plotted three dimentionally, that can
be separate subpopulation of cells
Coulter principle (electrical impedence): sizing and counting cells by detecting and
measuring changes in electrical resistance when cell passes through small aperture.
Dimorphic : two population of cells in single blood sample
Forward angle light scatter: light from laser source is scatter in forward direction (0
degree) when it strike a cell or particle, larger object more forward light scatter
Forward high angle light scatter: similar to forward angle light scatter, but angle is 5
to 15 degree variation
Forward low angle light scatter: similar to forward angle light scatter, but angle is 2
to 3 degree variation
3. Introduction
Haematology comprise of
„Haima‟ = blood in Greek
„Logos‟ = study
Haematology is a unique super speciality in medicine
which encompasses the fields of
pathology, physiology, biochemistry, molecular
biology, obstetrics and gynecology, medicine and
paediatrics
4. CBC
A complete blood count is a series of tests used to
evaluate the composition and concentration of the
various cellular component of the blood.
Is a basic test
Most informative single investigation
Tests consists of
1. Counts of RBC, WBC, Platelets
2. Haemoglobin, haematocrit, and red cell indices
3. TLC, DLC
4. Platelet count, mean platelet volume, plateletcrit,
PDW
5. Histogram of RBC, WBC, Platelets
5. How important is CBC ?
To know the importance of CBC we need to know…..
What is CBC?
Why CBC?
What are various parameter of CBC?
What are variation in parameter of CBC?
What these variation can tell us?
How these variations affect the assessesment and care of
patients?
6. Why CBC?
CBC is an inexpensive tool and powerful
tool which provide information about
Blood, also about
Marrow,
Health or disease state of other organ
of body
7. CBC USES
To diagnose
1. Anemia
2. Haemoglobinopathies
3. Bone marrow aplasia
4. Nutritional deficiencies
5. Thrombocytopenia
6. Autoimmune conditions
7. Infections and Parasitemia
8. Malignancies, response to drug, chemotherapy etc.
9. RBC produced in marrow and requires
Iron, copper, magnease, cobalt
Vitamins; especially B12, folic acid
Regulated by erythropoietin, thyroid
hormone, androgens
Counts depend upon
age, sex, altitude, exercise, drug, tobacco
use etc.
Life span - 120 days
10. Clinical importance of assessment of RBC is to: measures oxygen
carrying capacity of blood
Normal values
Newborn 4.1-6.1 million/mm3
Children 3.6-5.5 million/mm3
Adult (M) 4.6-6.0 million/mm3
Adult (F) 4.2-5.0 million/mm3
11. Decreased RBCs
Blood loss Impaired production Increased destruction
• Trauma
• Surgery
• GI bleed
• Gynecological
disturbance
• Pure red cell aplasia
• Pernicious anemia
• Megaloblastic anemia
• Iron deficiency anemia
• Thalassemia
• Anemia of prematurity
• Anemia of chronic
disorder
Intra-corpuscular
• Hereditary spherocytosis
• Sickle cell anemia
• Abetalipoprotienimia
• G6PD
• Pyruvate kinase deficiency
• PNH
Extra-corpuscular
• Autoimmune
• Haemolytic disease of newborn
• Mismatch transfusion
• Microangiopathic haemolytic
anemia TTP, HUS
• DIC
• infections
12. • Increased RBCs
• Polycethemia vera
• High altitude
• chronic obstructive pulmonary disease(COPD,
emphysema, chronic bronchitis),
• pulmonary hypertension,
• Hypoventilation syndrome,
• congestive heart failure
• obstructive sleep apnea,
• poor blood flow to the kidneys, and
13. Haemoglobin
Oxygen carrying component of blood
Synthesize in polychromatic normoblast stage of red cell development
Values
Newborn 15.5-24.5 g/L
Adult male 13.5-16.5 g/L
Adult female 12.0-15.5 g/L
14. Hb estimation
Cynemethamoglobin Method: Recommended
20 microL blood + diluent (potassium cynide
and potassium fericynide)
Mixed and read in photo colorimeter
Photo colorimeter is used to determine the
concentration
Hb% =(test sample absorbance/ standard sample
absorbance)x concentration of standard x dilution
factor
Advantage – haemoglobin, methamoglobin and
carboxyhaemoglobin are used in measurment.
Disadvantage – sulphamethamoglobin cannot be
included in measurment, takes more time for
estimation
16. Reticulocyte
Normal value 0.5% - 1.5%.
Hence 0.5% - 1.5% RBCs are replaced per day
Uses
To evaluate anemia
Response to treatment of anemia
Note
If the disease causing the anemia is inside the
marrow, the reticulocyte count is decreased
If the disease causing the anemia is outside the
marrow, the reticulocyte count is increased
17. Methods
Manual reticulocyte count using supravital stain
Automated reticulocyte count by flouroscent
method - gives immature reticulocyte fraction
(IRF) and removes errors like Howell-Jolly
bodies, pappenheimer bodies
Reticulocyte production index or corrected
reticulocyte count: an index corrected according
to level of anemia
Reticulocyte index = reticulocyte count x
patient‟s haematocrit/ normal
haematocrit
18. Reticulocyte proliferation index: Index is used to
determine if a person's bone marrow is properly
responding to the body's need for red blood cells
Shift correction factor: normal reticulocyte count
survive 3.5 days in marrow and 1 day in peripheral
circulation at normal PCV. In case of variation in PCV
the survival time is increased which is termed as shift
correction factor
Reticulocyte proliferation index = reticulocyte
index/ shift correction factorShift correlation factor
PCV% Maturation days = shift correction factor
45 1
35 1.5
25 2
15 2.5
20. Reticulocyte haemoglobin
measurement (RET-He)
Reticulocyte Hemoglobin (Ret-He) is a direct assessment of the incorporation
of iron into erythrocyte hemoglobin.
It is a direct estimate of the recent functional availability of iron (2–3 days).
Traditional chemistry tests used for iron assessment (serum iron, Tsat,
ferritin) are indirect measurements.
As a direct measurement, Ret-He may identify iron deficiency earlier than
traditional parameters.
It is an established parameter used in KDOQI (Kidney Disease Outcome
Quality Initiative) guidelines for assessing iron status
21. Haematocrit
Ratio of the volume of erythrocytes to that of the whole blood in percentage
Most precise method for determining the degree of anemia or
polycythemia i.e. increase or decrease RBC concentration
Normal values
Newborn 42-68%
Upto 1 year age 29-41%
Adult Male 39-47%
Adult female 36-44%
Rule of 3:– RBC x 3 = Hb and Hb x 3 = Hct
22. High
Polycythemia vera
Dehydration
Low oxygen in blood
Congenital heart disease
Cor pulmonale
Smoking
Haemoconcentration (Dengue)
Low
Anemia
Blood loss
Haemolysis
Bone marrow aplasia
Leukamia
Malnutrition
An elevated haematocrit may be due to spleen hyper
function, and reduced haematocrit may indicate low thymus
function
23. Mean corpuscular volume
Measures average volume of RBC
MCV = haematocrit/ red cell count x100
Normal values
Newborn 103-106fL
Child upto 1 year 78 fL
Adult 79-98fL
Classified accordingly as
Microcyte – MCV <79
Macrocytic – MCV >98
Presence of microcytic and macrocytic cells in same sample may result
in normal MCV
MCV <72 without heterogeneity, is a sensitive and specific predictor
of thalassemia trait
24. Microcytic MCV
Hypochromic
Iron deficiency
Thalessemia
Lead poisoning
Porphyria
Normochromic
Anemia of chronic
disease
haemoglobinopath
ies
Macrocytic MCV
Megaloblastic
anemia
Pernicious anemia
Sprue
Di Gulielmo disease
MDS
Post spleenectomy
Alcoholism
Liver disease
Drugs
(anticonvulscents,
anticancer etc)
• Normocytic MCV
• Acute haemorrhage
• Diamorphic anemia
• Haemoglobinopathi
es
• Endocrinopathies
29. MCHC decreased in
Hypocromic microcytic anemia
MCHC increased in
Heridietery spherocytosis
Infant and newborns
Autoagglutinations
Interference in MCHC
Marked leukocytosis
Haemolysis
Cold aggutinins
Rouleaux
30. Red cell distribution width
(RDW)
Red cell distribution is a quantative measure or numerical
expression of anisocytosis. It is a coefficient of variation of the
distribution of individual RBC volume
In microcytes, RDW increased in iron deficiency anemia but in
thalessemia it is not raised
31. RDW-CV:It is the ratio of standard deviation to the
mean corpuscular volume
RDW-CV = standard deviatiom of RBC volume/ mean MCV x
100
value 11.5%-14.5%
RDW-SD: It is the actual measurnment of the width of
the RBCdistribution curve
Values 35-45 fL
33. Preparation
The wedge slide (push slide) technique was developed
by Maxwell Wintrobe as is a standard method
The “zone of morphology” (area of optimal thickness for
light microscopy examination) should be at least 2cm in
length. The smear should occupy the central area of the
slide and be margin free at the edges.
34. RBCs in peripheral smear
Microcytic hypochromic
Size smaller than the nucleus of small
lymphocyte
< 7 micron
Markedly increase central pallor >1/3
of the diameter of RBC
Causes
Iron deficiency anemia
Thalassemia
Sideroblastic anemia
Anemia of chronic disease
Haemoglobinopathies
35. Macrocytic cells
Size > 8.3 micron kin diameter
Causes
Vitamin B 12 and folic acid deficiency
Alcoholism
Liver disease
Myleodysplastic syndrome
Hypothyroidism
Drug that impair DNA synthesis
36. Oval macrocytes
Vitamin B 12 and folic acid deficiency
Pernicious anemia
Myleodysplastic syndrome
Hypothyroidism
Drug that impair DNA synthesis
37. Round hypochromic macrocytes
Alcoholism
Hypothyroidism
Liver disease
Post splenectomy
Blue tinged macrocytes
Neonate
Response to anemic stress
38. Target or bell cell
They have a characteristic ringed
appearance. This is because of the
“increase surface area to volume ratio”
i.e. increase in red cell membrane which
get pooled at the centre of cells
Causes
Thalessemia
Haemoglobinopathies Hb AC or CC,
HbSS,SC
Liver disease
Post spleenectomy
Severe iron deficiency anemia
abetalipoprotenimia
39. Schistocytes
„Schisto‟ = split or cleft
Physical assault to erythrocytes with in the
blood stream creates these cells
which include
Helmet cells
Triangles
Crescents
Microspherocytes
Horns
Purse
41. Tear drop cells(Dacrocytes)
Pear shape cells, usually microcytic and hypochromic
Seen in
Newborn
Thalassemia major
Myleoproliferative disorder
Leukoerythroblastic reaction
42. Spherocytes
Ball shaped red cells, decreased surface: volume
ratio, hyperdense (> MCHC)
Seen in
Hereditary spherocytes
ABO incompatibility
Autoimmune haemolytic anemia
Microangiopathic haemolytic anemia
SS disease
Hyperspleenism
Burns
Posttransfusion
43. Elliptocytes
Elliptical and normochromic cells, seen normally in
less than 1% of RBCs
Causes
Hereditary elliptocytosis
Iron deficiency anemia (increased with severity)
SS disease and SA trait
Thalassemia Major
Leukoerythroblastic reaction
Malaria
Megaloblastic anemia
44. Burr cells (Echinocytes)
10-30 spicules equal in size and evenly distributed over
RBC surface; caused by alteration in extracellular
environment
Seen in
Liver disease
Renal failure
Dehydration
Pyruvate kinase deficiency
Storage artefacts
45. Spur cell - Acanthocyte
Acantho = thorn
Cells with 5-10 specules of varying length, irregular in
shape, thickness, with wide bases and appear smaller than normal
cell because they assume spheroid shape
Result from changes in membrane lipid content
Seen in
Spur cell anemia
Alcoholism
Hypothyroidism
Abetalipoprotinemia
Vitamin E deficiency
Malsbsorption
Postsplenectomy
46. Bite cell (Degmacyte)
Appear as a cookie with a bite taken
out
Seen in G6PD
When spleen removes the Heinz bodies
from RBCs
47. Stomatocyte
When examined on dry smear, it has a central slit or stoma
Seen in
Few may be seen normally
Various cardiovascular
and pulmonary disorders
Hereditary
Alcoholism
Liver disease
Malignancies
48. Howell – Jolly bodies
Small well defined, rounded, densely stained
inclusions, 1 micron in diameter, ecentric, that
represent DNA fragments
Associated with rapid or abnormal RBC formation
Seen in
Post spleenectomy
Newborns
Megaloblastic anemia
Dyserythopoietic anemias
Hereditary spherocyosis
49. Heinz Bodies
Inclusion of denatured haemoglobin caused by oxidation
of globin portion of haemoglobin
Removal of Heinz body leads to formation of „bite cells‟
Causes
Drugs
Certain foods like fava beans
and onion
50. Sideroblastic granules/
pappenheimer bodies
Irregular dark blue iron containing granules occuring in
small clusters, predominantly in periphery
Seen in
Sideroblastic anemia
Spleenectomy
Haemolytic anemia
Myelodysplastic syndromes
Lead poisoining
Its presence can rule out iron deficiency anemia
51. Sickle cell
Crescent shape cells develop in
people homozygous for haemoglobin S
Heterozygous HbS and either
thallasemia or another Hb like Hb C
52. Nucleated red cells
Cells have dense dark nucleus in the center
of the cell
Results from marked stimulation of the
bone marrow
Seen in
New born (first 3-4 days)
Acute bleeding severe haemolytic anemia
Megaloblastic anemia
Congenital infections (syphilis, CMV, rubella)
Postspleenectomy
Leukoerythroblastic reaction
Fungal and mycobacterial infections
Dyselectropoeitic anemia
53. Basophilic stippling
Numerous small, purplish inclusions, which results from
RNA and mitochrondrial remenants
Seen in
Lead toxicity
Thalessemia
Haemoglobinopathies
Macrocytic anemia
54. Cabot ring
These are delicate thread like inclusions, remenants of
the nuclear membranes, in the RBC
They can take any shape like purplish ring, figure of
eight, incomplete ring
Seen in
Pernicious anemia
Lead poisoning
Alcoholic jaundice
Severe anemia
Leukamia
55. Roulex formation
A stack like arrengment of red blood cells where the
biconcave surdface of RBCs are next to each other.
Seen in
Increase in cathodal protien,
such as immunoglobins
and fibronegen
Multiple myleoma
Macroglobulimias
Acute and cronic infections
Connective tissue disease
Diabetes mellitus
Malignancies
56. Grading of inclusions
Rare 0-1/hpf
Few 1-2/hpf
Mod 2-4/hpf
Many >5/hpf
Qualitative grading of abnormal RBC morphology
Grade degree of abnormalities
1-5 cells /10fields slight
6-15cells /10fields moderate
>15cells /10fields marked