Blood Practical CBC & ESR PDF

BLOOD PRACTICAL CBC & ESR At the end of this lesson you should be able to recognize: -The Procedure used for taking both capillary and venous blood -The methods used to measure the ESR and hematocrit -The normal values recorded when taking these measurements -The methods used to get...

BLOOD PRACTICAL CBC & ESR At the end of this lesson you should be able to recognize: -The Procedure used for taking both capillary and venous blood -The methods used to measure the ESR and hematocrit -The normal values recorded when taking these measurements -The methods used to get CBC and assess RBCs indices including Mean corpuscular volume, Mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration. It is a test panel requested by a doctor or other medical professional that gives information about the cells in a patient's blood.  It counts and measures the size of the cells by detecting and measuring electrical resistance when a liquid pass through aperture. While passing the aperture, the cells impedes the current and causes a measurable pulse. Number of pulses --> number of particles. Height of pulses --> volume of particles. Normal values 1.  RBC = aneamia 2.  RBC = polycythemia 3.  WBC = leucopenia 4.  WBC = leucocytosis 5.  Platelets = thrombocytopenia 6.  Platelets = thrombocytosis Low numbers of RBCs may indicate: Blood loss (Hemorrhage). Bone marrow failure (for example, from radiation, toxin, fibrosis, tumor). Erythropoietin deficiency (secondary to renal disease). Hemolysis (RBC destruction).  Types Of Anemia Cause Hemorrhagic Anemia Blood loss Aplastic Anemia Bone marrow suppression by drugs or radiation Nutritional Anemia Iron, Folic acid , Vit B12 deficiency Hemolytic Anemia Increased destruction of RBCs such as sickle cell anemia Dr Sitelbanat 2011 High numbers of RBCs may indicate: Low oxygen tension in the blood – Congenital heart disease – Cor pulmonale – Pulmonary fibrosis Polycythemia rubra vera. Dehydration (such as from severe diarrhea). Renal (kidney) disease with high erythropoietin production. High numbers of WBCs (Leucocytosis) may indicate: Infectious diseases. Inflammatory disease (such as rheumatoid arthritis or allergy). Leukemia. Severe emotional or physical stress. Tissue damage (burns). Low numbers of WBCs (leukopenia) may indicate: Bone marrow failure (for example, due to infection, tumor or fibrosis). Presence of cytotoxic substance. Autoimmune/collagen-vascular diseases (such as lupus erythematosus). Disease of the liver or spleen. Radiation exposure. Platelet count: Thrombocytosis : - Chronic myeloid leukaemia. Thrombocytopenia : - A plastic anemia. - Chemotherapy.  Hematocrit The ratio of volume of red blood cells to volume of blood.  Capillary blood obtained from pricking finger tip after cleaning it with alcohol Fill a heparinized capillary tube, then seal one end by plasticine. Centrifuge for 5 minutes to packed the cells at one end of the tube leaving a clear plasma on top. Use the hematocrit reader to find the packed cell volume. Dr Sitelbanat 2011  Normal value PCV Male Female Average PCV % 40-54 35-47 35-54 High hematocrit indicates: Elevated red blood cell counts, causes are: Dehydration – Burns – Diarrhea Polycythemia rubra vera. Low oxygen tension (smoking, congenital heart disease, living at high altitudes). 6 Low hematocrit indicates: A person with low hematocrit is referred to as being anemic ,causes are: Blood loss (hemorrhage). Bone marrow failure (for example, due to radiation, toxin, fibrosis, tumor). Hemolysis (RBC destruction) related to transfusion reaction. 1. Mean cell volume (MCV) – The average volume of red blood cell measured by femtoliters (fl) MCV = PCV x 10 = 78 - 98 m3 (fl) RBC count - MVC : microcytes - MCV : macrocytes 2. Mean cell hemoglobin (MCH) – The average weight of Hb in a single red blood cell measured by picogram (pg) – MCH = Hb x 10 = 27- 32 pg RBC count. - MCH : hypochromic - MCH : hyperchromic 3. Mean cell Hb concentration (MCHC) – Concentration of Hb per 100 ml of RBC measured in g/dl – MCHC = Hb x 100 = 32- 36 g/dl PCV  Average MCV 78-98 m3 MCH 27-32 pg MCHC 30-35 g/dl Types of Anemia Low Low Low Low Low Low Low high Low N/ high Low N/low Microcytic Macrocytic Hypochromic megaloblastic Iron deficiency Vit B12 or Folic deficiency  Is the rate at which red blood cells sediment in a period of 1 hour. non-specific measure of inflammation.  Normally RBCs have negative charges therefor they repel each other while plasma proteins (fibrinogen) have positive charges promoting aggregation. In inflammation, the high fibrinogen level causes RBCs to stick to each other due to aggregation to form stacks (rouleaux), which settle faster.  Westergren’s sedimentation apparatus. Anticoagulant (EDTA). Disposable sterile syringes and needles. Procedure 1. Using a sterile syringe draw 1.6ml of blood from a suitable vein. Transfer it to a test tube containing EDTA and then draw up blood into a Westergren tube exactly to the zero mark. 2. Place the tube upright in the stand and leave undisturbed. The height of the column of clear plasma at the top of the tube is noted at the end of an hour, this will be ESR reading. Dr Sitelbanat 2011  Normal value of ESR ranges 0 mm- 7mm. In females values are slightly higher than males due to less number of RBCs Moderately elevated ESR occurs: infections, inflammation, anemia, malignancies, pregnancy, and old age. A very high ESR associated with multiple myeloma, polymyalagia Rheumatic, temporal arteritis.  Nonspecific test. Prognostic not diagnostic. Monitor disease activity and response to therapy. ESR is a nonspecific marker of inflammation and is affected by other factors, ESR results must be used along with other clinical findings.  C-reactive protein is an acute phase protein produced by the liver during an inflammatory reaction. Since C-reactive protein levels in the blood rise more quickly after the inflammatory or infective process begins, ESR is often replaced with C-reactive protein measurement. Thank you