Haem Investigation PDF

Lab Tests FBE/FBC - full blood count Iron Studies Basically ordered for everything Serum Fe: iron in plasma Hct = % of blood comprised of RBC Serum ferritin: storage in body MCV = average volume of single RBC ○ Stored esp in liver and bone marrow but...

Lab Tests FBE/FBC - full blood count Iron Studies Basically ordered for everything Serum Fe: iron in plasma Hct = % of blood comprised of RBC Serum ferritin: storage in body MCV = average volume of single RBC ○ Stored esp in liver and bone marrow but leaks out of cells so serum ferritin is proportional to iron in body ○ IL-6 drives ferritin production Transferrin: iron transport Transferrin saturation (%) Note: when iron decreases serum Fe and ferritin decrease. Less iron is bound in blood so transferrin saturation dec but transferrin (Free) increases Lab Tests Flow Cytometry Cytogenics and Molecular Studies Determines immunophenotype (how many cells of Cytogenics: chromosomes each type) Molecular: DNA Cells are stained with fluorescent monoclonal antibody then passed through flow cytometer Lab Tests Haemolysis Screen FBC - anaemia Bilirubin - inc (unconjugated) Lactate dehydrogenase - inc Haptoglobin - dec (mops up free Hb) Direct coombs test Reticulocyte count - inc Blood film - normocytic / reason why! Blood Film - RBC Blood Film - RBC Blood Film - RBC Blood Film - RBC Blood Film - RBC Blood Film - RBC Blood Film - RBC Blood Film - Platelets Blood Film - Neutrophils Blood Film - Neutrophils Blood Film - Neutrophils Blood Film - Other WBC Blood Film - Other WBC Blood Film - Other WBC  Blood Film Hyposplenism Target cells - dotted black Howell-jolly bodies - black dot Acanthocytes - blue arrow Spherocytes - green arrow  Blood Film Bacterial Infection Neutrophilia Left shift Morphological changes in neutrophils - toxic granulation, dohle bodies, vacuolation, intracellular/extracellular bacteria  Blood Film Leucoerythroblastic blood film I.e. young leukocytes (WBC) and erythrocytes (RBC) Myeloid and erythroid precursors on film Severe systemic illness - sepsis, severe hypoxia Marrow infiltration (haematological malignancy, primary myelofibrosis, metastatic carcinoma)  Blood Film Smear cells = chronic lymphocytic leukaemia  Bone Marrow Biopsy Performed from iliac crest under local anaesthetic Normal: Should see erythroblasts, myeloid precursors, megakaryocytes Indications: 40-60% fat Unexplained excess/deficiency of any peripheral blood cell type Unexplained splenomegaly/pyrexia Suspected blood malignancy Lymphoproliferative disorders Iron deficiency Monitor treatment Aplastic anaemia