1. Complete Blood Count

2. Normal Ranges WBC: WBC DIFFERENTIAL: 4,000 – 11,000/cubicmm
Neutrophil %
Lymphocytes %
Monocytes %
Eosinophils %
Basophils %

3. examples of causes of a high count
Test
examples of causes of
a low count
examples of causes of a high count
White Blood
Cell Count
Known as leukopenia
or damage
Autoimmune conditions
Severe infections (sepsis)
lymphoma or other cancer that spread to the bone marrow
Diseases of immune system (e.g., HIV)
Known as leukocytosis
infections most commonly bacterial or viral
Leukemia, myeloproliferative disorders
inflammation
Allergies , Asthma
Tissue death (trauma, burns, heart attack)
Intense exercise or severe stress

4. examples of causes of a low count examples of causes of a high count
Test
Full Name
examples of causes of a low count
examples of causes of a high count
Neu, PMN, polys
Absolute neutrophil count, % neutrophils
Known as neutropenia
Severe,over whelming infection (sepsis)
Autoimmune disorders
Reaction to drugs, chemotherapy
Immunodeficiency
Bone marrow damage (e.g., chemotherapy, radiation therapy)
Known as neutrophilia
Acute bacterial infections
Inflammation
Tissue death (necrosis) caused by trauma, heart attack, burns
leukemia
eos
Absolute eosinophil
count, % eosinophils
 not medically significant.
Parasitic infections, asthma,allergic reaction.
baso
Absolute basophil count, % basophils
not medically significant
bone marrow related conditions such as leukemia or lymphoma

5. examples of causes of a low count examples of causes of a high count
TEST
Full Name
examples of causes of a low count
examples of causes of a high count
mono
Absolute monocyte 
count, % monocytes
not medically significant.
bacterial infection, tuberculosis, malaria, monocytic leukemia
lympho
Absolute 
Lymphocyte count, % lymphocytes
Known as lymphocytopenia
Autoimmune disorders (e.g., lupus rheumatoid arthritis)
Infections (e.g., HIV, viral hepatitis , typhoid fever, influenza)
Bone marrow damage (e.g., chemotherapy, radiation therapy)
Corticosteroids
Known as lymphocytosis
Acute viral infections (e.g., chicken pox,cytomegalovirus (CMV), Epstein-Barr virus (EBV),herpes)
Certain bacterial infections (e.g. tuberculosis
Lymphocytic leukemia, lymphoma
Stress (acute)

6. Complete Blood Count : Hb, RBC, MCV, MCH, MCHC, WBC & Diff, Platelet, Reticulocyte

7. Anemia Anemia: RBC mass
ed level of Hb more than 2SD of mean normal of Hb according to age
Age Hb level
New born <13 gr/dl
2-3 months < 9 FT
< 7 premature
6m-2y <9.5
2y – 6 years old <10.5
6 – 12 y/o <11.5
>12 y/o Male < 14
Female < 12
Anemia

8. Mean corpuscular volume:  100 (fl) Age: 2-10 y/o MCV= Age (year) + 70
Age ≥ 10 y/o MCV < 80: Microcytosis
MCH
Mean corpuscular hemoglobin:  100 (Pg)
More sensitive than MCV
MCH hypochromia

9. Calculating the Hematocrit
More commonly the Hct is calculated directly from the RBC and MCV
Hematocrit % = RBC (cells/liter) x MCV (liter/cell)
Because the Hct is a derived value, errors in the RBC or MCV determination will lead to false results
Calculating the Hematocrit

10. Mean Corpuscular Volume
The MCV is a measure of the average volume, or size, of an RBC
It is determined by the distribution of the red blood cell histogram
The mean of the red blood cell distribution histogram is the MCV
Mean Corpuscular Volume

11. RBC Distribution Histogram
Number Of
cells
MCV 60
120
Cell Size (fl)

12. Use of MCV Result The MCV is important in classifying anemias
Normal MCV = normocytic anemia
Decreased MCV = microcytic anemia
Increased MCV = macrocytic anemia

13. RBC Distribution Histogram
Number Of
cells
Microcytic
Red blood cells
Macrocytic
Red blood cells
MCV 60
120
Cell Size (fl)

14. MCHC Mean corpuscular hemoglobin concentration:
 100   100
It is important in diagnosis of congenital Spherocytosis (MCHC > 35) :

15. PCV or Hematocrit
57% Plasma
1% Buffy coat – WBC
42% Hct (PCV)

16. Measurement Normal Range
RBC count million to 6
Hemoglobin 15 g% 12 to 17
Hematocrit to 50
A x 3 = B x 3 = C - This is the rule of thumb
Check whether this holds good in given results
If not -indicates micro or macrocytosis or hypochro.

17. ‘RBC to be’ or Apprentice RBC Fragments of nuclear material
RETICULOCYTE COUNT %
‘RBC to be’ or Apprentice RBC
Fragments of nuclear material
RNA strands which stain blue
Normal
Less than 2%

18. The reticulocyte count
Increased reticulocytes (greater than 2-3% or 100,000/mm3 total) are seen in blood loss and hemolytic processes, although up to 25% of hemolytic anemias will present with a normal reticulocyte count due to immune destruction of red cell precursors.
Retic counts are most helpful if extremely low (<0.1%) or greater than 3% (100,000/mm3 total).

19. To be useful the reticulocyte count must be adjusted for the patient's hematocrit.
Thus:
Corrected retic. = Patients retic. x (Patients Hct/45)
Reticulocyte index (RPI) = corrected retic. count/Maturation time
(Maturation time = 1 for Hct=45%, 1.5 for 35%, 2 for 25%, and 2.5 for 15%.)
Absolute reticulocyte count = retic x RBC number.

21. Red Cell Size

22. Microcytic Normocytic Macrocytic MCV Iron Deficiency IDA
Chronic Infections
Thalassemias
Hemoglobinopathies
Sideroblastic Anemia
Chronic disease
Early IDA
Primary marrow disorders
Combined deficiencies
Increased destruction
Megaloblastic anemias
Liver disease/alcohol
Metabolic disorders
Marrow disorders

23. Classification by Pathophysiology
Blood Loss
Decreased Production
Increased Destruction
Classification by Morphology
Normocytic
Microcytic
Macrocytic

24. RDW Red cell distribution width = anisocytosis RDW = 11-14.5%
IDA: RDW
-thalassemia minor: RDW

25. Evaluation of platelets
The platelet count is the number of platelets in a person's sample of blood.
Mean platelet volume (MPV) may be reported with a CBC. It is a calculation of the average size of platelets.
Platelet distribution width (PDW) may also be reported with a CBC. It is a measurement of the variation of platelet size.

26. Normal Range Platelet count : 140,000 to 450,000 /cubic mm
Mean platelet volume: 7.5 – 11.5 fL
Platelet distribution width: % %

27. Test
examples of causes of low result
examples of causes of high result
Platelet Count
Known as thrombocytopenia:
Viral infection (mononucleosis,hepatitis)
Rocky mountain spotted fever
Platelet autoantibody
acetaminophen, quinidine, sulfa
cirrhosis
Autoimmune disorders
Sepsis
Leukemia, lymphoma
Myelodysplasia
Chemo or radiation therapy
Know as thrombocytosis:
Cancer (lung, GI,lymphoma)
Rheumatoid arthritis, IBD, lupus
IDA
Hemolytic anemia
Myeloproliferative disorder (essential thrombocythemia)

28. Examples of causes of low result
Test
Examples of causes of low result
Examples of causes
of high result
Mean Platelet Volume
Indicates average
size of platelets
is small; older
platelets are
generally
smaller than younger ones
and a low MPV may mean
that a condition is affecting the
production of platelets
by the bone marrow.
Indicates a high number
of larger, younger platelets
in the blood; this may be
due to the bone marrow
producing and releasing
platelets rapidly into
circulation.
Platelet Distribution Width
Indicates uniformity in
Indicates increased
variation in the size of the
platelets, which may mean
that a condition is present
that is affecting platelets