CLINICAL PATHOLOGY REVISED STUDY GUIDE ( NEW) 2023 GRADED A+.

CLINICAL PATHOLOGY REVISED STUDY GUIDE ( NEW) 2023 GRADED A+. Blood A – RBCs B – Hematocrit C – Hb D – RBCs indecies E – WBCs + DLC F – Platlet Items outside CBC but may be helpful  Reticulocytes (0.5-1.5%)  Staff segment(15 – 110)  Blood film  BM aspiration  RDW  Bleeding time  Coagulation profile CLINICAL PATHOLOGY D- RBCs indices 1- Mean corpuscular volume (MCV):- measures the mean or average size of individual red blood cells = The hematocrit is divided by the total RBC count. Microcytic red blood cells  iron deficiency anemia  thalassemia.  Sidroblastic anaemia  Anaemia of chronic illness (some times) Macrocytic red blood cells DD of Macrocytosis Without megaloblasts 1. Reticulocytosis 2. Pregnancy 3. Alcoholism 4. Hypothyroidism 5. Liver cell failure 6.Chronic renal failure With megaloblasts Vit B12 Folic acid Normochromic normocytic anemia  Hemolytic anemia  Aplastic anemia ( reticulocytes )  Hypersplenism ( reticulocytes ) 2- Mean corpuscular hemoglobin (MCH) :- measures the amount of hemoglobin present in one RBC. = dividing the hemoglobin by the total RBCs Hematocrit RBCs MCV: 80 - 95 femtoliter MCH: 27 - 31 pg/cell MCHC: 32 - 36 gm/dl Hemoglobin RBCs CLINICAL PATHOLOGY The MCH and the MCHC are used to assess whether red blood cells are normochromic, hypochromic, or hyperchromic . E- WBC:4,000 - 11,000 cells/mm3 Granulocytes (or polymorphonuclears) Relative value Absolute value Neutrophils: 45 - 70% Eosinophils: 2 – 4% 50 – 400 Basophils: 0 – 2% 0 - 100 Agranulocytes (or mononuclears) Relative value Absolute value Lymphocytes 25 - 40% 1700 – 3400 Moncytes 4 - 8% 400 - 800 Anemias can be classified using erythrocyte indices in the following way: 1- MCV, MCH and MCHC normal normocytic, normochromic anemia 2- Decreased MCV, MCH, and MCHC microcytic, hypochromic anemia 3- Increased MCV, variable MCH and MCHC macrocytic anemia Thelifespanofwhitebloodcellsrangesfrom13to20days CLINICAL PATHOLOGY 59 Scheme of diagnosis 1 st step RBCs (Hb) Increased Decreased RBCs only All element:- RBCs. WBCs & platlets 1ry polycythemia 2ry polycythemia All element:- RBCs. WBCs & platlets Pancytopenia Anaemia RBCs only Reticulocytes Increased Hypersplenism Decreased Megaloblastic MCV or CI : increased Anisocytosis & poikylocytosis Aplastic anemia By : BM aspiration Increased WBCs Decreased Platlets ةداس Alone Leukaemia Thromboctytopenia (prolonged BT) blast cells increased Acute L Decreased Chronic L RBCs indices Normocytic normochromic Microcytic hypochromic Macrocytic Megaloblastic anaemia Fe deficiency: Decreased Fe Level + Marked eosinophilia:- Ankylostoma Chronic blood loss Increased reticulocytes  Acute bleeding  Haemolytic anaemia CLINICAL PATHOLOGY 60 WBCs Increased RBCs & Platelets normal Leukocytosis due to infection Look at D.L.C Mainly PNL Leukocytosi s Abnormal monocytes Glandular fever Confirmed by : Paul bunnel test or monospot test Decreased Leukemia Acute (blast cells 30 % ) Lymphocytes ( ALL ) Neutrophils ( AML ) Lymphocytes ( CLL ) Neutrophils ( CML ) Severe Anaemia WBCs : 100.000 Blast cells Reduced platelets Mild anaemia WBCs 100.000.