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Medicine Haematology Summary
- Course
- Medicine (SCMD3000)
- Institution
- University Of The Witwatersrand (wits)
3rd year haematology summary of lecture notes
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Haematology BlockSection 2 Summary
Chaandanee Bhayroo
1420214
GEMP 1
,Laboratory Investigations of Blood Cells
● FBC is performed on an automated machine
● First look at WBC, haemoglobin, and platelets = main cell types in the peripheral blood
● REMEMBER = ANAEMIA IS DEFINED BY [Hb] COUNT AND NOT RBC
● Then look at red cell indices
● Always refer to the reference ranges (change according to lab equipment, age, gender and
altitude) – and thus may be normal in certain patients
White Cell Count
● Neutrophils, lymphocytes and monocytes = not disclosed on FBC
● Pancytopenia – have to do a differential count to determine which cells are affected
Platelet Count
● Important concept of platelet clumping – will not be
counted as platelets in the automated machines
(determines according to size)
● Blood smear done if thrombocytopenia is diagnosed in FBC
● Not indicative of any pathological disease
Red Cell Count
● ANEMIA IS NOT DEFINED BY RED CELL COUNT!!!
● RATHER BY THE TOTAL AMOUNT OF [Hb] – carries oxygen
Red Cell Indices
● Haemoglobin - measurement of Hb concentration found after RBC lysis
● Red cell count – RCC
● Haematocrit – Hct (measured using RCC and MCV)
● Mean cell volume – MCV
● Mean cell haemoglobin – MCH (depends on the size of the cell)
● Mean cell haemoglobin concentration – MCHC (very important!)
● Range of distribution width – RDW (compares big cells to small cells)
Characterisation of Red Cells
● Colour – “chromia”
● Size – “cytosis”
● Examples:
o Normochromic, normocytic
o Hypochromic, microcytic
o Normochromic, macrocytic
Quantification of all nucleated cells in the peripheral
blood
● Abnormal cells
● Corrected count = WBC – NRBC
● Differential count
,Approach to all Cytopenias
There is always a BALANCE between production and loss
Reticulocytes:
● Anaemia = can see premature RBCs
● Reticulocyte = dense granular ribosomes and mRNA (rER)
● Reticulocyte count is done on the automated machine
Reticulocyte production index calculated to determine whether an anaemia is due to a production
defect or increased loss of red cells
RPI = % reticulocytes x Hb (pt) / Hb (n) x ½
< 1% - decreased production
1 – 2% - normal
> 2% - increased production
Microcytic Hypochromic Red Cells
● Larger central pallor
● Smaller than lymphocytes
● RDW ↑
● MCV ↓
● MCHC ↓
Most common causes:
● Iron deficiency
● Anaemia of chronic disorders
● Thalassemia minor
Macrocytic Normochromic Red Cells
● Larger and oval cells
● Normal pallor
Cause = Megaloblastic anaemia
Spherocytes
● Small round cells
● RDW ↑
● Difference in colour of cells
Microcytic Normochromic Red Cells
, ● Very small and fragmented (lysed)
● MCV ↓
● RDW ↑
● MCHC N
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