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CBC interpretation
Reticulocyte
- An early, immature form of a red blood cell. Over time, the reticulocyte develops to become a mature, oxygen-carrying red
blood cell.
Reticulocytosis
- Increase in the number of circulating reticulocytes above 1% of the total number of RBCs
- Occurs during active blood regeneration (stimulation of red bone marrow)
- Seen in certain anemias, especially congenital hemolytic anemia.
Microcytes
- Microcytes are unusually small red blood cells associated with certain anemias.
Microcytosis
- Condition in which RBCs are unusually small as measured by their mean corpuscular volume. It is also known as
"microcythemia". When associated with anemia, it is known as microcytic anemia.
Anisocytosis
- Medical term meaning that a patient's red blood cells are of unequal size.
- Commonly found in anemia and other blood conditions.
- Can be seen in various types of anemia and vitamin deficiencies.
- Hyperproliferative Reticulocytes (> 2%) bone marrow working harder and some anemia going on
- Hypoproliferative Reticulocytes (< 2%) bone marrow not working enough could be due to cancers?
Hemoglobin:
- Hemoglobin concentration reflects the number of RBCs in the blood
- Hgb constitutes over 90% of RBCs
- Decrease in Hgb concentration = ANEMIA
- Increase in Hgb concentration =
POLYCYTHEMIA
o Absolute: RBCs high all the time
(high altitude)
o Relative
Hematocrit:
- Measure of the % of the total blood volume that
is made up by RBCs
- HEMOGLOBIN x 3 = HEMATOCRIT
Feedback:
- Positive feedback: anemia bone marrow produce RBCs
- Negative feedback: High RBCs tell liver to stop producing erythropoietin stop producing RBCs
Leukocytosis
- WBCs above normal range
- Frequently a sign of inflammatory response and most commonly, infection
o Other causes: parasitic invasion, bone tumors, leukemia, FUO, strenuous exercise, epilepsy, emotional stress,
pregnancy/labor, anesthesia, and epinephrine administration
Types of Leukocytosis
Neutrophilia
- Higher than normal number of neutrophils
o May occur without an increase in total granulocyte pool (TBGP)
o Or from a true increase in the total granulocyte pool size = TRUE neutrophilia
- Normal value = 55-60% of total WBCs
- Causes:
o M.C.= primary WBC that responds to BACTERIAL infections
Especially pyogenic infections
o Increase in ACUTE inflammation, after heart attack, other infarct, or burns
Eosinophilia
- High number of eosinophils
- Can indicates a parasitic infection, allergic reaction, or cancer
- Normal value = 1-3%
- Usually less than 7% of circulating leukocytes
Basophilia
- High number of basophils
- Associated with pruritus due to histamine release
- Normal value = 0-1%
- Generally linked to allergic/hypersensitivity disorders or chronic inflammatory conditions like eczema, or hay fever
Lymphocytosis
- Increase in number of lymphocytes in the blood
- Normal value = 20-40%
- Three main types
o Natural killer cells
o T-Cells
o B-Cells
- Seen in: TB, lymphoma, leukemia, infectious mononucleosis (EBV), mumps, etc.
Pancytopenia
- Deficiency of all three cellular components of the blood (red cells, white cells, and platelets).
Monocytosis
- Increase in monocytes, normal range is 5-10%
- Monocytes present antigens to T lymphocytes for immune response
- Monocytes turn into macrophages when they get to the tissues
o Alveolar macrophages – Lungs
o Histiocytes – Connective tissue
o Kupffer cells – Liver
o Osteoclastic – Bone
- Monocytosis is seen in TB, Fungal infection, Listeriosis, Leukemia
Poikilocytosis
Types of Poikilocytes
- As name indicates these poikilocytes or RBCs are termed as teardrop due to their resemblance with tear drops.
- Target cell: Poikilocytes or RBCs having shape like bull's eye are termed as target cells
- Spherocyte: Poikilocytes or RBCs have shape like sphere or having spherical shape are termed as spherocytes.
- Sickle cell: Poikilocytes or RBCs having look like crescent are termed as sickle cells
- Schistocyte: Poikilocytes or RBCs having no proper shape are termed as schistocytes.
- Acanthocyte: Poikilocytes or RBCs arranged in an irregular pattern are termed as acanthocytes
- Stomatocyte: Cup shaped Poikilocytes or RBCs.
- Bite cell: Due to removal of one or more semicircular portions from the cell margin
Target cell
Leukopenia