PHR 327 Hematology

Common Blood Tests:
Hematology
ZTG
PHR 327
Fall 2019
Hematology:
• Study of blood and its components
Complete Blood Count (CBC)
• Measure hemoglobin and

hematocrit, RBC count, RBC
indices, WBC count, WBC
differential.
• May check RBC morphology

CBC
• Complete blood count
–With or without differential
–(CBC) is a group of tests used for
basic screening purposes. It is
probably the most widely
ordered laboratory test
–Enumeration of the cellular
elements of the blood,
measurement of RBC indices,
and determination of cell
morphology
CBC
• Peripheral venous blood is

collected in an EDTA
anticoagulant containing lavendar
tube
• should be thoroughly mixed
• Specimen:
–Whole blood
–Clotted or greater than 48 hours
old: unaccceptable.
Indications of hematology tests :
• Detect hematologic disorder, neoplasm,
leukemia, or immunologic abnormality
• Determine the presence of hereditary
hematologic abnormality
• Evaluate known or suspected anemia and
related treatment
• Monitor blood loss and response to
blood replacement
• Monitor the effects of physical or emotional stress
• Monitor fluid imbalances or treatment for
fluid imbalances
Normal Values (Conventional and SI
• RBC:
units)
– Males:
• 4.71-5.14 X 106 cells/mm3
• 4.71–5.14 X 1012 cells/L
– Females:
• 4.20-4.87 X 106 cells/mm3
• 4.20–4.87 X 1012 cells/L
• Hgb:
– Adult Male
• 13.2–17.3 g/dL
• 132–173 mmol/L
– Female
• 11.7–15.5 g/dL
• 117–155 mmol/L
• Hct: Normal Values
– Adult Male 43–49 %
– Female 38–44 %
• MCV: (fl)
– Male 85–95
– Female 85–95
• RDW:
– Male: 11.6–14.8
– Female:11.6–14.8
Normal Values
• Platelet:
• 1–5 yr:
– 217,000–497,000/mm3
– 217–497 X 109/L
• Adult:
– 150,000–450,000/mm3
– 150–450 X 109/L
CBC: Measured Components
• Red blood cell data
– Total red blood cell count (RBC)
– Hemoglobin (Hgb)
– Hematocrit (Hct)
– Platelet (PLT)
– RBC indices:
• Mean corpuscular volume (MCV)
• Red blood cell distribution width (RDW)
• Mean corpuscular hemoglobin (MCH)
• mean corpuscular hemoglobin concentration (MCHC)
• White blood cell data
– Total white blood cell (leukocyte) count (WBC)
– A white blood cell count differential may also
be ordered
Critical Values
• Hemoglobin:
– Less than 6 g/dL
–Greater than 18 g/dL
• Hematocrit:
– Less than 18% •
– Greater than 54%
Critical Values
• WBC count (on admission):
– Less than 2500/mm3
– Greater than 30,000/mm3
• Platelet count:
– Less than 20,000/mm3
– Greater than 1,000,000/mm3
• Presence of abnormal cells,

other morphologic characteristics
abnormalities
Interfering factors
•Failure to fill the tube sufficiently (less than
three-fourths full) may yield inadequate
sample volume for automated analyzers and
may be a reason for specimen rejection.
• Hemolyzed or clotted specimens should
be rejected for analysis.
• Elevated serum glucose or sodium
levels may produce elevated mean
corpuscular volume values because of
swelling of erythrocytes.
• Recent transfusion history should be
considered when evaluating the CBC
RBC
Red Blood Cell Count
• Sample: Whole Blood 1 ml
• Number of RBCs per litre or 1mm3
of peripheral venous blood
• for the transport and exchange of
oxygen, the number of circulating RBCs is
important
• affected by posture, extreme
exercise, excitement, age, gender,
altitude, dehydration
RBC
RBC: Hemoglobin
• The hemoglobin concentration measures
the amount of Hgb in the peripheral
blood, which reflects the number of red
blood cells in the blood
– Hgb constitutes over 90% of the red blood cells
– Measure of O2 - carrying capacity of blood
• Decrease in Hgb concentration =
– Anemia , hemorrhage
• Increase in Hgb concentration =
– Polycythemia
Hgb
RBC: Hematocrit
• Hematocrit: percentage red blood cells
in a whole volume of blood
• A hematocrit (Hct) of 45% means that a
100-mL sample of blood contains 45 mL
of packed RBCs
– Compares the height of the red blood cell
column to the column of the whole blood
Hct
Calculating the Hematocrit
• Calculated directly from the RBC and MCV
– Hematocrit % = RBC (cells/liter) x MCV
(liter/ cell)
• Because the Hct is derived from MCV and

RBC values, errors in the RBC or MCV
determination will lead to invalid results
Mean Corpuscular Volume
• Average volume, or size, of an RBC
• Determined by the distribution of the
red blood cell histogram
– MCV is represented by the mean of the
red blood cell distribution histogram
Red Cell Distribution Histogram
Number
Of
cells
MCV
60 120 Cell Size (fl)

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

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

Red Blood Cell Distribution Width Index
• RDW indicates variation in the RBC size
(anisocytosis)
• It is derived from the red blood cell histogram
and represents the coefficient of variation of
the curve
• In general, an elevated RDW (indicating more
variation in the size of RBCs) has been
associated with anemias with various
deficiencies, such as iron, B12, or folate
• Thalassemia is a microcytic anemia that
characteristically has a normal RDW
WBC: Leucocytes
White Blood Cell Count 
• Important for body’s defense

against infections etc.
• A count of the total WBC, or leukocyte,
count in 1mm3 of peripheral blood
– changes with age, stress, exercise,
diurnal rhythm
• A decrease in the number of WBCs =

– Leukopenia
• An increase in the number of WBCs =
– Leukocytosis: invading organism,
tissue destruction
WBC
WBC Differential
• When a differential is ordered, the
percentage of each type of leukocyte
present in a specimen is measured.
• Name the types of leukocytes
– Neutrophils (includes bands: left shift)
– Lymphocytes: Lymphocytosis, commonly due
to viral infection
– Monocytes
– Eosinophils
– Basophils
• WBC differentials are either performed
manually or by an automated instrument
WBC: Bands
• Bands: immature neutrophils –
• appear if prolonged heavy demand for
neutrophils results in release of immature
cells = “shift to the left” - referring to
usual left to right illustration of
neutrophil development
Platelet
Platelet Count (PLT)
• Platelets important for clotting process
• A count of the number of platelets
(thrombocytes) per cubic milliliter of
blood
– A decreased number of platelets =
• Thrombocytopenia: Chemotherapy → bone
marrow depression → thrombocytopenia
– An increased number of platelets =
• Thrombocytosis
PLT
Short hand depiction

PHR 327 Hematology

Uploaded by

Copyright:

Available Formats

PHR 327 Hematology

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

PHR 327 Hematology

Uploaded by

Copyright:

Available Formats

Common Blood Tests:

• Measure hemoglobin and

• May check RBC morphology

• Peripheral venous blood is

• Presence of abnormal cells,

• Because the Hct is derived from MCV and

60 120 Cell Size (fl)

– Normal MCV = normocytic anemia

– Decreased MCV = microcytic anemia

– Increased MCV = macrocytic anemia

60 120 Cell Size (fl)

• Important for body’s defense

• A decrease in the number of WBCs =

You might also like