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    Hemograma Buna 2023 Buna

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    MirelDabuleanu
    This document provides a summary of a hemogram, or complete blood count test. It discusses both manual and automatic methods for analyzing blood components like red blood cells, white blood cells, platelets, and cell precursors. Normal ranges for various blood parameters are provided for men and women. Peripheral blood smears are also summarized as a method for examining cell morphology and identifying abnormalities. Key cells and measures analyzed in a hemogram are outlined.

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    Hemograma Buna 2023 Buna

    Uploaded by

    MirelDabuleanu
    22 views71 pages
    This document provides a summary of a hemogram, or complete blood count test. It discusses both manual and automatic methods for analyzing blood components like red blood cells, white blood cells, platelets, and cell precursors. Normal ranges for various blood parameters are provided for men and women. Peripheral blood smears are also summarized as a method for examining cell morphology and identifying abnormalities. Key cells and measures analyzed in a hemogram are outlined.

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    This document provides a summary of a hemogram, or complete blood count test. It discusses both manual and automatic methods for analyzing blood components like red blood cells, white blood cells, platelets, and cell precursors. Normal ranges for various blood parameters are provided for men and women. Peripheral blood smears are also summarized as a method for examining cell morphology and identifying abnormalities. Key cells and measures analyzed in a hemogram are outlined.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    22 views71 pages

    Hemograma Buna 2023 Buna

    Uploaded by

    MirelDabuleanu
    This document provides a summary of a hemogram, or complete blood count test. It discusses both manual and automatic methods for analyzing blood components like red blood cells, white blood cells, platelets, and cell precursors. Normal ranges for various blood parameters are provided for men and women. Peripheral blood smears are also summarized as a method for examining cell morphology and identifying abnormalities. Key cells and measures analyzed in a hemogram are outlined.

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    HEMOGRAM

    COMPLETE BLOOD COUNT

    MD.PhD DENISA BRATU


    HEMOGRAM:-a lot of tests which inform
    about elements of the blood
    ”blood diagram ”
    “haima”(grec.)=“haema”(lat.)=blood(engl)
    -it can be carried out - manually
    - automatically
    AUTOMATIC ANALYSER
    Principles:
    -ELECTRIC IMPEDANCE
    -HYDRODYNAMIC FOCUSING
    DETECTION METHOD
    -SCATTERED LIGHT-SEMICONDUCTOR
    LASER
    -FLUORESCENSE
    First-Coulter
    Sysmex,Advia,Beckmann-Coulter,Mindray
    COULTER PRINCIPLE
    SAMPLE
    -peripheral blood-venous
    -capillary
    -vacutainer-purple stopper-2mL venous
    -anticoagulant-EDTA-K2,K3
    -Na2,Na3
    PERIPHERAL BLOOD SMEAR
     -Glass blades
     -one drop blood
     -second blade for strech smear-
     -absolute alchool(methylic,ethylic)-fixing
     -Giemsa,Romanowski,Wright-dyeing
    Segmented 65
    Eosinophil 2
    Basophil 1
    Lymphocytes 26
    Monocytes 6
    Blasts 5
    Promyelocytes 2
    Myelocytes 2
    Metamyelocyteas 2

    Band Form 4
    Segmented 28
    Lymphocytes 45
    Monocytes 13

    Middlee hypochromia
    Mild agglutination
    Promyelocytes 1
    Band Form 2
    Segmented 5
    Eosinophil 2
    Lymphoyd Elements 88
    Monocytes 2

    Lymphoyd Elements,middle /high,coarse chromatin,,fine cytoplasm,some


    with clefted nucleoulus
    Rolls
    Nuclear ghosts(few)
    Segmented 65
    Eosinophil 1
    Basophil 1
    Lymphocytes 29
    Monocytes 4

    Middle poikylocytosis(ovalocytes,stomatocytes,teardrop cells)


    Rolls
    Nuclear ghosts(few)
    Segmented 69
    Eosinophil 3
    Basophil 1
    Lymphocytes 22
    Monocytes 5

    Rolls
    Segmented 3
    Lymphoids Elements 92
    Monocytes 5

    Stomatocytes
    Rolls
    Common
    Nuclear ghosts

    Common lymphoids elements with monocytoid


    aspect
    Smear 1:Blasts 3
    Promyelocyte 1
    Blasts 3
    Promyelocyte 1
    Segmented 45
    Eosinophil 1
    Basophil 1
    Lymphocytes 46
    Monocytes 3

    Erythroblasts 80/100
    ERITROCYTES,RED BLOOD CELLS: -anucleated

    Structure: biconcave plate shape(optical microscope),7,2µ highness,2,4 thickness

    RED BLOOD CELLS


    MENS WOMENS
    PARAMETERS
    HEMOGLOBINE
    13,5 - 17,5 12,0 - 16,0
    g/dL
    RED BLOOD CELLS
    4,5 - 6,0 4,0 - 5,4
    NUMBER x 106/μL
    HEMATOCRIT (%) 40 - 52 36 - 48

    Labels figures : average ± 2 standard deviations for healthy persons , white,


    residing at the sea shores.( Coulter analyser determinations•) Red blood cells
    parameters are : sex, age, , plasmatic volume (blood dilution,blood
    concentration), altitude, smoke, obesity, gymn, stress., dependent.
    NORMAL RED BLOOD CELLS
    PARAMETERS ♂ ♀
    RBC (x 106/mmc) 4,3 – 5,5 3,7 – 4,9
    Ht (%) 40,5 – 52,5 36 – 46
    Hb (gr./dL) ̸ L 13 – 17 11 – 14,6

    MCV(fl)* 80 – 94 (Ht/RBC x 10)


    MCH (pg)** 25 – 33 (Hb/RBC x 10)
    MCHC (g/dL) 32 – 36 (Hb/Ht x 100)

    Ret (%) 0.5 – 2


    RDW (red cell distribution width): 12,5 ± 1
    * fl = 10 -15 l
    ** pg = 10 -12 g

    Basic equations: 3 x RBC = Hb


    3 x Hb = Ht ± 3

     Ex.: 3.0 x 1012 /L (RBC) - - - - - > 3 x 3 = 9


     9.2g/dL (Hb) - - - - - > 3 x 9.2 = 27.6
     26% (Ht)
    Microcytic Anemia
    (MCV < 80 fl)
    Hypocromia
    (HCM < 27 pg) (HCMC ˂30g/dL)

    Normocytic Anemia (CMV 80 –100 fl) Normocromia 32 – 36


    Normocromia
    (HEM > 27 pg)

    Macrocytic Anemia
    (MCV > 100 fl)

    ANEMIA: CIRCULATED RED BLOOD CELLS PARAMETERS DECREASE

    NUMBER
    VOLUME / HEMATOCRIT
    HEMOGLOBINE CONTENT
    On the peripheral blood smear:

    Anisocytosis(size variability of red blood cells):- normocytes


    (A) -macrocytes
    orthochrom,polychrom
    -microcytes
    Poikilocytosis (different forms):ovalocytes,teardrop cells,stomatocytes,
    schistocytes,spherocytes,microspherocytes,echinocytes,achantocytes,
    piropoikilocytes,target cells,sickle cells,elliptocytes
    (P)
    Hipochromia (the degree of hemoglobin loading of red blood cell)
    (H)
    All of them will be quantified with three degrees:-mild (+)
    -middle(++)
    -high(+++)
    WBC WHITE BLOOD CELLS, (x 103/ μL): 4 WBC- ↑Leucocytosis: infection
    – 9 (M: 6.9) inflamation, neoplasia, leukemia
    FL: Band Form(N) ~ 2-4% ~200/mmc lymphoma, chronic disease
    Segmented Granulocytes(S) ~ 40-60% -↓Leucopenia :neoplasia
    ~ 4000 / mmc leukemia, lymphoma, chronic
    Eosinophil (E) ~ 2-4 % ~ 200 / disease
    mmc
    S- ↑ Neuthrophylia
    Basophil(B) ~ 0.5-1 % ~ 50 /
    infection, inflamation
    mmc
    ↓Neuthropenia
    Lymphocytes(L) ~ 20-40% ~
    E- ↑Eosinophylia-
    2000 / mmc
    parasitoses, lymphoma.
    Monocytes ~ 4-8% ~ 400 / mmc
    B- ↑Basophylia -stress,
    MPD(Myeloprolypherative
    ! Immature Granulocytes (Left Shift) on
    disease)
    peripheral blood smear = PATHOLOGY
    Leukemoid Reaction L -↑Lymphocytosis: phthisia,
    . viroses, cough chin, CLPS
    -↓Lymphopenia;CLPS

    M- ↑Monocytosis-smokers,
    infection ,toxic disease,
    , neoplasia
    On the peripheral blood smear:

    Immature Granulocytes(precursors):
    Blasts-myeloblasts,monoblasts,lymphoblasts,megakaryoblasts
    Promyelocytes
    Myelocytes
    Metamyelocytes

    Red blood cells precursors:-erythtroblasts –orthochrome


    (NRBC) -polychrome
    -basophil

    Megakaryocytes,free nucleus of megakaryocyte-rarely


    Plasmocytes
    ALL THESE POSSIBILITIES=PATHOLOGY
    PLATELET NUMBER-150-450 X 10³/µL
    VPM ~ 9.4 fl.
    PDW ~ 16.

    -↑-after bleeding,hematological disease

    -↓-pregnancy ,hematological disease

    -leading part in coagulation-hemostasis-


    adhesiveness and property to aggregate

    -play a prominent part in immunity


    Peripheral blood Giemsa 40x :LYMPHOCYTE,RED BLOOD CELLS WITH LOW CONTENT OF HEMOGLOBIN(HYPOCHROMIA)
    Peripheral blood Romanowski 100x:MACROCYTES(OXYPHILE)
    Peripheral blood Giemsa 40x:MICROSPHEROCYTES,AGGLUTINATION
    Peripheral blood Giemsa 100x :ERITHROBLAST,TARGET CELLS,SCHISTOCYTES,STOMATOCYTES,OVALOCYTES,BURR CELL
    Peripheral blood Giemsa 100x:HOWELL JOLLY BODY
    Peripheral blood Romanowski100x:BASOPHILIC STRIPPLES,CABOT RING
    Peripheral blood Giemsa 40x:LYMPHOCYTE,MONOCYTE
    PeripherL blood Giemsa 100x:MONOCYTE,SEGMENTED NEUTHROPHILS
    Peripheral blood Giemsa 100x:BAND FORM,SEGMENTED NEUTHROPHIL,LYMPHOCYTE
    PB Giemsa 100x:SEGMENTED EOSINOPHIL
    PB Giemsa 100x:SEGMENTED NEUTHROPHIL

    PB Giemsa 100x:SEGMENTED BASOPHIL


    BMA 100x:METAMYELOCYRE EOSINOPHIL,BAND FORM NEUTHROPHIL,ERYTHROBLASTS
    BMA Giemsa 100 X:MEGAKARYOCYTE
    BMA Giemsa 100 x ::ERYHROBLASTS,MEGALOBLASTOID,,GIANT BAND FORM
    BMA Giemsa 100x: NEST OFMYELOMA PLASMA CELLS
    BMA Giemsa 100X:MYELOMA PLASMA CELLS,GRANULOCYTIC PRECURSORS AND MATURE CELLS
    PB Giemsa 100x:”FLAMB CELL” MYELOMA PLASMA CELL
    PB Giemsa 100x:Lymphoplasmocyte,rolls,Waldenstrom disease
    BMA Giemsa 100x :Myeloblasts(nest)
    2

    BMA Giemsa 100x:Myeloblast(1),monoblast(2)


    2

    1
    BMA Giemsa 100x:Blasts(some with vacuoles)
    Electhronic microscopy:red blood cell,thrombocyte,lymphocyte
    Thank You !

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