Pengantar Lab Upd 2012

PENGANTAR LAB. IPD.

Lab. Urine dan faeces lihat petumjuk praktikum.

I. DARAH RUTIN.

KADAR HB. ; AE; AL; AT BACA BUKU PETUNJUK PRAK. GANDA

SUBRATA/ LAB PK.

II. . Diff. count prosentase macam- macam seri leukosit.( EOSINOFIL; BASOFIL;

MONOSIT; NETROFIL BATANG, NETROFIL SEGMENT; LIMFOSIT.

III. GAMBARAN DARAH TEPI (GDT).

- BUAT PREPARAT APUS DIVCAT GIEMSA. LIHAT DI LAB

- PEMBACAN :

-

A. SERI ERITROSIT :

- JUMLAHNYA, PENYEBARAN MERATA / TIDAK

- UKURAN DIBANDINGKAN DENGAN LEKOSIT DEWASA

SAMA = NORMOSITIK

LEBIH KECIL = MIKROSITIK; LEBIH BESAR = MAKROSITIK.

DILIHAT HALONYA , LEBIH LUAS HIPOKROMIK, SAMA

NORMOKROMIK

- ADANYA : ANISOSITOSIS, POIKILOSITOSIS, STOMASITOSIS,

OVALOSITOSIS.,TEAR DROP, TARGET CELL, ROULEAUX

FORMATION .

1

1. Proerythroblast   2. Polychromatic normoblast   3. Pycnotic normoblast   4. Monocyte   5. Plasmocyte   6. Basophil   7. Lymphocyte  8. Neutrophil myelocyte   9. Neutrophil metamyelocyte   10. Promyelocyte. (Tahap perkembangan sel darah).

RETIKULOSIT GDT NORMAL

2

MICROCYTES MEGALOCYTES /MAKROSITIK

ANISOSITOSIS HIPOKROMIK

SEL TARGET. BURR-CELLS (ECHINOCYTES)

3

Panel A shows Burkitt's lymphoma, with three basophilic vacuolated lymphoma cells. Hypogranular promyelocytic leukemia is shown in Panel B, with two characteristic bilobed leukemic promyelocytes. Panel C depicts cryoglobulin deposition in a blood sample from a patient with hepatitis C virus infection. Panel D shows Target cells (short arrow), Acanthocytes (long arrow), and a Howell–Jolly body (arrowhead) — all features of hyposplenism — in a blood smear from a patient with iron-deficiency anemia and splenic atrophy as features of celiac disease. All specimens were stained with May–Grünwald–Giemsa stain.

Acanthosis : Abnormal RBC shape (thorn-like surface protrusions) seen in a number of conditions, inherited or acquired, affecting RBC membrane lipid structure.RBCs develop normally in marrow but once in plasma adopt characteristicshape. RBCs lose membrane and become progressively less elastic.DD: - Inherited conditions resulting in significant acanthocytosis - A-b-lipoproteinaemia. - McLeod phenotype (lacking Kell antigen).

4

- In(Lu) phenotype.- In association with abnormalities of band 3 protein.- Hereditary hypo--lipoproteinaemia.

- Acquired conditions resulting in mild acanthocytosis- Post-splenectomy and hyposplenic states.- Starvation including anorexia nervosa.- Hypothyroidism.- Panhypopituitarism.- A-b-lipoproteinaemia* Autosomal recessive.- Congenital absence of b apolipoprotein.- Cholesterol:phospholipid ratio 4. RBC precursors normal. Usually obvious in early life with associated malabsorption of fat (including vitamins A, D, E and K). Sphingomyelin accumulates. Autosomal recessive. Congenital absence of b apolipoprotein.-Cholesterol:phospholipid ratio 4. RBC precursors normal. Usually obvious in early life with associated malabsorption of fat (including vitamins A, D, E and K). Sphingomyelin accumulates.

ELIPSITOSIS SPEROSITOSIS

Poikilocyte (DIC), TEAR DROP

5

Howell-Jolly's body, r, May-Giemsa1000 ROULEAUX FORMATION

THALLACEMIA MALLARIA

SERI GRANULOSIT :

GRANULOPOIESIS

Granulopoiesis constitutes 40-80% of the haemopoietic cells in the normal bone marrow. The myeloblast is the first recognizable cell of the granulopoiesis. The myeloblast enlarges and differientiates to the promyelocyte. At this stage specific granules begin to appear (eosinophilic granules in the eosinophilic leucocytes, basophilic granules in the basophilic granulocytes and neutrophilic granules in the neutrophilic leucocytes). The promyelocytes mature and become the myelocytes and then metamyelocytes. In the end of the maturation process metamyelocytes become band neutrophil and then segmented neutrophil. These cells move from the marrow to the blood. The majority of granulopoiesis in the normal marrow consists of neutrophilic leucocytes.The percentage of eosinophilic leucocytes and basophilic leucocytes should not exceed 5% and 1% respectively.

- JUMLAH, PENYEBARAN ? - SEL BLAST / MUDA LAINNYA.

6

GDT NORMAL NETROFIL

GDT NNORMAL NETROFIL , EOSINOFIL DAN TROMBOSIT

AML.

7

BONE MARROW SMEAR

BLOOD SMEAR MAY-GIEMSA 1000X.

SERI LIMFOSIT: - JUMLAH, PENYEBARAN ? - SEL BLAST/ MUDA LAINNYA.

8

ALL.

BONE MARROW SMEAR, MAY – GIEEMSA 1000X

BLOOD SMEAR , MAY-GIEMSA 1000X

SERI TROMBOSIT : - MUDAH DIKETEMUKAN / TIDAK : MEGAKARIOBLAST; MEGAKARIOSIT; TROMBOSIT.

9

IV. URINE RUTIN BUKU LAB.V. FAECES RITUN BUKU LAB.

-------------------------------------------------------------------------------------------------------

10