(Heamatology Laboratory) . : (Complete Blood Count CBC) . ( ) (Differential Count) (Reticulocyte Test) . (Erythrocytes Sedimentation Rate ESR) . (B.T) . (PT) . (PTT) .

: . . : (CBC) . (PT) (PTT) (Coagulation). (ESR). . :1- (Anemia) .2- (Leukemia) .3- (Bleeding Diorders) .4- (Inflammation) 5- (Bone Marrow) : (Complete Blood Count CBC) : : (HB% RBC HCT MCV MCH MCHC- WBC PLT ) .

1- - ( 1): ( ) (%) . : . - Drabkin Method ( ) (Spectrophotometer ) ( 2).

540 (Blank) . .

: 1- 5 + 20 (Fresh Blood) . 2- 3-5 . 3- 540 . 4- (Standard) : X 3.6 = / 100 X 6.9 = HB % :13 18 % ( ) 3 6 10 12

9.5 13.5 %1.05 13.5 %1.05 13.5 % 12 14 %11.5 - 14.5 %

11.5 16.5 %

11 %

( 16.5 19.5 %

2- R.B.Cs Counting Haemocytometer ( 3 ). 1- 200:1 ( 9%) 20 4 ( 0.5 1 101 0.5 101 ).( 4 )

2- .3- ( 5 ).

4- 10 40 5 ( 6 ) ( + ). 6 : /3 = X 10000

- 20 . . . . - : 20 . . . . .

4.5 6.5 /

3.8 5.8 /

(3 ) 3.2 4.8 /

( 3 6 ) 4.1 5.5 /

(10 12 ) 4 5.4 /

: . :

....

3- Packed Cell Volume (PCV) Haematocrit (HCT) - , .- . - (MCV / MCHC) 42- 50 %. 39-48 %. - - - B12.- .

. ( 7 ) :

Blood Indices - Mean Cellular Volume .. MCV .- Microcyte : Iron deficiency anaemia. Thalassemia.- Macrocyte Megaloblastic anaemia : .. Folate deficiency. .B12 deficiency. ( ): MCV: 80 to 95 femtoliter - Mean Corpuscular Haemoglobin .. MCH: MCH () . MCH . ( ): MCH: 27 to 31 pg/cel - Mean Corpuscular Haemoglobin concentration ..MCHC: MCHC . MCHC . MCHC Hypochromia Iron deficiency anaemia. ( ) : MCHC: 32 to 36 gm/dL - Red Cell Distribution Width .. RDW , .

( )11.5 : 14.5 . . . 4- Total Leucocytic Counting Haemocytometer . 1- 1 20 ( ) 20 380 ( 0.5 - 1 - 11 0.5 11. ( 8 )

82- .3- .( 9)

9

( 7 ) : 10 .( 10 )

10 : /3 = X 50 :

. .

/ 4000 11.0003 / 3

/ 6000 18.0003( )

/ 5000 15.0003 ) 4-7 )

3/ 4.500 13.500 (8 12 )

: ( ) ( . . ). :

. . .

White Blood Cell Differential Count: : ( 11 ) :1- :- (Neutrophils) . 40-75 %- (Eosinophils) . 1-6 % - (Basophils) . 1 % 2- :- (Lymphocytes) . 20 45%.- (Monocytes) .: 2-10 % (10 5 )

: - Neutrophils: ( 13 ) * Neutrophilia :- ( / / / (.- : ( / ).- .- , .- . - . * Neutropenia :- .- Typhoid fever / Brucellosis.- . 13- B12 .- .- , .- : / / / / /

- Eosinophils : ( 14) * Eosinophila:- , , .- .- .- .- .

* Eosinopenia :- Stress / Shock / Burns.- . 14- .

- Basophils: ( 15)* Basophilia : - .- .- .

* Basopenia :- .- .. 15

- Lymphocytes: ( 16) * Lymphocytosis : - - .- Viral hepatitis.- .- . 16

* : Lymphocytopenia- .- .- .- .

- Monocytes ( 17) * Monocytosis:- T.B . - Malaria.- .- .

* Monocytopenia:- B12 .- Leukemia.- Aplastic anaemia

175- Platelets : . . ( 18).

Haemocytometer ( 19 ) : ( 20)1- 20:1 ( ammonium oxalate ) 20 380 ( 0.5 - 1 - 11 0.5 11.( ( )

202- 15 20 .3- ( 21).

214- 10 40 5 ( 22) ( + ). 22

: /3 = 5 X 10000 : 150000 400000* : Thrombocytosis : .. Iron Deficiency Anaemia .. Haemolytic Anaemia T.B... Mycobacterium Tuberculosis .. Polycythaemia - .* : Thrombocytopenia- : ... Idiopathic thromcocytopenia Pupura I.T.P . ( // / / .. ( / B12 Folic acid MPV, mean platelet volume . : 7 11 MPV . Platelet Distribution Width .. PWD . 19 MCH MCV MCHC ( 23)

- RBC: Red Blood Cell Count.- HGB: Hemoglobin.- HCT: Hematocrit.- MCV: Mean Corpuscular Volume.- MCH: Mean Corpuscular Hemoglobin.- MCHC: Mean Corpuscular Hemoglobin Concentration.- RDW: RBC Distribution Width . 23- WBC: White Blood Cell Count. - NEUT%: Neutrophil Ratio. - NEUT#: Neutrophil Count.- LYMPH%: Lymphocyte Ratio. - LYMPH#: Lymphocyte Count.- MONO%: Monocyte Ratio. - MONO#: Monocyte Count.- EO%: Eosinophil Ratio. - EO#: Eosinophil Count.- BASO%: Basophil Ratio. - BASO#: Basophil Count.- PLT: Platelet Count.- MPV: Mean Platelet Volume.- PDW: Platelet Distribution Width. Sysmex or coulter

Beckman coulter 890 , Coulter S880 , Coulter staker , Sysmex , : RBC,WBC,Plt,Hb,Hct or PCV,MCH,MCHC,MCV,MPV,RDW . .

( 24 ) : Electrical Impedance cell Counting : : poor conductor Electrolyte Solution , aperture or opening 100um . . Impedance / interruption Pulses . . .

: Light Scattering Cell Counting : 24 : Laser beam or tungsten-halogen photo detector . . Bayer ADVIA 120 ABBOTT cell Dyn 3500 .

: : 1- Plt , RBCs . 2- Hb , WBCs . : Plt , RBCs RBCs Plt ( ) aggregation collagen , Epinephrine or Ristocetin .

: Hb , WBCs : Drabkin Haemoglobincyanide (HICN ) Drabkin solution potassium ferricyanide and potassium cyanide RBC Oxidation ferricyanide methemoglobin stable haemoglobincyanide HICN Cyanide 540nm WBC 3 parts : Lymphocyte , monocyte , granulocyte 5 parts : Lymphocyte , monocyte , granulocyte , Eosinophil , Basophil

: Shrink Size . 99 35 fl ( famtoliter ) Lymphocyte . 100-200 fl ( mid ) Mononuclear cells . 200fl Granulocyte .

: Histogram , five part Differential counting .

Comment TextComment Title

Mild hypochromic normocytic anemia.Anemia

Mild macrocytic anemia.Anemia

Mild microcytic hypochromic anemia.Anemia

Mild normocytic normochromic anemia.Anemia

The Red cell show mild anisopoikilocytosis.Aniso

The Red cell show mild anisopoikilocytosis with moderate degree of targeting and polychromasia and rouleaux formation seen in film.Aniso

The Red cell show mild microcytosis, anisocytosis and hypochromia.Aniso

Mild normoblastemia.Normoplast

Mild thrombocytopenia.Platelets

Platelets show anisocytosis and platlets aggregates seen in filmPlatelets

Mild thrombocytosisPlatelets

A case of pancytopenia .if it is not already diagnosed, recommended for bone marrow examination. Recom.

Recommended for C.B.C follow up, bone marrow examination and RT-PCR for bcr/abl chimeric gene product.Recom.

Recommended for serum Iron, TIBC, serum ferritin and Hb electrophoresis. Recom.

Mild reticulocytosis.Retic.

WBCs show absolute and relative Neutrophilia.WBCs

WBCs show leucocytosis with absolute & relative Neutrophilia and left shift to (% Blasts.)WBCs

WBCs show marked leucopenia for which, differential count could not be performed.WBCs

WBCs show mild easinophilia.WBCs

WBCs show mild leucocytosis with absolute and relative NeutrophiliaWBCs

WBCs show mild leucocytosis with absolute and relative lymphocytosis and many smudge cells seen in film. Lymphocytes small and mature-looking and %prolymphoctes.A picture suggestive of C.L.L Recommended for bone marrow examination and immunophenotyping.WBCs

WBCs show mild leucopenia with absolute and relative neutropeniaWBCs

:6- (Reticulocyte Cells) : ( 25)

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: (Bone Marrow) ( ) ( ) .: RBC , , 7.5 8.5 , RNA : 0.2 2 % . 2 6 % : ) (Reticulocytosis) :- (sickle cell anemia)- (thalassemia)- (acute post-hemorrhagic anemia)- (hemolytic anemia)- (Hereditary spherocytic anemia) ) (Reticulocytopenia) : (pernicious anemia ) (a plastic anemia) :

: : -1 : , .-2 (Plastic anemia) (Hereditary spherocyte).-3 , . (Megaloplastic anemia ) . : ( + ) ( NEW METHYLENE BLE ) ( BRILLANT CRESYL BLUE) 15 37 . . . FIELDS. : = / 100 ( ..........% ) .: (Erythrocyte Sedimentation Rate ESR) : : / . . (ESR) . : ( 0 15 ) / . ( 0 20 ) / . ( 0 20 ) / . ( 0 30 ) / ( 0 13) /

(T.B) . ( ). A.S.O .. rheumatoid factor ( (

: congestive heart failure . Polycythemia .

( 26) : mm/hr . (manual) ( 300( (Westergreen) .

: (Coagulation Factor Test) :(1) (Bleeding Time B.T) : : () (B.T) . ( 27) : . 27(2) (Prothrombin Time PT) : photometric halogen . 405nm . cuvettes . . Shaker . ( 28)

28 : . (Extrinsic Pathway) . : (PT) 11 16 .

(3) (Partial Thromboplastin Time PTT) : : (Intrinsic Pathway) . : (PTT) 25 35 .

: (A, B, AB ,O) Blood Group (Rh) (A + ve) A .. . ( 29: + 50 2 )

29

. (Rh) . ( 30)

Rhesus factor 1940 rhesus monkeys . (Rh+) 85 % (Rh-) 15 % . . (RH): .

:1- (Rh+) 2- (Rh-) .3- (Rh-) (Rh+) .4- (Rh+) (Rh-)

: (Rh incompatibility)

Rh + Rh - (Rh+) " ". " " " " . : 72 ( d: Anti - d Globulin ) - (Rh+) . 6 72 (Rh incompatibility) . ( 31) : + 50 2 )

31RH +Ve Rh -Ve : (Sickling Test) : (Anemia) Hb S)) . (6 / 100 ) (15-40%) . :

. . : "". : (Haemoglobin Electrophoresis) : .

: (Direct Coombs Test) : (Antibody) . : (Indirect Coombs Test) : . : (Osmotic Fragility Test O.F.T) : (Normal Saline) Na Cl . : Iron ( ) Haemoprotein Respiratory Enzymes Mitochondria 4 70% . 75-175 / (9-31.3 / : Total Iron Binding Capacity - TIBC . TIPC 250-410 / 100 (45-73 / ) 20%-25%. Serum Iron : () . ( )

:Total Iron Binding Capicity +

Transferrin Saturation = ( / ) X100

: Ferittin : (Fe++) + ( ) . . .

: ( lymphocytic leukemia ) ( ) ( ).

(myelogenous leukemia ) ( ) .

: ( acute lymphocytic leukemia ALL ) 75 80 % .

: ( acute myeloid leukemia AML ) 20 % .

: ( Chronic myelogenous leukemia CML ) 2 % ( Philadelphia chromosome ) 90 % .

: ( Chronic lymphocytic leukemia CLL ) 1 : 4 .

: E GLOCUSE 6 PHOSPHATE DEHYDROGENAS () 6 (GLOCUSE 6 PHOSPHATE DEHYDROGENASE ) ( G6PD). . . . ( 100 ) ( ) . . . .Heamatology RefUnitSampleTest NameNo.

See reportEDTA BloodBlood Picture1.

See reportEDTA BloodRBC * WBC * HB2.

37 47 %EDTA BloodHematocrit3.

150.000 450.000cmmEDTA BloodPlatelets4.

0.5 2 %%EDTA BloodReticulocytes5.

See reportFresh filmDiff. Count6.

See reportEDTA BloodBlood Group ( ABO )

7.

See reportEDTA BloodR H Group8.

See report%PlasmaProthrombin Time & Activity& INR9.

Up To 40secPlasmaPTT10.

1st H. Up To 10

2nd H. UpTo 20 mmCitrated BloodE.S.R11.

ug/dlSerumIron12.

ng/mlSerumTIBC13.

mg/dlSerumTransferrin14.

SerumFerritin15.

6.97 - 20.5u/g HbEDTA BloodG6PD Quantitative 16.

Normal activityEDTA BloodG6PD Qualitative17.

Normal curve5ml heparinized bloodOsmotic Fragility18.

NegativeEDTA BloodSickling Test19.

Ref.RangeUniteSampleTest NameNo.

NegativeEDTA bloodCoomb's test (Direct)20.

NegativeSerumCoomb's test Indirect (Anti-Rh-D-Ab)21.

NegativeBlood collected in wide tubeL.E cells22.

See reportFilmB.M. aspirates consultation23.

See reportFilmB.M. biopsy consultation24.

150 400 mg/dl2 ml blood on 200uL Na citrateFibrinogen25.

Negative (less than 200)ug/dlCitrated plasmaFDP26.

NegativeSerum (aspirated &delivered worm)Cryoglobulin27.

See reportSerum / EDTA bloodHb Electrophoresis28.

Less than 200ug/dlCitrated plasmaD.Dimer29.

18 32mg/dlEDTA plasmaC I inhibitor30.

0.7 1.8mg/dlSerumB2-microglobulin31.

Up to 40SecPlasmaLupus anticaglunat32.

Less than 12mg/I1 ml urineAlpha-I- microglobulin33.

130 300

Less than 9.4mg/dl

mg/ISerum

1 ml urineAlpha-2- microglobulin34.

20 60 mg/dlSerumCeruloplasmin35.

90 200 mg/dlSerumAlpha-I-antitrypsin36.

See reportSerumProtein electrophoresis37.

NegativeEDTA bloodSucrose lysis test38.

5

Spectrophotometer

RBCs

A+B+C+D 50

( 5) 10000

1

3

6

2

WBCs

4

Plateletes

( 5) 10000

6

26

12

30

7

PAGE 19