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    Physiological Blood Count

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    Rhea Saldanha
    This document provides reference ranges for common physiological blood counts including hemoglobin, hematocrit, erythrocyte count, and leukocyte differential count. It also defines terms used to describe increases and decreases in various blood cell types, such as anemia, leukocytosis, and thrombocytopenia. Finally, it reviews factors that cause increases or decreases in red blood cells, white blood cells, neutrophils, lymphocytes, and thrombocytes as well as indications and examinations used to assess coagulation.

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    Physiological Blood Count

    Uploaded by

    Rhea Saldanha
    25 views4 pages
    This document provides reference ranges for common physiological blood counts including hemoglobin, hematocrit, erythrocyte count, and leukocyte differential count. It also defines terms used to describe increases and decreases in various blood cell types, such as anemia, leukocytosis, and thrombocytopenia. Finally, it reviews factors that cause increases or decreases in red blood cells, white blood cells, neutrophils, lymphocytes, and thrombocytes as well as indications and examinations used to assess coagulation.

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    This document provides reference ranges for common physiological blood counts including hemoglobin, hematocrit, erythrocyte count, and leukocyte differential count. It also defines terms used to describe increases and decreases in various blood cell types, such as anemia, leukocytosis, and thrombocytopenia. Finally, it reviews factors that cause increases or decreases in red blood cells, white blood cells, neutrophils, lymphocytes, and thrombocytes as well as indications and examinations used to assess coagulation.

    Copyright:

    © All Rights Reserved
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    Download as docx, pdf, or txt
    25 views4 pages

    Physiological Blood Count

    Uploaded by

    Rhea Saldanha
    This document provides reference ranges for common physiological blood counts including hemoglobin, hematocrit, erythrocyte count, and leukocyte differential count. It also defines terms used to describe increases and decreases in various blood cell types, such as anemia, leukocytosis, and thrombocytopenia. Finally, it reviews factors that cause increases or decreases in red blood cells, white blood cells, neutrophils, lymphocytes, and thrombocytes as well as indications and examinations used to assess coagulation.

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    Physiological Blood Count

    Hemoglobin (Hb) Male: 134-175 g/l


    Female: 120-165 g/l
    Hematocrit (Ht) Male: 0.38-0.49
    Female: 0.35-0.45
    Erythrocytes (RBC) Male: 4.0-5.3 x 1012/l
    Female: 3.8-5.2 x 1012/l
    Mean corpuscular volume (MCV) 80-95 fl
    Mean corpuscular hemoglobin (MCH) 27-32 pg
    Mean corpuscular hemoglobin concentration 320-370 g Hb/l rbc
    (MCHC)
    Red blood cell distribution width (RDW) 11.6-15.2 %
    Reticulocytes 0.5-2%
    Thrombocytes (PLT) 140-440 x 109/l
    Mean platelet volume (MPV) 7.8-11 fl
    Platelet distribution width (PDW) 15.5-17.1%
    Leukocytes (WBC) 3.8-10.0 x 109/l

    Differential count WBC

    Neutrophil granulocytes (segments) 50-75%


    2500-7500 x 109/l
    “bands” – less mature neutrophils 1-5%
    100-500 x 109/l
    Eosinophil granulocytes 1-5%
    100-500 x 109/l
    Basophil granulocytes To 1%
    0-150 x 109/l
    Lymphocytes 15-40%
    1500-4000 x 109/l
    Monocytes 3-10%
    200-900 x 109/l

    Basic Terminology
    Cell type Increasing Decreasing
    Erythrocytes Polyglobulia/polycythemia Anemia
    Leukocytes Leukocytosis Leukopenia
    Lymphocytes Lymphocytosis Lymphocytopenia
    Granulocytes Granulocytosis Granulocytopenia
    Agranulocytosis
    Neutrophils Neutrophilia Neutropenia
    Eosinophils Eosinophilia Eosinopenia
    Thrombocytes Thrombocytosis Thrombocytopenia
    All cells Pancytopenia
    RBC
    Increasing Decreasing
    Polyglobulia/polycythemia Anemia
    Increased production in marrow Aplasia or damaged bone marrow
    - primary polycythemia vera Lack of:
    - secondary cardial or pulmonary distress - Fe
    - high altitude - B12
    - smoking - Folic acid
    - stress Chronic diseases
    - increase epo in kidneys Hemolysis
    - tumor production of epo Blood loss
    - dehydration Inborn defect of Hb production
    Renal insufficiency
    pregnancy

    Mean volume of RBC (MCV) = 80-95 fl


    Macrocytes Microcytes
    - lack of B12 - lack of Fe
    - lack of folic acid - defect of Hb production (thalasaemia)
    - liver diseases - sideroblastic anemia
    - ethylism - anemia of chronic diseases
    - myxedema - lead intoxication
    - aplasia of marrow
    - drug intake (metformin, steroid
    contraception)

    WBC
    Leukocytosis Leukopenia
    - increased production - low production in marrow
    - increased output from marrow - decreased output WBC
    - lowered retire from blood to tissues - increased consumption

    Neutrophils
    Neutrophilia Neutropenia
    Increased output Damage of marrow
    - inflammation - inborn
    - hypoxia, stress - drug related (immunosuppression,
    - malignancy radiation, infiltration by tumor)
    - drug intake (corticosteroids, epinephrine, change of distribution of neutrophils
    lithium) - splenomegaly
    lowered retire from blood to tissues - viral infection
    - long term intake of steroids increased consumption of neutrophils
    - myeloproliferative diseases - autoimmune diseases (SLE)
    - necrosis - drug intake
    - chronic inflammation (RA, IBD, etc)
    Lymphocytes
    Lymphocytosis Lymphopenia
    - viral infection (EBV, CMV) - damage of marrow (chemotherapy,
    - pertussis, TB, toxoplasmosis radiation)
    - lymphatic leukemia - corticosteroids
    - lymphoma - hypercorticalism (?)
    - adrenal insufficiency - viral infection, TB
    - Whipple disease
    - AIDS
    - Malignancy
    - Siderosis multiplex (?)

    Thrombocytes
    Thrombocytosis Thrombocytopenia
    1. asymptomatic 1. asymptomatic
    2. symptomatic – bleeding in case of 2. symptomatic – bleeding
    thrombocytopathy or increased blood
    clotting - damage of marrow (chemotherapy,
    radiation)
    - ethylism
    - myeloproliferation - lack of B12
    - chronic inflammation (crohn, RA) - infection
    - infection - increased consumption – artificial valves,
    - splenectomy hemangiomas, DIC, autoimmunity (ITP,
    - tumors SLE)
    - sepsis, hypersplenisms
    - pregnancy

    Examination of coagulation – indications


    - screening – before operations, biopsy, invasive procedures
    - suspicion of defect of coagulation, thrombophil state
    - measure of liver proteosynthesis
    - monitoring of anticoagulation therapy

    Examination of coagulation
    - Common:
    o Quick test
    o APTT
    o Fibrinogen
    o Thrombin time
    o Anti-thrombin
    o D-dimer
    - Special:
    o Protein C
    o Protein S
    o APCR
    o Factor V
    o Factor VIII
    o Factor X
    o Factor XII
    APTT: activated partial thromboplastin time
    - test of factors XII, XI, IX, VIII and factors X, V, II, I
    - physiology: 8-40s, comparison with normal plasma APTT
    - prolonged:
    o heparin intake
    o hemophilia A (fVIII), B(fIX), C(fXI)
    o antiphospholipid syndrome
    o consumption coagulopathy – DIC
    o von Willebrand disease
    - shortened
    o prothrombotic state

    Quick Test: prothrombin time, TT (thromboplastin time)


    - test of prothrombin complex
    - physiology: 12-15s, INR 0.8 1.2 (80-120%)
    - prolonged:
    o newborns (lack of fVIII
    o warfarin – INR 2-3
    o K hypovitaminosis
    o Defect of liver proteosynthesis
    o DIC
    o Deficiency of fV or vitamin K dependent f II, VII, X

    Other coagulation examinations


    - D-dimers
    o Markers of activated fibrinolysis
    o Markers of thrombotic disease
    o High sensitivity, low specificity
    - Antithrombin III
    o Deficit – risk of thrombophilia
    o Primary, secondary (DIC)

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