1. CBC --- Interpretations

3. objectives The CBC interpretation are useful in the diagnosis of various types of anemias. It can reflect acute or chronic infection, allergies, and problems with clotting.

12. Types of Anaemia

19. Reticulocytes Leishman’s Supravital

20. Anaemia Hypoproliferative Hemolytic Retics < 2 Retics > 2 Hb% < 12, Hct < 38%

21. Normal CBC

24. Anaemia Workup - MCV Microcytic MCV Normocytic Macrocytic Iron Deficiency IDA Chronic Infections Thalassemias Hemoglobinopathies Sideroblastic Anemia Chronic disease Early IDA Hemoglobinopathies Primary marrow disorders Combined deficiencies Increased destruction Megaloblastic anemias Liver disease/alcohol Hemoglobinopathies Metabolic disorders Marrow disorders Increased destruction

25. Red cell Distribution Width - RDW Normal Population Uniform RDW High Population Double

27. IDA -CBC

28. Microcytic Hypochromic - IDA

29. IDA – Special Tests Iron related tests Normal IDA Serum Ferritin (pmo /L) 33-270 < 33 TIBC ( µg/dL) 300-340 > 400 Serum Iron ( µg/dL) 50-150 < 30 Saturation % 30-50 < 10 Bone marrow Iron ++ Absent

32. Microcytic Anaemias MCV < 80 fl Serum Iron TIBC BM Perls stain Iron Def. Anemia ↓↓ ↑↑ 0 Chronic Infection ↓↓ ↓↓ + + Thalassemia ↑↑ N + + + + Hemoglobinopathy N N + + Lead poisoning N N + + Sideroblastic ↑↑ N + + + +

35. MBA

36. Macrocytosis -MBA

37. HSN - MBA

38. Basophilic Stippling - MBA BS occurs in Lead poisoning also

39. MBA - BM

40. Pernicious Anaemia - Tongue Bald, smooth, lemon yellowish red tongue

44. RBC Size – Anisocytosis Different sizes of RBC

45. Poikilocytosis Different Shapes of RBC

46. Polychromasia - Spherocytosis