BLOOD

BLOODPRESENTED BY:Sonika Roll No.714MDS (Ist Year)

WELCOME TO THE WORLD OF

HAEMATOLOGY

BLOOD

EVERYONE HAS IT,

EVERYONE NEEDS IT

Respiratoryfor communication and protection NutritiveExcretoryHomeotasisRegulation of body temperatureChemical Functions performed by plasma proteins

FUNCTIONS OF BLOOD

COMPOSITION OF BLOOD

BLOOD (If anticoagulated sample is allowed to stand)

(CELLS 45total % of Blood vol.)

PLASMA (clear-straw colored fluid and represents 55% of total blood volumeErythrocytes

LeucoytesThrombocytes

91% Water 9% Solids

1% inorganic

8% organic

MAIN COMPONENTS OF BLOOD

PLASMA CELLS: RBCs WBCs PLATELETS

RBCs and WBCs

PLATELETS

Na+, Cl-, HCO3-, Ca2+ (Mainly extracellular)

K+, Mg2+, Cu2+, PO43- (Mainly intracellular)

Fe2+ and Fe3+

INORGANIC COMPONENTS

Plasma Proteins Non-Protein Nitrogenous Substances - Urea (20 to 40 mg%) - Uric Acid (2 to 4 mg%) - Creatine (1-2 mg%) - Creatinine (0.6-1.2mg%) - Xanthine (Traces) - Hypoxanthine (Traces)

ORGANIC COMPONENTS

NON NPN SUBSTANCES Neutrsl fats (30-150%) - Phospholipids e.g. Lecithin, Sphingomyelin, Cephalin (150-300 mg%) - Glucose (Fasting) 70-90 mg% - Cholesterol 150-240 mg% OTHERSUBSTANCES - Enzymes - Hormones - Antibodies

ESTIMATION OF SPECIFIC GRAVITY OF

BLOOD COPPER SULPHATE FALLING DROP

METHOD CHLOROFORM AND BENZENE MIXTURE GLYCERINE AND WATER

SIGNIFICANCE:Screening of donor blood,mass survey in anemia,handling emergencies like burn cases.

SPECIFIC GRAVITY OF BLOOD

• INCREASES IN• Polycythemia• Severe

dehydration• Loss of plasma in

case of burns causing hemoconcen tration.

DECREASE IN• Pregnancy• Anemia• Hemodilution• Malnutrition• Starvation• Renal disease.

VISCOSITY OF BLOOD

INCREASES IN Polycytmemia CHF,DM Multiple myeloma Profuse sweating Severe vomitting Diarrhoea Leukemias

DECREASE IN Anaemia Oedematous state

ELECTROPHORESIS

ELECTRO:Application of electricity. PHORESIS:means transmission. BROUGHT ABOUT BY:A.TISELIUM,1930 APPLICATION AND USES:• Seraration of proteins• Estabilizating the purity of a protein• Detecting impurities and isoenzyme.

ELECTROPHORESIS OF SERUM PROTEINS

The serum proteins areSeparated by electrophoresis. As the current flows,the serum proteins

move towards the +ve electrode. The stronger the –ve charge on a

protein,the faster it migrates After 20 minutes,current is turned

off,proteins are stained to make them visible.

SEPARATION OF PROTEINS

THE SEPARATED PROTEINS APPEAR AS DISTINCT BANDS.

THE PROTEIN THAT MOVES CLOSEST TO +VE ELECTRODE IS SERUM ALBUMIN

CLINICAL INTERPRETATION OF ELECTROPHORETIC

PATTERNS: PATTERNS IN INFECTION:

Bacterial infection:increase α

globulin Viral infection:increase α globulin Chronic infection:increased α

globulin and γ globulin.

PATTERNS IN NON

BACTERIAL INFECTION: Acute traumatic injuries: α

globulin. Tissue necrosis:α globulin. Burns: albumin, α globulin

PATTERNS IN RENAL DISEASES: Acute nephritis: Chronic nephritis: globulin

PATTERN IN RETICULOSIS: albumin globulin, globulin.

COMPONENTS:55% albumin (3-5g%) Avg.=4.8g%)38% Globulin (2-3g%) Avg. =2.3g%) - 13% Globulin - 14% Globulin - 11% -Globulin7% Fibrinogen 0.3g%Prothrombin 40 mg%

(Albumin/Globulin = 1.7:1)

PLASMA PROTEINS(Normal Value (6.4 - 8.3 g%)

In Embryo: Mesenchymal CellsIn Adults: - Albumin and Fibrinogen- LIVER - Globulin: (a) Tissue macrophages (b) Plasma Cells (c) Lymphocytes

ORIGIN OF PLASMA PROTEINS

FORMS OF PLASMA PROTEINS & THEIR

FUNCTIONSType Normal

Plasma LevelFunctions

Pre-albumin(MW=60,000)

0.03g% Binds T4 and T3

Albumin (MW=69,000)

3-5g% Controls COPTransport of ions, dyes, drugs, hormones etc.

Globulin(MW=Variable)

2-3g% Depending upon types

Fibrinogen(MW=3,50,000)

0.3g% Helps in blood clotting

Prothrombin(MW=68,000)

40 mg% Helps in blood clotting

FORMS OF GLOBULIN GLYCOPROTEIN LIPOPROTEIN:α globulin+lipid HDL LDLVLDL CHYLOMICRONS TRANSFERIN:PLASMA CONC.=0.24g% HAPTOGLOBINS: globulin,MW:90,000 NORMAL PLASMA LEVEL:0.12% CERULOPLASMIN

CERULOPLASMIN:0.04% COAGULATION FACTORS FETUIN:present in foetus and

newborns Growth promoting factor.MW=45000

ANGIOTENSINOGEN: HAEMAGGLUTININS:antibodies

against red cell antigen.

α

IMMUNOGLOBULINS(Ig) :γ globulin

Ig G Ig M Ig A Ig D Ig E

FUNCTIONS OF PLASMA PROTEINS

COAGULATION OF BLOOD MAINTAINS COP ACROSS THE

CAPILLARY WALL. MAINTAINS VISCOSITY OF BLOOD PROVIDE STABILITY TO BLOOD MAINTAINS SYSTEMIC ARTERIAL B.P MAINTAINS ACID BASE BALANCE

IMMUNE RESPONSE TRANSPORT FUNCTION RESERVIOR FUNCTION

VARIATION IN PLASMA PROTEIN CONCENTRATION: DECREASES IN HAEMORRHAGE(result in decrease

in all forms of plasma proteins-fibrinogen,globulin,albumin and regenerated in the same order)

INCREASES IN SECONDARY TO

BURNS DEHYDRATION DIABETES

INSPIDUS

DECREASE IN ALBUMIN LEVEL

PHYSIOLOGICAL in infacy and

newborns. Pregnancy.

PATHOLOGICAL Impaired protein

synthesis: Hepatitis Liver cirrhosis Severe malnutrition Malabsorption

Excessive loss Burns,nephrosis

INCREASE IN γ GLOBULIN:due to destruction of tissues in

Multiple Myeloma TB,Lymphatic leukemia Cirrhosis of liver,acute hepatitis Nephritis

FIBRINOGEN INCREASE IN: PREGNANCY MALARIA TISSUE INJURY ACUTE/CHRONIC

INFECTIONS.

DECREASE IN: CONGENITAL(rare) CARCINOMA

PROSTATE EXTENSIVE

CARDIAC SURGERY.

INTRAVASCULAR COAGULATION.

RBCs

HISTORY OF RBC In 1658, the Dutch biologist Jan

Swammerdam was the first to describe red blood cells. He had used an early microscope

ERYTHROCYTES GENERAL

STRUCTURE: Circular,biconcave,

non nucleated disc. mature RBC has

no nucleus,ribosome,mitochondria.

RBC contains Hb.

RBC CONTAINING Hb

The cell member of RBC contain circular pores,which are concered with ingress and egress of water and electrolytes.

Below cell membrane is contractile layer of lipoprotein SPECTRIN arranged in fibrillar manner.

It maintains the shape n flexibility of RBC membrane;also contains blood group antigen.

PRESENCE OF ANTIGENS ON RBCs

COMPOSITION OF RBCs:

62.5% water 35% Hb(29.5+-2.5pg/RBC) 2.5%:SUGAR LIPIDS:Cephalin,cholesterol,lecithin PROTEINS:Glutathione,albumin like Insoluble protein,act as reducing

agent thus prevents damage to Hb.

ENZYMES:Glycolytic pathway,carbonic anhydrase,catalase.

VITAMIN DERIVATIVES

IONS:Na,K,PO ,SO

DIAMETER:• 6.5-8.8 m(avg.7.3 m)• Thickness at periphery:2.0-2.4 m• at centre:1.2-1.5 m• SURFACE AREA:140 m• VOLUME:78-94 m (86+8 m)

DIAMETER OF RBC

LIFE SPAN:120 days SITE OF DESTRUCTION:Tissue

macrophage. FUNCTIONS:same as that of Hb. :helps in identification of

blood group specific antigens.

LIFE CYCLE OF RBC

Kidney releases erythropoietin

That travels to red bone marrow and stimulates RBC production

RBCs enter circulation

Old ones destroyed in spleen.

OSMOTIC FRAGILITY OF RBCs

Ease with which the RBCs are broken down in hypotonic solution

Expressed in terms of conc. Of hypotonic solution in which cells are hemolysed.

RBCs in isotonic solution:no change RBCs in hypotonic solution(<0.9%

NaCl):swell up and finally burst. RBCs in hypertonic

solution(>0.9%NaCl):red cells shrink.

VARIATION IN SIZE,SHAPE N STRUCTURE OF RBCs

ANISOCYTOSIS:Variation in size POIKILOCYTOSIS:Variation in shape SPHEROCYTOSIS:RBCs spherical n fragile ANEMIA:Reduction in no.of RBCs less

than 4million/cumm or Hb less than 12g% or both

POLYCYTHEMIA:RBC count >6million/cumm.

VARIATION IN NUMBER OF RBCs

VARIATION IN SHAPE OF RBCs

ACANTHOCYTES ECHINOCYTES(Burr cells) ECHINOCYTES (Crenated or berry

cells) KNIZOCYTES LEPTOCYTES OVALOCYTES/ELLIPTOCYTES DREPANOCYTES SPHEROCYTES

STOMATOCYTE CODOCYTES DACROCYTES SCHIZOCYTE RBC AGGLUTINATION ROULEUX FORMATION

ACANTHOCYTES ACANTOHOCYTES Spherical,spine thorn

like projection. Associated with low

conc Of ß lipoprotein Seen in liver disease

fatmalsbrorption,enzyme defeciencies.

ECHINOCYTES ECHINOCYTES Cells look like a

burr,sharp,pointed irregular projections

Seen in liver diseases

Associated with impaired renal function n hemolytic anemia

ECHINOCYTES CRENATED/BERRY Have serrated or

goose bump outline on the member of RBC.

Usually artifactual due to moisture on slide surface or blood smears.

KNIZOCYTES A nondiscoid RBC

with two or more concavities of central pallor with Hb forming a bridge across the centre of the cells

Associated with hemolytic anemia.

LEPTOCYTES Thin flat RBC,appear

hypochromic on fixed smears

Looks like codocytes but without the target appearance.

Associated with thalassemia,liver disease,iron defeciency anemia.

OVALOCYTES elliptocytes or pencil

cells Oval,elliptical or

elongated Seen in iron def.

anemia- Liver diseases- Megaloblastic

disorders.

DREPANOCYTES SICKLE CELLS Under reduced

oxygen tension CELLS become crescent / sickle shaped.

Caused by an inherited abnormality due to HbS.

SPHEROCYTES Spherical,variable

size.Lack of central zone of pallor, stained red brown with wright’s stain

Have low surface to volume ratio which increases osmotic fragility.

STOMATOCYTE RBC with mouth or

slot like zones of pallor.

Result from RBC Na pump defect seen in HEREDITARY stomatocytosis,AL, alcholism,liver disease,severe infections.

CODOCYTES Target cells have

deeply stained centres n borders

Separated by a pale ring of central pallor

Appear target/gum drop shaped.

CAN BE AN ARTIFACT.

DACROCYTES Elongated at one

end,forms tear drop or pear shaped cell.

Can’t come back to normal shape as the is stretched for long period.

RBC AGGLUTINATION

Seen due to Ag-Ab binding

Seen in cold agglutination by M.pneumonia

RBC count low MCV high reading RECOVERY:Heat the

specimen at 37°c.

RBC AGGLUTINATION

ROULEUX FORMATION

RBCs line up on top of each other giving a stack of coin appearance.

Caused by increase in globulin content.

Seen in waldenstrom’s macroglobinemia.

RBC INDICES HELP IN DIAGNOSTING TYPES OF ANAEMIA Mean corpuscular volume(MCV):volume of

single rbc in µm MCV=PCV per 100ml blood RBC Count million/cumm Mean corpuscular HAEMOGLOBIN:

(MCH):average amount of Hb in a single RBC in pg.

MCH=Hb in g%/RBC count.

Mean corpuscular Hb concentration:amount of Hb expressed as % of volume of RBC.

MCHC=Hb in g% x100 PCV in 100ml of blood

COLOUR INDEX Hb in g%/RBC%

MORPHOLOGICAL CLASSIFICATION

MICROCYTIC:small cell size

Normochromic:in chronic infections, malignant diseases.

Hypochromic:in chronic haemorrhage, plummer vinson syndrome,achlorhydria, ankylostomiasis.

NORMOCTIC:normal cell size

Normochromic:in acute haemorrhage, hemolysis,hypoplasia of bone marrow.

Hypochromic: in defeciency of iron due to less intake,more loss or excessive demand.

MACROCYTIC: Cell size more

Normochromic: in defeciency of haematopoietic factor like vit.B12,FOLIC ACID.

Hypochromic: in intense activity of bone marrow as in hemolytig anemia.

HAEMOPOIESIS

HAEMOPOIESISTHEORIES: Monophylectic:Different cells

arise from a single ancestral cell-PLURIPOTENT STEM CELL.75% cells in bone marrow are myeloid series;25% erythroid series

Polyphylectic:separate stem cells for each type of cell.

MONOPHYLETIC THEORY

PRINCIPLE INTERLEUKINS AND COLONY STIMULATING FACTORS IL-1:secretion of CSF,all blood cell

except lymphocytes IL-3:secretion of CSF,all blood cells

except lymphocytes IL-6:-do- IL-4:basophil production IL-5:EOSINOPHIL PRODUCTION G-CSF:production of neutrophils

M-CSF:production of monocytes

GM-CSF:production of neutrophils monocytes,eosinophil,platelet,RBCs

ERYTHROPOIETIN:production of RBCs.

ERYTHROPOIESIS DURING INTRAUTERINE LIFE:

Mesoblastic stage:upto 3 months of life RBCs are formed from mesoderm of yolk sac/area vasculosa

Hepatic stage:liver and spleen are sites of blood formation.

Myeloid stage:from middle of foetal life,RBC formation occurs in bone marrow.

MESOBLASTIC STAGE

MESOBLASTIC STAGE:

Upto 3 months in i.u life,RBCs are formed from mesoderm of yolk sac

INTRSVASCULAR

HEPATIC STAGE After 3 months of

foetal life,liver n spleen are the site of bloob formation.

RBCs develop from the mesenchyme b/w bloodvessels and tissue cells.

MYELOID STAGE From the middle

of foetal life,RBC forms in bone marrow.

EXTRAVASCULAR

IN CHILDREN: In all bones with red marrow Liver Spleen

IN ADULTS: After 18-20 years,from red bone marrow Liver n spleen,if bone marrow is destroyed.

BLOOD CELLS IN BONE MARROW

STAGES OF ERYTHROPOIESIS

HEMOCYTOBLAST:19-23 m PROERYTHROBLAST:15-20 m EARLY NORMOBLAST:14-16 m INTERMEDIATE NORMOBLAST:10-14 m LATE NORMOBLAST: early n late type RETICULOCYTE:7-8 m ERYTHROCYTE:7.2-7.4 m

ERYTHROBLAST

PRECURSORS OF RBCs

REGULATION OF ERYTHROPOIESIS

GENERAL FACTORS:Hypoxia Effect mediated by ERYTHROPOIETIN Erythropoietin:glycoprotein,74% protein

26% carbohydrates,contains 165 aa. Sources:kidney,liver,tissue macrophage Inactivated;in liver,kidney Excretion:urine

SPECIAL MATURATION FACTORS Diet Castle’s intrinsic factor Extrinsic factors:vit.B12,FOLIC ACID I.F+E.F=Haematinic principle i.e

heips in maturation of proerythroblasts to mature RBCs.

RETICULOCYTE COUNT

NORMAL VALUE: Adults(0.2-2%)

Infants:(2-6) Clinical significance: To assess erythroid

activity of bone marrow.

Assessing treatment and prognosis of anemia

INCREASE IN Infants High altitude After haemorrhage Chr. Hemolytic

anemia Disorders of spleen Disorders of bone

marrow

ERYTHROCYTE SEDIMENTATION RATE

PHASES:• Phase of rouleax formation:10 minutes• Phase of settling:40 minutes• Phase of packing:10 minutes METHODS: Westergren Wintrobe Micro ESR

NORNAL VALUES OF ESR

WESTERGREN: Males:3-5mm 1st hour Females:4-7mm 1st hour

WINTROBES: Males:2-8mm 1st hour Females:4-10mm 1st hour

PHYSIOLOGICAL VARIATIONS IN ESR

AGE SEX HIGH ALTITUDE PREGNANCY

VARIATIONS IN ESR INCREASE IN All acute infections Inflammation Malignancies SLE,Vasculitis Anemias Bone diseases Lung disease

DECREASES IN Afibrinogemia Polycythemia

ESR AND PCV BLOOD SAMPLES

PACKED CELL VOLUME

It is the ratio of RBCs to that of whole blood expressed as%

METHODS: Macromethod using wintrobe tube Microhematocrit Electronic method

FORMULA:Height of RBCs packed (mm)

Height of rbc+plsma

NORMAL VALUES: Females:44% Males:42%

ANTICOAGULATED BLOOD SAMPLE AFTER

CENTRIFUGATION

COMPONENTS OF BLOOD

RBC COUNT RBC PIPETTE BLOOD

WITHDRAWN UPTO MARK 0.5

DILUTENT:HAYEM’S FLUID

DILUTION FACTOR : 200 TIMES.

RBC COUTING CHAMBERS

HAEMOGLOBIN

The red oxygen carrying pigment in the RBCs of vertebrates

STRUCTURE: Haem:Fe containing porphyrin Iron:in ferrous form Globin:protein consist of two α

chains and two β chains MOLECULAR WEIGHT=68,000

HAEMOGLOBIN

STRUCTURE OF HAEMOGLOBIN

SHOWING TWO ALPHA AND TWO BETA CHAINS.

HEAME GROUPS IN RED

IRON ATOMS IN PURPLE.

BINDING OF OXYGEN TO Hb

OXYGEN BINDS TO THE IRON ATOM DIRECTLY BELOW THE PLANE OF HEME GROUP.

SOME IMPORTANT DEFINITIONS

OXY Hb:combination of Hb with oxygen CARBAMINO Hb: HbNH COOH REDUCED Hb:oxygen removed from Hb CARBOXY Hb:CO+Hb METHAEMOGLOBIN:Hb exposedto

various drugs,the ferrous is oxidised to ferric form.

NORMAL VALUES

AT BIRTH:23g% AT THE END OF 3 MONTHS:

10.5g% AFTER 3 MONTHS: 12.5% ADULTS: Males:14-18g% :Females:12-15.5g%

FUNCTIONS OF HAEMOGLOBIN

Transport of oxygen from lungs to tissues

Transport of carbondioxide from tissues to lungs

Acid base buffer.

OXY AND DEOXY Hb

TRANSPORT OF CO2 AND BOHR EFFECT

SYNTHESIS OF HAEMOGLOBIN

Takes place in developing RBCs

REQUIRES: Proteins Minerals: Fe,Cu,Co,Ca Role of vitamins:B12,folic acid.

FATE OF HAEMOGLOBIN

OLD RBCs are destroyed in tissue macrophages The system includes:

Kuppfer cells in liver Alveolar macrophages in lungs Osteoclasts in the bone Microglia in the brain Lymph nodes,spleen,Littoral cells

VARIETIES OF HAEMOGLOBIN

Hb A1C: Glycosylated Hb HbA :Adult Hb HbF: Foetal Hb HbS:Sickle shaped RBCs

GLYCOSYLATED HAEMOGLOBIN RED-Haemoglobin GREEN-GLUCOSE

LEVEL OF HbA1C

GLYCOSYLATED HAEMOGLOBIN

HbA1C IN WELL N POORLY CONTROLLED DIABETES

HbA1c levels by coincidence nearly equate to glucose levels. So an HbA1c level of 10% means the average glucose level for the previous 10 weeks was 13mmol/l.

But at lower levels there is even less difference, so an  HbA1c of 7% means the average glucose level was 8mmols/l

SICKLE SHAPED RBC

SICKLE CELL(EM)

SICKLE CELLS IN BLOOD VESSEL

HAEMOGLOBIN ESTIMATION

VARIOUS METHODS ARE: Sahli’s method Cyanomet Hb method Oxy Hb method Haldane’s method Wu’s method CuSO FALLING DROP METHHOD

Tallquist method Electronic counter method

Direct reading haemoglobinometer

ELECTRONIC Hb METER

LEUCOCYTES GRANULOCYTES: Neutrophils:50-70% Eosinophils:1-4% Basophils:<1%

AGANULOCYTES: Lymphocytes:20-405 Monocytes:2-8%

NEUTROPHIL WITH BARR BODY

LEUCOPENIA TLC below 4000/cumm CAUSES: Starvation Typhoid fever VIRAL or PROTOZOAL infections Bone marrow depression

LEUCOCYTOSIS TLC above 11,000/cumm CAUSES: Newborns Exercise Pregnancy,lactation,menstruation Steroids Any pyogenic infection

NEUTROPHILS SIZE: 10-14 m NUCLEUS:purple,multilobed CYTOPLASM:slightly blue in colour

GRANULES:fine pinpoint Neutrophilic in nature Contains proteins,lipids,nucleic acid

NEUTROPHIL

NEUTROPHIL WITH BARR BODY

GRANULES OF NEUTROPHILS PRIMARY: Lysozymes ,cationic proteins Acid hydrolases,Elastases SECONDARY: Lysozymes,alkaline phosphatase Collegenases,Lactoferrin TERTIARY:Gelatinase,Cathepsin

VARIATIONS IN THE COUNT NEUTROPHILIA:• Acute infections• Burns,acute

heamorrhage,hemolysis,truma,surgery.

• Tissue necrosis

NEUTROPENIA Bone marrow

depression Typhoid fever Viral influenza Severe

overwhelming infections.

EOSINOPHILS SIZE: 10-14 m NUCLEUS:purple

colour,bilobed(85%) and trilobed(15%)

CYTOPLASM:acidophilic,granular GRANULES:coarse,stain bright red :contain histamine,lysozyme,ECF-A.

EOSINOPHIL

EOSINOPHIL IN PBF

VARIATIONS IN COUNT

EOSINOPHILIA Allergic conditions Parasitic infections EOSINOPENIA Acute stressful conditions ACTH treatment

BASOPHILS SIZE:10-14 m NUCLEUS: as in eosinophils CYTOPLASM:Basophilic,granular GRANULES:coarse,stains purple/blue Plenty in number Overcrowd the nucleus Contains histamine n heparin.

BASOPHIL

BASOPHIL IN PBF

VARIATIONS IN COUNT

BASOPHILIA: Chicken pox Smallpox TB Influenza

BASOPENIA: Drug induced

reactions After

glucocorticoid administration.

LYMPHOCYTES SIZE: Large-10 to14 m; small-7to10 m NUCLEUS:single,very big,purple :round or indented :central in position nuclear chromatin

coarse,lumpy CYTOPLASM:pale blue,scanty.

LYMPHOCYTE

LYMPHOCYTE IN PBF

VARIATIONS IN COUNT

LYMPHOCYTOSIS:

In children Chronic infections

eg.TB Leukemia Viral influenza.

LYMPHOPENIA Hypoplastic

bone marrow AIDS

MONOCYTES SIZE:10-18 mNUCLEUS: Pale staining Single,round/kidney sheped Eccentric in position Nuclear chromatin finely reticular. CYTOPLASM:pale blue n clear GRANULES: fine purple dust like granules.

MONOCYTE

MONOCYTE IN PBF

VARIATIONS IN THE COUNT

MONOCYTOSIS: TB Syphilis Leukemias

MONOCYTOPENIA: Hypoplastic bone marrow.

STAGES OF GRANULOPOIESIS

PRIMITIVE WBC:18-23 m MYELIBLAST:16-20 m MYELOBLAST A/PREMYELOCYTE:14-18 MYELOCYTE B:12-16 m MYELOCYTE C/METEMYELOCYTE:10-

14 MATURE WBCs

SENILE LEUCOCYTES

CHARACTERIZED BY: Loss of mobility Nucleus seen lying free Nuclear lobulations increases Poorly stained granules Cell break up readily while making

blood smear.

TOTAL LEUCOCYTE COUNT

THE ENTIRE KIT REQUIRED FOR

WBC COUNT RBC COUNT PLATELET

COUNT.

PIPETTE SHOWING TOTAL WBC

METHOD OF COLLECTION OF BLOOD

COLLECTION OF BLOOD SAMPLE

WBC PIPETTE GET A FINGER

PRICK DONE WITHDRAW

BLOOD UPTO MARK 0.5

WIPE THE EXCESS BLOOD ON OUTER PORTION OF PIPETTE.

AREA FOCUSSED -BULB

MIXING THE BLOOD WITH TURK’S FLUID

DILUTION:20 TIMES

KEEP IN FOR 2-3 MINUTES.

DISCARD FEW DROPS BEFORE CHARGING .

CHARGING THE CHAMBER

NEUBAUER CHAMBER

SHOWING DEPTH OF 0.1mm

FIELDS FOR WBC N RBC COUNTS

HOW TO PREPARE A BLOOD SMEAR?

STAINNING APPARATUS

MICROSCOPE TO VISUALIZE SMEAR

ERRORS IN SMEAR PREPRATION SHOWING FEATHER EDGE

THIN IDEAL THICK

BLOOD AS A CULTURE MEDIA

Blood is classified as: SPECIAL MEDIA/ENRICHED MEDIA INDICATER MEDIA:Blood agar

mediun is an enriched media but certain bacteria lyses red bllod cells showing clear zone around the colonies.Thus its in indicater media as well.

COMMONLY ISOLATED PATHOGENS FROM BLOOD

CULTURE Hemolytic Streptococci Staphylococci-pathogenic n

saprophytic Colliform bacilli Hemophilus influenza Enterococci Pseudomonas sp. Bacteroides sp. Salmonella sp.

MALARIAL PARASITE INVADING ERYTHROCYTES

TRYPANOSOME PARASITE WITH MAMMALIAN RBCs

CAUTION! BLOOD AS AN

OCCUPATIONAL HAZARD.

SOURCE OF DISEASES LIKE HBV AND HIV (BE HIGHLY ALERT)

PRACTICE UNIVERSAL PRECAUTIONS

VARIOUS BLOOD TESTS

CONCLUSION

A MESSAGE-DONATE BLOOD-

SAVE LIFE

REFERENCES

REFERENCES Hofferband,Lewis,Post Graduate in

HAEMATOLOGY,4th edition A.K Jain,Text book of Physiology,Vol.1 Hasrh Mohan,Text Book of Practical

Pathology. C.L Ghai,A text book of Practical

Physiology,5th edition Gyton,Medical Physiology

Victor,Colour atlas of Histology REFERENCES FROM NET:GOOGLE

IMAGES CONCERNING BLOOD N ITS COMPONENTS.

THANK YOU