Clinical Interpret at Ing Data Power Point
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Transcript of Clinical Interpret at Ing Data Power Point
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Clinical Interpretating data
HEMATOLOGIC SYSTEM
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Hematologic System
Blood consists of : Plasma and cells
suspended in plasma
Plasma c.o. : water, dissolved protein,electrolytes, organic and inorganic
substances
Blood cells c.o. : Erythrocyte (RBC),
Leucocyte (WBC) and Thrombocyte
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Pluripotent stem cell
Thrombocyte RBC WBC
Granulocyte MonocyteLymphocyte
Basophil
EosinophilNeutrophil
Myeloblast, Promyelocyte,
Myelocyte, Metamyelocyte,
Band neutrophils,
Polymorphonuclear cells
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Laboratory test
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1. Coagulation test
a. Bleeding time : duration of bleeding
b. Prothrombine time (PT) : evaluate the extrinsic factor andcommon clothing pathways ( II, V, VII, X, fibrinogen).
Evaluate warfarin therapy and hepatic function.
c. Activated Partial Thromboplastin Time (APTT) : to evaluate
intrinsic factor ( VIII, IX, XI) and to monitor heparin therapy.d. Thrombin Time : used to evaluate the heparin therapy and
thrombolytic drug, coagulation abnormalities.
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2. Complete Blood Count/ Full
blood count
a. Haemoglobine (Oxygen carrying
RBC protein)
b. Hematocrite /PCV/EVF (RBC in 100
ml blood)
c. RBC count (RBC in 1 ml blood)
d. WBC counte. Platelet
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a red blood cell (rbc)
b white blood cell (lymphocyte)c white blood cell (neutrophil)
d white blood cell (eosinophil)
e plasma (matrix)
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Lab Test by specific
cell types
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Fibrinogen
Serum protein electrophoresis (albumin, Globulin)
Platelets
Carboxyhemoglobine (CO Hb)
Coombs test
Erythrocyte sedimentation rateFolate serum
Iron metabolism (Ferritin, Iron, TIBC, Transferrin)
MCH, MCHC, MCV , RCDW (RBC)
Reticulocytes (immature RBC contain RNA recidual)
Vit B 12Eosino, Baso, Neutro (WBC)
Lymphocyte
Monocyte
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Disease with haematologic lab
Anemia
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Erythrocytes (RBC)
Erythropoesis
Erythropoetin
Producted on kidneyIncreased RBC poduction on BM
Use Nutrients;Iron, B 12, Folate.
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Anemia
Definition : Hb, symptom of an
underlying disease
Anemia Causes :Iron deficiency,
Folate def, Vit B 12 def, haemolysis
Due to decreased production
Loss of erythrocytes Pregnancy
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Hows the lab?
A decrease in level of hemoglobin
How to evaluate?- Hemaglobin (ethnic, age, altitude)- Hematocrit,- Mean cell Hemoglobin (Hb/RBC)
- Mean cell hemoglobin concentration (Hb concentrationaverage in 100 ml RBC
- Mean cell volume (Average volume of single red cells)- Red cell distribution width (histogram of the distribution of
RBC vol)- Peripheral Blood smear (anisocytosis, poikilocytosis)- specific causa
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Micrositic anemia
Iron deficiency anemia (Low Iron,Low
ferritin,High TIBC )
MCHC and MCH
MCV < 80 m 3
Hb, Htc
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Megaloblastic anemia
Folate deficiency, B 12 deficiency
Htc
Increased of homocystein and
methylmalonic.
MCHC normal/fall
MCH
MCV >80 m 3
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Anemia of chronic disease
Chronic infections, inflammation and
malignancy
COPD, CHF,DM,Hypertension
Impairment in the delivery of iron to thedeveloping rbc.
DD : liver disease, connective tissue
disease (SLE, RA), infection, malignancy,endocrine disorders (PTH,TH)
Low Iron, Low TIBC,High Ferritin
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Spesific disease with anemia
Thalassemia : chain of the globin molecule is affected:in thalassemia, the production of globin isdeficient, while in thalassemia the production of globin is defective. (Micro Hypo, low MCV, low RBC)
Sickle Cell anemiaAplastic anemia :is a condition where bone marrowdoes not produce sufficient new cells to replenishblood cells (low rbc, wbc and platelet)
PRCA (anemia characterized by absence of red cellprecursors in the bone marrow )
Hereditary anemia
Hemolytic anemia
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Disease with Platelet
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Disorders with Platelet count
1. Thrombocytopenia :- Viral inf- Immunologic (CLL, Lymphoma Hodgkins ,
Non Hodgkins- ITP
2. Thrombocytosis
-Physiologic (exercise, stress, epinephrine)
-Essential (CML, agnogenic myeloidmetaplasia, polycythemia vera)
-Reactive (blood loss, hemolytic anemia,infectious disease, RA, IBD, lymphoma)
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Disorders with Coagulation
cascade
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Prolonged PTT
With normal PT : Heparin,Def.
Intrinsic Pathway factor (prekallikrein,
XII, Xi, IX, VIII), Inhibitor factor,
Willebrand disease, Lupusanticoagulant
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Prolonged PT
With normal PTT : Factor VIII def, Liver
disease, Vit K def, warfarin therapy
INR estimation :
PT patient
PT control
What is INR for?- Adjustmen anticoagulant dose
- Give therapy
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Prolonged PT and PTT
Fac I, II, V, X def
Heparin therapy
Warfarin therapyVit K def
Liver disease
DIC
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Disease with WBC
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WBC
Neutrophils
Monocytes
LymphocitesEosinophil
Basophil
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Disease with eosinophil
Contain numerous inflammatorymediators
Parasitic inf ( helmintic) ,
Protozoa inf ( Isospora belii, Dientamoeba fragilis),
Other inf ( aspergillosis, coccidioidomycosis),
allergic reactions,
skin disorders,
neoplastic disease
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Disease with Basophilia
Form heparin therapy
Hypersensitive, Infection,
malignancies, RA, DM, Fe deficiency.
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Disease with Neutrophil
Refers to mature and band neutrophilsIncrease in (neutrophilia): infections,necrosis, inflammatory disease, leukemias,metabolic disorders, gout, smoker
Increased by : corticosteroids, ephinefrine,oral contraceptive
Decrease in (neutropenia): Some bacterialinfection, viral inf, protozoa inf, liver disease,
marrow depressant.Decreased by : anticonvulsants, antithyroid,NSAID
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Disease with Lymphocyte
T,B,NK
Increase in : Viral infection ( hepatitis,
MMR, HIV), corticosteroids,
malignancies, SLE, bacterial disease,
chronic inflammation
Decrease in : immunodeficiency
syndromes, severe illness, lymphatic
circulatory system
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Diseasse with Monocyte
Increase in : Infectious, collagen
vascular disease,
Infection (TB, Typhoid, endocarditis),
Malaria, Syphillis, Fungal