CHAPTER 2 FULL BLOOD COUNT, RED CELL INDICES AND
PERIPHERAL BLOOD FILM
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, Reticulocyte Count........................................................................................................... 16
1. Types of Bone Marrow Investigations.......................................................................... 24
2. Significance of Bone Marrow Examination...................................................................24
EXAM PREP.......................................................................................................................... 25
Case Studies.........................................................................................................................31
Full Blood Count (FBC).................................................................................................... 33
Red Cell Indices............................................................................................................... 34
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Anemia............................................................................................................................. 35
Mixed Concepts................................................................................................................36
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Case Study 1: Iron Deficiency Anemia...............................................................................38
Case Study 2: Vitamin B12 Deficiency............................................................................... 39
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Case Study 3: Anemia of Chronic Disease........................................................................40
Question 1: Providing specific examples, critically discuss the value of the laboratory
tests used by the haematologist in the determination and classification of anaemia.. 42
Question 2: Explain the role of the reticulocyte count in the diagnostic workup of
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anemia and its significance in distinguishing between different types......................... 45
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, Full Blood Count (FBC)
The Full Blood Count (FBC) is a common blood test that provides essential information
about the cells in a patient’s blood, including red blood cells (RBCs), white blood cells
(WBCs), and platelets.
Key Components of FBC:
1. Red Blood Cells (RBCs)
● Measured as RBC count (million cells per microliter of blood)
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● Important for oxygen transport
2. Hemoglobin (Hb)
● Oxygen-carrying protein in RBCs
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● Measured in g/dL
3. Hematocrit (Hct) or Packed Cell Volume (PCV)
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● Percentage of blood volume occupied by RBCs
4. White Blood Cells (WBCs) and Differential Count
● Total WBC count: Measures immune cells (e.g., neutrophils, lymphocytes,
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● Differential: Determines the proportion of different WBC types
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5. Platelets (PLT)
● Essential for blood clotting
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Red Cell Indices
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Red cell indices are calculated values that help assess RBC characteristics:
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1. Mean Corpuscular Volume (MCV)
● Measures the average size of RBCs
● Normal range: 80–100 fL
● Low MCV (<80 fL): Microcytic anemia
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● High MCV (>100 fL): Macrocytic anemia
2. Mean Corpuscular Hemoglobin (MCH)
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● Average amount of hemoglobin per RBC
● Normal range: 27–32 pg
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3. Mean Corpuscular Hemoglobin Concentration (MCHC)
● Average concentration of hemoglobin in RBCs
● Normal range: 32–36 g/dL
● Low MCHC: Hypochromic anemia
4. Red Cell Distribution Width (RDW)
● Measures variation in RBC size
● High RDW suggests anisocytosis (variation in RBC sizes), common in iron
deficiency anemia
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