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[leodiagnostics]

Haematology

Haematology is a discipline concerned with the production, function, and disorders of blood cells and blood proteins. We are familiar with blood from the time of our first skinned knee, but what is it really made of? Blood is a liquid consisting of plasma (water, electrolytes, nutrients, waste products, and many soluble proteins) in which red cells, platelets and a variety of white cells are suspended. Its volume is about 70 mL/kg or about 5L total in an average size adult. 40-50% of blood volume is occupied by red cells.

1 Some of the important proteins in the blood are:

· Albumin, which contributes a large portion of the oncotic pressure of plasma.

· Immunoglobulin (antibodies), which combat infection

· A number of proteins involved in the clotting cascade.

2 The cellular components of blood include:

· Red blood cells (RBC, about 5 x 106 / µL), which carry oxygen to tissues

· Platelets (about 250,000 / µL), which facilitate clotting.

· White blood cells (WBC, about 5,000 / µL), which fight infection. WBC can be further subdivided into neutrophils, lymphocytes (T, B, and natural killer [NK] cells), monocytes, eosinophils, and basophils (listed in order of typical frequency).

One of the most common blood test in wakad ordered by all medical specialties is the complete blood count, or CBC. The pathology labs in wakad uses an analyzer that functions both as a spectrophotomer and a flow cytomer. This instrument can determine the concentration (count) of RBC, platelets and WBC, the hemoglobin (Hgb) concentration, and the mean size of the red cells (MCV). The flow cytometer can accurately distinguish and count the various types of WBC, which it reports as a “differential”. The hematocrit (Hct), which represents the percentage of blood volume occupied by red cells, is calculated from the RBC count and the MCV. As the CBC results can tell you a great deal about potential disease processes affecting a patient.

Note the higher values in the newborn. This is due to the predominance of HgbF (fetal), which is more efficient at extracting oxygen from the placenta but less efficient in delivering oxygen to the tissues (left shifted O2 dissociation curve, see below).  The differences between adult males and females are due to testosterone(hormonal test in wakad), which increases erythropoietin production. In aged men, testosterone(hormonal test in wakad) levels fall and the disparity between men and women decreases.  The mean cell volume (MCV) can be a helpful clue as to the cause of low Hgb levels.