40. Mean Corpuscular Volume (MCV) – index of single erythrocyte volume (fL) MCV (fL) = Hct (%) X 10 RBC (10 12 /L) Mean Corpuscular Hemoglobin Concentration (MCHC) – average [Hb] in RBCs MCHC (g/dL) = Hb (g/dL) X 100 Hct (%) Mean Corpuscular Hemoglobin (MCH) – average Hb weight per RBC MCH (pg/cell) = Hb (g/dL) X 10 RBC (10 12 /L)
41. Red Cell Size Distribution Width (RDW) – indication of the degree of anisocytosis RDW (CV%) = Standard deviation of RBC size X 100 MCV
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44. 1 = Normal ESR 2 = Normal ESR with reddish plasma in hemolysis (disease or artifact) 3 = Blurring of the plasma-erythrocyte border in reticulocytosis 4 = White turbidity and blurring in severe leukocytosis of leukemia 5 = Accelerated ESR and lipemic plasma after a fatty meal 6 = Accelerated ESR and icteric plasma 7 = "Zero" ESR in polycythemia 8 = Severely accelerated ESR in multiple myeloma
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Editor's Notes
Normal blood, dense area
Normal blood, thin area
Normal blood - side edge, large cells - 20X
Normal blood - dense area - 100X
Much rouleaux formation of the red cells in this thick area of red cell distribution. This is pathologic rouleaux in contrast to normal stacking of red cells in a thick area of a normal blood smear. The background has a bluish tinge. Two small lymphocytes and one mature neutrophil are in the field. Multiple myeloma. Blood - 50
Rouleaux formation of the red cells, one mature Plasma Cell and a blue tinge to the background. This is an area of good thickness for proper evaluation of a blood smear. Multiple myeloma. Blood - 50X
Right Shift : Neutrophils may also show increased lobulation
Megaloblastic anemia : A hypersegmented neutrophil (7 lobes).
A macropolycyte compared with a normal neutrophil. The macropolycyte is twice as large as the normal neutrophil and has a nucleus with seven or eight lobes which is also twice as large as a normal neutrophil nucleus.
Normal mature megakaryocytes. Normal marrow biopsy. H & E stain - 50X
Normal bone marrow, medium power microscopic, with bony trabeculae and cellular marrow and adipose tissue.
Aplastic anemia: decreased bone marrow cellularity
CLINICAL IMPLICATION The endocrine system is an important regulator of the number of leukocytes in the blood. Hormones affect the production of leukocytes in the blood-forming organs, their storage and release form the tissue and their disintegration. A local inflammatory process exerts a definite chemical effect on the mobilization of leukocytes. The life span of leukocytes varies from 13 – 20 days, after which the cells are destroyed in the lymphatic system; many are excreted from the body in fecal matter. Leukocytes fight infection and defend the body by a process called phagocytosis (encapsulate foreign organism and destroy them). Leukocytes also produce, transport and distribute antibodies as part of the immune response to a foreign substance (antigen)
Hb and Hct are both high during and immediately after hemorrhage
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