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BAC K
FIRST YEAR C OURSES
Blood Smear & Differential Count
Bioch em istry
Gro ss Anato m y
Histolo gy
Blood Smear
Im m uno logy
Introduction to Me dicin e
I
Microb iology
Neuro science
Physiology
FOURTH YEAR
C OURSES
macroscopically, the blood film looks purplish. If blue, the w ash w ater was too alkaline; if pink to red, the water
was too acid.
macroscopically, the smear has a "feathered" edge (see picture below )
microscopically, red blood cells appear pinkish gray, platelets look deep pink, and w hite blood cells have purple-
blue nuclei and lighter cytoplasm.
can distinguish red blood cells; platelets; eosinophilic white blood cells (eosinophilic granules are bright purple-
red); neutrophilic w hite blood cells (neutrophilic granules are purple) and basophilic w hite blood cells (basophilic
granules are blue)
When counting 100 w hite blood cells, start at the X and move in the direction of the arrows. Only count cells in the
monolayer area in which the cells are evenly distributed and don't show artifact. First, use the high dry objective (40X)
to count the number of w hite blood cells per 5 to 10 random fields. The white blood cell count is normal if the average
number of white blood cells seen per 40X field averages between 2 and 7. Only five or more 40X objective fields are
necessary if a consistent number of cells is seen. A total of 10 fields may need to be counted if there are abnormalities.
Using the 100X objective, classify 100 white blood cells from the smear. The movement from the end of one vertical line
to the beginning of the next represents one 100X field. Moving farther than one field will result in reaching the thick
area in w hich the cells are overlapping. The initial vertical pattern may only be a few fields. As the width of the
monolayer area increases, the length of the vertical movement and the number of fields available for evaluation will
increase.
terrehaute.medicine.iu.edu/body.cfm?id… 1/2
11/11/2010 Blood Smear & Differential Count
Eosinophils ( D) can increase in response to allergic disorders, inflammation
of the skin, and parasitic infections. They can also occur in response to some
infections or to various bone marrow malignancies. Decreased levels of
eosinophils can occur as a result of infection (normal=0-3% eosinophils).
Monocyte (F) levels can increase in response to infection of all kinds as well
as to inflammatory disorders. Decreased monocyte levels can indicate bone
marrow injury or failure and some forms of leukemia. (normal=3-7%
monocytes)
terrehaute.medicine.iu.edu/body.cfm?id… 2/2