Components of the CBC Test WBC Name White Blood Cell Increased/decreased May be increased with infections, inflammation,

cancer, leukemia; decreased with some medications (such as methotrexate), some autoimmune conditions, some severe infections, bone marrow failure, and congenital marrow aplasia (marrow doesn't develop normally)

% Neutrophil Lymphs % Mono % Eos % Baso Neutrophil Lymphs Mono Eos Baso RBC Hgb Hct MCV MCH MCHC RDW

Neutrophil/Band/Seg/Gran Lymphocyte Monocyte Eosinophil Basophil Neutrophil/Ban/Seg/Gran Lymphocyte Monocyte Eosinophil Basophil Red Blood Cell Hemoglobin Hematocrit Mean Corpuscular Volume Mean Corpuscular Hemoglobin Mean Corpuscular Hemoglobin Concentration RBC Distribution Width This is a dynamic population that varies somewhat from day to day depending on what is going on in the body. Significant increases in particular types are associated with different temporary/acute and/or chronic conditions. An example of this is the increased number of lymphocytes seen with lymphocytic leukemia. For more information, see Blood Smear and WBC.

Decreased with anemia; increased when too many made and with fluid loss due to diarrhea, dehydration, burns Mirrors RBC results Mirrors RBC results Increased with B12 and Folate deficiency; decreased with iron deficiency and thalassemia Mirrors MCV results May be decreased when MCV is decreased; increases limited to amount of Hgb that will fit inside a RBC Increased RDW indicates mixed population of RBCs; immature RBCs tend to be larger Decreased or increased with conditions that affect platelet production; decreased when greater numbers used, as with bleeding; decreased with some inherited disorders (such as Wiskott-Aldrich, Bernard-Soulier), with Systemic lupus erythematosus, pernicious anemia, hypersplenism (spleen takes too many out of circulation), leukemia, and chemotherapy Vary with platelet production; younger platelets are larger than older ones

Platelet

Platelet

MPV

Mean Platelet Volume

Elevated WBC count, medically known as leukocytosis, indicates an increase in disease-fighting white blood cells (leukocytes) circulating in the bloodstream which can occur for a number of reasons.

1. Significance o A count of more than 10,500 leukocytes per microliter of blood is usually considered a high white blood cell count in adults. Function
o

An elevated white blood cell count usually indicates an infection in the body, a drug reaction, a bone marrow disease or an immune system disorder.

Specific Causes
o

Some possible causes of an elevated white blood cell count include leukemia, allergic reaction, drugs (such as corticosteroids and epinephrine), measles, myelofibrosis, infection, smoking, rheumatoid arthritis, severe emotional or physical stress, tissue damage, tuberculosis and whooping cough.

Read more: What Does an Elevated WBC Count Indicate? | eHow.com http://www.ehow.com/facts_5751422_elevated-wbc-count-indicate_.html#ixzz1Y13QDzfe The hematocrit is used to screen for anemia, or is measured on a person to determine the extent of anemia. An anemic person has fewer or smaller than normal red blood cells. A low hematocrit, combined with other abnormal blood tests, confirms the diagnosis. The hematocrit is decreased in a variety of common conditions including chronic and recent acute blood loss, some cancers, kidney and liver diseases, malnutrition, vitamin B 12 and folic acid deficiencies, iron deficiency, pregnancy, systemic lupus erythematosus, rheumatoid arthritis and peptic ulcer disease. An elevated hematocrit is most often associated with severe burns, diarrhea, shock, Ad dison's disease, and dehydration, which is a decreased amount of water in the tissues. These conditions reduce the volume of plasma water causing a relative increase in RBCs, which concentrates the RBCs, called hemoconcentration. An elevated hematocrit may also be caused by an absolute increase in blood cells, called polycythemia. This may be secondary to a decreased amount of oxygen, called hypoxia, or the result of a proliferation of blood forming cells in the bone marrow (polycythemia vera). Read more: Hematocrit - test, blood, tube, complications, pregnancy, cells, Definition, Purpose, Precautions, Description, Aftercare, Risks, Normal results http://www.surgeryencyclopedia.com/Fi-La/Hematocrit.html#ixzz1Y13myuEB Normal and Expected Changes Maternal circulation changes during pregnancy to accommodate an increase in blood volume of up to 50%. Because of the increase in workload, upon auscultation of the heart you may hear a split first sound, a systolic murmur, or even a third heart sound. The increased blood volume peaks in the third trimester and returns to pre-pregnant state somewhere around 2 to 3 weeks postpartum (Blackburn, 2008). The increased blood supply includes a 45% to 50% increase in plasma volume and 20% to 30% increase in red blood cells. Since these percentages are not equal, the subsequent hemoglobin (HGB)/hematocrit (HCT) will reflect a normal physiologic anemia of pregnancy. The HCT will appear to fall as the volume increases more than the packed cell count.

During pregnancy, the systemic vascular resistance (SVR) of the blood vessels lowers due to increased levels of hormones. This decreasing SVR is an expected result of the increasing progesterone and prostaglandin levels, which relax smooth muscle, producing vasodilatation. As a result of the increased volume and decreased resistance, cardiac output rises. Therefore, you normally will see a lowering of the blood pressure, especially in the second trimester. This sometimes causes dizziness or feeling faint in women as they rise to standing during the second trimester. Their pressure should stabilize and approach pre-pregnancy numbers by the third trimester. An abnormal rise in blood pressure could be an indication of preeclampsia, which involves multiple systems of the patient. (Keep this expected decrease in SVR in mind when you read the preeclampsia section later in this course.) White blood cell (WBC) counts, especially neutrophils, increase naturally during pregnancy. During active labor there may be another normal increase, even in the absence of infection. In nonpregnant patients a normal WBC count is somewhere between 5 and 10 (5,00010,000 cells/mm3), but for pregnancy those normal values can be between 6 and 16 in the third trimester and may reach 20 to 30 in labor and early postpartum. When evaluating for infection, therefore, you need to look for other clinical indicatorssuch as increased temperature, bacteriuria, WBC in urine, uterine tenderness, and fetal tachycardiaand document them. NORMAL HEMATOLOGIC VALUES Nonpregnant Pregnant Hemoglobin (HGB) Hematocrit (HCT) Red blood cells (RBC) 1216 g/dl 3648 45.36 11.515 g/dl 3236.5 no change 620

White blood cells (WBC) 410.6

Pregnancy is typically considered a hypercoagulable statemeaning that most pregnant women clot more readily than normal and are predisposed to deep-vein thrombosis or other clot-related conditions. During pregnancy there is an increase in certain factors in the clotting cascade due to normal adaptation (see table). Platelets are usually unchanged in pregnancy, and increased levels of platelets are rare. Normal levels should be 140,000 to 300,000 per mm3. NORMAL LEVELS FOR CLOTTING FACTORS Nonpregnant Factor V Protein S 50150 61161 Increased 3070 Should remain stable (a decrease indicates increased thrombosis risk) Pregnant

Antithrombin 80130