VARITION IN SIZE,SHAPE&STRUCTURE

OF RBC
ANISOCYTOSIS VARIATION IN THE SIZE OF RBC
NORMOCYTE DIA. 7.5 m
MACROCYTE - DIA. INCREASE e g-MAGALOBLASTIC
ANEMIA
MICROCYTE - DIA. DECREASE e g IDA
POIKILOCYTOSIS - VARIATION IN THE SHAPE OF RBC
OVALOCYTOSIS
SICKLE CELL
TEAR SHAPED CELL
 VARITION IN SIZE,SHAPE&STRUCTURE
OF RBC
SPHEROCYTOSIS - SPHERICAL RBC(MORE FRAGILE) HEREDITORY
SPHEROCYTOSIS
HYPOCHROMIC INCREASE CENTRAL PALLOR
DUE TO DECREASE Hb CONC. IN THE RBC
e g IDA, SIDEROBLASTIC ANEMIA
HYPERCHROMIC - DECREASE CENTRAL PALLOR
DUE TO INCREASE Hb. CONTENT ,INCREASE PINK AREA
e g magaloblastic anemia
NORMOCHROMIC - NORMAL
VARITION IN SIZE,SHAPE&STRUCTURE
OF RBC
POLYCHROMATIC CELL/RETICULOCYTE
Due to Bone marrow activity
normal count in - adult - 0-1%
- infant -2-3%
- it having more than one type of color
NORMOBLASTAEMIA - Means Nucleated
RBC SEEN In PBF
e g seen in hemolytic disease in newborn
VARITION IN SIZE,SHAPE&STRUCTURE
OF RBC
HOWELL-JOLLY BODIES - SMALL NUCLEAR
ssssPART SEEN IN THE RBC
- BASOPHILIC IN NATURE
- FOUND IN - MAGALOBLASTIC ANEMIA
TARGET CELL CENTRAL ROUNDED PINK AREA &
PERIPHERAL RIM OF Hb.
e g IDA,THALASSEMIA,CHRONIC LIVER DISE.
SICKLE CELL - SICKLE SHAPED
e g - sickle cell anemia
VARITION IN SIZE,SHAPE&STRUCTURE
OF RBC
ACANTHO CYTOSIS - COARSE PROJECTION
ON SURFACE OF RBC
- e g- chronic liver disease
BURR CELLS ONE OR MORE SPINE PRESENT
ON SURFACE OF RBC
STOMATO CYTOSIS CENTRAL AREA OF
RBC HAVING SLIT LIKE
e g - alcoholism
RBCs INDICES(WINTROBE CONSTANT)
THEY HELP IN DIGNOSIS THE TYPE OF ANEMIA.

MEAN CORPUSCULAR VOLUME (MCV) : Volume of a single

RBC in cubic micron(m3)

it can be calculated as :

PCV/100ml blood
MCV : ------------------- --------------- ------ 10 m3
TOTAL RBC Count in million/mm3
NORMAL VALUE : 82 92 m3
NORMO CYTES : RBC WITH NORMAL VALUE
MICRO CYTES : RBC WITH LESS THAN NORMAL VALUE e g.
IDA
MACROCYTES : : RBC WITH MORE THAN NORMAL VALUE e g .
Magaloblastic anemia
RBCs INDICES(WINTROBE CONSTANT
MEAN CORPUSCULAR HAEMOGLOBIN-(MCH)
average amount of Hb in single RBC in p g
Hb in gm %
MCH : 10 p g
------------------- --------------- ------
TOTAL RBC Count in million/mm3

NORMAL VALUE : 28 32 p g

MCH IS NOT USE IN FIND OUT THE TYPE OF ANEMIA

 RBCs INDICES
MEAN CORPUSCULAR HAEMOGLOBIN CONC.(MCHC)
Its is the Hb concentration in a single RBC
Hb in gm%
MCHC ------------------------- 100
PCV/100 ml of blood
Normal range : 35 3 %
NORMO CHROMIC : MCHC IS WITHIN NORMAL RANGE
HYPO CHROMIC : MCHC IS LESS THAN NORMAL RANGE
-------- MCHC IS NEVER MORE THAN 38% BECOZ CELL CANNOT
HOLD Hb BEYOND ITS LIMITS(DUE TO METABOLIC LIMIT OF
THE CELL Hb FORMING MECHANISM) SO ANEMIA CAN NEVER
BE HYPERCHROMIC
 RBCs INDICES
COLOR INDEX : RATIO OF Hb TO RBC
Hb%
CI ----------
RBC%
14.8 gm% Hb IS TAKEN AS 100% Hb &
5 million/cu.mm RBC IS TAKEN AS 100% RBC
NORMAL RANGE : 0.85 1.15
 ERYTHROCYTE SEDIMENTATION RATE
ESR: THE RATE AT WHICH RBC SETTLE OUT IN VERTICAL
COLUMM OF ANTI-COAGULANT BLOOD
FALL DOWN OF RBC IN VERTICAL COLUMM IN ONE HRS.
3.8% SODIUM CITRATE USE AS ANTICOAGULANT.
NORMAL VALUE:
WINTROBE METHOD
MALE - 0 -9mm/hrs.
FEMALE - 0-20mm/hrs.
WESTERGREN METHOD
MALE - 3 -5 mm/hrs.
female - 5 -12 mm/hrs.
 ERYTHROCYTE SEDIMENTATION RATE
ESR IS MANILY DEPENDS ON:
ROULEAUX FORMATION
PLASMA PROTEINS -
FIBRINOGEN
GAMMA-GLOBULIN
C-RECTIVE PROTEIN
VISCOSITY OF BLOOD:
ANEMIA - DECREASE VISCOSITY INCREASE ESR
POLY CYTHEMIA INCREASE VISCOSITY - DECREASE ESR
ESR MAINLY HELP IN PROGNOSIS OF DISEASE NOT
DIGNOSIS
 OSMOTIC FRAGILITY OR RBC
HEMOLYSIS OF RBC IN HYPOTONIC SOLUTION
WHAT IS THE CONC. OF HYPOTONIC SOLUTION IN WHICH RBC
ARE HEMOLYSED
MAINLY THREE TYPES OF SOLUTION USED IN PHYSIOLOGY
1. ISO TONIC SOLUTION: (0.9%NaCl,5% glucose.10%
Menitol,20%urea) SAME TONICITY AS PLASMA
- RBC PLACED IN ISOTONIC SOL. NEITHER SWELL NOR
SHRINK.
2. HYPER TONIC SOLUTION:( > 0.9% NaCl)
- RBC PLACED IN HYPER TONIC SOL. THAN RBC SRINK DUE
TO EXOMOSIS
3. HYPO TONIC SOL. :(<0.9%NaCl)
- RBC PLACED IN HYPO TONIC SOL. THAN RBC SWELL DUE TO
ENDOMOSIS
 OSMOTIC FRAGILITY OR RBC
ONSET OF FRAGILITY SEEN AT 0.48% NaCl
SOL.
ENDING OF FRAGILITY SEEN AT - 0.34% NaCl
OSMOTIC FRAGILITY INCREASE IN CONGENTIAL
SPHEROCYTOSIS
IT BEGINS AT 0.7% NaCl & END AT 0.45% NaCl SOL.
OSMOTIC FRAGILITY DECREASE - IN IDA
IT BEGINS AT 0.36% NaCl & END AT 0.24% NaCl SOL.