Medical Laboratory Tests: Tang Ping
Medical Laboratory Tests: Tang Ping
Medical Laboratory Tests: Tang Ping
Tang Ping
First Teaching Hospital
Zhengzhou university
Contents
Haematology
Urine analysis
CSF and other body fluids analysis
Stool examination
Clinical enzymology
Liver function tests
Evaluation of renal function tests
…
The Blood
Composition and Function of blood
RBC, Hb, Hct, Ret, MCV, MCH,MCHC.
WBC, DC.
Anemias, homeostasis
Bone marrow examination
ESR
…
Composition & Function
of blood
Blood Components
Hematocyte Plasma
Water 90%
Plasma proteins 7%
Other solutes 3%
Peripheral blood examination
Pronormoblast
Basophilic normoblast
Polychromatic normoblast
Orthochromatic normoblast
Marrow reticulocyte
Reticulocyte
erythrocyte
Red blood cells
Non-nucleated
Carriers of oxygen and
nutrients
Biconcave disc shape
» requires specialized cytoskeleton
» spectrin
About 8 microns
Normal values
Fe ion in
heme group
reversibly
binds O2
Hemoglobin Function
Transport and exchange respiratory gases
» Ease at which hgb binds and releases O2 is
oxygen affinity
» oxyhemoglobin: hgb with O2
» deoxyhemoglobin: hgb without O2
» 2,3 diphosphoglycerate (2,3, DPG) controls hgb
affinity for O2
– TENSE FORM : lower affinity for O2, 2,3 DPG
salt bridges formed (deoxygenated form)
– RELAXED FORM : increased affinity for O2,
molecule shrinks (oxygenated form)
Hb determination
Sahli’s acid haematin method
Normal Range of Hb
Age
Gender
Environment, e.g. altitude
Pregnancy
Hydration
Others, e.g. smoking
Clinical significances
RBC increase in RBC decrease in
Polythethymia vera Anemia
Tabaco abuse Hemolytic anemia
High altitude
Acute hemorrhage
Renal cell carcinoma
Marrow failure
Cardiovascular diseases
Stress Chronic renal failure
Dehydration
Clinical significances
Hb increase in Hb decrease in
Vigorous exercise
As in RBC
High altitude
Anemia
Dehydration
Tabaco abuse Hemolytic anemia
Polycythemia Vera Acute hemorrhage
Renal cell carcinoma Marrow failure
Cardiovascular
diseases Chronic renal
Stress failure
Erythrocyte abnormalities
Osmotic changes
» Renal failure
Hemoglobin genetic
defects
» Sickle cell anemia
» Thalassemia
Elliptocytosis and
Spherocytosis
» Deficiency in spectrin of
rbc cell membrane 返回
Morphologic abnormalities
of erythrocytes
Morphologic abnormalities
of erythrocytes
SIZE
正常红细胞
•Macrocyte( 大红细胞 ), magalocyte( 巨红细胞 ) and
hyperchromic
•Microcyte( 小红细胞 ) and hypochromic
•Anisocytosis ( 红细胞大小不等 )
Morphologic abnormalities
of erythrocytes
形态变化 MORPHOLOGY
1. Spherocyte (球形红细胞)
2. Elliptocyte (椭圆形红细胞)
3. Target cell (靶形细胞)
4. Sickle cell ( 镰形细胞 )
5. Dacryocyte, teardrop cell (泪滴形红细胞)
6. Acanthocyte (棘形红细胞)
7. Schistocyte or poikilocytosis ( 裂细胞或异形细胞 )
8. Rouleaux formation ( 红细胞缗钱状形成 )
Morphologic abnormalities
of erythrocytes
血红蛋白含量异常
HEMOGLOBIN CONTENTS
低色素性 hypochromic
高色素性 hyperchromic
嗜多色性 Polychromatic
Morphologic abnormalities
of erythrocytes
红细胞中出现异常结构 :
Abnormal structure of erythrocyte
点彩红细胞
Basophilic stippling
染色质小体
Howell-Jolly body
卡波氏环
Cabot ring
有核红细胞
Nuckeated erythrocyte
The END
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