CBC
أول حاجه عنينيا تروح عليها هيا Hb
لو لقيناه قليل يبقى انيميا نبص على MCHC&MCH&MCV
عشان نعرف نوع االنيميا
بعد كده نبص على platelet
بعد كده نبص على WBCsلقيناها زايده نبص على ال differntial
بتاعها
نركز على 3حاجات 1.Neutrophil
2.Lymphocyte
3.blast cell
كمان نبص على reticulocytesلو زايدة يبقى فيه hemolysis or
hemorrhage
ملحوظة:
لو لقينا blasts in peripheral bloodيبقى على طول ده حالة
acute leukemia
و بنكتب بس acute leukemiaمن غير ما نكتب نوعها ألن الcbc
مش بيفرق هيا myloidو ال lymphoid
#مش محتاجين تحفظوا النورمال الن فى االمتحان بتكون مكتوبه بس
فيه حاجات زى الهيموجلوبين و الPLو ال WBCsدول هتحفظوهم
بالتكرار
Comment: normocytic normochromic anemia, thrombocytopenia, leucopenia
1.What is the most probable
diagnosis?
Acute leukemia
2.Most important investigation?
Bone marrow biobsy(most imp)
-others
immunophenotyping-cytogenetics-
uric acid
3.What is the clinical pic
expected?
Sym of anemia as headache ,
syncobal attack, dysnea
Bleeding-infection-
hepatosplenomegaly
Comment: sever isolated thrombocytopenia
1.What is the most probable
diagnosis?
ITP
2.Differential diagnosis?
Drugs as antiplatelet or heparin
Or NSAIDS
Hereditary-viral infections as
HBV,HCV,HIV,CMV
H.pylori
2. Investigation required?
Anti platelet ab for itp
HBV&HCV markers
HIV ab
Stool analysis for h pylori
Comment: pancytopenia
1.What is the clinical pic
expected?
Sym of anemia as headache ,
syncobal attack, dysnea
infection-hepatosplenomegaly
خدوا بالكم الصفايح هنا مش قليلة لدرجة اننا
bleeding نكتب
2.Differential diagnosis?
Sever infection
Comment: pancytopenia
1.Differential diagnosis?
Aplastic anemia,myelofibrosis,
Myelodysplastic
syndrome,autoimmune disease
as sle, sever infection,septicemia
8.1
2.What is the clinical pic mcv 84.9
expected?
Sym of anemia as headache ,
syncobal attack, dysnea-bleeding Platelet 10
0.37
infection-hepatosplenomegaly wbcs
خدوا بالكم الصفايح هنا قليلة جدااا لدرجة اننا
☺ bleeding نكتب
3.Most important investigation?
Bone marrow biobsy(most imp)
-others
ANA& anti ds dna for sle
Viral markers for infection
Comment: normocytic normochromic anemia, thrombocytosis, leukocytosis
1.What is the most probable
diagnosis?
cml
2.Most important investigation?
Cytogenetic BCR ABL gene
Philadelphia chromosome
BM biobsy, us
3.What is the clinical pic expected?
huge splenomegaly,sym for
leukostasis as tremors&blurred
vision&thrombosis(dvt-priapism)
Sym of anemia as headache ,
syncobal attack, dysnea
-infection-pruritis
4.Differential diagnosis
Leukmoid reaction
Prolonged cst therapy
15
Comment: isolated thrombocytosis
1.What is the most probable 15
diagnosis?
Essential thrombocythemia
2.Most important investigation?
JAK2 mutation
BM biobsy
3.Differential diagnosis?
Early stage myelofibrosi
Reactive to splenectomy
Reactive to bleeding
Reactive to infection
4.What is the clinical pic expected?
Thrombosis
Comment: macrocytic anemia, thrombocytopenia, leukocytosis
1.Differential diagnosis?
Megaloblasti anemia(vit b12 or folic
acid deficiency)
Non megaloblastic (more common)
a.Hemolytic anemia
b.Toxins (liver or kidner failure)
c.Hypothyrodism
d.Aplastic anemia
e.Drugs as hydroxyurea
2.investigation?
Vitb12 &folic acid
Reticulocyte count
TSH
BM biobsy
