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The procedure of set abouting a white cell differential really similar in procedure to the ruddy cell derived function, with cognition of leukocytes it is possible to recognize the possible presence of disease. In the normal peripheral blood, it is normal for mature phagocytic cells and lymphocytes to be present. Their map is to protect the organic structure against infection, this procedure is closely connected to the protein systems in the organic structure ; Igs and complement, which are besides involved in the devastation of blood cells in some diseases.

The beginnings of the constituents of blood and the immune system. Taken from Immunobiology: The Immune System in Health and Disease. 5th edition. Janeway CA ( 2001 ) As with ruddy cells there are several types of white cells with different morphologies, some of which, in wellness, are merely found in the bone marrow, nevertheless in disease may be found in the peripheral blood. The Thymus and the bone marrow are the primary lymphoid variety meats in postpartum life, these are the countries in which lymphocytes develop. The lymph nodes, lien and lymphoid tissues of the alimental and respiratory piece of land are the secondary lymphoid variety meats, these produce the specific immune response. A specific immune response will depend on either/or the T and B cells, these cells originate from the hematopoietic root cell. Developing in the bone marrow, B cells are present and circulate in the peripheral blood until they are facilitated and mature into memory B cells, characterised by their unusual unit of ammunition karyon with its typical chromatin form. Alternatively T cells reach ripening in the Thymus, this occurs when they pass from the cerebral mantle to the myelin, during this transition the T cells that possess the human leukocyte antigen ( HLA ) are selected, the mature cells will show CD4 and the cytotoxic cells will show CD8, these act as co-receptors to the T cell. Simply primary map of the B cell is to bring forth antibodies and the T cells is to help the B cells in antibody production and to assail viruses and malignant neoplastic disease cells.

In this practical the blood movies of 3 instance surveies will be analysed along with the brief background information. From this it will be possible to approximately name the instance surveies based on what is seen on the blood movies and from the blood counts provided.

Consequences

Case Study 1 – 60C

Eosinophil

11 %

Lymphocyte

50 %

Monocyte

2 %

Neutraphil

8 %

Basophil

Multilobed

1 %

Plasma cell ( w/ aura )

5 %

Plasma cell ( anti-release )

7 %

Large thrombocytes

Large lymph cell

14 %

Case Study 2 – 49

Eosinophil

33 %

Lymphocyte

18 %

Monocyte

1 %

Neutraphil

37 %

Basophil

33 %

Multilobed

6 %

Plasma cell ( w/ aura )

Plasma cell ( anti-release )

Large thrombocytes

Large lymph cell

18 %

Case Study 3 – 30c

The blood movie showed no important changes other than high degrees of thrombocytes.

Discussion

Case Study 1

15 twelvemonth old male child went to GP with conceited secretory organs around the cervix. He was tired and listless. He besides complained of tenderness in the venters.

Blood Count –

Hb 13.5g/dl ( Normal Range is 13.5-17.5 )

WBC 18.0 x 109 /L ( Normal Range is 4.3-10.8 )

Platelets 270×109/L ( Normal Range is 150-450 )

MCV 94 Florida ( Normal Range is 80-95 )

RBC 6.0 ten 1012/L ( Normal Range is 4.5-6.5 )

Hct 46 % ( Normal Range is 40-52 % )

The brief list of physical symptoms given ab initio fit with the clinical symptoms that are used to name infective glandular fever caused by the Epstein-Barr virus ( EBV ) , where patients are typically between the ages of 15 and 40. They present with concerns, lassitude, stiff cervix and unease, when the disease progresses there is swelling of the lymph nodes, sore pharynx, febrility ( runing from mild to chair ) and possible tangible splenomegaly.

In this instance the patient ‘s blood count shows the WBC to be above the normal scope, this is characteristic of this disease. The per centums from the patient ‘s blood movie are 50 % lymph cells and 11 % big lymph cells, the latter being untypical in wellness. The big lymph cells indicate a viral infection, which in this instance would bind in with the diagnosing of infective glandular fever.

It should be taken into history that the patient has a compromised immune system, utilizing the procedure of differential diagnosing it would be prudent to govern out ague leukemia, particularly sing the patient ‘s age. Other possible causes for the symptoms and the attendant blood movie and blood count are HIV, German measles, grippe, CMV, toxoplasmosis, bacterial tonsillitis and infective hepatitis.

There is no direct intervention for infective glandular fever, merely intervention of the symptoms is normally required. Patients normally recover within 4-6 hebdomads, prolonged unease and lassitude frequently persists.

Case Study 2

28 twelvemonth old male admitted to A & A ; E with weariness, hematuria and little Jaundice.

Blood Count –

Hb 6.1g/dl ( Normal Range is 13.5-17.5 )

WBC 11.0 x 109 /L ( Normal Range is 4.3-10.8 )

Platelets 169×109/L ( Normal Range is 150-450 )

MCV 74 Florida ( Normal Range is 80-95 )

RBC 3.0 ten 1012/L ( Normal Range is 4.5-6.5 )

Hct 29 % ( Normal Range is 40-52 % )

The patient blood count shows decreased degrees of Hb and RBCs, decreased MCV and Hct with a somewhat increased WBC degree.

The blood movie consequences show increased degrees of eosinophils and basophils and lowered degrees of lymph cells. The addition in eosinophils could be the consequence of a bacterial infection or an allergic reaction. However the patient does present with icterus, weariness and hematuria and is perchance enduring from a signifier of anemia or hepatitis. Further probe into the patient history such as recent travel, sexual activity, old unwellnesss or drug history would supply more inside informations that could supply a stronger diagnosing.

Case Study 3

58 twelvemonth old male who had post gastrectomy 3 hebdomads ago was re-admitted for a splenectomy operation.

Blood Count –

Hb 13.5g/dl ( Normal Range is 13.5-17.5 )

WBC 12.0 x 109 /L ( Normal Range is 4.3-10.8 )

Platelets 370×109/L ( Normal Range is 150-450 )

MCV 105 Florida ( Normal Range is 80-95 )

RBC 6.3 ten 1012/L ( Normal Range is 4.5-6.5 )

Hct 46 % ( Normal Range is 40-52 % )

In this instance the patient ‘s blood movie appeared to be comparatively normal, the blood count consequences show increased WBCs and an increased MCV, the addition in MCV is likely tied in with the addition in the WBCs. The patient ‘s brief history informs of a major operation with another scheduled.

The addition in WBC could be the consequence of a station operative infection or merely a lowered immune system as a consequence of the operation, the RBC degrees are within normal scope which does n’t instantly bespeak a upset set uping the spleen ensuing in its at hand remotion nevertheless the high thrombocyte degrees are. Another possibility and cause of the increased WBC degree could be malignant neoplastic disease in the tummy that has spread to the lien, or during surgery the lien was damaged when the gastrectomy was taking topographic point.

Mentions

Hoffbrand, AV. ( 2006 ) . The white cells 1 ; granulocytes, monocytes and their benign upsets. In: Moss, PAH Pettit JE Essential Haemotology. Oxford: Blackwells Publishing. 94-100.

Immunobiology: The Immune System in Health and Disease. 5th edition. Janeway CA, Travers P, Walport M, et al. New York: Garland Science ; 2001.

Practical 2 – Immunohaematology

Introduction

The ABO grouping system is the system where by a individual ‘s blood can be grouped based on the specific antigens and antibodies present. This system is highly of import with respects to blood transfusions ; if a individual receives the incorrect blood type so the effects can be really serious.

There are 3 allelomorphic cistrons A, B and O, the A and B cistrons synthesise enzymes that are responsible for saccharides

Consequences

ABO Controls

A cells

B cells

O cells

Anti A

3 +ve

-ve

-ve

Anti B

-ve

3 +ve

-ve

Anti A+B

1 +ve

3 +ve

-ve

NaCl

-ve

-ve

-ve

ABO grouping of patients 1-4

P1 ( serum )

P2 ( serum )

P3 ( serum )

P4 ( Serum )

A cells

2 +ve

-ve

-ve

2 +ve

B cells

4 +ve

4 +ve

-ve

-ve

O cells

-ve

-ve

-ve

-ve

P1 ( Cells )

P2 ( Cells )

P3 ( Cells )

P4 ( Cells )

Anti A

-ve

5 +ve

2 +ve

-ve

Anti B

-ve

-ve

3 +ve

3 +ve

Anti A+B

-ve

-ve

2 +ve

3 +ve

NaCl

-ve

-ve

-ve

-ve

Rhesus Grouping

O Rh Pos

O Rh Neg

P1

P2

P3

P4

+ve

-ve

-ve

+ve

+ve

+ve

Discussion

Mentions

Practical 3 – Curdling

Introduction

Consequences

Prothrombin Time

Normal – 16s

Test – 43s

Mention Range – 10-14s

Activated Partial Thromboplastin Time

Normal – 34s

Test – 70s

Mention Range – 30-40s

Thrombin Time

Normal – 15s

Test – 70s

Mention Range – 14-16s

Discussion

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