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## RBC Count Calculation and Normal Range

Question: Calculation of RBC count and comments on the obtained results, if it’s on the range and factors which could have triggered?

The red blood cell count under the 400X magnification was 306

Cells/ milliter calculation = av. count (306) X factor of dilution (200) X 20ml

= 1,224,000 cells per 20 ml

Red blood cell per ml = 1,224,000 cells/20ml

= 61200 cells per ml

Convert to mcL= 61200 cells per ml X 100

= 6,120,000 cells/mcL

= 6.12 million/mcL

Ranges for the standard RBC count:

 Women ranges 4.2 _5.4 million/mcL Men ranges 4.8 _ 6.1 million/mcL Children category 4.7 _ 4.8 mill/ mcL The volume under range is blood  microliter
• The red blood cell count is high and it could be attributed to incidence of disease in the blood; there could be presences of congenital disease, dehydration, excess production of red blood cell, obstructive lung cancer and pulmonary fibrosis.
• However in some cases a higher red blood cell count shows the ability of increased capacity of oxygen carriage in the body. It can however limit the oxygen supply or red blood cell production levels in the body.
• This elevated levels of RBC is referred to as polycythaemia, which is characterised by thicker blood making it harder for it to circulate in the body, higher RBCs can have the following side effects such as blurred vision, headaches, dizziness, high BP, itching , muscle pain.
• Polycythaemia can be grouped into three types; primary, secondary and red cell production. Primary polycythaemia is increased red blood cells due to the production levels in the body, secondary type occurs as a reactionary to other inherent factors or conditions that facilitate red blood cell production. Lastly erythropoesis production takes place in the bone marrow and increased levels of EPO, leads to increased red blood cell count in the body.

1) Results

Calculation of WBC and statement concerning the results in comparison with the standard reference values for white blood cells, the if different what could have led so;

White blood cells count under X400 magnification was 65

Cells/milliter calculation = average count (65) X factor of dilution (20) X 20ml

= 26,000 cells/20ml

Cells per ml = 26,000/20ml

= 1,300 cells per ml

Or

WBCs = 65cellsX 20 dilution factor X 104

WBCs = 13,000,000 cells per ml

Convert to mm3 of blood = 13,000,000cells per ml/10000

= 1,300 cells/ mm3

 WBC Standard Reference Ranges Lower range Lower than 4,000 WBC/mm3 Standard range Between 4,500- 10, 000 WBCs/mm3 Elevated range Higher than 11,000 WBCs/mm3 Volume represented in  cubic millimetre

- A lower range white blood cell count can be a reflective of the following; compromised immune system, reduced bone marrow ability, chemotherapy sessions impacts and effects and infections either from viral sources.

- The production of RBCs is done in the bone marrow cartilage. Viruses can disrupt temporarily the work of bone marrow activity in the body. Auto immune disorders on the other hand destroys white blood cells , infections can also destroy white blood cells in faster rate, like blood cancer i.e. leukaemia. Consumption of antibiotics has proved to affect the white blood cell count in the body.

Results

The calculation of the haemotocrit level is as follows;

Blood sample calculation found is 19%

The average range values for the human being are as follows

 Standard measure for women 38% -46% Standard measure for  men 42% - 54% Values are percentages of total blood
• Don’t fall within the standard range values

The results are not normal and this could be attributed with the following

• Hematocrit measure is an indication that a patient might have erythrocytosis or changes in plasma level volume in the body
• The low hematocrit level could be associated with excess blood loss, deficiency of foliate, Fe, leukaemia and consequences of chemotherapy sessions or its pharmacological effects.
• High hematocrit level could be associated with dehydration, heart disease, lung condition such as hypoxia or polcythemia, congenital heart doses, thickening of lung, bone marrow disease that is responsible for abnormal increase in red blood cells.
• In some cases among ladies, during pregnancies , hematocrit measure can be decreased , in line with increased plasma volumes also if the population where the samples were drawn are residing in high altitude areas then there is direct increase in oxygen carrying capacities at elevated levels
• Complete the table below
 Cell category Observed number Percentage  of total Range of  neutrophils (segmented) 50% 60% -70% Range of  neutrophils (band form) 11 % 9 % Range of Lymphocytes 20% 25 % Range of  monocytes 5 % 5% Range of  eosinophil 5% 2-4% Range of  basophil 0 0.5 % Sum total 100%
 Neutrophils – Below set range - It could be due bacterial infection, pancytopaenia or typhoid fever Lymphocytes – Below the range - Factors attributed could be patient could be having pancytopaenia or is elderly Monocytes -  Between the range, - It is between the phagocyte properties of the body, thus able to defend the very well, no presence of diseases Eosinophil – Below the normal range - The low range could be attributed to absence of disease conditions in the system, the body is healthy with no parasitic infections, and usually elevated levels are attributed to parasitic infections. Basophil – below the range - The person in whom the blood is drawn is an older person it terms of age.
• Brief comment on the results obtained in the experiment include

Haemoglobin Testing

• It is used clinically to measure the protein component in blood cells, it aids in carrying oxygen to the lungs and tissues and excretion of carbon dioxide from the organs and tissues to the lungs to be inhaled.

Findings analysis

The results obtained signify the following;

 Patient category Analysis of the result shows Conclusion remarks A - Hb normal range - RBC falls under normal range - The patient is well with no medical condition affecting the body - The blood film is normal showing no irregular formation B - Hb below the normal range linked to an association to a disease condition - RBC level is below the normal range - This is associated with diseases - It can be attributed to heavy menstrual bleeding for women, diseases and dietary insufficient like lack of folic acid and vitamin B12 or anaemia C -  Below the normal range occur when there is a problem in the body can be disease or the body produces fewer red blood cells, or the body destroys the RBC - The HB is below the normal range and the red blood cell, is below the normal range. There could be a multiple diseases condition affecting the patient. - Even the blood film is irregular showing presence of infection or bacterial infection

The analysis of the results shows

• Process of screening test is usually for the detection of sickle cell or presence of Hbs, The chemical change appearance of crystal like features and milky substances  is a likelihood of sickle cell anaemia diseases

The advantage of the haemoglobin electrophoresis was to know measurement of the different type of Hgb in the bloodstream that carries oxygen in the blood.

Haemoglobin electrophoresis is a protein in the red blood cell that transports oxygen throughout the circulatory system into the tissue and organs.

• Positive result of the test signifies that the gene type of the patient make is  sickle cell victim, the genes of sickle cell can be transferable and there is probability of genetic transfer to offspring

Direct Anti globulin test results include the following results;

1. The clinical significance of the obtained diagrams and report  shows that;
• On the first tube its shows agglutination has occurred hence the blood can’t pass through the paper exclusion chromatography. It shows presence autoimmunein vivo or if the blood was for a baby it shows likelihood of baby's red cells is positive for anti RhD.
• The other tube shows no agglutination occurred as blood was penetrated in the paper exclusion chromatography. It signifies that there are no anti RhD factors and autoimmune cells.
1. False negative and false positive appearance in conducting clinical observations refers to the following concepts with regard to Direct Ant globulin Test are;
• A false test result indicates that a person don’t have a disease when he/she actually have. It may occur in pregnancy situations, TB or Lyme diseases tests for presence of drugs and alcohol.
• False negative indicates that has a person has a specific diseases when the person actually does not have. An example include in detection melanoma among others.
1. When DAT testing turns to be positive then another test is performed which is referred to as Indirect Anti globulin Test, which entails;
• If Direct Anti globulin Testing  polyspecifc is positive result, then either  IgG antibodies or complement is coating the cells,  then another confirmatory tests need to be done,
• If agglutination occurs with Anti-Ig G indicates antibodies are coating the cells,

While agglutination with Anti- C3 indicates complete is coating the cells, and it is an indicative that both Ig G and complement may be present in the test.

1. The main difference of direct anti globulin and indirect globulin tests is that;
• DAT is used to test if RBCs are smoothening inwards, complementary or both occurrences immunoglobulin, complement or both. This test is used for the purpose of selecting of Ig G or C3 in the blood cell surface.
• While indirect globulin test refers to determination of presence of antibody or plasma in the blood. Clinically it is referred to as antibody screen. It detects the agglutination process and determination of specificity of antibodies in positive result.
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