
A complete blood count (CBC) or full blood count (FBC) is a test requested by a physician or other medical professional that gives information about the cells in a patient's blood. The cell that circulate in the blood are generally divided into three types: white blood cells (leukocytes), red blood cells (erythrocytes), and platelets. Abnormally high or low counts may indicate the presence of many forms of disease, and hence blood counts are amongst the most commonly performed blood tests in medicine. ==Methods== ===Samples=== Blood is taken in a test tube containing an anticoagulant (EDTA, sometimes citrate) to stop it from coagulation, and transported to a laboratory. In the past, counting the cells in a patient's blood was performed manually, by viewing a slide prepared with a sample of the patient's blood under a microscope (a blood film, or peripheral smear). Nowadays, this process is generally automated by use of an automated analyser, with only specific samples being examined manually. ===Automated blood count=== The blood is well mixed (though not shaken) and put through a machine. The machine, called an automated analyser, counts the numbers and types of different cells within the blood. The machine prints out the results and/or sends them to a computer. Blood counting machines work by sampling blood, and sucking a standard amount through narrow tubing. Within this tubing, there are sensors that count the number of cells going through it, and can identify the type of cell. The two main sensors used are light detectors, and electrical impedance. Because an automated cell counter samples and counts so many cells, it gives a very precise estimate. However, with certain abnormal cells in the blood, they may be identified incorrectly, and not be as accurate as a manual count. Automated blood counting machines include the Sysmex XE-2100 and the Abbott Laboratories Cell-Dyn range. ===Manual blood count=== Counting chambers that hold a specified volume of diluted blood (as there are far too many cells if it is not diluted) are used to calculate the number of red and white cells per litre of blood. To identify the numbers of different white cells, a blood film is made, and a large number of white cells (at least 100) are counted. This gives the percentage of cells that are of each type. By multiplying the percentage, with the total number of white blood cells, an estimate of the absolute number of each type of white cell can be obtained. Manual counting has the advantage in that it can identify blood cells that may be misidentified by an automated counter. It is, however, subject to human error, and has a much smaller sample size. Additional factors, such as the quality of the blood film, also play a greater part. ==Results== A complete blood count will normally include: ===Red cells=== *Total red blood cells - The number of red cells is given as an absolute number per litre. *Hemoglobin - The amount of hemoglobin in the blood, expressed in grams per litre. (Low hemoglobin is called anemia.) *Hematocrit or packed cell volume (PCV) - This is the fraction of whole blood volume that consists of red blood cells. *Mean cell volume (MCV) - the average volume of the red cells, measured in femtolitres. Anemia is classified as microcytic anemia or macrocytic anemia based on whether this value is above or below the expected normal range. Other conditions that can affect MCV include thalassemia and reticulocyte. *Mean cell hemoglobin (MCH) - the average amount of hemoglobin per red blood cell, in picograms. *Mean cell hemoglobin concentration (MCHC) - the average concentration of hemoglobin in the cells. *Red cell distribution width (RDW) - a measure of the variation of the RBC population ===White cells=== *Total white blood cells - All the white cell types are given as a percentage and as an absolute number per litre. A complete blood count with differential will also include: *Neutrophil granulocytes - May indicate bacteria infection. May also be raised in acute viral infections. *Lymphocytes - Higher with some virus infections such as glandular fever and. Also raised in lymphocytic leukaemia CLL. *Monocytes - May be raised in bacterial infection *Eosinophil granulocytes - Increased in parasite infections. *Basophil granulocytes A manual count will also give information about other cells that are not normally present in peripheral blood, but may be released in certain disease processes. ===Platelets=== * Platelet numbers are given, as well as information about their size and the range of sizes in the blood. ==Interpretation== Certain disease states are defined by an absolute increase or decrease in the number of a particular type of cell in the bloodstream. For example, leukopenia refers to an absolute decrease in the number of circulating white blood cells, whereas leukocytosis refers to an absolute increase in the number of circulating white blood cells. Anemia refers to a reduced number or quality of circulating red blood cells, and erythrocytosis refers to an increased number of circulating red blood cells. Finally, thrombocytopenia and thrombocytosis refer respectively to an increased or decreased number of circulating platelets. Pancytopenia refers to a decrease in all three cell lines, generally as the result of decreased production from the bone marrow. Pancytopenia is a common complication of cancer chemotherapy. Many disease states are heralded by changes in the blood count. For example, leukocytosis can be a sign of infection, while thrombocytopenia can result from drug toxicity. Medical tests
This is more for interest than anything else, but whereabouts do you request a CBC and only get a total white count (without diff)? User:Tristanb 12:16, 14 Apr 2004 (UTC) :In the Netherlands, where I gained most of my clinical experience, many hospitals do not routinely perform the ''diff''. IMHO, this is folly, and in the UK (where I work now) a full/complete blood count is indeed ''full/complete'', including the ''diff''. In addition, microscopy is performed on samples when expressly requested (e.g. patient with fever, confusion and bruising - DD TTP. Schistocytes?) User:Jfdwolff User:Jfdwolff | User_talk:Jfdwolff 14:27, 14 Apr 2004 (UTC) It is a bit strange a differential isn't routinely done there. If it's done with a machine, the additional cost of running the sample through the diff channel (and the reagents needed for this) must be a small proportion of the total cost. Insignificant for the extra information obtained with a diff. User:Tristanb 10:06, 15 Apr 2004 (UTC) On the east coast of the US, you can't assume you'll get a differential when you get a WBC, unless you specifically request it, and even then your request may not be honored. The lab has established criteria (one differential every three days max for hospitalized patients (unless otherwise ordered), or no differential if WBC not elevated unless requested. Doing fewer differentials saves not only on the reagents, but on technician time. It's not optimal but it's workable. - User:Nunh-huh 10:13, 15 Apr 2004 (UTC) :If it's done on an automated analyser it won't be any more work for the technicians, (the sample will spend longer on the machine, but this usually won't affect the amount of work) but i get your point. I've worked in a hospital and a 'community' (private) lab in New Zealand, (in two different provinces). Diffs get done on everything. In the hospital i worked in, retics and NRBCs were done on all paed samples (as they're put through the machine manually) even if the result is never seen. But i s'pose inefficiencies like this exist in every industry. User:Tristanb 10:55, 15 Apr 2004 (UTC) ::In this instance at least, the feeling was that if a differential was given it could not be merely a machine differential: it was an indication that an actual and hopefully knowledgable human had actually looked at the peripheral smear, with all the possibilities for thereby discerning things a machine would not detect. - User:Nunh-huh 21:33, 15 Apr 2004 (UTC) :A machine differential will give a more precise, and nearly as accurate diff as a human; and in a 'normal' sample you'll get the results (#s of neuts/lymphs/monos/etc) you want. Where I am now, a blood film is done if the diff is abnormal enough to expect a change in morphology (e.g. WBCs > 15 x109/L). The machine will also flag things like blasts, immature grans, atypical lymphs etc, and a film is done on these. User:Tristanb 22:33, 15 Apr 2004 (UTC) In the UK haematology lab I work at the rough rule of thumb is that if a patient is ill we will do a diff, if they are injured then we will not by default. The main catagories of parients who do not get one are: pregant women, postnatal women, pre-op and post op patients. The reason it is done is money. the 5-10% of samples we put through "diff off" save the department £2000 per year. Not much really, but then this is the NHS. Microscopy is done on all paed samples, and retics are done on newborns. other patients get it when they are outside normal ranges and especially is the analyser flags up blasts etc. We do not use the analyser for retics as the reagent is quite expensive, and its cheaper to do one manually using a Merrett tube. --User:Povmcdov 16:44, 8 Jan 2005 (UTC) ==full blood count vs cbc== I was surprised to find this title. Where is "full blood count" used more than cbc? Is this european or british usage? I've never heard the term in the US. User:Alteripse 16:44, 23 Jun 2004 (UTC) :It's UK usage. Asking for a CBC would draw a blank in this part of the world. User:Jfdwolff | User_talk:Jfdwolff 00:39, 24 Jun 2004 (UTC) OK thanks. User:Alteripse 00:45, 24 Jun 2004 (UTC) In our lab (in the UK) we use Coulter Gen S series cell counters (made in the US). When selecting the type of test the menu you are presented with offers "CBC only" and "CBC + Diff" as options. It seems that Coulters view is that CBC refers only to the WCC/RBC/PLT component of the test and not to the diff. I'm willing to trust them, after all, They did invent the rheostatic method of cell counting (ie. the coulter principle) --User:Povmcdov 16:30, 8 Jan 2005 (UTC) Per wikipedia naming conventions, the more common name should be the title. CBC is far more common than FBC. User:Ace-o-aces 05:39, 8 May 2005 (UTC) == Request: normal range of counts in mammals == Could someone please provide a normal range of the above counts in the most important mammals (like human, mouse, cow, pig) and possible diseases, if out of range (maybe separated by "below" and "above"). THANKS. User:Mjanich 09:41, 22 Nov 2004 (UTC) :The spectrum of diseases is probably quite similar, but I have no access to the veterinary reference ranges. Perhaps Google will help. User:Jfdwolff | User_talk:Jfdwolff 18:13, 22 Nov 2004 (UTC) == Glandular fever / infectious mononucleosis == I will be making a minor edit to the section regarding significance of results. It states that monocytes are raised in GF/IM. This is not the case, it is the lymphocytes that increase in number. I suspect the error was made because of the similarity between the terms monocyte and mononuclear lymphocyte. I am not a stste registed BMS, just a tech, but I do monospot tests most days. --User:Povmcdov 16:55, 8 Jan 2005 (UTC) :Thanks mate, your expertise is much welcomed. User:Jfdwolff | User_talk:Jfdwolff 19:59, 8 Jan 2005 (UTC)
See other meanings of words starting from letter:
Words begining with Complete_Blood_Count:
Complete_blood_count
Complete_blood_count
Complete blood count
A complete blood count (CBC) or full blood count (FBC) is a test requested by a physician or other medical professional that gives information about the cells in a patient's blood. The cell that circulate in the blood are generally divided into three types: white blood cells (leukocytes), red blood cells (erythrocytes), and platelets. Abnormally high or low counts may indicate the presence of many forms of disease, and hence blood counts are amongst the most commonly performed blood tests in medicine. ==Methods== ===Samples=== Blood is taken in a test tube containing an anticoagulant (EDTA, sometimes citrate) to stop it from coagulation, and transported to a laboratory. In the past, counting the cells in a patient's blood was performed manually, by viewing a slide prepared with a sample of the patient's blood under a microscope (a blood film, or peripheral smear). Nowadays, this process is generally automated by use of an automated analyser, with only specific samples being examined manually. ===Automated blood count=== The blood is well mixed (though not shaken) and put through a machine. The machine, called an automated analyser, counts the numbers and types of different cells within the blood. The machine prints out the results and/or sends them to a computer. Blood counting machines work by sampling blood, and sucking a standard amount through narrow tubing. Within this tubing, there are sensors that count the number of cells going through it, and can identify the type of cell. The two main sensors used are light detectors, and electrical impedance. Because an automated cell counter samples and counts so many cells, it gives a very precise estimate. However, with certain abnormal cells in the blood, they may be identified incorrectly, and not be as accurate as a manual count. Automated blood counting machines include the Sysmex XE-2100 and the Abbott Laboratories Cell-Dyn range. ===Manual blood count=== Counting chambers that hold a specified volume of diluted blood (as there are far too many cells if it is not diluted) are used to calculate the number of red and white cells per litre of blood. To identify the numbers of different white cells, a blood film is made, and a large number of white cells (at least 100) are counted. This gives the percentage of cells that are of each type. By multiplying the percentage, with the total number of white blood cells, an estimate of the absolute number of each type of white cell can be obtained. Manual counting has the advantage in that it can identify blood cells that may be misidentified by an automated counter. It is, however, subject to human error, and has a much smaller sample size. Additional factors, such as the quality of the blood film, also play a greater part. ==Results== A complete blood count will normally include: ===Red cells=== *Total red blood cells - The number of red cells is given as an absolute number per litre. *Hemoglobin - The amount of hemoglobin in the blood, expressed in grams per litre. (Low hemoglobin is called anemia.) *Hematocrit or packed cell volume (PCV) - This is the fraction of whole blood volume that consists of red blood cells. *Mean cell volume (MCV) - the average volume of the red cells, measured in femtolitres. Anemia is classified as microcytic anemia or macrocytic anemia based on whether this value is above or below the expected normal range. Other conditions that can affect MCV include thalassemia and reticulocyte. *Mean cell hemoglobin (MCH) - the average amount of hemoglobin per red blood cell, in picograms. *Mean cell hemoglobin concentration (MCHC) - the average concentration of hemoglobin in the cells. *Red cell distribution width (RDW) - a measure of the variation of the RBC population ===White cells=== *Total white blood cells - All the white cell types are given as a percentage and as an absolute number per litre. A complete blood count with differential will also include: *Neutrophil granulocytes - May indicate bacteria infection. May also be raised in acute viral infections. *Lymphocytes - Higher with some virus infections such as glandular fever and. Also raised in lymphocytic leukaemia CLL. *Monocytes - May be raised in bacterial infection *Eosinophil granulocytes - Increased in parasite infections. *Basophil granulocytes A manual count will also give information about other cells that are not normally present in peripheral blood, but may be released in certain disease processes. ===Platelets=== * Platelet numbers are given, as well as information about their size and the range of sizes in the blood. ==Interpretation== Certain disease states are defined by an absolute increase or decrease in the number of a particular type of cell in the bloodstream. For example, leukopenia refers to an absolute decrease in the number of circulating white blood cells, whereas leukocytosis refers to an absolute increase in the number of circulating white blood cells. Anemia refers to a reduced number or quality of circulating red blood cells, and erythrocytosis refers to an increased number of circulating red blood cells. Finally, thrombocytopenia and thrombocytosis refer respectively to an increased or decreased number of circulating platelets. Pancytopenia refers to a decrease in all three cell lines, generally as the result of decreased production from the bone marrow. Pancytopenia is a common complication of cancer chemotherapy. Many disease states are heralded by changes in the blood count. For example, leukocytosis can be a sign of infection, while thrombocytopenia can result from drug toxicity. Medical tests
Complete blood count
This is more for interest than anything else, but whereabouts do you request a CBC and only get a total white count (without diff)? User:Tristanb 12:16, 14 Apr 2004 (UTC) :In the Netherlands, where I gained most of my clinical experience, many hospitals do not routinely perform the ''diff''. IMHO, this is folly, and in the UK (where I work now) a full/complete blood count is indeed ''full/complete'', including the ''diff''. In addition, microscopy is performed on samples when expressly requested (e.g. patient with fever, confusion and bruising - DD TTP. Schistocytes?) User:Jfdwolff User:Jfdwolff | User_talk:Jfdwolff 14:27, 14 Apr 2004 (UTC) It is a bit strange a differential isn't routinely done there. If it's done with a machine, the additional cost of running the sample through the diff channel (and the reagents needed for this) must be a small proportion of the total cost. Insignificant for the extra information obtained with a diff. User:Tristanb 10:06, 15 Apr 2004 (UTC) On the east coast of the US, you can't assume you'll get a differential when you get a WBC, unless you specifically request it, and even then your request may not be honored. The lab has established criteria (one differential every three days max for hospitalized patients (unless otherwise ordered), or no differential if WBC not elevated unless requested. Doing fewer differentials saves not only on the reagents, but on technician time. It's not optimal but it's workable. - User:Nunh-huh 10:13, 15 Apr 2004 (UTC) :If it's done on an automated analyser it won't be any more work for the technicians, (the sample will spend longer on the machine, but this usually won't affect the amount of work) but i get your point. I've worked in a hospital and a 'community' (private) lab in New Zealand, (in two different provinces). Diffs get done on everything. In the hospital i worked in, retics and NRBCs were done on all paed samples (as they're put through the machine manually) even if the result is never seen. But i s'pose inefficiencies like this exist in every industry. User:Tristanb 10:55, 15 Apr 2004 (UTC) ::In this instance at least, the feeling was that if a differential was given it could not be merely a machine differential: it was an indication that an actual and hopefully knowledgable human had actually looked at the peripheral smear, with all the possibilities for thereby discerning things a machine would not detect. - User:Nunh-huh 21:33, 15 Apr 2004 (UTC) :A machine differential will give a more precise, and nearly as accurate diff as a human; and in a 'normal' sample you'll get the results (#s of neuts/lymphs/monos/etc) you want. Where I am now, a blood film is done if the diff is abnormal enough to expect a change in morphology (e.g. WBCs > 15 x109/L). The machine will also flag things like blasts, immature grans, atypical lymphs etc, and a film is done on these. User:Tristanb 22:33, 15 Apr 2004 (UTC) In the UK haematology lab I work at the rough rule of thumb is that if a patient is ill we will do a diff, if they are injured then we will not by default. The main catagories of parients who do not get one are: pregant women, postnatal women, pre-op and post op patients. The reason it is done is money. the 5-10% of samples we put through "diff off" save the department £2000 per year. Not much really, but then this is the NHS. Microscopy is done on all paed samples, and retics are done on newborns. other patients get it when they are outside normal ranges and especially is the analyser flags up blasts etc. We do not use the analyser for retics as the reagent is quite expensive, and its cheaper to do one manually using a Merrett tube. --User:Povmcdov 16:44, 8 Jan 2005 (UTC) ==full blood count vs cbc== I was surprised to find this title. Where is "full blood count" used more than cbc? Is this european or british usage? I've never heard the term in the US. User:Alteripse 16:44, 23 Jun 2004 (UTC) :It's UK usage. Asking for a CBC would draw a blank in this part of the world. User:Jfdwolff | User_talk:Jfdwolff 00:39, 24 Jun 2004 (UTC) OK thanks. User:Alteripse 00:45, 24 Jun 2004 (UTC) In our lab (in the UK) we use Coulter Gen S series cell counters (made in the US). When selecting the type of test the menu you are presented with offers "CBC only" and "CBC + Diff" as options. It seems that Coulters view is that CBC refers only to the WCC/RBC/PLT component of the test and not to the diff. I'm willing to trust them, after all, They did invent the rheostatic method of cell counting (ie. the coulter principle) --User:Povmcdov 16:30, 8 Jan 2005 (UTC) Per wikipedia naming conventions, the more common name should be the title. CBC is far more common than FBC. User:Ace-o-aces 05:39, 8 May 2005 (UTC) == Request: normal range of counts in mammals == Could someone please provide a normal range of the above counts in the most important mammals (like human, mouse, cow, pig) and possible diseases, if out of range (maybe separated by "below" and "above"). THANKS. User:Mjanich 09:41, 22 Nov 2004 (UTC) :The spectrum of diseases is probably quite similar, but I have no access to the veterinary reference ranges. Perhaps Google will help. User:Jfdwolff | User_talk:Jfdwolff 18:13, 22 Nov 2004 (UTC) == Glandular fever / infectious mononucleosis == I will be making a minor edit to the section regarding significance of results. It states that monocytes are raised in GF/IM. This is not the case, it is the lymphocytes that increase in number. I suspect the error was made because of the similarity between the terms monocyte and mononuclear lymphocyte. I am not a stste registed BMS, just a tech, but I do monospot tests most days. --User:Povmcdov 16:55, 8 Jan 2005 (UTC) :Thanks mate, your expertise is much welcomed. User:Jfdwolff | User_talk:Jfdwolff 19:59, 8 Jan 2005 (UTC)
See other meanings of words starting from letter:
C
CA | CB | CD | CE | CF | CG | CH | CI | CJ | CK | CL | CM | CN | CO | CP | CR | CS | CT | CU | CW | CX | CY | CZ |Words begining with Complete_Blood_Count:
Complete_blood_count
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