This document provides information about performing a peripheral blood smear examination, including the different types of blood smears, proper procedures for making blood smears, characteristics of a good smear, common causes of a poor smear, staining techniques, performing a manual differential count and assessing red blood cell morphology. Key steps include making wedge or spun smears from EDTA blood, allowing the smear to air dry before staining with Leishman's stain, examining under 10x, 40x and 100x magnification to perform white blood cell counts and differentials, and platelet and red blood cell morphology assessments. Causes of abnormal smears and signs of abnormal white blood cell morphology are also outlined.
Peripheral blood smear examination plays an important role in the evaluation of various blood disorders. A good peripheral smear should be prepared using the wedge or coverslip technique to obtain an even distribution of red blood cells. The smear is then stained using the Romanowsky method which involves fixing the cells using methanol followed by staining with Giemsa stain. During examination, red blood cells, white blood cells, platelets and any abnormal cells or inclusions are evaluated under the microscope. Changes in the size, shape, color and structural features of red blood cells can provide clues to underlying hematological conditions.
The document discusses different staining techniques used in hematology to differentiate blood cells. It describes routine stains like Leishman, Giemsa, Wright, and Jenner stains which use combinations of basic and acidic dyes to stain cell nuclei and cytoplasm. Proper preparation of thin and thick blood films, including fixation in methanol, is outlined. The principles, procedures, and interpretations of common Romanowsky stains are explained in detail.
The document discusses various routine and special stains used in hematology. Routine stains like Leishman, Giemsa, and Wright stains are used to stain peripheral blood films and differentiate blood cells. Special stains require additional processing but can identify characteristics not seen with routine stains, such as periodic acid Schiff stain which detects carbohydrates like glycogen by oxidizing glycol groups and producing a red reaction. Proper staining techniques such as fixation, washing, and timing are important for preparing clear blood smears and accurately identifying blood components.
How to make a blood smear, including all steps: Preparation, fixation and staining. Veterinary clinical Examination for small and large animals. Methanol - Fixation. Additionaly basic information about blood.
The blood smear document defines a blood smear, outlines its uses in diagnosing conditions like anemia and infections, and provides detailed instructions on preparing, staining, examining, and interpreting a blood smear slide. A well-prepared blood smear shows red and white blood cells with normal morphology, and is examined under microscopy to check for abnormalities and identify blood parasites or immature cells that can indicate conditions like infection or leukemia.
This document discusses total leukocyte count and differential counting. It describes the types of white blood cells including granulocytes (neutrophils, eosinophils, basophils) and agranulocytes (lymphocytes, monocytes). The procedure for a total leukocyte count involves diluting a blood sample and counting cells under a microscope. A differential count identifies percentages of each type of white blood cell by examining stained blood smears under oil immersion lens. Normal ranges and abnormal findings are also outlined.
This document provides information on preparing, fixing, and staining blood smears or peripheral blood films. It describes how to make thin and thick blood films using different methods like the slide, cover glass, and spin methods. Films need to be fixed using methanol to preserve cell morphology before staining. Various Romanowsky stains are commonly used like Leishman, Giemsa, Wright, Field, and Jenner stains. Proper staining techniques and precautions are outlined to produce high quality blood films for microscopic examination and identification of blood cells and parasites.
This document discusses a differential leucocyte count (DLC) test. It provides information on the types of white blood cells (WBCs), how a blood smear is prepared and stained, and how the different WBCs are identified and counted under a microscope. A DLC involves counting 100 WBCs and recording the percentages of neutrophils, lymphocytes, monocytes, eosinophils, and basophils present. Normal ranges for each cell type are provided. Eosinophilia, an elevated eosinophil count, and its physiological and pathological causes are also summarized.
This document provides information on preparing blood smears with different staining methods. It discusses preparing thin and thick blood smears using various techniques like the slide method, cover glass method, and spin method for thin smears. For thick smears, a large drop of blood is spread on the slide. Various staining methods are described like Leishman stain, Giemsa stain, Wright stain, and Field stain. Proper preparation, fixation in methanol or ethanol, and staining are required to visualize blood cells and parasites under the microscope. Reticulocyte staining is also briefly mentioned.
This document discusses platelets, including their structure, function, production, and methods for detection. Key points include:
- Platelets are non-nucleated blood cells that help form blood clots and repair damaged blood vessels.
- They are produced from megakaryocytes in the bone marrow and have an average lifespan of 10 days.
- Platelet functions include initiating blood clotting and wound healing through the release of chemical signals.
- Platelet counts can be measured using a hemocytometer to manually count platelets in a diluted blood sample under a microscope.
This document provides information on staining blood films and smears. It discusses the different types of stains used including Romanowsky stains like Leishman stain, Giemsa stain, Wright stain, and Field stain. Specimens should be collected in EDTA and smears prepared within an hour then fixed in methanol or ethanol to preserve cell morphology before staining. Romanowsky stains use methylene blue and eosin dyes to reveal subtle differences in cell structures and components.
This document provides information on how to perform an erythrocyte sedimentation rate (ESR) test. It begins by explaining that ESR measures the rate at which red blood cells sediment in one hour, and though nonspecific, an increased ESR can indicate infection, inflammation or malignancy. It then notes some limitations before describing the basic principles behind ESR, including how plasma proteins promote rouleaux formation and faster sedimentation. Finally, it states that the Westergren method is the preferred technique for determining ESR over the Wintrobe method.
This document provides information about preparing and examining peripheral blood smears. It discusses how to make a good blood smear by ensuring the smear is evenly spread and covers most of the slide. The document also describes staining blood smears using the Leishman's stain method and examining smears under a microscope. Key things to observe during examination include the different types of white blood cells, red blood cell morphology, and any abnormal findings. Performing a manual differential count involves identifying 100 white blood cells and categorizing them by type.
Reticulocyte stains are used to identify immature red blood cells (reticulocytes) by precipitating their residual RNA. A stain is prepared using new methylene blue and potassium oxalate or commercial stains can be purchased. Equal volumes of blood and stain are mixed and incubated before making blood films. Reticulocytes are identified and counted under a microscope by their blue aggregates or granules of precipitated RNA. Counts of reticulocytes are an indicator of bone marrow response to anemia. The percentage of reticulocytes correlates with the level of polychromatophilic erythrocytes seen on blood films.
A study on drug utilization evaluation of bronchodilators using DDD method
The abstract was published as a conference proceeding in a Newsletter after being presented as an e-posture and secured 2nd prize during the scientific proceedings of "National Conference on Health Economics and Outcomes Research (HEOR) to Enhance Decision Making for Global Health" held at Raghavendra Institute of Pharmaceutical Education and Research (RIPER)- Autonomous in association with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR)-India Andhra Pradesh Regional Chapter during 4th& 5th August 2023.
Nasir A. A study on drug utilization evaluation of bronchodilators using the DDD method. RIPER - PDIC Bulletin ISPOR India Andhra Pradesh Regional Chapter Newsletter [Internet]. 2023 Sep;11(51):14. Available from: www.riper.ac.in
stackconf 2024 | On-Prem is the new Black by AJ Jester
In a world where Cloud gives us the ease and flexibility to deploy and scale your apps we often overlook security and control. The fact that resources in the cloud are still shared, the hardware is shared, the network is shared, there is not much insight into the infrastructure unless the logs are exposed by the cloud provider. Even an air gap environment in the cloud is truly not air gapped, it’s a pseudo-private network. Moreover, the general trend in the industry is shifting towards cloud repatriation, it’s a fancy term for bringing your apps and services from cloud back to on-prem, like old school how things were run before the cloud was even a thing. This shift has caused what I call a knowledge gap where engineers are only familiar with interacting with infrastructure via APIs but not the hardware or networks their application runs on. In this talk I aim to demystify on-prem environments and more importantly show engineers how easy and smooth it is to repatriate data from cloud to an on-prem air gap environment.
Call India AmanTel allows you to call from any country in the world including India to the USA and Canada at the cheapest rate Limited offers new users some free minutes.
stackconf 2024 | Buzzing across the eBPF Landscape and into the Hive by Bill ...
The buzz around the Linux kernel technology eBPF is growing quickly and it can be hard to know where to start or how to keep up with this technology that is reshaping our infrastructure stack. In this talk, Bill will trace how he got into eBPF, explore some of the applications leveraging eBPF today, and teach others how to dive into the hive of activity around eBPF. People just beginning with eBPF will learn how eBPF makes it possible to have efficient networking, observability without instrumentation, effortless tracing, and real-time security (among other things) without needing your own kernel team. Those already familiar with eBPF will get an overview of the eBPF landscape and learn about many new and expanding eBPF applications that allow them to harness the power without needing to dive into the bytecode. The audience will walk away with an understanding of the buzz around eBPF and knowledge of new tools that may solve some of their problems in networking, observability, and security.
stackconf 2024 | Using European Open Source to build a Sovereign Multi-Cloud ...
The European Commission has clearly identified open source as a strategic tool for bringing some balance to an EU cloud market currently dominated by a handful of non-EU hyperscalers. Part of that commitment comes through a series of ambitious, multi-million EU projects like the SIMPL platform for Data Spaces and the multi-country “Important Project of Common European Interest on Next Generation Cloud Infrastructure and Services” (IPCEI-CIS). For the first time in the history of the European Union, it is the EU industry who will be leading large-scale open source projects aimed at building European strategic technologies. In this talk we will explain in detail how specific European open source technologies are being brought together as part of some of those projects to start building Sovereign Multi-Cloud solutions that ensure interoperability and digital sovereignty for European users while preventing vendor lock-in in the cloud market, opening up competition in the emerging 5G/edge.
In this presentation, I have shown major risks that are to face in a business investment. Also I have shown their classification and sources.
This information have taken from my text book -" Investment Analysis and Portfolio Management ~chapter 2 Investment~ " For complete this Presentation I used Figma and Canva.
My Role:
a. Student Final year - Accounting
b. Presentation Designer
Destyney Duhon embodies a singular blend of creativity, resilience, and purpose that defines modern entrepreneurial spirit. As a visionary at the intersection of artistry and innovation, Destyney fearlessly navigates uncharted waters, sculpting her journey with a profound commitment to authenticity and impact.This Brand exploration power point is a great example of her dedication to her craft.
A blood smear is a sample of blood that's spread on a glass slide which is treated with a special stain. In the past, all blood smears were examined under a microscope by laboratory professionals. Now automated digital systems may be used to help examine blood smears.
This document provides information on examining a peripheral blood smear, including specimen collection, smear preparation, staining, and examination. It discusses collecting a blood sample in an EDTA tube to prevent clotting. For smear preparation, the wedge technique is described as the most common method used. Proper staining is also outlined, typically using Wright-Giemsa stain. Examination involves assessing smears under different magnifications to evaluate cell morphology and counts of red blood cells, white blood cells, and platelets.
This document provides information and instructions for making and examining a blood smear. There are three main types of blood smears: the cover glass smear, wedge smear, and spun smear. Additional types like the buffy coat smear are used for specific purposes. The document outlines the proper procedure for making a wedge smear from a blood sample and describes characteristics of a good smear. Common causes of a poor smear and biological factors that can affect the smear are also discussed. The document then covers slide fixation, staining using Leishman's stain, and examining the smear under the microscope to perform tasks like a manual differential count and assessing red blood cell morphology.
This document provides information about performing a peripheral blood smear examination, including the different types of blood smears, proper procedures for making blood smears, characteristics of a good smear, common causes of a poor smear, staining techniques, performing a manual differential count and assessing red blood cell morphology. Key steps include making wedge or spun smears from EDTA blood, allowing the smear to air dry before staining with Leishman's stain, examining under 10x, 40x and 100x magnification to perform white blood cell counts and differentials, and platelet and red blood cell morphology assessments. Causes of abnormal smears and signs of abnormal white blood cell morphology are also outlined.
Peripheral blood smear examination plays an important role in the evaluation of various blood disorders. A good peripheral smear should be prepared using the wedge or coverslip technique to obtain an even distribution of red blood cells. The smear is then stained using the Romanowsky method which involves fixing the cells using methanol followed by staining with Giemsa stain. During examination, red blood cells, white blood cells, platelets and any abnormal cells or inclusions are evaluated under the microscope. Changes in the size, shape, color and structural features of red blood cells can provide clues to underlying hematological conditions.
The document discusses different staining techniques used in hematology to differentiate blood cells. It describes routine stains like Leishman, Giemsa, Wright, and Jenner stains which use combinations of basic and acidic dyes to stain cell nuclei and cytoplasm. Proper preparation of thin and thick blood films, including fixation in methanol, is outlined. The principles, procedures, and interpretations of common Romanowsky stains are explained in detail.
special and routine stains in haematology 1Dr.SHAHID Raza
The document discusses various routine and special stains used in hematology. Routine stains like Leishman, Giemsa, and Wright stains are used to stain peripheral blood films and differentiate blood cells. Special stains require additional processing but can identify characteristics not seen with routine stains, such as periodic acid Schiff stain which detects carbohydrates like glycogen by oxidizing glycol groups and producing a red reaction. Proper staining techniques such as fixation, washing, and timing are important for preparing clear blood smears and accurately identifying blood components.
Blood smear preparation, fixation, staining. Veterinary Clinical Examination ...Gansbaai SA
How to make a blood smear, including all steps: Preparation, fixation and staining. Veterinary clinical Examination for small and large animals. Methanol - Fixation. Additionaly basic information about blood.
The blood smear document defines a blood smear, outlines its uses in diagnosing conditions like anemia and infections, and provides detailed instructions on preparing, staining, examining, and interpreting a blood smear slide. A well-prepared blood smear shows red and white blood cells with normal morphology, and is examined under microscopy to check for abnormalities and identify blood parasites or immature cells that can indicate conditions like infection or leukemia.
This document discusses total leukocyte count and differential counting. It describes the types of white blood cells including granulocytes (neutrophils, eosinophils, basophils) and agranulocytes (lymphocytes, monocytes). The procedure for a total leukocyte count involves diluting a blood sample and counting cells under a microscope. A differential count identifies percentages of each type of white blood cell by examining stained blood smears under oil immersion lens. Normal ranges and abnormal findings are also outlined.
This document provides information on preparing, fixing, and staining blood smears or peripheral blood films. It describes how to make thin and thick blood films using different methods like the slide, cover glass, and spin methods. Films need to be fixed using methanol to preserve cell morphology before staining. Various Romanowsky stains are commonly used like Leishman, Giemsa, Wright, Field, and Jenner stains. Proper staining techniques and precautions are outlined to produce high quality blood films for microscopic examination and identification of blood cells and parasites.
Differential leucocyte count & eosinophiliasandeep singh
This document discusses a differential leucocyte count (DLC) test. It provides information on the types of white blood cells (WBCs), how a blood smear is prepared and stained, and how the different WBCs are identified and counted under a microscope. A DLC involves counting 100 WBCs and recording the percentages of neutrophils, lymphocytes, monocytes, eosinophils, and basophils present. Normal ranges for each cell type are provided. Eosinophilia, an elevated eosinophil count, and its physiological and pathological causes are also summarized.
This document provides information on preparing blood smears with different staining methods. It discusses preparing thin and thick blood smears using various techniques like the slide method, cover glass method, and spin method for thin smears. For thick smears, a large drop of blood is spread on the slide. Various staining methods are described like Leishman stain, Giemsa stain, Wright stain, and Field stain. Proper preparation, fixation in methanol or ethanol, and staining are required to visualize blood cells and parasites under the microscope. Reticulocyte staining is also briefly mentioned.
This document discusses platelets, including their structure, function, production, and methods for detection. Key points include:
- Platelets are non-nucleated blood cells that help form blood clots and repair damaged blood vessels.
- They are produced from megakaryocytes in the bone marrow and have an average lifespan of 10 days.
- Platelet functions include initiating blood clotting and wound healing through the release of chemical signals.
- Platelet counts can be measured using a hemocytometer to manually count platelets in a diluted blood sample under a microscope.
This document provides information on staining blood films and smears. It discusses the different types of stains used including Romanowsky stains like Leishman stain, Giemsa stain, Wright stain, and Field stain. Specimens should be collected in EDTA and smears prepared within an hour then fixed in methanol or ethanol to preserve cell morphology before staining. Romanowsky stains use methylene blue and eosin dyes to reveal subtle differences in cell structures and components.
This document provides information on how to perform an erythrocyte sedimentation rate (ESR) test. It begins by explaining that ESR measures the rate at which red blood cells sediment in one hour, and though nonspecific, an increased ESR can indicate infection, inflammation or malignancy. It then notes some limitations before describing the basic principles behind ESR, including how plasma proteins promote rouleaux formation and faster sedimentation. Finally, it states that the Westergren method is the preferred technique for determining ESR over the Wintrobe method.
This document provides information about preparing and examining peripheral blood smears. It discusses how to make a good blood smear by ensuring the smear is evenly spread and covers most of the slide. The document also describes staining blood smears using the Leishman's stain method and examining smears under a microscope. Key things to observe during examination include the different types of white blood cells, red blood cell morphology, and any abnormal findings. Performing a manual differential count involves identifying 100 white blood cells and categorizing them by type.
Reticulocyte stains are used to identify immature red blood cells (reticulocytes) by precipitating their residual RNA. A stain is prepared using new methylene blue and potassium oxalate or commercial stains can be purchased. Equal volumes of blood and stain are mixed and incubated before making blood films. Reticulocytes are identified and counted under a microscope by their blue aggregates or granules of precipitated RNA. Counts of reticulocytes are an indicator of bone marrow response to anemia. The percentage of reticulocytes correlates with the level of polychromatophilic erythrocytes seen on blood films.
Similar to Peripheral Smear technique and reporting (20)
A study on drug utilization evaluation of bronchodilators using DDD methodDr. Afreen Nasir
The abstract was published as a conference proceeding in a Newsletter after being presented as an e-posture and secured 2nd prize during the scientific proceedings of "National Conference on Health Economics and Outcomes Research (HEOR) to Enhance Decision Making for Global Health" held at Raghavendra Institute of Pharmaceutical Education and Research (RIPER)- Autonomous in association with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR)-India Andhra Pradesh Regional Chapter during 4th& 5th August 2023.
Nasir A. A study on drug utilization evaluation of bronchodilators using the DDD method. RIPER - PDIC Bulletin ISPOR India Andhra Pradesh Regional Chapter Newsletter [Internet]. 2023 Sep;11(51):14. Available from: www.riper.ac.in
stackconf 2024 | On-Prem is the new Black by AJ JesterNETWAYS
In a world where Cloud gives us the ease and flexibility to deploy and scale your apps we often overlook security and control. The fact that resources in the cloud are still shared, the hardware is shared, the network is shared, there is not much insight into the infrastructure unless the logs are exposed by the cloud provider. Even an air gap environment in the cloud is truly not air gapped, it’s a pseudo-private network. Moreover, the general trend in the industry is shifting towards cloud repatriation, it’s a fancy term for bringing your apps and services from cloud back to on-prem, like old school how things were run before the cloud was even a thing. This shift has caused what I call a knowledge gap where engineers are only familiar with interacting with infrastructure via APIs but not the hardware or networks their application runs on. In this talk I aim to demystify on-prem environments and more importantly show engineers how easy and smooth it is to repatriate data from cloud to an on-prem air gap environment.
Call India AmanTel allows you to call from any country in the world including India to the USA and Canada at the cheapest rate Limited offers new users some free minutes.
stackconf 2024 | Buzzing across the eBPF Landscape and into the Hive by Bill ...NETWAYS
The buzz around the Linux kernel technology eBPF is growing quickly and it can be hard to know where to start or how to keep up with this technology that is reshaping our infrastructure stack. In this talk, Bill will trace how he got into eBPF, explore some of the applications leveraging eBPF today, and teach others how to dive into the hive of activity around eBPF. People just beginning with eBPF will learn how eBPF makes it possible to have efficient networking, observability without instrumentation, effortless tracing, and real-time security (among other things) without needing your own kernel team. Those already familiar with eBPF will get an overview of the eBPF landscape and learn about many new and expanding eBPF applications that allow them to harness the power without needing to dive into the bytecode. The audience will walk away with an understanding of the buzz around eBPF and knowledge of new tools that may solve some of their problems in networking, observability, and security.
stackconf 2024 | Using European Open Source to build a Sovereign Multi-Cloud ...NETWAYS
The European Commission has clearly identified open source as a strategic tool for bringing some balance to an EU cloud market currently dominated by a handful of non-EU hyperscalers. Part of that commitment comes through a series of ambitious, multi-million EU projects like the SIMPL platform for Data Spaces and the multi-country “Important Project of Common European Interest on Next Generation Cloud Infrastructure and Services” (IPCEI-CIS). For the first time in the history of the European Union, it is the EU industry who will be leading large-scale open source projects aimed at building European strategic technologies. In this talk we will explain in detail how specific European open source technologies are being brought together as part of some of those projects to start building Sovereign Multi-Cloud solutions that ensure interoperability and digital sovereignty for European users while preventing vendor lock-in in the cloud market, opening up competition in the emerging 5G/edge.
Risks & Business Risks Reduce - investment.pdfHome
In this presentation, I have shown major risks that are to face in a business investment. Also I have shown their classification and sources.
This information have taken from my text book -" Investment Analysis and Portfolio Management ~chapter 2 Investment~ " For complete this Presentation I used Figma and Canva.
My Role:
a. Student Final year - Accounting
b. Presentation Designer
Destyney Duhon personal brand explorationminxxmaree
Destyney Duhon embodies a singular blend of creativity, resilience, and purpose that defines modern entrepreneurial spirit. As a visionary at the intersection of artistry and innovation, Destyney fearlessly navigates uncharted waters, sculpting her journey with a profound commitment to authenticity and impact.This Brand exploration power point is a great example of her dedication to her craft.
3. Venipuncture
◦ Should be collected in an EDTA (disodium or tripotassium
ethylene diamine tetra-acetic acid) tube
◦ Chelates calcium.
◦ 1.2 mg anhydrous EDTA salt/ml of blood used.
◦ EDTA effect
5. Wedge method
Cover glass method
Spinner method
Specific methods
Buffy coat smear for WBC < 1.0 x10^9/L
Thick blood smear for blood parasites
6. A. Hold spreader slide at correct
angle
B. Blood spread across width of
slide
C. Completed wedge smear
7. WEDGE METHOD
Place a drop of blood in the centre of a clean
glass slide 1cm away from the end.
Place the spreader in front of the drop at an
angle of 30 degrees to the slide and move it
back to make contact with the drop.
The drop should spread quickly along the line
of contact, with a steady movement of the
hand spread the drop of blood along the
slide.
Smear should be 3 cm in length,
smooth,tongue shaped.
Air dry and stain.
8. COVER GLASS METHOD
Take 22 mm clean cover glass,touch it on drop
of blood and place it on another cover glass in
cross wise direction with slide containing drop
of blood facing down.
9. SPINNER METHOD
Automated method-place a drop of blood
in the centre of the glass slide and spin at a
high speed in a centrifuge cytospin.
Blood spread uniformly, dry it and stain.
10. Does not cover the entire area of
slide.
Should be tongue shaped, ie broad
at starting point (head.) & taper
towards end.
Has both thick and thin areas with
gradual transition.
Does not contain any lines or
holes. Smooth margins.
Tail
Head
11. Labelling of PS-
The film should be labelled immediately after
spreading with lab reference number or the
patients name.
Fixing-
To preserve the morphology of cells ,films must
be fixed without delay.
Take methanol in a coplin jar ,give 4 to 6 dip to
the smear in methanol and air dry.
Methanol is used as a fixative & must be free from water.
Methanol precipitates the plasma proteins, which then acts
as a glue to fix the cells to the slide.
12. Romanowsky stains –
Differentially stain the blood cell components on the basis
of their pH.
Standardized stain is composed of:
Azure B-trimethylthionine-cationic dye
Eosin Y-tetrabromofluoroscein-anionic dye
Polychrome methylene blue and eosin are the outgrowths
of the original method.
Methylene blue and azure B are basic dyes that stains
acidic components of the cell like nucleic acids, granules
of basophil.
The eosin is acidic or anionic dye that stain basic
components like hemoglobin & granules of eosinophils .
13. Stains include-
AzureB EosinY stain-highly purified standard.
May-Grunwald-Giemsa stain(used in Europe)
Wright’s stain(used in N. America)
Leishman’s stain
Field stain( Rapid)- used in our department.
Giemsa stain
JSB stain- for malarial parasite
Automated stains
14. MAY-GRUNWALD-GIEMSA METHOD
1. Air dry slides.
2. Fix in Methanol for 2-3 minutes at room temperature.
3. Stain for 15 mins in May-Grunwald stain freshly
diluted with an equal volume of buffered distilled
water, pH=6.8
4. Stain for 10 minutes in Giemsa stain freshly diluted
with buffered distilled water, pH=6.8 (1/9)
5. Wash in running tap-water and then leave for 3-4
minutes in buffered distilled water, pH 6.8
15. It consists of methylene blue and eosin dissolved in absolute
methyl alcohol.
Weigh 0.2 gm of powdered dye in conical flask & add 100 ml
methanol & warm the mixture to 50C for 15 min. Allow to
cool & filter.
METHOD:
1.Air dry the film & flood the slide with stain for 2 min.
2.Add double volume of water & stain the film for 5-7 min.
3.Wash in a stream of buffered water & dry it.
LEISHMAN METHOD
17. RAPID STAINING METHOD: Field’s
method
(45 sec)
Tap
water
(3 sec)
(1 min 15 sec)
Wash gently to
remove excess stain,
under tap water. Drain
and dry.
Methanol Eosin
Polychromed
methylene
blue
18. Cell Component Staining Colour
Chromatin(including Howell-
Jolly body)
Purple
Promyelocyte granules & Auer
rods
Purplish-red
Cytoplasm of lymphocytes Blue
Cytoplasm of monocytes Blue-grey
Cytoplasm rich in RNA(i.e.
Basophilic cytoplasm)
Deep blue
Dohle bodies Blue-grey
Specific granules of neutrophils,
granules of lymphocytes,
granulomere of platelets
Light purple or pink
Specific granules of basophils Deep purple
Specific granules of eosinophils Orange
Red cells Pink
STAINING FEATURES OF CELL COMPONENTS WITH ROMANOWSKY STAIN
20. OPTIMAL ASSESSMENT AREA
TOO THICK
TOO
THIN
1. RBCs are uniformly and singly
distributed
2. Few RBC are touching or overlapping
3. Normal biconcave appearance
21. 1.Assess the overall quality of the smear.
2.Find an area where red cells are evenly distributed and not
distorted.
3.Check to see if there are good counting areas available free
of ragged edges and cell clumps.
4.Check the number,distribution and staining of leukocytes.
5.Assess whether red cell agglutination, platelet aggregation
or fibrin strands are present.
22. WBC estimation
•Choose a portion of the peripheral smear where there
is only slight overlapping of the RBCs.
•Count 10 fields, take the total number of white cells
and divide by 10.
•To do a WBC estimate by taking the average number
of white cells and multiplying by 2000.
•WBC:RBC::1:500 (normal leucocrit approx.)
24. Reporting results
•Absolute number of cells/µl = % of cell type in
differential x white cell count
•If 10 or more nucleated RBC's (nRBC) are seen, correct
the leucocyte Count using this formula:
Corrected WBC Count =
WBC x 100/( nRBC + 100)
B) Platelet estimation
26. RBC distribution
Morphology
◦ Colour
◦ Size
◦ Shape
◦ Structure
◦ Inclusions
◦ Young rbcs
27. CAUSE RESULTANT ABNORMALITY
Abnormal Erythropoeisis-
Effective/Ineffective
Anisopoikilicytosis,Basophilic
stippling,dimorphism(sometime
s)
Inadequate Hb synthesis Hypochromia/Anisochromia/
Dimorphism
Damage to normal cells after
leaving bone marrow/
Hyposplenism/Splenectomy
Poikilocytosis- Specific/Non
specific;
Red cell inclusions
Compensatory increased
erythropoeisis by bone marrow
Less mature cell release:
Polychromasia,Erythroblastemia
MECHANISM OF RBC ABNORMALITY &
RESULTANT FEATURES
33. B) ANISOCHROMASIA- Increased variation in degree of
haemoglobinization of RBC
Seen in development/resolution of iron
deficiency anaemia; anaemia of chronic disease
34. C) DIMORPHIC CELL
POPULATION
•Seen after
response to iron
therapy in iron
deficiency
anemia;
• macrocytic
anemia post
blood
transfusion;
• sideroblastic
anaemia;
•Post stem cell
transplantation
35. DAMAGE TO RED CELLS AFTER RELEASE FROM
MARROW
A) HYPERCHROMASIA
In presence
of
macrocytes
Abnormally
round cells
Seen in:
36. B) SPHEROCYTOSIS
CAUSES
•Warm autoimmune hemolytic
anaemia
•ABO hemolytic disease of
newborn/Rh hemolytic disease
of newborn
•Cold autoimmune hemolytic
anemia/paroxysmal cold
hemoglobinuria
•Hereditary Spherocytosis
•Clostridium sepsis
•IV water infusion or fresh
water drowning
•Bartonellosis
•Snake bite
•Hyposplenism
•Hypophosphatemia
•Rh-null phenotype
37. ELLIPTOCYTOSIS and OVALOCYTOSIS
Large number of elliptocytes
Hereditary Elliptocytosis
Small number of elliptocytes
•Iron deficiency
•Thalassemia trait and major
•Megaloblastic anaemia
•Myelodysplastic syndrome
•Myelofibrosis
39. D)SPICULATED CELLS and RED CELL FRAGMENTATION
SCHISTOCYTE
ECHINOCYTE
ACANTHOCYT
E
KERATOCYT
E
On basis of electron
microscopy [ Bessis]
SCHISTOCYTE
41. CAUSES
•Artifact
•Uremia and chronic
renal disease
•Hypophosphatemia
•Disseminated
malignancy
•Liver disease
•Vitamin E deficiency
•Pyruvate kinase
deficiency
•Phosphoglycerate
kinase deficiency
•Early post transfusion
of RBC
•Hyperlipidemia
•Myeloproliferative
disorders
ECHINOCYTE
42. ACANTHOCYTES
Large numbers of acanthocytes
•Advanced liver disease
•Spur cell hemolytic anaemia
•Abetalipoproteinemia
•Hypobetalipoproteinemia, homozygous
•McLeod phenotype
•In(Lu phenotype)
•Choreoacanthycytosis
Small numbers of acanthocytes
•Post splenectomy
•Hypothyroidism
•Panhypopituitarism
•Vitamin E deficiency
•Malnutrition
•Thalassemia
•Iron deficiency
•Psoriasis
50. Howell Jolly body DNA
Basophilic Stippling RNA
Pappenheimer body Iron containing inclusions
Heinz body Denatured Haemoglobin
Hb H disease beta-globin tetramer
Fessus body Alpha-globin tetramer
Crystal Hb C
Cabot Ring Mitotic Spindle
RED CELL INCLUSIONS CONTENT
51. ROULEAUX and AUTOAGGLUTINATION
ROULEAUX- due to-
Increased plasma proteins
(polyclonal or other proteins)
•Inflammatory state
•Infection
Increased plasma proteins
(monoclonal)
•MGUS
•Myeloma
•Amyloidosis
•Lymphoma
RED BLOOD CELL
AGGLUTINATION
•Cold agglutinins
•Cold autoimmune hemolytic
anaemia
•Paroxysmal cold hemoglobinuria
•Ig M paraproteinemia
54. RETICULOCYTOSIS
o They are juvenile red cells containing remnants of
ribosomal ribonucleic acid.
o They react with a basic dye to form a blue or purple
precipitate of granule or filaments.
o This reaction needs supravital staining and unfixed
preparation.
o Dye used-brilliant brilliant cresyl blue, new
methylene blue, azure B.
o Normal count—in adults and children-0.5%-2.0%.
o In infants(cordblood)-2%-5%
60. B. Toxic Neutrophilia with toxic
vacuolation
A. Toxic granulation
IN SEVERE SEPSIS~
Azurophilic
cytoplasmic granules
seen in severe infections,
other toxic and reactive
conditions
Seen in infections,
indicating phagocytosis
66. F. Pyknotic neutrophils : Undergoing apoptosis.
◦ May normally be found in infection.
◦ Cells have round, dense, featureless nuclei and
cytoplasm is dark pink.
69. Myeloblast :
◦ Large cell 10-18um.
◦ Round oval nucleus
occupying most cell
area.
-- Nucleoli are typically
prominent (2-5)
-- Deep blue scanty
cytoplasm no
granules.
70. Promyelocyte
Slightly larger 12-20um
Shares same features with
myeloblast .
Less prominent nucleoli.
Cytoplasm contains blue purple
primary azurophilic granules.
Myelocyte :
Size 12-18 um
Nucleus is oval or slightly
indented, fine chromatin.
No nucleoli are seen or very rare.
Cytoplasmic granules now acquire
specific characters. Both primary
and secondary granules seen.
71. Metamyelocyte :
◦ Size 10-18m
◦ Indentation less than ½ diameter
of nucleus
◦ Condensed chromatin.No
nucleoli.
◦ Cytoplasm is abundant with
secondary granules only.
Band cells :
◦ 10-16 micron.
◦ Indentation more than ½ diameter
of nucleus.
◦ Cytoplasm is abundant with
secondary granules only.
73. SMALL LYMPHOCYTES
•Size-6-10 microns
•High nucleocytoplasmic
ratio
•Scant amount of
slightly basophilic
cytoplasm.
•Smooth contour with
mature “closed”
chromatin and absent
nucleoli.
74. LARGE LYMPHOCYTE
•Size- 12-15 micron
•Moderate nuclear-
cytoplasmic ratio
•Oval nucleus
•Slightly open
chromatin
•Pale cytoplasm
•About 1/3rd may
contain azurophilic
granules; larger than
neutrophilic
granules
75. NORMAL
CLL
ALL L1 type of
lymphoblast
shown here
usually has a high
nuclear:cytoplasmi
c (N:C) ratio with
an immature or
“open”
chromatin
CLL cells appear as slightly
larger versions of normal
small lymphocytes.
CLL cells can display
clumped or “soccer ball”
chromatin.
Small lymphocyte
77. ‘TURK CELL’; IMMUNOBLAST
•10-15 um size.
•Round nucleus,
abundant deeply
basophilic cytoplasm
•Seen in severe
bacterial and viral
infection
78. PLASMA CELL
•Larger than small
lymphocyte
•Oval in shape with
eccentric round nucleus
with clumped nuclear
chromatin.
•Moderate amount of
basophilic cytoplasm with
prominent nuclear hof
Plasma cell
79. MATURE MONOCYTE
•Size : 14-20 um
•Irregular, lobulated
nucleus
•Has the most delicate
nuclear chromatin
pattern.
• Abundant light gray
cytoplasm with fine
granularity and
vacuolation seen
Deeply indented
nucleus
80. Figure 33-24 Promonocyte (center) shows immature
chromatin and finely convoluted nuclear folds in
comparison with monoblasts.
83. ◦ Normal platelets are 2-4 um in diameter.
◦ Irregular outline with fine red granules .
◦ Normal peripheral count 1.0 -5 lac/mm3
◦ Remain viable in circulation for 10 days.
◦ Large Platelets seen in–hyposplenism, Bernard-Soulier
syndrome, May-Hegglin anomaly.
86. 1. MALARIA PARASITE :Plasmodium
◦ Blood is collected at or just after the height of a
febrile paroxysm.
◦ One thick & one thin smear should be prepared .
◦ Procedure-Take a large of drop of blood in the
centre of a clean glass slide & spread it in an area
of 1.5 cm with a slide.
◦ Dry and stain by any Romanowsky combination.
Leishman, Giemsa method are suitable.
In P. falciparum often only early trophozoite (ring
form) +/- gametocytes are found.
In P. vivax, all stages of life cycle usually present.
88. 2.MICROFILARIA:W.bancrofti
Blood is collected at midnight
between 10 p.m.-4a.m.
Blood concentration of
microfilaria is higher in capillary
blood than in venous blood.
Morphology:
When stained with
Romanowsky stain:
•A hyaline sheath seen
projecting beyond the
body.
•Nuclei appear as granules
in central axis of body
extend from head to tail,
but not to the tip of tail.
89. 3.TRYPANOSOMA
BRUCEI
(African sleeping sickness)
Trypomastigotes can be found
in peripheral blood,lymph node
aspirate and CSF.
When stained with Leishman
stain, cytoplasm & the
undulating membrane appear
pale blue and the nucleus
reddish purple or red.
Kinetoplast & flagellum dark
red.
90. 4. TRYPANOSOMA CRUZI
– (Chagas disease)
Two forms are found
a. Trypomastigote form can only
be found in blood in acute form
of Chagas disease.
b. Amastigote form (in striated
muscles)
Trypomastigote form appear as
C or U shaped.
91. 5. LEISHMANIA DONOVANI
◦ Diagnosed by direct visualization of
amastigote (LD bodies)
◦ Causes kala azar .
◦ In aspirate smears amastigote forms
are seen in groups inside
macrophages or lying free between
the cells.
◦ In buffy coat smears they are seen
within monocytes or neutrophils in
peripheral blood.
◦ Small round bodies 2-4 micron in
diameter, indistinct cytoplasm, a
nucleus, a small rod shaped
kinetoplast .
92. Red Blood Cells, Examine for :
1.Size and shape ( Anisocytosis, Poikilocytosis)
2.Relative hemoglobin content.
3.Polychromatophilia.
4.Inclusions.
5. Rouleaux formation or agglutination
White Blood Cells
1.Check for even distribution and estimate the number present (also, look for any
gross abnormalities present on the smear).
2.Perform the differential count.
3.Examine for morphologic abnormalities and immature cells.
Platelets.
1.Estimate number present.
2. Examine for morphologic abnormalities, aggregates.
Comment on any haemoparasites, if present.