Full Blood Count

ALTERNATE NAMES:

  • FBC – full blood count; FBE – full blood examination; FBP – full blood picture
  • CBC – complete blood count; CBE – complete blood examination; CBP – complete blood picture

RED BLOOD CELLS:

ANAEMIA

  • Decreased production – nutritional deficiencies/malabsorption, marrow failure, low level of hormones (EPO, thyroid hormones)
  • Increased production – haemolytic anaemia (congenital/acquired)
  • Bleeding
  • Haemodilution

MCV = mean cell volume

Anaemia with low MCV – microcytosis

  • Fe deficiency
  • thalassaemia
  • sideroblastic anaemia

Anaemia with high MCV – macrocytosis

  • folate or B12 deficiency
  • alcohol abuse
  • chronic liver disease
  • hypothyroidism
  • reticulocytosis
  • myelodysplasia

Anaemia with normal MCV

  • chronic disease
  • chronic renal failure
  • pregnancy
  • haemolysis
  • bone marrow failure
  • mixed haematinic deficiency (Fe, B12)

Macrocytosis

  • alcohol
  • B12 deficiency
  • folate deficiency
  • myelodysplastic syndrome
  • therapy with cytotoxics or immunosuppressants
  • hypothyroidism

POLYCYTHAEMIA (Hb > 160g/L)

Relative (reduced plasma volume)

  • burns
  • severe dehydration

Absolute

  • polycythaemia ruba vera
  • myeloproliferative disorders
  • chronic hypoxia (OSA, Eisenmenger)

RETICULOCYTOSIS

  • acute blood loss
  • any cause of premature RBC destruction

WHITE BLOOD CELLS:

NEUTROPHILIA

  • stress
  • sepsis
  • leukemoid reactions
  • corticosteroids
  • malignancy
  • vasculitis

NEUTROPAENIA

  • infection
  • cytotoxic agents
  • idiosyncratic drug reactions (clozapine, carbimazole, sulphonamides, beta-lactams)

LYMPHOPAENIA

  • simple stress response
  • prior corticosteroid therapy
  • autoimmune disease (SLE)
  • infection: viral, severe sepsis, Tb, brucelliosis, histoplasmosis, HIV, CVM
  • cytotoxic drugs
  • radiation

LYMPHOCYTOSIS

  • infection: viral, Tb, toxoplasmosis, syphilis
  • thyrotoxicosis
  • leukaemia
  • lymphoma

ATYPICAL LYMPHOCYTES

  • viral infections: EBV, CMV, HIV
  • toxoplasmosis
  • leukaemia
  • lymphoma
  • lead poisoning
  • drug hypersensitivity

MONOCYTOSIS

  • Tb
  • leukaemia
  • lymphoma
  • myelodysplasia
  • IBD
  • convalescence from any infection

EOSINOPHILIA

  • allergy
  • Addisons
  • parasitic infections
  • sarcoidosis
  • polyarteritis nodosa
  • leukaemia
  • lymphoma
  • melanoma
  • irradiation
  • convalescence from any infection

BASOPHILIA

  • infection: viral, Tb
  • hypothyroidism
  • IBD
  • polysplenectomy
  • leukaemia
  • systemic mastocytosis
  • haemolysis
  • polycythaemia ruba vera

PANCYTOPAENIA

Reduced Marrow Production

  • replacement of marrow (malignant cells)
  • idiosyncratic Drug Reaction (chloramphenicol, sulphonamides, phenytoin, carbamazepine, gold)
  • megaloblastic haematopoiesis (B12 deficiency)
  • autoantibodies (SLE)
  • myelofibrosis
  • myelodysplasia
  • toxins (benzene)
  • cytotoxic agents
  • overwhelming infections

Increased Peripheral Cellular Destruction

  • SLE
  • HIV infection
  • hypersplenism
  • paroxysmal nocturnal haemoglobinuria

THROMBOCYTOPAENIA

Pseudothrombocytopaenia

  • -> film
  • -> blue tube

Decreased Production

  • bone marrow failure
  • pernicious anaemia

Increased Destruction

  • sepsis
  • immune (ITP, TTP, HUS, HITTS)
  • intravascular device (IABP, ECMO, PAC, bypass)
  • drug induced (antibiotics, thiazides, H2 antagonists)
  • antiphospholipid syndrome
  • DIC
  • HELLP
  • haemolysis

Dilution

  • post resuscitation
  • massive transfusion

CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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