Usually, platelets will also be checked with the CBC. The CBC tests for the amount of RBCs, hemoglobin, hematocrit, reticulocytes, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration. When blood oxygen is low, erythropoietin stimulates the bone marrow to produce more RBCs. Red blood cell production is regulated by erythropoietin, a hormone released by the kidneys. Cells of the blood include the erythrocytes, which are the red blood cells (RBC) the leukocytes, which are the WBC and the thrombocytes, also known as platelets.īlood cells are produced in the bone marrow by a process called hematopoiesis. The cells are the blood components that will be discussed in this review. Plasma makes up more than half of the total blood volume. The plasma consists of water, plasma proteins (a few of which are serum albumin and globulin and fibrinogen), and other constituents. Plasma is the liquid part of the blood in which the formed cells are suspended. Most of us are well acquainted with hemoglobin, hematocrit and white blood cells (WBC), but perhaps the rest of those numbers are insignificant to the particular patient being tested … or are they? What is the meaning of those other components of the CBC and diff? Blood Componentsīlood is made of two major components-plasma and cells. If you don’t use it you lose it! That aptly applies to interpreting the complete blood count (CBC) and differential (diff). He is complaining of non-specific abdominal pain.Hemoglobin, hematocrit and WBC are just the beginning–don’t overlook erythrocytes, leukocytes and thrombocytes for important assessment data. In severe cases (plasma concentrations >700mg/l)Ī normally fit and well 11 year-old boy presents with diarrhoea and vomiting.Acidosis increases salicylate transfer across the blood brain barrier Additional boluses of bicarbonate to maintain alkalinisation.Bicarbonate will increase any pre-existing hypokalaemia – so don’t let it happen.Ensure urine pH over 7.5 (use indicator paper).Give 225ml of 8.4% bicarbonate solution over 1hr.In mild/moderate cases (plasma concentration 500-700mg/l).Gastric lavage within 1h of ingestion (although no evidence for mortality reduction).If dropping sats or any suspicion of ARDS (non-cardiogenic pulmonary oedema).Renal failure (rare) sometimes other electrolyte imbalances.Paracetamol levels (always check in any case of poisoning by anything).Plasma salicylate concentration (initial and repeats).From the kidneys ( renal tubular acidosis)Ī 67 year-old man with a history of peptic ulcer disease presents with persistent vomiting.From the GI tract (diarrhoea or high-output stoma).DKA, lactic acidosis (produced by poorly perfused tissues).However, another way is to think about the mechanism of acidosis: Diabetic ketoacidosis (and alcoholic/starvation ketoacidosis).The traditional mnemonic for the causes of a metabolic acidosis with raised anion gap is ‘MUDPILES’: Question 2.Ī 75 year old gentleman living in the community is being assessed for home oxygen. See relevant pages in the respiratory section for further information. Pulmonary oedema: Sit patient up, furosemide, consider catheter.Asthma: Salbutamol, ipatropium and steroid in the first instance.Pneumonia: Antibiotics for hospital acquired pneumonia.Remember this patient is post-op so it is a complex decision. PE: Heparinisation or thrombolysis if unstable.Raised JVP, ankle swelling, fine basal creps: more likely oedema.Pulmonary embolus will be the only condition that will likely be normal on auscultation. Pyrexia points more towards pneumonia (but PE can give a mild pyrexia). All of these conditions can may you tachypnoeic and tachycardic.Acutely unwell: ABCDE and call for help.
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