Transcription
Hey guys, thank you so much for watching. Thank you for everybody who supports me. Thank you for your comments. Lots of people are writing to me that my lectures are helping them with their studies, so thumbs up to you. Thank you so much. Now we will start talking about leukemias and lymphomas, your most requested topics ever. So I'm very interested in starting, but first I would like to tell you these videos take a lot of time preparing. So if you'd like to support these videos, go to my Patreon page, WWBT on comm forward slash medic OSes, and support me. Just one dollar a month is all what I'm asking, and for this you will get access to other notes on Patreon that are not available on YouTube, and you will get early access to all of my future videos before everybody else. So that's cool. Again, thank you so much in advance.
Now let's start talking about leukemias and lymphomas, but first we need to talk about the complete blood count. As you know, hematology is a lab field. If you don't know how to read labs, don't go into hematology, for heaven's sake; you will hate yourself. But the good news is you can learn to read labs; they are so easy. One of the most routinely requested lab tests is the complete blood count, and if you live in the United States of America or Canada, whenever you go to the doctor, they order a complete blood count even before saying good morning to you. Okay, in the future maybe you have CBC and colonoscopy as a routine, so you get a scope every time you go in. That's how common colon cancer is becoming, or colon disease in general, because we eat a lot of meat.
Anyways, let's get started. So complete blood count looks at all of your blood cells. Here we have your red blood cells, platelets—these are not cells, okay—platelets are fragments of the cytoplasm of the glorious parent called megakaryocytes. Here are your white blood cells. Here we have the neutrophil with the segmented nucleus; here we have the eosinophil—it looks like headphones; here you have basophil with its basophilic granules; here we have the monocyte, which looks like a magnet—horseshoe magnet—so horseshoe magnet monocyte; and here is your lymphocyte—the nucleus is very widespread; there is a little rim of cytoplasm left—and this is your lymphocyte. So again, neutrophil is neutral; basophil has basophilic granules; eosinophil has eosinophilic granules; and then you have monocytes and lymphocytes; those do not have granules. We call these granulocytes and these agranulocytes, or non-granulocytes, are the components of the complete blood count. Here is a nice fishbone drawing, okay, for you to remember. There is another fishbone for the basic metabolic panel BMP, but this is a completely different topic. So we are looking at red blood cells, white blood cells, platelets. Red blood cells by looking at hemoglobin and hematocrit; white blood cells here; and platelets here. Okay, this is just a summary. The real deal is like this: for the red blood cell, we need hemoglobin, hematocrit, RBC count—like the total red blood cell count—then we have RBC indices—again, we have talked about this in a previous video—such as mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration. Also, don't forget your red cell distribution width. Then let's look at platelets, and then let's look at white blood cells. We have the total white blood cell count, then we have neutrophils, lymphocytes, monocytes, eosinophils, and basophils. That's fine. Okay, now it's not routine; the doctor may order it or may not—peripheral blood smear to look at the morphology of your red blood cells, white blood cells, platelets, etc.
Since we have finished talking about anemia, let's make a quick review. Here is the Maltese Cross of the B thalassemia. This is RBC osis. Here is your immature large nucleated red blood cell. Here is your spherocyte—could be due to hemolysis or hereditary spherocytosis. Here is your target cell blast in thalassemia or lead poisoning. Here is the basophilic stippling of the red blood cell in lead poisoning. Here is an elliptocyte in hereditary elliptocytosis. Here are your stomatocytes—can be a sign of dehydration or hereditary stomatocytosis. Here are your acanthocytes in liver disease. Here are your acanthocytes in kidney disease. Here are your target cells—we see it in cases of hemoglobinopathies. Here are your schistocytes—helmet cell or fragmented cell—we see it in DIC, TTP, HUS, HELLP syndrome, as well as valve abnormalities such as calcified aortic valve or metallic valve replacement. Or this one, the last one is the tear drop cells. Why is the red blood cell crying? Because your bone marrow is fibrosis, or because your spleen is now useless—okay—called asplenia, such as cases of sickle-cell disease. That's it. It was a very quick review. Again, I've talked about all of these separately in their own videos; check my hematology playlist. Hey, this is just an introduction to know what a CBC is. In the next video, we will discuss your great white blood cells; indeed they are very important for your immune system. I'll see you in the next video. Stay happy; study hard.