Title INTEGRATED SYSTEMS (1).pdf ✅

Pulse Medical Institute - Integrated Hematology - Target 175 By Dr KK - Dr Roundz MEGA REVISION PROGRAMME 270 • Proerythroblast→ early normoblast→ intermediate normoblast → late normoblast → reticulocyte → RBC. • Basophilic appears blue, polychromic normoblast will be both pinkish and bluish, and late normoblast is pinkish color (orthochromatic), • As we move along from proerythroblast largest cell), the cell size decreases and nuclear size also decreases. • At the stage of reticulocyte, the RBC has no nucleus Reticulocyte is the first cell which is non- nucleated and takes 1-2 days to mature into an RBC. • Hemoglobin production starts at the stage of proerythroblast and can only see in electron microscopy • In intermediate normoblast, the hemoglobin is visible through a light microscope Reticulocyte: • It’s is the immediate precursor of RBC and 1 st precursor with no nucleus • Normal reticulocyte count is: 0.5-1.5 % • Special stain used to view a reticulocyte: supravital stain • 1. Brilliant cresyl blue, • 2. New methylene blue (best stain for retic) Bone marrow examination: Patient Positioning: • Position: Left lateral (L Lateral) • Orientation: Back facing the doctor Common Sites of Bone Marrow Aspiration / Biopsy: • Adults: • Primary: Iliac crest (Posterior Superior Iliac Spine > Anterior Superior Iliac Spine) • Alternative: Sternum (used cautiously, mainly for aspiration – never for biopsy) • Children: • Primary: Tibia (usually the anterior medial surface of the tibia) Types of Needles Used: 1. Salah’s Needle • Commonly used for aspiration • Simple and widely used in many regions 2. Jamshidi Needle • Versatile: Used for both bone marrow biopsy and aspiration • Has a trephine design, ideal for obtaining core biopsies 3. Klima Needle • Less commonly used, similar function as Salah’s Bone marrow aspirate: Dry Tap: Page 270