01 WHAT IS A CBC & WHY IS IT DONE?

Definition A Complete Blood Count (CBC) — also called Full Blood Count (FBC) — is a panel of
blood tests that evaluates the three major cellular components of blood: Red Blood
Cells, White Blood Cells, and Platelets. It is one of the most commonly ordered
laboratory tests in medicine.

Specimen 3–5 mL of venous blood collected in an EDTA (purple/lavender top) tube. EDTA
prevents clotting by chelating calcium. Fingerstick capillary blood may be used in
children or emergencies.

Machine Automated haematology analyser (e.g., Sysmex, Coulter). Uses electrical impedance,
light scattering, and flowcytometry. Peripheral blood smear is reviewed manually when
flags appear.

Common Clinical Indications

Indication What CBC Detects

Fatigue, pallor, dyspnoea Anaemia (low Hb)

Fever, infection Leukocytosis, left shift

Bleeding, bruising Thrombocytopenia, platelet dysfunction

Routine screening / health check Silent haematological disease

Pre-operative assessment Anaemia, coagulopathy risk

Cancer monitoring (chemotherapy) Myelosuppression, aplasia

Splenomegaly evaluation Cytopenias, abnormal cell forms

Follow-up of known blood disorder Disease progression/remission

 02 RED BLOOD CELLS (RBC) & INDICES

RBC Count LOW NORMAL HIGH

Males: 4.5–5.9 ×10¹²/L | Females: 4.0–5.2 ×10¹²/L
3.0 4.5 5.9 7.5

Index Full Name Normal Range Formula Clinical Significance

Mean Corpuscular Size of RBC Micro <80,

MCV 80–100 fL Hct / RBC × 10
Volume Macro >100

Mean Corpuscular Hb content per cell

MCH 27–33 pg Hb / RBC × 10
Haemoglobin Hypochromic if low

Mean Corpuscular Hb conc. per cell High in

MCHC 32–36 g/dL Hb / Hct × 100
Hb Concentration hereditary spherocytosis

Red Cell SD of MCV / mean Variation in RBC size

RDW 11.5–14.5%
Distribution Width MCV × 100 (Anisocytosis)

Reticulocy Immature RBCs 0.5–1.5% Counted by machine / Bone marrow response

tes (RNA-containing) (25–75×10■/L) manual supravital stain High=blood loss/haemolysis

MCV Interpretation — The KEY Diagnostic Tool

MCV Classification Common Causes Additional Tests

< 80 fL MICROCYTIC 1. Iron Deficiency Anaemia (IDA) — most Serum iron, Ferritin, TIBC Hb
Anaemia common 2. Thalassaemia (alpha/beta) 3. electrophoresis Blood smear
Sideroblastic Anaemia 4. Anaemia of Chronic
Disease (some cases) 5. Lead Poisoning

80–100 fL NORMOCYTIC 1. Acute blood loss 2. Haemolytic anaemia 3. Reticulocyte count LDH,
Anaemia Aplastic anaemia 4. Anaemia of Chronic Disease Haptoglobin Coombs test
5. CKD (EPO deficiency) 6. Mixed deficiency Renal function

> 100 fL MACROCYTIC 1. Vitamin B12 deficiency (pernicious anaemia) 2. B12, Folate levels TFTs,
Anaemia Folate deficiency 3. Hypothyroidism 4. Liver LFTs Peripheral smear
disease / Alcohol 5. Medications (methotrexate, (Hypersegmented PMNs)
hydroxyurea) 6. Myelodysplastic syndrome
 03 HAEMOGLOBIN & HAEMATOCRIT

Haemoglobin (Hb) LOW NORMAL HIGH

Males: 13.5–17.5 g/dL | Females: 12.0–15.5 g/dL | Children: 11–14 g/dL
7.0 13.5 17.5 20.0

Haematocrit (Hct / PCV) LOW NORMAL HIGH

Males: 41–53% | Females: 36–46%
20 41 53 65

Haemoglobin Severity Classification

Hb Level (g/dL) Severity Symptoms Management

>12 (F) / >13.5 (M) Normal None —

Investigate cause; oral

10–12 Mild Anaemia Mild fatigue on exertion
supplements

Fatigue, pallor, dyspnoea on Treat cause; consider

8–10 Moderate Anaemia
exertion transfusion if symptomatic

Dyspnoea at rest, tachycardia,

6–8 Severe Anaemia Transfusion often required
palpitations

High-output cardiac failure, Urgent transfusion; ICU if

<6 Life-threatening
cardiovascular compromise needed

Rule of 3s (Quick Sanity Check):

If values disagree →
Hb × 3 ≈ Hct Hb × 3 ≈ RBC count suspect haemolysis or
(millions) lab error
 04 RBC MORPHOLOGY — SIZE, SHAPE & COLOUR

Normal vs Abnormal RBC Size

>9µm No pallor
Biconcave Large Sphere Shape
#Normal <6µm Oval
Small

Microcyte
Normal Elliptocyte
Macrocyte Spherocyte

Abnormal RBC Shapes — Blood Film Findings

Target Sickle Schistocyte Tear-drop Acanthocyte Rouleaux

Cell Cell (Fragment) (Dacryocyte) (Spur)

Morphology Appearance Associated Conditions Mechanism

Target Cell Bullseye: central Thalassaemia, IDA, liver disease, Excess membrane relative
(Codocyte) density + peripheral Hb C disease, post-splenectomy to Hb content
ring

Sickle Cell Crescent/sickle-shape Sickle cell anaemia (HbSS), Hb SC HbS polymerisation under
(Drepanocyte) d disease hypoxia

Schistocyte Irregular fragments, Microangiopathic haemolytic Mechanical RBC

(Fragmented) helmet cells anaemia, TTP, HUS, DIC, destruction by fibrin
mechanical heart valve strands

Spherocyte Small, dense, no Hereditary spherocytosis, Loss of membrane lipid →

central pallor autoimmune haemolytic anaemia spherical shape
(AHA)

Elliptocyte Oval/elongated cells Hereditary elliptocytosis (>25%), Cytoskeletal protein defect

(Ovalocyte) IDA, thalassaemia (mild) (spectrin, protein 4.1)

Tear-drop Pear/teardrop shape Myelofibrosis, thalassaemia, Spleen squeezes

(Dacryocyte) myelophthisic anaemia inclusion-containing cell,
deforms it

Acanthocyte (Spur Irregular spiky Abetalipoproteinaemia, liver Altered lipid ratio →

cell) projections disease (spur cell haemolytic membrane projections
anaemia)
 Echinocyte (Burr Uniform short Uraemia (CKD), pyruvate kinase Membrane lipid changes
cell) projections deficiency, artefact or crenation

Rouleaux Stack of coins Multiple myeloma, Waldenstrom, Protein coating reduces

appearance high fibrinogen/globulin states charge between RBCs

Howell-Jolly bodies Nuclear remnants Post-splenectomy, hyposplenia, Spleen normally removes

(dark dots in RBC) megaloblastic anaemia these; absent spleen →
persist

Basophilic Dark blue dots in RBC Lead poisoning, thalassaemia, Aggregated ribosomes /
Stippling sideroblastic anaemia abnormal Hb precipitation

RBC Colour Changes

Colour Appearance Term Cause Diseases

Central pallor > 1/3 Hypochromia Low Hb content per IDA, thalassaemia, sideroblastic
diameter cell

Normal central pallor ~1/3 Normochromia Normal Hb Normal / haemolytic anaemia

No central pallor, dark cell Hyperchromia / Excess Hb or Hereditary spherocytosis, AIHA

spherocytosis spherocyte

Polychromatic (blue-grey) Polychromasia Young RBCs Haemolysis, bleeding, response to

cells (reticulocytes) Rx
 05 WHITE BLOOD CELLS — TYPES & NORMAL COUNTS

Total WBC CountLOW NORMAL HIGH

Normal: 4,000–11,000 /µL (4–11 ×10■/L)
1.0 4.0 11.0 30.0

WBC Differential (%)

Neutrophils (60%) Absolute Count
Cell Type % of WBC
Lymphocytes (30%) (/µL)
Monocytes (7%)
1%
2%7% Neutrophils 50–70% 1800–7700
Eosinophils (2%)
Basophils (1%) Lymphocytes 20–40% 1000–4800

30% Monocytes 2–10% 200–1000

60%
Eosinophils 1–4% 45–440

Basophils 0–1% 0–100

First responder Immune memory Phagocyte Allergy/parasite Allergic rxn

cytoplasm
Granules+ Scant cytoplasm Abundant Red granules Dark granules
nucleus nucleus nucleus nucleus nucleus
Multi-lobed Large round Kidney-shaped Bi-lobed S-shaped

Neutrophil Lymphocyte Monocyte Eosinophil Basophil

Individual WBC Types — Functions & Diseases

Cell Origin Key Functions High (↑) Causes Low (↓) Causes

Neutrophil Bone marrow • First responder to Bacterial infection, Severe infection,

(myeloid) bacterial/fungal infection • inflammation, steroids, drugs (chemo),
Phagocytosis & killing by CML, stress leukocytosis aplastic anaemia,
MPO/ROS • Forms pus autoimmune

Lymphocyte Bone marrow • T cells: cell-mediated Viral infection (EBV, HIV/AIDS,

→ thymus (T) / immunity • B cells: CMV), CLL, ALL, steroids,
bursa-equiv (B) antibody production • NK pertussis, lymphoma immunodeficiency,
cells: tumour/viral killing post-chemo,
radiation

Monocyte Bone marrow; • Phagocytosis of debris, Chronic infection (TB, Hairy cell
differentiates to bacteria • Antigen SBE), monocytic leukaemia, bone
macrophage presentation • Cytokine leukaemia (AML M5), IBD, marrow failure,
production malaria steroid use
Eosinophil Bone marrow • Combats Parasites (NAACP Acute
(myeloid) parasitic/helminth mnemonic), bacterial/viral
infections • Modulates allergy/asthma, atopy, infection, steroids,
allergic reactions • eczema, drug reactions, Cushing syndrome
Contains toxic granules Loeffler syndrome,
(MBP) lymphoma

Basophil Bone marrow • IgE-mediated allergic CML (hallmark!), allergic Anaphylaxis

(myeloid) responses • Releases reactions, hypothyroidism, (degranulated),
histamine, heparin, myeloproliferative steroids,
leukotrienes • Similar to disorders hyperthyroidism,
mast cells stress
 06 WBC DIFFERENTIAL — DISEASE PATTERNS

Pattern Definition Key Diseases Blood Smear Clue

Leukocytosis Total WBC elevated Infection (bacterial), inflammation, May see left shift (bands,
(WBC >11×10■/L) leukaemia, stress, steroids, metamyelocytes)
pregnancy

Leukopenia (WBC Total WBC reduced Viral infection, SLE, aplastic Normal or hypersegmented
<4×10■/L) anaemia, HIV, drug toxicity, PMNs
hypersplenism

Neutrophilia Neutrophils Bacterial infection, MI, burns, Left shift, toxic granulation,
>7.7×10■/L surgery, steroids, CML, G-CSF Dohle bodies
therapy

Left Shift Immature neutrophils Severe infection (bands >10%), Bands, metamyelocytes,
in peripheral blood CML (all precursors), leukaemoid myelocytes
reaction

Lymphocytosis Lymphocytes Viral illness (EBV, CMV, Atypical lymphocytes in

>4.8×10■/L hepatitis), CLL (mature EBV; smear cells in CLL
lymphocytes), ALL, pertussis

Eosinophilia Eosinophils NAACP: Neoplasm, Bilobed nuclei, pink

>0.44×10■/L Allergy/Asthma, Addison, granules
Collagen vascular disease,
Parasites

Monocytosis Monocytes >1×10■/L TB, brucellosis, SBE, monocytic Kidney-shaped/folded

AML (M5), IBD, recovery phase of nucleus
neutropenia

Pancytopenia All 3 lines reduced Aplastic anaemia, B12/folate Hypocellular marrow on

deficiency, hypersplenism, biopsy
leukaemia, myeloma

Leukaemoid WBC >50×10■/L Severe infection, TB miliary, LAP score HIGH (vs CML
Reaction non-leukaemic malignancy, hemolysis where LOW)

Toxic Changes in Neutrophils (markers of severe infection)

Finding Description Significance

Toxic Granulation Coarse, dark primary granules visible Severe bacterial infection; granules contain
in cytoplasm MPO, defensins

Dohle Bodies Light blue cytoplasmic inclusions Infection, burns, pregnancy; alongside toxic
(retained rough ER) granulation

Cytoplasmic Vacuoles in neutrophil cytoplasm Phagocytosis of bacteria; sepsis marker

Vacuolation

Hypersegmentation Neutrophil with ≥5 lobes (or ≥1 cell Megaloblastic anaemia (B12/folate def);
with 6 lobes) pathognomonic finding

Pelger-Huet anomaly Bilobed or unilobed (pince-nez) Hereditary (benign) or pseudo-Pelger in MDS;

nucleus nuclues hyposegmented
 07 PLATELETS — COUNT, FUNCTION & DISORDERS

Platelet Count LOW NORMAL HIGH

Normal: 150,000–400,000 /µL (150–400 ×10■/L)
20 150 400 700

Thrombocytopenia → Normal Range → Thrombocytosis

<150,000/µL 150,000 – 400,000/µL >400,000/µL

Platelet Count Spectrum

Platelet Count Term Clinical Features Common Causes

>400×10■/L Thrombocytosis Usually asymptomatic; risk of Reactive: iron deficiency,

thrombosis at very high infection, post-splenectomy,
counts inflammation Primary: Essential
thrombocythaemia, CML,
polycythaemia vera

150–400×10■/L Normal No bleeding tendency —

100–150×10■/L Mild Usually no bleeding Same as moderate causes (mild)

thrombocytopenia

50–100×10■/L Moderate Bleeding with trauma/surgery ITP, viral illness, drug-induced

thrombocytopenia

20–50×10■/L Severe Spontaneous bruising, ITP, TTP, HUS, heparin (HITT),

thrombocytopenia mucosal bleeding SLE

<20×10■/L Critical Spontaneous intracranial/GI Aplastic anaemia, DIC, severe

(life-threatening) bleed risk ITP, leukaemia, chemotherapy

Mean Platelet Volume (MPV) — Additional Index

MPV Interpretation Disease Association

Normal (7–12 fL) Normal platelet size Healthy state

High MPV + Low Large young platelets = peripheral ITP (immune destruction; BM compensates with
platelets destruction larger platelets)

Low MPV + Low Small old platelets = BM failure Aplastic anaemia, marrow infiltration
platelets
 08 ANAEMIA WORKUP — DIAGNOSTIC FLOWCHART

Low Hb / Anaemia Detected

Check MCV (Mean Cell Volume)

LOW■<80 fL NORMAL■80-100 fL HIGH■>100 fL

Microcytic Normocytic Macrocytic

Anaemia Anaemia Anaemia

Check Serum Iron Check Reticulocytes Check B12/Folate

& Ferritin
High Retics=Blood Low B12=
Low Fe+Ferritin=IDA loss/Haemolysis Pernicious Anaemia
Normal=Thalassaemia Low Retics=Aplastic Low Folate=
High=Sideroblastic Anaemia/CKD/CKD Diet/Alcohol

Key Discriminating Tests for Anaemia

Test IDA Thalassaemia ACD Sideroblastic B12/Folate Def

Serum Iron ↓ LOW Normal/↑ ↓ LOW ↑ HIGH Normal

Ferritin ↓ LOW Normal/↑ ↑ HIGH ↑ HIGH Normal/Low

TIBC ↑ HIGH Normal ↓ LOW Normal Normal

Transferrin Sat ↓ (<15%) Normal ↓ Low ↑ (>50%) Normal

Serum B12/Folate Normal Normal Normal Normal ↓ LOW

Hb Electrophoresis Normal Abnormal bands Normal Normal Normal

(HbA2 ↑ in
beta-thal)

Peripheral Smear Hypochromic Target cells, Normochromi Ring Macro-ovalocyte

microcytes, basophilic c normocytic sideroblasts on s, hyperseg
pencil cells stippling BM biopsy PMNs

Reticulocytes Low/Normal Normal/↑ Low Variable Low

 09 POLYCYTHAEMIA & PANCYTOPENIA

Polycythaemia (Erythrocytosis) — Hb >17.5 (M) / >15.5 (F) g/dL

Type Mechanism Key Features CBC Findings

Relative / Spurious Reduced plasma Normal RBC mass; corrects with High Hb/Hct, RBC
Polycythaemia volume (dehydration, hydration; Gaisbock syndrome normal, platelets normal
diuretics)

Absolute Primary: Clonal stem cell Plethora, splenomegaly, pruritus High RBC/Hb/Hct; WBC
Polycythaemia Vera disorder; JAK2 V617F after hot bath (aquagenic), ↑; Platelets ↑; Low EPO
(PV) mutation (95%) thrombosis, Budd-Chiari

Absolute Secondary Hypoxia → ↑ EPO High altitude, COPD, cyanotic High RBC/Hb/Hct;
(appropriate) production heart disease, sleep apnoea, WBC/platelets normal;
smoking EPO ↑

Absolute Secondary EPO secreted by Renal cell carcinoma, High RBC/Hb; EPO ↑;
(inappropriate) tumour hepatocellular carcinoma, look for tumour on
cerebellar haemangioblastoma imaging

Pancytopenia — ALL THREE cell lines reduced

Cause Mechanism Key Features Diagnosis

Aplastic Anaemia Immune destruction of Fatigue, infections, bleeding; BM biopsy (gold standard);
haematopoietic stem hypocellular BM; >70% fat CD34 cells ↓
cells cells on biopsy

Megaloblastic B12/folate deficiency Macro-ovalocytes, Serum B12, folate; MCV

Anaemia → impaired DNA hypersegmented PMNs (5+ markedly elevated
synthesis lobes), neurological symptoms
(B12)

Bone Marrow Tumour replaces Tear-drop cells, immature BM biopsy; trephine;

Infiltration marrow WBC+RBC in blood; leukoerythroblastic smear
(Myelophthisis) (leucoerythroblastic splenomegaly
picture)

Hypersplenism Sequestration and Splenomegaly; cells are USS abdomen; treat

destruction of cells in morphologically normal underlying cause
spleen

Acute Leukaemia Blast cells replace Blasts on smear; Peripheral smear, flow
(replacement) normal haematopoietic lymphadenopathy; cytometry, BM biopsy
cells constitutional symptoms

SLE / Autoimmune Autoantibodies against Multi-system involvement; Serology; direct Coombs;

marrow cells and blood anti-dsDNA, ANA positive ANA panel
cells
 10 EMERGENCY (CRITICAL) VALUES & RAPID INTERPRETATION

Parameter Critical LOW Critical HIGH Immediate Action

Haemoglobin < 7 g/dL > 20 g/dL LOW: assess symptoms, consider

(polycythaemia) transfusion; HIGH: venesection / treat
cause

WBC < 2×10■/L (or > 50×10■/L LOW: infection precautions, G-CSF;
neutrophils <0.5) (leukostasis risk) HIGH: rule out leukaemia, leukapheresis if
>100

Platelets < 20×10■/L > 1000×10■/L LOW: platelet transfusion if bleeding;

HIGH: aspirin, treat cause

Neutrophils < 0.5×10■/L — Neutropenic precautions, empirical

(agranulocytosis) antibiotics if febrile

Step-by-Step CBC Interpretation Approach

Check each parameter against reference range. Flag any
Step 1 Look at the numbers
abnormal values.

Classify anaemia if Use MCV → Micro/Normo/Macro. Then use RDW to narrow

Step 2
present further.

Look at WBC total +

Step 3 Identify leukocytosis/leukopenia. Which cell line is abnormal?
differential

High = BM responding (loss/haemolysis). Low = BM failure

Step 4 Check reticulocyte count
(aplastic, infiltration)

Thrombocytopenia with high MPV = ITP; low MPV = BM

Step 5 Check platelets + MPV
failure

Gold standard for morphological confirmation. Look for blasts,

Step 6 Request blood smear
fragments, etc.

CBC does not diagnose — it guides you to the next test.

Step 7 Correlate clinically
Always integrate with history/exam.
11 DISEASE CORRELATION MASTER TABLE

Disease Hb/RB MCV WBC Platelets Smear Clue Key Extra Tests
C

Iron Deficiency ↓ Hb ↓ Normal Normal/↑ Hypochromic, Ferritin ↓, Iron ↓, TIBC ↑

Anaemia (IDA) Micro microcytes, pencil
cells

Pernicious ↓ Hb ↑ Normal Normal Macro-ovalocytes, B12 ↓, anti-IF Ab,

Anaemia / B12 Macro (may ↓) (may ↓) hyperseg PMNs anti-parietal cell Ab
def

Folate deficiency ↓ Hb ↑ Normal Normal Same as B12 but no Folate ↓, homocysteine

Macro neuro sx ↑

Alpha-Thalassae ↓ mild ↓ Normal Normal Microcytes, target Normal

mia Trait Hb Micro cells HbElectrophoresis; gene
analysis

Beta-Thalassaemi ↓↓ Hb ↓ ↑ Normal/↑ Gross HbA2 >3.5%, HbF ↑;

a Major Micro anisopoikilocytosis, electrophoresis
target cells,
nucleated RBC

Sickle Cell ↓ Hb Norm ↑ ↑ Sickle cells, HbS on electrophoresis;

Disease al (splenic (asplenia) Howell-Jolly bodies sickling test
loss→inf
ect)

Autoimmune ↓ Hb Norm Normal Normal/↑ Spherocytes, Direct Coombs +ve; LDH

Haemolytic al/↑ polychromasia ↑, Haptoglobin ↓
Anaemia

Hereditary ↓ mild Norm Normal Normal Spherocytes; no Osmotic fragility; EMA

Spherocytosis Hb al/↓ central pallor binding test

G6PD Deficiency ↓ Hb (e Norm Normal Normal Bite cells, blister G6PD enzyme assay
pisodic) al cells, Heinz bodies (test after crisis)

TTP / HUS ↓↓ Hb Norm Normal/ ↓↓ LOW Schistocytes, helmet ADAMTS13

al ↑ cells (TTP);↑LDH; ↑creatinine
(HUS)

DIC ↓ Hb Norm Variable ↓↓ LOW Schistocytes; PT/APTT ↑; fibrinogen ↓;

al fragments D-dimer ↑

Aplastic Anaemia ↓ Hb Norm ↓↓ ↓↓ Hypocellular; no BM biopsy: fat↑, cells↓;

al abnormal cells CD34↓

Acute ↓ Hb Varia ↑ or ↓ ↓ Lymphoblasts (large Flow cytometry;

Lymphoblastic ble nuclei, prominent karyotype; TdT+
Leukaemia (ALL) nucleoli)

Acute Myeloid ↓ Hb Varia ↑ or ↓ ↓ Myeloblasts; Auer Flow cytometry;

Leukaemia (AML) ble rods (M2,M3) cytogenetics (t15;17 M3)

CML ↓ mild Norm ↑↑ ↑ often All myeloid stages; BCR-ABL (Philadelphia

Hb al (>100) basophilia key clue chromosome); LAP ↓
CLL ↓ mild Norm ↑ lymph ↓ (autoim Smear cells CD5+, CD23+; flow
Hb al ocytes mune) (Gumprecht cytometry
shadows); mature
lymphocytes

Polycythaemia ↑ Hb Norm ↑ (WBC ↑ Plethoric smear; no JAK2 V617F; EPO ↓;

Vera al +plt) abnormal cells BM biopsy: hypercellular

Multiple Myeloma ↓ Hb Norm Normal/ Normal/↓ Rouleaux formation; Serum electrophoresis

al ↓ plasma cells (M-spike); BJP; SFLC

Infectious Normal Norm ↑ lymph ↓ (mild) Atypical lymphocytes Monospot test; EBV VCA
Mononucleosis al ocytes (large, irregular IgM; heterophile Ab+
(EBV) nuclei)
12 MEMORY MNEMONICS & QUICK REVIEW

NAACP — Causes of Eosinophilia

Neoplasm / Lymphoma / Hodgkin disease

N
Allergy, Asthma, Atopic conditions
A
Addison disease (adrenal insufficiency)
A
Collagen vascular disease (SLE, RA, polyarteritis nodosa)
C
Parasites / Helminthic infections (Ascaris, hookworm, Toxocara)
P
AEIOU — Causes of Macrocytosis

Alcohol and liver disease

A
Extra need: pregnancy, haemolysis (reticulocytes = larger)
E
Ineffective synthesis: B12/folate deficiency (megaloblastic)
I
Other drugs: methotrexate, hydroxyurea, azathioprine, AZT
O
Underactive thyroid (hypothyroidism)
U
FILM — Reading a Blood Smear

Flags — review automated analyser flags first

F
Inventory — count WBC types; check overall cellularity
I
Look at RBC — size, shape, colour, inclusions
L
Make sense — correlate with clinical picture and other tests
M
STOP — Emergency Response to CBC

Seriously low Hb (<7) → assess for transfusion

S
Thrombocytopenia severe (<20) → platelet transfusion if bleeding
T
Oh no — blasts on smear → urgent haematology consult
O
Phone the doctor with critical values — never delay
P
RAPID CBC REFERENCE CARD
 Male Female
Parameter ↓ Low = ? ↑ High = ?
Normal Normal

Hb (g/dL) 13.5–17.5 12.0–15.5 Anaemia Polycythaemia

RBC (×10¹²/L) 4.5–5.9 4.0–5.2 Anaemia Polycythaemia / dehydration

Hct (%) 41–53 36–46 Anaemia Polycythaemia / dehydration

MCV (fL) 80–100 80–100 Micro = Fe/Thal Macro = B12/Folate/alcohol

MCH (pg) 27–33 27–33 Hypochromic Hypochromic (if low MCH)

MCHC (g/dL) 32–36 32–36 IDA, thalassaemia Hereditary spherocytosis

Anisocytosis (mixed
RDW (%) 11.5–14.5 11.5–14.5 Not clinically significant
deficiency)

Infection/marrow
WBC (×10■/L) 4–11 4–11 Infection/leukaemia/steroids
failure/drugs

Neutrophils (%) 50–70 50–70 Viral / marrow failure Bacterial infection / CML

HIV/steroids/immunodeficie
Lymphocytes (%) 20–40 20–40 Viral / CLL
ncy

TB / chronic infection /
Monocytes (%) 2–10 2–10 Hairy cell leukaemia
AML-M5

Eosinophils (%) 1–4 1–4 Steroids / Cushing NAACP mnemonic

Basophils (%) 0–1 0–1 Hyperthyroidism / steroids CML hallmark / allergy

Platelets (×10■/L) 150–400 150–400 ITP / TTP / DIC / aplasia Reactive / ET / CML

Reticulocytes (%) 0.5–1.5 0.5–1.5 BM failure / aplastic Blood loss / haemolysis

This guide was created for medical education. Always correlate CBC findings with clinical history, examination, and additional
investigations. A CBC guides — it does not diagnose alone.