Bronchoscopy

Bronchoscopy is a diagnostic test that is used to view the airways, throat and larynx. This procedure can also facilitate removal of a growth or obstruction from the airway. Bronchoscopy is useful in diagnosing lung diseases and lung cancer. Any growth in the airways can be treated or removed. Other diagnostic tests such as CBC test, arterial blood gas test and PFT may be prescribed before embarking on bronchoscopy. The secretions in the mouth and airways are dried up with suitable medications. The vocal chords are also numbed. Fluroscope is also used to capture the images on a monitor. Avoid eating or drinking for a few hours prior to a bronchoscopy procedure. There might be blood in the sputum in case of biopsy.

Flexible bronchoscope allows a better view of the smaller airways and permits biopsy procedure too. This is called a transbronchial biopsy. Local anesthesia is often sprayed into the nose and mouth.

Rigid bronchoscope often necessitates the patient to be anesthesized and is resorted to when large samples need to be taken for biopsy and to remove pieces of food or dilating the airway. Use of laser is possible for removal for obstructions.

Abnormal results of bronchoscopy may be indicative of lung cancer, tumor, enlarged lymph nodes, ulceration or abnormality in the bronchial wall. Bronchoscopy is prescibed in cases where the patient coughs up blood or chest x-ray shows abnormal findings. If a person has inhaled a foreign body into the lung, bronchoscopy can help in removing it.

Complete Blood Count

A Complete Blood Count test CBC is a diagnostic test to measure the following in blood - the number of red blood cells, the number of white blood cells, Platelets and the total amount of hemoglobin in blood. Hematocrit (HCT) is the fraction of blood composed of red blood cells.

A Complete Blood Count normally includes the following components:

• Red Blood Cell Count (RBC) (also known as Erythrocyte Count)
  
• Red Blood Cell Indices : MCV (Mean Corpuscular Volume), MCH (Mean Corpuscular Hemoglobin) and MCHC (Mean Corpuscular Hemoglobin Concentration)
  
• Hemoglobin (Hgb)
  
• Hematocrit ( HCT)
  
• White Blood Cell count (WBC or leukocyte count)
  
• Platelet count (thrombocyte count)
  

A CBC test provides information on measurements such as average red blood cell size or MCV, Hemoglobin per blood cell or Mean Corpuscular Hemoglobin MCH, hemoglobin concentration or the amount of hemoglobin relative to the size of the cell, per red blood cell or MCHC and platelet count.

Why Complete Blood Count test?

This is a complete lab test and is used to detect or monitor different health conditions. A doctor may require this test for various reasons: As a routine check up

If the patient exhibits symptoms such as fatigue, weight loss, fever or any other signs of infection, weakness, bruising, bleeding or signs of cancer

Blood count results may change if you are receiving treatment for medicines and radiation

To monitor any chronic health problem that can change your blood count results such as chronic kidney disease.

Results of CBC

Though blood count may vary with altitude, in general the normal ranges are given below. But it should be noted that these ranges may vary slightly from one laboratory to another. Various laboratories use varied measurements or test different samples. It is best to have it interpreted by a health care provider.

Normal Values:

Red blood cell indices:

MCV (Mean Corpuscular Volume): 80 to 95 femtoliter
MCH (Mean Corpuscular Hemoglobin): 27 to 31 pg/cell
MCHC (Mean Corpuscular Hemoglobin Concentration): 32 to 36 gm/dL

RBC (erythrocyte) count:

Male: 4.7 to 6.1 million cells/mcL
Female: 4.2 to 5.4 million cells/mcL

WBC (leukocyte) count:

4,500 to 10,800 cells/mcL

Hematocrit:

Male: 40.7 to 50.3%
Female: 36.1 to 44.3%

Hemoglobin:

Male: 13.8 to 17.2 gm/dL
Female: 12.1 to 15.1 gm/dL

Platelet (thrombocyte) count:

150,000 to 450,000/dL

What abnormal results mean?

An abnormal result means elevated RBC, hemoglobin or Hematocrit. These may be due to various factors including lack of adequate water and fluids due to severe diarrhea, excessive sweating or if diuretics are used to treat hypertension.

Low RBC, hemoglobin or hematocrit is also a sign of which result due to blood loss on account of heavy menstrual periods over long periods of time, bone marrow failure from radiation, infection or tumor, Hemolysis or breakdown of red blood cells, chronic kidney disease, ulcerative colitis or rheumatoid arthritis, leukemia, multiple myeloma, long term infections such as hepatitis, poor diet and nutritional deficiencies of iron, Vitamin B6, Vitamin B12 and folate.

High levels of Hematocrit can be the result of dehydration, diarrhea, erythrocytosis or myeloproliferative disorders such as Polycythemia Vera.

Lower than normal white blood cell count, or Leukopenia (Leucopenia), can be the result of alcohol abuse and liver damage, autoimmune diseases, bone marrow failure due to infection, tumor, radiation or fibrosis, chemotherapy medicines, disease of liver or spleen, enlarged spleen, infections caused by viruses such as AIDS or medications.

High WBC count is called leukocytosis which can result from certain medicines such as corticosteroids, infections, diseases such as rheumatoid arthritis or allergy, leukemia and severe emotional and physical stress, tissue damage

High platelet count may be due to bleeding - diseases such as cancer, iron deficiency, problems with the bone marrow.

Low platelet count may be due to anemia, disorders where platelets are destroyed during pregnancy, enlarged spleen, bone marrow failure (for example, due to infection, tumor, radiation, or fibrosis), Chemotherapy medicines used to treat cancer.

Disease of the platelets is known as Thrombocytopathy, which could be due to lower Platelet counts (a condition called as Thrombocytopenia or Thrombopenia), or due to a decrease in function (called as Thrombasthenia) or an increase in the number of platelet (addressed as Thrombocytosis). Normal platelet counts do not necessarily indicate normal functioning. In some cases the platelet counts may appear normal but the platelets themselves are dysfunctional. Aspirin inhibits cyclooxygenase-1 (COX1) which results in the disruption of platelet function affecting coagulation. Normal platelet function will be restored only when the affected platelets have been replaced which can take a week.

Precaution : At the time of drawing the blood, it is necessary to clean the venipuncture site with alcohol.