What is the patient's total White Blood Cell (WBC) count if 360 cells are counted in four square millimeters on a Neubauer ruled hemacytometer with a 1:10 dilution?

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Calculation of Total WBC Count on a Neubauer Hemacytometer

The patient's total WBC count is 9000/mm³ (option C).

Understanding the Calculation

When performing a manual WBC count using a Neubauer hemacytometer, the following formula applies:

WBC count/mm³ = (Number of cells counted × Dilution factor) ÷ (Area counted in mm² × Depth of chamber)

Let's break down the components of this calculation:

  • Number of cells counted: 360 cells
  • Dilution factor: 1:10 (which equals 10)
  • Area counted: 4 square millimeters
  • Depth of chamber: 0.1 mm (standard for Neubauer hemacytometer)

Step-by-Step Calculation

  1. Apply the formula: WBC count/mm³ = (360 × 10) ÷ (4 × 0.1) WBC count/mm³ = 3600 ÷ 0.4 WBC count/mm³ = 9000

Clinical Relevance

The calculated WBC count of 9000/mm³ falls within the normal reference range for adults (typically 4,000-11,000/mm³) 1. This is important because:

  • WBC counts are crucial diagnostic indicators in various clinical scenarios
  • Accurate manual counting techniques remain important for verification of automated results
  • The Neubauer hemacytometer is a standard tool for cell counting in laboratory medicine

Common Pitfalls in Manual WBC Counts

  • Failing to account for the dilution factor (which would result in a count of 900/mm³)
  • Miscalculating the area counted (using only one square millimeter would yield 36,000/mm³)
  • Not considering the depth of the chamber (standard depth is 0.1 mm)
  • Inadequate mixing of the sample before loading the hemacytometer
  • Poor technique in filling the chamber, leading to uneven cell distribution

Verification

To verify the accuracy of manual counts, laboratories should:

  • Perform duplicate counts when possible
  • Compare with automated analyzer results when available
  • Ensure proper maintenance and calibration of the hemacytometer
  • Follow standardized procedures for sample preparation and counting

The correct answer is C: 9000/mm³, which represents the patient's total WBC count based on the provided data.

References

Guideline

Management of Leukocytosis with Neutrophilic Shift

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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