Blood film

Question 1

Teardrop poikilocyte

Answer 1

Myelofibrosis

Question 2

Helmet cell

Answer 2

Microangiopathic haemolysis

Question 3

Pencil cell

Answer 3

Fe deficiency anaemia

Question 4

Elliptocyte

Answer 4

Hereditary elliptocytosis

Question 5

Spherocytes

Answer 5

Warm autoimmune haemolysis, hereditary spherocytosis

Question 6

Target cells

Answer 6

Post-splenectomy, liver disease, thalassaemia, IDA

Question 7

Polychromasia

Answer 7

Young red cells - implies high reticulocyte count

Question 8

Rouleaux

Answer 8

High ESR

Question 9

Agglutinates

Answer 9

Cold agglutins

Question 10

Ring sideroblasts

Answer 10

Sideroblastic anaemia. Iron granules in ring around erythroblast nucleus.

Question 11

Sideroblastic anaemia causes

Answer 11

Myelodysplastic disorders, alcohol, malignancy, anti-TB drugs (give pyridoxine to prevent)

Question 12

Smear cells

Answer 12

CLL

Question 13

Reed-sternberg

Answer 13

‘owl’s eye’ nucleoli. Hodgkin’s.

Question 14

Schistocytes

Answer 14

DIC

Question 15

Howell Jolly Bodies

Answer 15

Splenectomy

Question 16

Heinz bodies

Answer 16

G6PD

Question 17

Blister cells

Answer 17

G6PD

Question 18

Basophilic stippling

Answer 18

Lead poisoning, thalassaemia, myelodysplasia

Question 19

High leukocyte alkaline phosphatase score

Answer 19

Leukaemoid reaction, myelofibrosis, PCV, Cushings, OCP

Question 20

Dohle bodies

Answer 20

Leukaemoid

Question 21

Left shift of neutrophils

Answer 21

Leukaemoid (three or fewer segments of nucleus)

Question 22

Low leukocyte alkaline phosphatase score

Answer 22

CML, pernicious anaemia, PNH, mono