Blood film

Question 1

What is this?

Answer 1

Hypochromic microcytic anaemia

Question 2

Describe this histological slide

Answer 2

• Small RBCs, huge middle pallor, bizzare shapes
• These hypochromic microcytic cells are seen in aniso/poikilocytosis i.e. iron deficiency anaemia

Question 3

Describe this histological slide and diagnose

Answer 3

• Some of the red cells are larger - called oval macrocytes
• There is a variation in size and shape here
• This is shown as an increase in MCV
• Macrocytes are seen in B12 or folate deficiency

Question 4

Macrocytes are seen in?

Answer 4

B12 or folate deficiency

Question 5

Describe this histological slide

Answer 5

Target cells seen in liver disease.

Instead of a central pallor, we have a central high colour area.

Question 6

Describe this blood film

Answer 6

Spherocytes seen in haemolysis.

Bluish tinge, immature cell, consequence of the fact RBC membrane is pinched off, so they are spherical.

Speckled appearance of reticulocytes.

The MCV will be large due to reticulocytes.

Question 7

Describe this blood film

Answer 7

Polychromasia.

This is when reticulocytes mix with mature RBCs

Question 8

Polychromasia

Answer 8

When reticulocytes mix with mature RBCs

Question 9

Describe this blood film. When is this usually seen?

Answer 9

Sickle cells. Seen in inherited abnormal Hb diseases.

Sickle cells can block small vessels.

Question 10

Describe this blood film and where is this usually seen?

Answer 10

Rouleaux.

Seen in myeloma.

Red cell stacking, typical appearance in myeloma due to increase in viscosity of plasma.

Question 11

Describe this blood film

Answer 11

Primitive white cells called ‘blasts’ seen in acute leukaemia (a bone marrow disease).

Here, white cells are huge in relation to red cells. Very immature.