Blood Film Flashcards
What causes basophilic stippling?
Denatured RNA in RBC
Lead poisoning
What are blasts?
Nucleated precursor cells
Seen in myelofibrosis, leukaemia and malignant marrow infiltration
What are howell jolly bodies?
DNA nuclear remnants in RBC which are normally removed by the spleen
Seen in hyposplenism; sickle cell, coeliac disease
What is hypochromia?
Reduced staining of RBC due to decreased Hb synthesis
Seen in IDA, thalassaemia and sideroblastic anaemia
What is a leukoerythroblastic film?
Immature cells (myelocytes, promyelocytes, metamyelocytes, normoblasts) +/- tear drop RBC from haemolysis or marrow infiltration
What is poikilocytosis?
Variation in RBC, e.g. in IDA, myelofibrosis and thalassaemia
What is polychromasia?
RBC of different ages stain (reticulocytes stain blue)
Response to bleeding, haematinic replacement, haemolysis or marrow infiltration
What is rouleaux formation?
Red cell stack on each other (raised ESR)
Seen in multiple myeloma
What are schistocytes?
Fragmented RBC from slicing via fibrin bands in intravascular haemolysis
Look for microangiopathic haemolysis; DIC, HUS, PET, mechanical heart valves, TTP
What are spherocytes?
Spherical cells found in hereditary spherocytosis and autoimmune haemolytic anaemia
What are target cells?
RBC with central staining, a ring of pallor and an outer rim of staining seen in liver disease, hyposplenism and thalassaemia
What are tear drop RBCs?
Seen in extramedullary hematopoiesis
What can cause a neutrophilia?
Bacterial infections Inflammation Myeloproliferative disorders Drugs (Steroids) Disseminated malignancy Stress
What can cause a neutropenia?
Viral infections
Drugs; post chemo, cytotoxic agents, carbimazole, sulfonamides
Severe sepsis
Neutrophil antibodies; SLE, haemolytic anaemia
Hypersplenism; felty’s syndrome
Bone marrow failure
What is a barr body?
Inactivated X chromosome
What can cause a lymphocytosis?
Acute viral infections
Chronic infections
Leukaemia and lymphoma; esp CLL
Large number of atypical lymphocytes = EBV
What can cause a l yphopenia?
Steroid therapy SLE Uraemia Legionnaire's disease HIV Marrow infiltration Post chemo/radiotherapy
What can cause an eosinophilia?
Drug reactions; erythema multiforme Allergies; asthma; atopy Parasitic infections; esp helminths Skin disease eGPA
What will megaloblastic anaemia show?
Oval macrocytes
Hypersegmented neutrophils
Hypercellular bone marrow
What will a blood film in iron deficiency anaemia show?
Microcytic Hypochromic anaemia Anisocytosis Poikilocytosis Reduced ferritin
By how much should an iron level rise with iron supplements?
10g/L a week
What can cause a thrombocytopenia?
Aplastic anaemia
Megaloblastic anaemia
Marrow infiltration (leukaemia, myeloma)
Marrow suppression (cytotoxic drugs, radiotherapy)
Excess destruction; TIP, SLE, CLL, heparin, viruses
DIC, TTP, HUS
Myeloproliferative disease, NSAIDs, increased urea
