Blood Films and Cases

Question 1

The 4 values you really want to look at on a CBC

Answer 1

WBC
HGB (hemoglobin)
MCV
PLT (platelets)
Tells you about the 3 cell lines and the RBC size

Question 2

How big should a normal red cell usually be?

Answer 2

About the same diameter as a lymphocyte nucleus

Question 3

How do we clinically diagnose anemia?

Answer 3

If a patient’s Hb is low

Question 4

What is the main cause of a lifelong microcytic anemia?

Answer 4

Thalassemia

Question 5

Basophilic stippling is found in what anemia?

Answer 5

Thalassemia

Question 6

Are retics high or low in thalassemia?

Answer 6

High

Its a type of hemolytic anemia

Question 7

What physical findings are common in thalassemia?

Answer 7

Jaundice

Splenomegaly

Question 8

2 cardinal features of anemia of chronic disease

Answer 8

MCV slightly low

Retics are not increased

Question 9

2 causes of macrocytic anemia with increased retics

Answer 9

Hemolysis

Bleeding

Question 10

What do WBCs look like in a megaloblastic anemia?

Answer 10

Hypersegmented

From B12 deficiency or drugs

Question 11

What is a cardinal sign of B12 deficiency

Answer 11

Macrocytic anemia with a very high MCV

Retics would not be increased

Question 12

What would the cause of a non-megaloblastic anemia be if the bone marrow was

1. Normal
2. Abnormal

Answer 12

1. Alcohol excess, liver disease, hypothyroidism, marrow suppression
2. Failure (MDS), infiltration (acute leukemia)

Question 13

Schistocytes + thrombocytopenia =

Answer 13

MAHA (microangiopathic hemolytic anemia)
Destruction of RBCs due to shearing across occluded small blood vessels
Forms schistocytes

Question 14

2 main causes of MAHA

Answer 14

HUS

DIC