diagnosis & further tests Flashcards
What to expect w/ condition of ovalocytes, *(include more0
- Macrocytic
- ovalocyte
- hypersegmentation*
Dx this? & what further testing would you do? FBC - dec. Hb - variable MCV - sub.-pop of RBC
Peripheral blood film
- poikilocytosis: spherocytes*, schistocytes
- polychromasia (+++)
- nRBC
- inc reticulocytes (>2%)
Dx: Haemolytic anaemia
- dec. Hb = anaemia
- variable MCV = macrocytes /reticulocytes
- polychromasia = reticulocytes
- reticulocytes = inc erythropoeisis = compensate for anaemia
Further tests
- Osmotic fragility = inc bc if mostly macrocytic
- Serum bilirubin bc low Hb = inc bilirubin released
- Direct antiglobulin test (DAT) > see if haemolysis is due to Ab
Dx this?
- Spherocytes
- osmotic fragility inc
- DAT: negative
- Reticulocytosis
Hereditary spherocytosis
Dx this?
>25% eliptocytes
~4% reticulocytes
hereditary elliptocytosis
Dx this? & further tests
- +++ stomatocytes
- macrocytosis
Dx: hereditary stomatocytes
Further test
- positive osmotic fragility test
- ektacytometric analysis
Dx this? & further test
- BF: heinz bodies, Bliseter cells, Bite cells, hemighost cells, shistocytes
-Dx: glucose-6-phosphate dehydrogenase deficiency
Further test
- Fluorescent screen test = dec. NADPH, dec. fluorescence
- Definitive test = G6PD enzyme assay
Dx this?
- echinocytes
- reticulocytosis
pyruvate kinase deficiency
Dx this? & further test?
- FBC: macrocytosis (MCV), reticulocytosis
- BF: aggregates of RBC, Poikilocytosis, inc polychromasia
Dx: AIHA cold type
- Test: DAT
- anemia,
- normocytic, normochromic,
- inc RDW (anisocytosis),
- reticulocytosis,
- hyperchromic/spheroc.
- BF: SPHEROCYTES*, inc. polychromasia/reticulo.
Dx: AIHA warm type Further test: - test: DAT = positive (IgG) - osmotic fragility = inc., - Ind. bilirubin = inc
Dx this?
- AIHA
+ immune thrombocytopenia
+/or netropenia
evan’s syndrome
What’s the condition that has
- Thrombocytopenia
- Anaemia
- leukopenia
pancytopenia
Leokocytosis further testing
- immunophenotype
- Functional assay
Dx reactive lymphocytosis
- **Viral infections
- Bacterial Infections
- Other infections: malaria
Dx (at chronic phases) & further tests*
- leukocytosis (+ or +++ inc in WBC)
- Inc granulocyte?*
- Eosinophilia, basophilia
- ~50 mature neutrophils
- (>10% blast = accelerated phase)
Dx: Chronic myeloid leukaemia
Further tests:*
- cytogenetics to detect translocation in 9, 22
- FISH (fluorescence in situ hybridisation) to confirm fusion of genes
Dx this? & Fyrther test?*
- inc Hb, PCV & RBC (*not always Hi)
- Thrombocytosis
- Granulocytosis
Dx: Polycythaemia vera
Further test*
- Epo conc. ?*
- JAK2?*
Dx this? & Further test?
- Thrombocytosis
- anisocytosis of plts (sml to giant)
- microcytic, hypochromic anaemia
Dx: Essential thrombocythaemia
Further test:
- JAK?*
Dx this? Further test?
- Left shift granulocytes
- Atypical MK
- Some (+, ++) microcytoc hypochromic anaema
Dx: Primary myelofibrosis - fibrotic phase
Dx this? Further test?
- monocytosis
- Leukocytosis (inc WBC)
- normal morphology (<20% blast)
Dx: Chronic myelomonocytic leukaemia (CMML)
Further test:
- Cytogenetics = neg
- BM assessment
Reasons/situations to explain reactive lymphocytes in cytoplasm
- Viral infections: influenza
- bacterial infections: tuberculosis
- Other infections: malaria
- Non-infectious: e.g. hypersensitivity
Dx this? Further test?
- Inc MCV
- Normochromic
- Ovalocytes
- mild to marked anaemia
Dx: Megaloblastic macrocytic anaemia
Further test:
- FOlate test: bc could be deficient in folic acid
- Vit. B12 test bc could be defiecient
Dx this? and further treatment
- anaemia
- leukopenia
- thrombocytopenia
- > 20% blast celles
Dx: acute leukaemia
Further test:
- Immunophenotype (detect cell linage affected?)
- Cytogenetic & genetic analysis
diagnosis basophilic stippling (granules) in RBC
D: sideroblastic anaemia (granules of iron in RBC)
FT: iron studies like ferritin test
dx this? further testing
- smudge cells
- lymphocytosis
- neutropenia, thrombocytopenia
Dx: (chronic) lymphocytic leukaemia
Further testing:
- immunophenotype
further test:
- immunophenotype: CD5+
dx this?
- MICROCYTIC
- HYPOCHROMIC
- DACROCYTES/poikilocytes
- occasional HbH includions
dx: (alpha) thalassemia (minor)
further testing:
Hb electrophorhesis: HPLC (can distinguish to IDA -> abnormal iron studies results)
