Emergency Morphology Flashcards
What investigation should be requested in a patient with unexplained anaemia?
What are some possible differentials that can be picked up by the investigation?
Always a blood film (+ other investigations clinically relevant)
- paroxysmal cold haemoglobinuria - will show, Spherocytes, Erythrophagocytosis , Atypical lymphocytes, agglutination
- Megaloblastic - hypersegmented neutrophils
What is paroxysmal cold haemoglobinuria?
It is a haemolytic anaemia caused by a red-cell membrane defect
Clinicalls presents with symptoms of anaemia, and concentrated/ dark urine in the morning
How can haematuria and haemoglobinuria be differentiated?
Centrifuge the urine and if it is haematuria there will be red cells at the bottom and urine at the top – this is haemoglobinuria
What are the main differnetial diagnosis for anaemia in the neonate?
- Haemolytic disease of the newborn
- G6PD deficiency (breast feeding may be relevant – has mother eaten fava beans or is she taking a relevant drug?)
- Maternal parvovirus infection (virus has crossed the placenta)
- Fetomaternal haemorrhage
What differnetials are investigated when peforming an blood film in a patient with acute renal failure?
- Multiple myeloma
- Haemolytic uraemic syndrome
- Thrombotic thrombocytopenic purpura
- Tumour lysis syndrome in high grade haematological neoplasms
- AML or lymphoma with hyperuricaemia
