Haematology

Question 1

Blood Film Findings

1. Anisocytosis - meaning and when is it seen?
2. Target cells - meaning and when is it seen?
3. Heinz bodies - meaning and when is it seen?
4. Howell-Jolly bodies - meaning and when is it seen?
5. Reticulocytes - meaning and when is it seen?
6. Schistocytes- meaning and when is it seen?
7. Sideroblasts -meaning and when is it seen?
8. Smudge cells - meaning and when is it seen?
9. Spherocytes- meaning and when is it seen?

Answer 1

1. Variation in size of blood cells. MDS.
2. Central pigmented area, surrounded by pale area. Bull’s eye target. IDA and post-splenectomy.
3. Blobs seen inside RBCs caused by denatured globin. G6PD and alpha-thalassaemia
4. Blobs of DNA inside RBCS. Post-splenectomy, severe anaemia
5. Immature RBCs. Haemolytic anaemia
6. Fragments of RBCs. HUS, DIC, TTP, haemolytic anaemia
7. Immature RBCs that contain blobs of iron. MDS
8. Ruptured WBCs. CLL
9. Spherical blood cells. Autoimmune haemolytic anaemia or hereditary spherocytosis.

Question 2

Anaemia

1. Causes of microcytic anaemia
2. Causes of normocytic anaemia
3. Causes of macrocytic anaemia

Answer 2

1. Thalassaemia, anaemic of chronic disease, IDA, lead poisoning, sideroblastic anaemia
2. Anaemia of chronic disease, acute blood loss, aplastic anaemia, haemolytic anaemia, hypothyroidism
3. B12, folate deficiency, alcohol, liver disease, hypothyroidism, reticulocytosis

Question 3

Haemolytic Anaemia

1. Features
2. Investigations

Hereditary Spherocytosis

1. Inheritance pattern
2. Presentation
3. Lab findings
4. Treatment

G6PD Deficiency

1. Inheritance pattern
2. Presentation
3. Diagnostic test
4. Meds that trigger haemolysis
5. Other things that trigger haemolysis

Autoimmune Haemolytic Anaemia

1. Causes of cold type AIHA
2. Management of AIHA

Answer 3

1. Anaemia, splenomegaly, jaundice
2. FBC - normocytic anaemia, blood film - schistocytes, direct Coomb’s test (positive in autoimmune haemolytic anaemia)
3. AD
4. Jaundice, gallstones, splenomegaly, aplastic crisis in presence of parvovirus
5. MCHC raised, reticulocytes raised, spherocytes on film
6. Folate and splenectomy
7. X-linked recessive
8. jaundice, gallstones, anaemia, splenomegaly, Heinz bodies
9. G6PD enzyme assay
10. Primaquine, ciprofloxacin, sulfonylureas, sulfasalazine
11. Infections, fava beans
12. Lymphoma, leukaemia, SLE, infections (EBV, CMV, HIV)
13. Transfusions, prednisolone, rituximab, splenectomy