MLSC 2121U Hematology I Final Practical Exam Review

Provide: Size & colour, unique characteristics, diagnosis, and differentiating tests

Size & colour: Normo, normo

Unique characteristics: N/A

Diagnosis: Normal

Differentiating tests: N/A

Size & colour: Micro, hypo

Unique characteristics: Faint staining, Targets

Diagnosis: IDA/A- or B-thal minor

Differentiating tests: Iron studies, Genetic testing

Hint: There’s basophilic stippling

Size & colour: Micro, hypo

Unique characteristics: Faint staining, Targets, basophilic stippling

Diagnosis: B-thal minor

Differentiating tests: Genetic testing, Hb electrophoresis

Size & colour: Macro, normo

Unique characteristics: Hypersegmented neutrophils, Oval macrocytes

Diagnosis: Megaloblastic anemia

Differentiating tests: B12/Folate assay, Schillings test

Size & colour: Macro, normo

Unique characteristics: Targets, slight decrease and large PLTs, punchout artifact, rare inclusion bodies

Diagnosis: liver disease / alcoholism

Differentiating tests: Liver enzymes, no response to B12 or folate

Size & colour: Normo, normo

Unique characteristics: Decreased WBCs and PLTs

Diagnosis: Aplastic anemia / pancytopenia

Differentiating tests: Bone marrow, decreased RETICs

Size & colour: Aniso, normo

Unique characteristics: Targets, Sickled cells, NRBCs, polychromasia

Diagnosis: HbSS

Differentiating tests: Sickledex pos., Hb electrophoresis

Size & colour: Aniso, normo

Unique characteristics: “Major mess” (Many different shapes and inclusions (except sickle cell), many NRBCs

Diagnosis: B-thal major

Differentiating tests: Iron studies, Hb electrophoresis

Size & colour: Normo, normo

Unique characteristics: Targets, HbC crystals

Diagnosis: HbCC

Differentiating tests: Hb electrophoresis

Size & colour: Normo, normo

Unique characteristics: Many spherocytes, polychromasia, occational NRBCs

Diagnosis: Hereditary spherocytosis

Differentiating tests: Genetic testing, DAT / (direct coombs test) neg., Increased: osmotic fragility, retic, and bili, Decreased: RBC survival

Size & colour: Agglutinated

Unique characteristics: Agglutination, short and grainy smear

Diagnosis: Cold agglutinin disease

Differentiating tests: DAT / (direct coombs test) pos., thermal amplitude titre

Size & colour: Normo, normo

Unique characteristics: Many elliptocytes

Diagnosis: Hereditary elliptocytosis

Differentiating tests: Genetic (family) studies

Size & colour: Normo, normo

Unique characteristics: Parasitemia level - rings, gametocytes (banana shaped)

Diagnosis: P. falciparum

Differentiating tests: Thick and thin smear, malaria rapid test, parasitemia level

Size & colour: Normo, normo

Unique characteristics: Parasitemia level - rings, schizonts, gametocytes

Diagnosis: Non - P. falciparum

Differentiating tests: Thick and thin smear, malaria rapid test, parasitemia level

Size & colour: Normo, normo

Unique characteristics: Fragments, decreased PLTs, spherocytes, polychromasia

Diagnosis: Microangiopathic hemolytic anemia (MAHA)

Differentiating tests: Rinal and coagulations studies

Size & colour: Normo, normo

Unique characteristics: Very short and thick slide, NRBCs, targets

Diagnosis: Hemolytic disease of the newborn

Differentiating tests: Antibody testing, DAT / (direct coombs test)