(1)Study group Haem practical
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67 Terms
What is the normal reticulocyte count?
0.5–2%.
What is the main diagnosis in a patient with Hb 6.9 g/dL, RBC 2.90 ×10¹²/L, PCV 23.1%, MCV 70.5 fL, MCH 23.8 pg and RDW 18.6%?
Iron deficiency anaemia.
Which haemoglobin finding supports anaemia in iron deficiency?
Low haemoglobin (6.9 g/dL).
Which RBC index indicates microcytosis?
Low MCV.
Which RBC index indicates hypochromia?
Low MCH.
What does an increased RDW indicate?
Anisocytosis (variation in red cell size).
What white cell abnormality may accompany iron deficiency anaemia in this case?
Neutrophilia.
Mention a cause of neutrophilia in iron deficiency anaemia cases.
Stress, infection or a reactive state.
Name one differential diagnosis of iron deficiency anaemia.
Anaemia of chronic disease.
Another differential diagnosis of iron deficiency anaemia?
Thalassaemia trait.
Another differential diagnosis of iron deficiency anaemia?
Lead poisoning.
Another differential diagnosis of iron deficiency anaemia?
Sideroblastic anaemia.
What is the best initial investigation for iron deficiency anaemia?
Serum ferritin.
Which iron study measures circulating iron?
Serum iron.
Which investigation measures the iron-binding capacity of transferrin?
Total Iron Binding Capacity (TIBC).
Which test estimates the proportion of transferrin occupied by iron?
Transferrin saturation.
How is the nucleus of a plasma cell positioned?
Eccentrically placed.
Describe the chromatin pattern of a plasma cell.
Clock-face (cartwheel) chromatin.
What is the staining characteristic of plasma cell cytoplasm?
Moderately to deeply basophilic.
What produces the perinuclear halo in plasma cells?
Prominent Golgi apparatus.
Plasma cells may occasionally have how many nuclei?
Two or multiple nuclei.
Uniform plasma cells suggest what process?
Clonal proliferation.
Is multiple myeloma a clonal disorder?
Yes.
Which immunoglobulin abnormality characterizes multiple myeloma?
Monoclonal immunoglobulin (M protein).
What is the common differential diagnosis for reactive plasma cell proliferation?
Reactive plasmacytosis.
Which lymphoma may resemble plasma cells morphologically?
Plasmablastic lymphoma.
Which lymphoplasmacytic lymphoma produces IgM paraprotein?
Waldenström macroglobulinaemia.
Which investigation demonstrates the M-protein spike?
Serum protein electrophoresis (SPEP).
Which bone marrow finding confirms multiple myeloma?
More than 10% clonal plasma cells.
Which investigation assesses clonality using the κ/λ ratio?
Serum free light chain assay.
Which differentiated B cell is responsible for antibody production?
Plasma cell.
What is another name for clock-face chromatin?
Spoke-wheel chromatin.
What is another name for the perinuclear clear zone?
Hof.
What characteristic RBC arrangement is seen in multiple myeloma?
Rouleaux formation.
What causes rouleaux formation?
Increased serum proteins reducing RBC surface charge.
How do RBCs appear in rouleaux formation?
Like stacked coins.
Which type of anaemia is classically seen in multiple myeloma?
Normocytic normochromic anaemia.
Why may platelet and neutrophil counts be reduced in multiple myeloma?
Bone marrow crowding suppresses normal haematopoiesis.
Which red cell abnormality with increased reticulocytes suggests haemolytic anaemia?
Spherocytes.
What is the likely diagnosis in severe anaemia with spherocytes and raised reticulocytes?
Autoimmune haemolytic anaemia (AIHA).
Give another differential diagnosis of haemolytic anaemia.
G6PD deficiency.
Another differential diagnosis of haemolytic anaemia?
Paroxysmal nocturnal haemoglobinuria (PNH).
Which mutation is commonly associated with Polycythaemia Vera?
JAK2 V617F mutation.
Which laboratory value strongly supports Polycythaemia Vera?
Markedly elevated haematocrit.
What genetic abnormality characterizes CML?
t(9;22)(q34;q11), the Philadelphia chromosome.
What fusion gene is produced by the Philadelphia chromosome?
BCR-ABL1.
What is the Leukocyte Alkaline Phosphatase (LAP) score in CML?
Low.
What is the molecular weight of the BCR-ABL protein commonly found in CML?
210 kDa.
What is the shelf life of blood stored in Acid Citrate Dextrose (ACD)?
21 days.
What is the shelf life of blood stored in CPD?
28 days.
What is the shelf life of blood stored in CPDA?
35 days.
What is the shelf life of blood stored in SAGM?
42 days.
How much blood can a standard blood bag hold?
450–465 mL.
What is the minimum weight for blood donation?
50 kg.
What is the minimum height for blood donation according to the slide?
1.5 m.
Which anticoagulant bottle is used for PCV and reticulocyte count?
Potassium EDTA bottle.
How does EDTA prevent clotting?
By chelating calcium.
Which bottle is commonly used for blood grouping and cross-matching?
Plain bottle.
Which bottle is used for PT and aPTT?
Sodium citrate bottle.
Which cell is diagnostic of Hodgkin lymphoma?
Reed–Sternberg cell.
Which chemotherapy regimen is standard for Hodgkin lymphoma?
ABVD.
What does the A in ABVD stand for?
Adriamycin (Doxorubicin).
What does the B in ABVD stand for?
Bleomycin.
What does the V in ABVD stand for?
Vinblastine.
What does the D in ABVD stand for?
Dacarbazine.
What blood film finding is characteristic of β-thalassaemia?
Target cells.
What is the diagnosis when target cells predominate on the smear?
Beta thalassaemia.