BLOOD FILM

Question 1

Starry sky

Answer 1

Burkitts lymphoma

Question 2

Tear drop poikilcytes

Answer 2

Myelofibrosis

Question 3

Schistocytes

Answer 3

Intravasc haemolysis

Question 4

Hypersegmented neutrophils

Answer 4

Megaloblastic anaemia (b12, folate)

Question 5

Pencil poikilocytes

Answer 5

Iron def anaemia

Question 6

Dimorphic film

Answer 6

Iron + B12/folate deficiency

Question 7

Howel-Jolly bodies

basophilic purple spot on oesinophilic pink RBC

Answer 7

Hyposplenism

eg Thalasaemia, sickle cell, post-splenectomy

Question 8

++++Spheroytes

Answer 8

Hered spherocytosis

Question 9

Heinz Bodies

Answer 9

G6PD deficiency

Question 10

Sickles RBC

Answer 10

Sickle cell

Question 11

Low HbA

High HbS

Answer 11

Sickle cell

NO HbA in HbSS homoxygous..

Question 12

Low HbA

High HbF

Answer 12

Thallasaemia

+ HbS = sickle cell

Question 13

+Dithionate

Answer 13

Sickle Solubility Test goes TURBID

Question 14

+ Sodium Meta-bi-sulphate

Answer 14

Mimics deoxygenation

Sickle cell SICKLES

Question 15

Hyposplenism

Answer 15

Target
Howel-Jolly
Pappenheimer
Siderotic granules
Acanthocytes

Question 16

Target
Howel-Jolly
Pappenheimer
Siderotic granules
Acanthocytes

Answer 16

Thalassaemia
Sickle cell
Post-splenectomy

Question 17

Burr cells

Answer 17

Micro (haemolytic uraemic, DIC, malig HTN)
Macroangiopathic haemolysis (mech valves)

Question 18

Helmit cells

Answer 18

Micro (haemolytic uraemic, DIC, malig HTN)
Macroangiopathic haemolysis (mech valves)

Question 19

Triangle cells

Answer 19

Micro (haemolytic uraemic, DIC, malig HTN)
Macroangiopathic haemolysis (mech valves)

Question 20

Ham’s acid lysis

Answer 20

Paroxysmal nocturnal haemoglobinuria

Question 21

Intermittent dark haematouria

Answer 21

Paroxysmal nocturnal haemaglobinuria

Question 22

Infection, pancytopenia + mouth ulcers

Answer 22

Aplastic anaemia

Question 23

Terminal ilium

Answer 23

B12

Question 24

RLB12 + IMB12 = increased RLB12 in urine

Answer 24

RLB12 + IMB12 = increased RLB12 in urine

DIETARY

Question 25

RLB12 + IF = increased RLB12 in urine

Answer 25

Pernicious anaemia! | ABs to parietal ells which produce IF

Question 26

RLB12 + ABx = increased RLB12 in urine

Answer 26

Bacterial overgrowth!

Question 27

RLB12 + Pancreatic enzymes = increased RLB12 in urine

Answer 27

Pancreatic insufficiency

Question 28

Jejunum

Answer 28

Folate

Question 29

Correct B12 or folate first? Why?

Answer 29

B12 > folate | Fulminant Neuroloical Deficit

Question 30

Low serum iron Low transferrin sat Low TIBC High ferritin

Answer 30

Anaemia of chronic disease

Question 31

Low serum iron Low transferrin sat Low ferritin High TIBC

Answer 31

Iron def anaemia

Question 32

Frontal bossing

Answer 32

Bmajor thallaemia

Question 33

Hair on end skull

Answer 33

Bmajor thalaesmia

Question 34

Avasc necrosis of femoral head

Answer 34

Sickle cell

Question 35

Anisocytes + Micro

Answer 35

Sickle cell | Iron def

Question 36

Parovirus B19

Answer 36

Sickle Aplastic crisis | temp BM failure, reticulocytopenia/ cytosis

Question 37

Sickle cell Acute HB drop

Answer 37

Haemolytic crisis

Question 38

Sickle cell sudden spleen enlargement

Answer 38

Splenic sequestration vaso-occlusive crisis

Question 39

Sicle cell sudden bone pain

Answer 39

Bony crisis

Question 40

Splenetomy leaves you prone to..?

Answer 40

Encapsulated: meningococcal, pneumococcal

Question 41

Fragile smudge cells

Answer 41

CLL