Blood Film Signs

Question 1

Sickle Cells

Answer 1

Sickle Cell Anaemia

Question 2

Spherocytes

Answer 2

Hereditary Spherocytosis

Question 3

Dacrocytes

Answer 3

Myelofibrosis

Question 4

Target Cells

Answer 4

Obstructive Jaundice
Liver Disease
Haemoglobinopathies
Hyposplenism

Question 5

Rounded Macrocytes

Answer 5

Alcoholic Liver Disease

Question 6

Oval Macrocytes

Answer 6

Vitamin B12/Folate Deficiency

Question 7

Polychromatic Macrocytes

Answer 7

Young RBCs

Question 8

Irregularly Contracted Cells

Answer 8

Oxidant Damage

Question 9

Elliptocytes

Answer 9

Hereditary Elliptocytosis

Question 10

Pencil Cells

Answer 10

Iron Deficiency

Question 11

Fragments

Answer 11

Mechanical Stress

Question 12

Rouleaux

Answer 12

Plasma Protein Abnormalities

Question 13

Agglutinates

Answer 13

Antibody causing agglutination

Question 14

Howell-Jolly Body

Answer 14

Nuclear remnant from cell, due to poor spleen function

Question 15

Left Shift

Answer 15

Severe bacterial infection

Question 16

Toxic Granulation

Answer 16

Infection, inflammation, necrosis, pregnancy

Question 17

Hypersegmented Neutrophils

Answer 17

Lack of vitamin B12/folate

Question 18

Heinz Body

Answer 18

Haemolytic anaemia

Question 19

Bence Jones Protein (urine)

Answer 19

Light chain, related to lytic lesions (multiple myeloma)

Question 20

Fibrin Split Products

Answer 20

DIC

Question 21

Ham’s Test

Answer 21

Paroxysmal Nocturnal Haemoglobinuria

Question 22

Coomb’s Test

Answer 22

Autoimmune Haemolytic Anaemia

Question 23

Metabisulfite Test

Answer 23

Sickle cell (accelerated deoxygenation)

Question 24

Osmotic Fragility Test

Answer 24

Hereditary Spherocytosis

Question 25

Reticulocyte Test

Answer 25

Decreased in aplastic anaemia, increased in hypersplenism

Question 26

Sudan Black

Answer 26

Differentiates AML and ALL (stains myeloblasts)

Question 27

Myeloperoxidase

Answer 27

Extramedullary Leukaemia

Question 28

Tartrate-Resistant Acid Phosphatase

Answer 28

Hairy Cell Leukaemia

Question 29

Leukocyte Alkaline Phosphatase

Answer 29

Elevated in polycythaemia vera, essential thrombocytosis and myelofibrosis Decreased in paroxysmal nocturnal haemoglobinuria and CML

Question 30

Factor V Deficiency

Answer 30

``` No input from extrinsic pathway Increased PT Increased APTT Normal Platelets Normal Bleeding Time ```

Question 31

Warfarin/Vitamin K Deficiency

Answer 31

``` Inhibition of factors 2, 3, 9, 12 Increased PT Increased APPT Normal Platelets Normal Bleeding Time ```

Question 32

Glanzmann's Thromboaesthesia

Answer 32

``` Platelets lack GLP IIb and IIIa, so fibrinogen binding is disrupted Normal PT Normal APPT Normal Platelets Increased bleeding time ```

Question 33

Bernard Soulier Syndrome

Answer 33

``` GLP Ib (receptor for vWF) is deficient Normal PT Normal APPT Normal Platelets Increased bleeding time ```