STUDY SLIDE 3 (july)

QUESTION :

Blood film‚ from an anaemic male patient aged 75 who had a gastrectomy for carcinoma of stomach six months previously. Comment on the findings.

ANSWER :
 
The red cells show marked membrane irregularities‚ principally acanthocytic changes and fragmentation. Haemolysis is sometimes a complication of red cell damage related to metastatic disease.

STUDY SLIDE 2 (july)

Question :
"A film prepared from the blood of a boy who returned to his boarding school following the summer holidays and developed a fever soon afterwards. The provisional diagnosis on the request form was ""?glandular fever"". What do you see?"

Answer : "Two ring forms of Plasmodium falciparum are shown. Routine examination of thick and thin films remains a sound procedure for the diagnosis of malaria despite the development of ""alternative"" methods. The real problem with making the diagnosis is failure to think of it in the first place."

STUDY SLIDE (july)

QUESTION SLIDE :
Supporting data: A woman of Mediterranean origins aged 30 years‚ the previously healthy mother of three children‚ now complaining of headaches and tiredness. Spleen palpable approximately 4 cm. below the left costal margin. Hb = 9.5 g/dl‚ red cell count 5.0 x10ˆ12/l. Examine the photomicrograph of the patient`s blood film‚ noting your findings and conclusions.

Answer : The red cells are microcytic and hypochromic. A target cell is shown (top left) and there are poikilocytes and small fragmentary forms. The MCH (which you could have obtained from the data provided) is 19 pg. The patient suffered from HbH disease‚ confirmed by electrophoresis and the HbH inclusions test. There was a neutrophil right shift‚ represented in the picture by the cell with six nuclear lobes‚ but a suspicion of folate deficiency was not confirmed by further investigations.