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Making the diagnosis in Hematology Part 1
 
Think of… ,[object Object],[object Object],[object Object]
RBC ,[object Object],[object Object]
Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Causes of microcytic anemia ,[object Object],[object Object],[object Object],[object Object]
Main lab features of iron deficiency anemia  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Main lab features of anemia of chronic disease ,[object Object],[object Object],[object Object]
Main features of sideroblastic anemia ,[object Object]
 
Thalassaemias ,[object Object],[object Object],[object Object],[object Object]
Types of Hemoglobin
β- thalassaemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
β- thalassaemia
β- thalassaemia ,[object Object],[object Object],[object Object],[object Object]
α  -thalassaemia ,[object Object],[object Object],[object Object],[object Object],[object Object]
α  -thalassaemia
[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of normocytic anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of macrocytic anemia ,[object Object],[object Object]
Causes of macrocytosis (Raised MCV) with  megaloblastic  marrow ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of macrocytosis (Raised MCV) with  normoblastic  marrow ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Megaloblast vs normoblast. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lab features in pernicious anemia ,[object Object],[object Object],[object Object],[object Object]
Principles of Schilling’s test. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other causes of B12 deficiency
Causes of aplastic anemia
Lab findings in aplastic anemia ,[object Object],[object Object],[object Object]
Causes for pancytopenia
Causes of Hemolytic anemia
Lab findings suggestive of hemolysis. ,[object Object],[object Object],[object Object],[object Object],[object Object]
Conditions with intravascular hemolysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Result of increased red cell breakdown ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Result of increased red cell production ,[object Object],[object Object]
Causes of inherited hemolytic anemia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of acquired hemolytic anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How to find the cause of hemolysis? ,[object Object],[object Object],[object Object]
Specific features of each condition. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of MAHA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Peripheral Blood film ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
A normal blood film, with a neutrophil, normal red cells, and platelets (arrows).
Microcytic hypochromic cells in iron deficiency anaemia
Poikilocytosis and anisocytosis seen in iron deficiency anaemia.
Pathological ring sideroblasts in the bone marrow, with a perinuclear ring of iron granules, found in sideroblastic anaemia
Acanthocytosis.
Basophilic stippling.
Burr cells
Left-shift: presence of immature neutrophils in the blood
Pappenheimer bodies
Reticulocytes. RNA in RBCs; supravital staining (azure B; cresyl blue) is needed
Rouleaux formation
Film in hyposplenism: target cell (short arrow), acanthocyte (long arrow) and a Howell-Jolly body (arrow head).
 
A Cabot ring; these red/purple-staining filamentous figure-of-8 rings are often seen in RBCs with basophilic stippling. They occur in severe or megaloblastic anaemia, leukaemia, and lead poisoning.
Megaloblastic anaemia: peripheral blood film showing many macrocytes and one hypersegmented neutrophil (normally there should be <5 segments).
A bite cell in G6PD, following removal of Heinz bodies by the spleen. Heinz bodies are formed from oxidized, denatured Hb during oxidative crises
Blister cells (arrows) in G6PD, following removal of Heinz bodies. Also contracted red cells (arrowheads).
 
Microangiopathic anaemia eg from DIC: numerous cell fragments (schistocytes) are present
Fibrin strands, deposited in HUS & TTP, slice up passing red cells (microangiopathic anaemia).
Hereditary spherocytosis.
 
Hereditary elliptocytosis
Blood film in sickle-cell anaemia: there are sickle cells, target cells, and a nucleated red cell .
 
 
 
 
 
Leg ulcers in sickle cell disease.

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Making the diagnosis in hematology