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lymphocyte

This is a photomicrograph of a peripheral blood film showing a large cell with several erythrocytes. The cell has a spherical basophilic nucleus. The chromatin is condensed and appears as coarse clumps with a scanty/thin rim of cytoplasm which is slightly basophilic with few azurophilic granules. Function. Acquired immunity eg against viruses, chronic infections etc

monocyte

This is a photomicrograph of a peripheral blood film showing a large cell with a an abundant basophilic cytoplasm containing scanty fine azurophilic granules. The nucleus is basophilic and closed,convoluted/bean shaped and eccentric it contain 2 nucleoli in the nucleus. Function. They migrate to tissues to become tissue macrophages and are involved in phagocytosis.

neutrophil

This is a photomicrograph of a peripheral blood film showing a large cell with abundant basophilic cytoplasm containing abundant granules. The nucleus contain 4 lobes linked by fine threads of chromatin.

Function. Innate immunity/ front line defense phagocytosis

Eosinophil

This is a photomicrograph of a peripheral blood film showing a large oval cell with some erythrocytes. The cell has abundant cytoplasm with many large elongated refractile specific eosinophilic granules. The nucleus is bilobed

Function. Hypersensitivity and parasite infection.

Plasma cells in multiple myeloma

This is a bone marrow aspiration film showing large number of plasma cells with many abnormal forms. Diagnosis. Multiple myeloma Treatment. CDT cyclophosphamide, dexamethasone, thalidomide. CVAD. Cyclophosphamide, vincristine adriamycin, dexamethasone. IDEX. Idarubicin, Dexamethasone. others melphalan, d- interferon. Clinical features. Bone pain features of anemia recurrent infections features of renal failure abnormal bleeding tendency amyloidosis

This is a peripheral blood film showingcells at various stages of granulopoiesis, including promyelocytes, myelocytes, metamyelocyte, band(arrow) and segmentet form of neutrophils Diagnosis. Chronic myeloid leukemia. Treatment. Tyrosine kinase inhibitor eg imatinib(Glivec) hydroxyurea alpha interferon busulphan. Clinical features. symptoms of hypermetabolism (weight loss, anorexia night sweat) splenomegaly features of anemia(palor, tachycardia) bruising, epistasis, menorrhagia, hemorrhage. gout due to hyperuricemia

This is a peripheral blood film showing parasitic infection of the blood(parasitemia) with some blood cells. The parasites appear slender. Flagelated (hemoflagelate) Diagnosis. Trypanosomiasis parasitemia Treatment. Melosoprole pentamidine Hematological findings

This is a lymph node biopsy showing two typical multinucleated Reed-Sternberg cells exceptionally prominent nucleoli, and abundant, usually slightly eosinophilic, cytoplasm. Particularly characteristic is a cell with two mirror-image nuclei or nuclear lobes, each containing a large (inclusion-like) acidophilic nucleolus surrounded by a distinctive clear zone with a characteristic owl eye appearance surrounded by lymphocytes, histiocytes, eosinophils. Diagnosis. Hodgkins disease/lymphoma Histological types. nodular sclerosis mixed cellularity lymphocyte rich lymphocyte depleted lymphocyte predominant Clinical feature. Painless non-tender asymmetric firm,descrete and rubbery enlargement of superficial lymph nodes Clinical splenomegaly Mediastinal involvement Cutaneous hodgkins disease Constitutional symptoms, fever pruritus alcohol induced pain weight loss Treatment. radiotherapy +- chemotherapy(ABVD. Adriamycin, bleomycin, vinblastine, dacarbazine) Investigation to confirm stage. Chest X-ray, lymph node biopsy

This is a peripheral blood film showing large blast myeloid cells(M1-without maturation) with scanty cytoplasm and eccentric nucleus. The cells show prominent Auer rods. Myeloblasts have delicate nuclear chromatin, prominent nucleoli, and fine azurophilic granules in the cytoplasm. Diagnosis. Acute myeloid leukemia Classification. FAB. M0- without differentiation M1- without maturation M2- with granulocytic maturation t(8;21) M3- acute promyelocytic t(15; 17) M4- granulocytic and monocytic maturation inv(16) M5- monoblastic(5a), monocytic(5b) M6- erythroleukemia M7- megakaryoblastic Clinical features. features of anemia, pallor, jaundice hepatosplenomegaly hemorrhage gingival hypertrophy ptosis due to leukemic deposit of cells in the posterior chamber. Treatment. Daunorubicin, cytosine, arabinoside, etoposide Prognosis Good= t(8; 21), t(15; 17), inv(16) nuleophosmin mutation(NPM), <5% blast after first course, <60 years, primary onset Bad= deletion of chromosome 5 or 7, flt-3 mutation, 11q23, t(6; 9), abn(3q), complex rearrangements, >20% blast after first course, > 60 years, secondary onset.

This is a peripheral blood film showing oval macrocytes and portion of the neutrophils show hypersegmented nuclei (6 lobes). Diagnosis. Megaloblastic anemia Causes. Folate and vitamin B12 deficiency pernicious anemia liver disease alcoholism chronic infections Pelger Huet anormaly Treatment. Hydroxocobalamin (intramuscular) folate orally.

Mixed cellularity of hodgkins lymphoma

This is a skull X-ray showing hair- on-end appearance as a result of expansion of the bone into cortical bone. Diagnosis. B- thalassaemia major Clinical features. Severe anemia at 3-6 month after birth enlargement of the liver and spleen expansion of bone by intense marrow hyperplasia. Treatments. Regular blood transfusion regular folate iron chelation- deferoxamine vitamin c to increase the excretion of iron produced by desferoxamine endocrine therapy either as replacement or to stimulate the pitutary if puberty delays allogenic bone marrow transplant

This is a peripheral blood film showing lymphocytes with thin rims of cytoplasm coarse condensed nuclear chromatin and rare nucleoli with a characteristic typical smudge or smear or basket cell (arrow) Diagnosis. Chronic lymphocytic leukemia Clinical features. Symmetrical enlargement of cervical, axillary, or inguinal lymph nodes features of anemia splenomegaly and less commonly hepatomegaly are seen commonly in later stage immunosupression with infections treatment. chlorambucil, cyclophosphamide, prednisolone, fludarabin, rituximab. Or combined therapy CHOP(cyclophosphamide, hydroxydaunorubicin, oncovin, prodnisolone)

This is a peripheral blood film showing various stages of granulopoiesis, including promyelocyte, myelocytes, metamyelocytes, and band and segmented forms of neutrophils. Diagnosis. Chronic myeloid leukemia. Clinical symptoms of hypermetabolism, weight loss lassitude, anorexia, night sweats. splenomegaly features of anemia bruising, epistasis menorrhagia gout or renal impairment dur to hyperuricemia rarly, visual disturbance and priapism Chromosomal abnormality associated. Philadelphia chromosome Ph =t(9; 22) Classification. Chronic myeloid leukemia Ph+( also called chronic granulocytic leukemia ) chronic myeloid leukemia Phjuvenile chronic myeloid luekemia chronic neutrophilic leukemia eosinophilic leukemia chronic myelomonocytic leukemia Treatment. tyrosin kinase inhibitor- imatinib(|Glivec) busulfan alpha interferon hydroxyurea

This is a peripheral blood film showing red blood cell with rouleaux formation. Diagnosis. Multiple myeloma Clinical feature. Bone pain features of anemia pallor tachycardia, lathargy, dypsnoea recurrent infections features of renal failure and/or hypercalcemia, polydipsia,polyurea abnormal bleeding tendency amyloidosis hyperviscosity syndrome with purpura, hemorrhage,visual failure. CNS symptoms neuropathy, heart failure Treatment. CDT(cyclophosphamide, dexamethasone, thalidomite), CVAD(cyclophosphamide, vincristine, adriamycin, dexamethasone), IDEX(idarubicin, dexamethasone,). others. Melphalan, d-interferon

This is a peripheral blood film showing red blood cells that are microcytic and pale(hypochromic) with pencil poikilocytes(arrow) and target cells. Diagnosis. Iron deficiency anemia Differential diagnosis. Liver disease(where you will find macrocytic and target cells) Causes. Chronic blood loss eg. In peptic ulcer increased demand eg during growth malabsorption eg in gastrectomy poor diet especially in children Clinical features. painless glositis angular stomatitis koilonychia Plummer-Vinson syndrome irritability poor cognitive function decline in psychomotor development Treatment. Oral ferrous sulphate, ferrous gluconate Parenteral iron dextran, iron sorbitol, ferric hydroxide sucrose

Abrams needle

Babcock tissue forceps

Bone marrow trephine(Jamshidi) biopsy needle

Can be used in polycythemia vera, myelofibrosis, lymphoma

Chest aspiration set

Lanes forceps

Morris bone holder

Spinal needle and stylet

Verres needle

The radiograph of the right elbow showing destruction of the joint space with bony ankylosis with subcortical cystic area. Diagnosis. Hemophilia A

Identify this specimen what anticoagulant is present what is the ratio of aanticoagulant to blood state 4 uses in haematology

Coagulation bottle. Trisodium citratein liquid form 1:9 aPTT Thrombin time Prothrombin time Factors V VII VIII IX assay

Identify this specimen what is the anticoagulant present state its uses in haematology list 5 products that can be prepared
Double unit blood bag Citrate phosphate dextrose adenine(CPDA) It is used to collect, prepare and store whole blood and blood products red cell concentrate platelet concentrate fresh frozen plasma platelet poor plasma platelet rich plasma cryoprecipitate cryosuppernatant

Identify this specimen what anticoagulant is present what is the ratio of blood to anticoagulant state its uses in haematology
EDTA(ethylene diamine tetracetic acid) bottle K2 or K3 EDTA in droplets 9:1 pcv full blood count wbc count platelets count Hb estimation Blood indices

Identify this specimen what is the name of the anticoagulant what is the ratio of blood to anticoagulant what are its uses in haematology Erythrocyte sedimentation rate(ESR) bottle. Trisodium citrate 4:1 Use to estimate ESR

It is markedly low. Anemic the normal values are Male=40-54 Female= 34-48 Hemoglobinopathies, SCA Bone marrow dysplasia e.g. red cell aplasia, aplastic anemia Deficiency e.g. iron deficiency Leukemia e.g. AML, CLL, ALL

PCV: 15% Comment on this result List 5 haematological disorders that can give rise to this result

The prothrombin time is markedly prolonged Normal values are, 11-16 seconds PTratio= patient PT/control PT=42/14=3 INR= Ptratio^ISI= 3^1.3=4.17 Normal= 0.8- 1.2 Warfarin therapy Aspirin therapy Liver disease Deficiency of factors I II V VII X DIC

Prothrombin time Patient: 42s Control:14s Comment on this result Calculate the PTR ISI of thromboplastin 1.30, calculate the INR What is the normal INR Give 4 factors that can lead to its prolongation

Identify this specimen state its use in haematology what are the normal values for the indicated use

Westergren bottle For estimating ESR Male= 10-30 Female= 19-35

Identify the specimen in what condition do u find this what are the histological types list 1 investigation that can be done to confirm staging list two treatment modalities

Identify this specimen what is ur diagnosis mention another diagnostic feature what are the clinical features of this condition what is the earliest manifestation list two confirmatory test list 4 indications for blood transfusion in this condition

A peripheral blood film showing sickle cells, target cell and polychromasia Diagnosis Sickle cell anemia Clinical features. severe hemolytic anemia leg ulcers crises. Vasoclusive, sequestration, aplastic, hemolytic. osteomyelitis autosplenectomy Hand and-foot syndrome Sickling test/solubility test, elecrophoresis Serious sequesration crisis Acute chest syndrome Priapism Bone pain

Identify this specimen what is your diagnosis what chromosomal abnormality is associated with this condition classify this condition list two treatment modalities

Identify this specimen what is your diagnosis list 4 good prognostic factors list 4 bad prognostic factors list 2 treatment modalities

This is a peripheral blood film showing blast cell with scanty cytoplasm without granules Diagnosis. Acute lymphocytic leukemia Classification. L1 blast cells small uniform, high nuclear to cytoplasmic ratio L2 blast cells larger, heterogenous, lower nuclear to cytoplasmic ratio L3 vacuolated blast, basophilic cytoplasm (usually B-ALL) Prognostic Good= low WBC, girl, B-ALL, child, normal or hyperdiploidy TELL rearrangement, <1 week to clear blast from blood, <4 weeks of remission, absence of CNS disease at presentation, negative minimal residual disease at 1-3 months Bad= high WBC(>50X1^9/L), boy, T-ALL, adult or infant <2 years, Ph+(Philadelphia chromosome),11q rearrangement, >1 week to clear blast from blood,> 4 weeks of remission, presence of CNS disease at presentation, minimal residual disease still positive at 3-6 months Treatment modality. induction. Vincristine, asparaginase. consolidation. E.g cytosine arabinoside in1-4 courses cranial prophylaxis. High dose systemic methotrexate +multiple inthratecal methotrexate maintenance therapy. E.g mercaptopurine, methotrexate dexamethasone late intensification(as consolidation). maintenance therapy. (as above 2-3 years)

The ESR is markedly raised Normal values male= 10-30 Female= 19-35 Hematological conditions sickle cell anemia Severe iron deficiency anemia Severe hemolytic anemia Aplastic anemia Leukemias e.g AML ALL. CML, CLL Anemia of chronic disease Non hematological. severe hemorrhage Waldenstrom macroglobulinemia Chronic infection e.g TB Thyrotoxicosis Autoimmune conditions, SLE RA Polymyalgia rheumatica

ESR: 130mm/hr Comment on the above result What is the normal ESR LIST 4 haematological disorders and 5 nonheamatological disorders that can give rise to this condition

Anti-A Patient 1 Patient 2 _ +

Anti-B v _

Anti-AB v +

Anti-D _ +

Patient3
Patient 4 Patient 5

_
v _

_
+ +

_
+ +

+
_ +

What are the blood group of these patients? Mention the antigens on the surface of the RBCs name the antibody/antibodies you will find in their serum what are the methods of blood grouping

A 22yr old female with generalised lymphadenopathy, fever, abdominal pain, hepatosplenomagaly. PCV: 21% WBC: 125 000/mm3 Neutrophil:5%, lymphocytes: 95% Platelets: 11 000/mm3 Comment on this result Whats ur diagnosis

Identiify this specimen whats the anticoagulant present list 6 uses in haematology

Sterile bottle. No anticoagulant Used for HBV screening HCV screning HIV screening

Identify this specimen what is the anticoagulant present stae its uses in haematology
Universal bottle No anticoagulant for HIV screening

Identify this specimen what is the anticoagulant present what is the volume of anticoagulant present what is the shelf life and storage temperature

Single unite blood bag Citrate phosphate dextrose adenine 63ml The blood collected is stored for 35 days at -2 to -6 oc

Identify this specimen what is ur diagnosis what are the clinical features of this condition what other variants do u know

Identify this specimen what is your diagnosis mention three other diagnostic features whtat is the MCV in this condition mention 2 mechanisms of this condition