LabCE Course - White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions

Decreased platelets

A blood specimen is received in the laboratory from a patient with suspected hemolytic uremic syndrome (HUS). A peripheral blood smear was made and schistocytes were observed. Which of the following would also be reported, if the patient's diagnosis is HUS

Parasitic infection

A peripheral blood smear was reviewed and a representative field is shown on the right. Which of the following conditions may produce the results seen in this image

Septicemia

A peripheral blood smear with many myeloid cells was presented for morphology review (see image on the right). Toxic granulation and vacuoles in the neutrophil most likely represent which of the following conditions

Allergic reactions

A peripheral smear was submitted for review due to increased monocytes on the automated differential. The images on the right are representative fields from the Wright-Giemsa stained blood smear (1000X magnification). The increased monocytes and peripheral picture are consistent with each of the following conditions EXCEPT

DIC Autoimmune thrombocytopenia

A representative field from a peripheral blood smear, seen on the right, was held for morophological and clinical review as the total platelet count was 10.0 X 109/L. Conditions associated with these findings are

Reactive/atypical lymphocytes

An automated hematology counter flagged the white blood cell count. Upon review of the peripheral blood smear, the technologist viewed many cells that appeared similar to those in this image. What should the technologist report

True

An automated platelet count of 40.0 X 109/L was reported. Review of the peripheral blood smear (see image to the right) reveals single platelets in open fields as well as platelet clumps. The platelet count is likely INCORRECT

Pelger-Huet anomaly

Approximately 80 - 90% of the neutrophils on the peripheral blood smear of a young man are similar to those in the image. This peripheral smear most likely represents which condition

Frame A Frame B Frame C Frame D

Chediak-Higashi anomaly Parasitic infections Chronic metabolic conditions, such as diabetes mellitus Severe inflammatory states

Use of EDTA as the anticoagulant

Platelet satellites (see image to the right) may account for low platelet counts as determined by automated hematology cell counters. Satellitosis is initiated by

False

The image on the right is a microscopic field from a Wright-Giemsa stained peripheral blood smear (1000X magnification). The structure indicated by the arrow is an artifact and should not be reported

Include "giant platelets" on the report as this is the cell indicated by the arrow

The image on the right is a representative field from a Wright-Giemsa stained peripheral blood smear (1000X magnification). Based on the cell that is indicated by the arrow, what action should be taken

Chediak-Higashi anomaly inclusions

The inclusions noted in the cytoplasm of this white blood cell are most suggestive of which of these conditions

Toxic left shift

The neutrophils illustrated in this image are representative of those seen in a female patient's peripheral blood smear. The total WBC was 28.5 X 109/L (reference interval = 4.0 - 11.0). Which of the following BEST describes the condition associated with this WBC count and the white blood cells that are present in the image

False

The association of increased platelets accompanying neutrophilia and toxic granulation, as illustrated in this image, is called thrombocytopenia

Severe burns

The cell containing the inclusions indicated by the arrows are often associated with which of the following conditions

Bacterial infections Hemolytic anemia

The peripheral blood smear shown in this image was held for review because of an increased platelet count. Conditions in which platelets are increased include

Multiple myeloma

The upper image of a peripheral blood smear reveals RBC rouleaux formation. Several blood cells that are similar in appearance to the one indicated by the arrow in the bottom image are also seen on the smear. Which of the following conditions is associated with both of these findings

False

The white blood cell indicated by the arrow is representative of the atypical white blood cell associated with infectious mononucleosis

A decrease platelet count

This image is representative of a peripheral blood smear. As a result of this phenomenon, some automated automated hematology analzyers may report

Lysosomal enzymes Primary azurophilic granules

Toxic granulation noted in the neutrophils' cytoplasm reflects an increase in activity of which of the following

Chediak-Higashi anomaly

Which of the following conditions is NOT associated with an increase in the white blood cell shown in the image on the right

May Hegglin

Which of the following conditions may produce the findings indicated by the arrows in the image on the right

Image B

Which of the images below represents an area of appropriate cell density to choose for performance of a manual differential

Platelet satellitosis

Which of these conditions is associated with a pseudo-thrombocytopenia