Haematology

WBC Demonstration Slides 1 – 3 show the normal morphology of white blood cells that may be seen in the peripheral blood. Please answer the questions asked in relation to each of the subsequent Slides (4 -11) Slide 4 Peripheral blood film of a 26-year-old male admitted with two a day history of fever. Hb 13.5, WBC 25 x 109/L, plat 300 x 109/L Question a. What is the most likely cause of this blood picture? Slide 5 (2 slides) The peripheral blood film of a 47 year old patient is provided. He is known to be a diabetic. Two days ago he injured his left foot and presents with features of cellulitis. Hb 10.8 g/dl, WBC 102 x 109/L, platelets 804 x 109/L Questions a. List the white cells seen on the slide b. What is the differential diagnosis? c. Give 2 laboratory tests that will help to differentiate them Slide 6 A 75-year-old female had her yearly medical which was normal. A routine CBC revealed Hb 11.1 g/dl, WBC 45 x 109/L, platelets 333 x 109/L Flow cytometry of the white blood cells showed positivity with CD 5, CD 19, and CD 20. Questions a. What is the most likely diagnosis? b. What is the stage of the disease and management of the patient? Slide 7 (2 slides) Peripheral blood film and trephine biopsy of a 70 year old male who presented with night sweats and weight loss. Questions a. What are the abnormal findings on the peripheral blood film and trephine

biopsy? b. What characteristic clinical finding would you expect?

Haematology

Slide 8 This peripheral blood film is from a 12 year old boy with gum bleeding and joint pains. Hb 6.3 g/dl, WBC 153 x 109/L, platelets 28 x 109/L Questions a. What are the abnormal findings on the film? b. List two differential diagnoses c. Give 2 laboratory tests that will help to differentiate them Slide 9 Examine the peripheral blood film of a 25 year old female with petechiae and pallor. Hb 4.2 g/dl WBC 110 x 109/L platelet 36 x 109/L Question a. Describe the abnormality on the slide and give the likely diagnosis. Slide 10 (2 slides) Peripheral blood film of a 42 year old female who presented with a 3 month history of skin rash and two day history of confusion. Questions a. Name the causative agent of this patient’s condition. b. Give 2 reasons for the patient’s confused state. Slide 11 (a & b – 3 slides) Peripheral blood film and bone marrow aspirate of a 66-year-old male who presented with a pathological fracture of his (L) humerus. Hb 7.6 g/dl WBC 6.2 x 109/L platelets 150 x 109/L Questions a. Identify the predominant cells seen on the bone marrow aspirate. b. What additional tests are needed to confirm the diagnosis? Indicate

expected results. c. Which one of the following protein electrophoretic strips (slide 11c) is in

keeping with the diagnosis above?