REVISION PRACTICAL SESSION

• The format of the assessment questions for your practical assessment is similar with this revision question
• You are expected to study all the practicals
• Pentra blood analyser


  • Advantages:
  • Provides result quickly: can analyse many blood samples in a shorter time
  • Provides automatic WBC differential count and cell blood count
  • Directly measures HCT, MCV, MCH, Hbg, platelet distribution width
  • Does not require a highly skilled haematologist unlike microscopy

  Disadvantages:

  • Comments on blood cell morphology cannot be generated
  • Abnormal cell shapes such as fragmented RBC cannot be recognised
  • Expensive: relatively high running costs than microscopy
• Bone marrow H & E staining histology (x40)

  1. Slide A

  2. Slide B

  3. Slide C
• Normal cellularity


  Proportion of blood cells is estimated to be between 30% to 70%
• Bone marrow hypercellularity


  Proportion of blood cells estimated to be greater than 70%
• Hypocellularity


  Fewer than 30% blood cells and more fat cells
• Patient's blood group is O negative


  No one is suitable as a donor
• Donor 1 is O+

  Cannot give blood to the patient because of Rh incompatibility
• Donor 2 is AB+


  Patient who is O cannot receive blood from AB+
• Patient is AB positive


  Is a universal recipient, can receive blood from any blood group with Rh positive donor
• Donor 1 is O+


  Can give blood to the patient
• Donor 2 is B+


  Can give blood to the patient
• Sickle cell anaemia


  Inherited disease caused by a defect in a gene
• Iron deficiency anaemia


  Caused by lack of iron, often because of blood loss, pregnancy, infection, and nutritional deficiency (inadequate iron containing nutrients consumption)
• A young male child is presented at the Emergency department with fever and sore throat
• The patient had a recent history of tiredness, multiple bacterial infections over preceding months including clinically diagnosed pneumonia, acute otitis media, streptococcal pharyngitis
• The skin presents diffused bruising
• Full blood count findings

  • RBCs (x10 12 /L): 1.36 (Reference: 4.60–5.40)
  • HB (g/dL): 4.3 (Reference: 11.5–14.5)
  • HCT (%): 13 (Reference: 35–49)
  • MCV (fL): 95.7 (Reference: 80–100)
  • MCH (pg): 31.4 (Reference: 26–32)
  • MCHC (g/dL): 32.8 (Reference: 32–36)
  • RDW (%): 20.8 (Reference: 11.5–14.5)
  • Platelets (x10 9 /L): 28 (Reference: 150–450)
  • Reticulocytes (%): 0.2 (Reference: 0.5–2.5)
  • WBCs (x10 9 /L): 287 (Reference: 3.6–10.6)
  • Neutrophils (%): 16 (Reference: 50–70)
  • Lymphocytes (%): 14 (Reference: 18–42)
  • Monocytes (%): 1.5 (Reference: 2–11)
  • Eosinophils (%): 0.1 (Reference: 1–3)
  • Basophils (%): 0 (Reference: 0–2)
  • Blasts (%): 68.4 (Reference: absent)
• Significantly altered blood counts

  • RBC, HB, HCT, Platelets, lymphocytes, Neutrophils, eosinophils and Reticulocytes significantly reduced

  WBC and RDW significantly increased

  More than two third of the total cells are blast cells which normally expected to be absent
• Acute Myeloid Leukaemia (AML)


  The most likely diagnosis because it significantly affects RBC and platelets, while Acute Lymphoid Leukaemia (ALL) usually does not
• Bone marrow transplantation


  A relatively best treatment option for the patient
• The blood film was performed