CLS 2551 HEMATOLOGY
PATHOLOGY
for the
CLINICAL LABORATORY TECHNICIAN
DIFFERENTIAL ASSIGNMENTS
The following slides are your assignment
for this semester. Follow the directions to complete each assignment.
01 Obtain a slide and evaluate it by performing the following:
A. Determine the relative WBC
count (%).
B. Estimate the platelet
morphology and number of platelets/OIF.
C. Evaluate erythrocyte
morphology (for this you will need the indices).
D. Write the definitive
diagnoses for each slide.
02 As you complete the case studies and stained blood film
evaluations, you will
develop the skills needed for working in the hematology unit of a clinical lab.
As a student in the two-year program, you will complete these assignments
with an accuracy level of 80% or better and accrue a cumulative grade of
70% or better.
ABOUT THE DEFINITIVE DIAGNOSIS
01 Use the report form provided by
the Program and evaluate the following blood smears.
02 The instructor will evaluate two of your blood film reports and
return it for corrections. After this, your reports will be graded and
returned when each diff has been completed by the class.
03 Calculate the indices for each patient. Also
show your calculations.
04
For this class:
A. Identifying the erythrocyte population as normocytic,
normochromic or if
the RBC count, hemoglobin, and hematocrit are
increased or decreased
then are the erythrocytes microcytic, macrocytic, normocytic, hypochromic,
or normochromic? Use the term hyperchromic, only if the patient is
diagnosed with hereditary spherocytosis.
B. Items 04
and 05 are to assist you in learning and using hematology
terminology.
05 For the leukocytes, you will have to
calculate the absolute leukocyte count for each leukocyte and determine if
it is neutropenia, neutrohilia, lymphocytosis, lymphocytopenia, monocytosis,
monocytopenia, eosinophilia, eosinopenia, basopenia, and/or basophilia.
06 If the WBC count is abnormal, then it
is either leukopenia or leukophilia. If the RBC count is abnormal,
then it is erythropenia or erythrophilia. If the platelet count is
abnormal, then it is thrombocytopenia or thrombocytophilia.
07 If any nucleated red blood cells are
present, you must calculate a corrected WBC count. Note:
Some laboratories will not do a corrected count if the NRBC count is only a few
cells.
08 Enumerate and report smudge cells on
every slide and report out as the # of smudge cells per 100 WBC's.
09 When counting and evaluating platelets:
A. Enumerate
the large platelets as you perform the 10 field platelet estimate
and report them as "# of large platelets per 10 fields.
B. Enumerate
the giant and bizarre platelets per 100 WBC's.
10 If you see five-lobed neutrophils, report how many you see.
11 If you see six or more lobed neutrophils, report how many
you see.
12 If you see vacuoles in any of the WBC's, report the leukocyte
in which you see vacuoles.
13 DO NOT quantitate hyperchromia in RBC's unless the
patient has hereditary spherocytosis.
14 Show calculations for "rule of three" and note if
the RBC's, hemoglobin, and hematocrit follow rule of three.
15 All information boxes for platelets must be
completed.
Use the following table for the adult
normal absolute leukocyte count/μL where the normal
WBC range is 5,000 to 10,500/μL.
Bands
0 - 600
Neutrophils
2000 - 6800
Lymphocytes
1000 - 4000
Monocytes
200 - 800
Eosinophils
0 - 300
Basophils
0 - 100
Diff- #01
PATH 1004-97
Patent is a 8 y/o female. WBC = 47,600/μL, RBC
= 2.96 × 106/μL, Hgb = 8.9 g/dL, Hct
= 26.4%, RDW = 24.6%, Plt Ct
=
132 × 103/μL, MPV = 8.2 fL.
She has been on chemotherapy.
01 Complete the definitive diagnosis information.
02 No other questions.
Diff- #02
PATH 1015
Patient is a young adult female. WBC = 4,100/μL, RBC
= 3.12 × 106/μL, Hgb = 11.3 g/dL, Hct
= 32.7%, RDW = 14.7%, Plt Ct =
43 × 103/μL, MPV = 9.0 fL.
Patient was diagnosed with septicema. Look to see if Dohle bodies
and intracelluar inclusions are present.
01 Complete the definitive diagnosis information.
02 No other questions.
Diff- #03
PATH 1016
Patient is a young adult female. WBC = 6,800/μL,
RBC = 3.91 × 106/μL, Hgb = 12.3 g/dL,
Hct = 35.3%, RDW = 11.9%, Plt
Ct = 191 × 103/μL, MPV = 7.3
01 Complete the definitive diagnosis information.
02 No other questions.
Diff- #04
PATH 1017
This female patient date of birth (12-17-66) who was prediagnosed with
AIDS. WBC =
4,000/μL,
RBC = 2.89 × 106/μL, Hgb = 7.5 g/dL,
Hct = 23.4%, RDW = 15.2%, Plt Ct
= 287 × 103/μL, MPV = 7.1 fL.
01 Complete the definitive diagnosis information.
02 What in this CBC is evident that would support this
patient's diagnosis?
Diff- #05
PATH 1020
The patient is an 27 y/o female and under a physician's care.. WBC =
14,000/μL, RBC
= 3.1 × 106/μL, Hgb = 8.8 g/dL, Hct
= 27.3%, RDW = 17.9%, Plt Ct =
32.2 × 103/μL, MPV = 6.4 fL.
On this slide, you are looking for a specific cell to make your primary
diagnosis. The patient was treated with oxygen..
01 Complete the definitive diagnosis information.
02 What is the primary diagnosis.
03 What is the prognosis for this patient?
Diff- #06 PATH
1023
The patient is an adult female born. WBC = 4,100/μL,
RBC = 2.66 × 106/μL, Hgb = 10.7 g/dL,
Hct = 33.5%, RDW = 15.4.6%, Plt Ct
= 200 × 103/μL, MPV = 7.8 fL.
Note....erythrocytes are
important to this diagnosis.
01 Complete the definitive diagnosis information.
02 Why is the RDW not significant in this CBC?
Diff- #07 PATH 1024
The patient is an adolescent male. WBC =
????/μL,
RBC = 2.66 × 106/μL, Hgb = 6.6 g/dL,
Hct = 22.7%, RDW = 27.5%, Plt Ct
= ???? × 103/μL, MPV = Not given
in the report
This is a RBC disorder. Pay attention t o the erythrocyte line.
01 Complete the definitive diagnosis information.
02 What medical term can describe this condition.
03 Write a reason why there would not be a WBC or platelet
count provided? If you have questions about this, see the
instructor.
Diff- #08 PATH 1030
The patient is an adult male, who was diagnosed with hepatitis and was jaundiced
when examined. WBC = 7,700/μL,
RBC = 4.46 × 106/μL, Hgb = 14.6 g/dL,
Hct = 43.4%, RDW = 15.6%, Plt Ct
= 236 × 103/μL, MPV = 8.9 fL.
Watch for reactive lymphocytes.
01 Complete the definitive diagnosis information.
02 No other questions.
Diff -
#09 PATH 1033
The patient is a 57 y/o female hospitalized with a TIA and DM.. WBC =
7,000/μL,
RBC = 3.83 × 106/μL, Hgb = 11.1 g/dL,
Hct = 33.3%, RDW = 14.1%, Plt. Ct =
169 × 103/μL, MPV = 8.0 fL.
01 Complete the definitive diagnosis information.
02 What is the meaning of the acronyms TIA and DM?
Diff - #10
PATH 1035
The patient is an elderly male. WBC = 27.6 × 103/μL,
RBC = 2.63 × 106/μL, Hgb = 10.0 g/dL,
Hct = 30.9%, RDW = 17.4%, Plt. Ct. =
28.0 × 103/μL, MPV = 7.2 fL.
The patient has either a malignancy or the start of a leukemoid reaction.
01 Complete the definitive diagnosis information.
02 Is this a leukemic condition, a leukemoid reaction, or is
the information
insufficient?
03 What laboratory test is available that would help you to
determine if this
is a leukemoid reaction or not?
Diff
- #11 PATH 1046
The patient is an elderly female. WBC = 2.3 × 103/μL,
RBC = 1.98 × 106/μL, Hgb = 4.1 g/dL,
Hct = 12.7%, RDW = 21.4%, Plt. Ct. =
63.0 × 103/μL, MPV = 7.5 fL.
This is important......the blood was diluted 1:4 in order to obtain the above
results.
01 Write the corrected CBC results. The RDW and MPV do
not have to be corrected....why is this?
02 Complete the definitive diagnosis information.
03 With what disorder did the physician diagnose this patient
as having?
Diff- # 12
PATH 1050
The patient is an infant male. WBC =
42,300/μL, RBC = 2.48 × 106/μL,
Hgb = 8.0 g/dL, Hct = 24.3%, RDW =
17.7%, Plt Ct = 180 × 103/μL, MPV
= 7.0 fL.
Pay attention to the RBC population.
01 Complete the definitive diagnosis information.
02 Why is the physician concerned about the platelet count?
Diff- #13 PATH
2044
Patient is a 89 y/o female. WBC =
7,700/μL, RBC = 3.70 × 106/μL, Hgb =
11.9 g/dL, Hct = 35.0%, RDW = 16.2%, Plt Ct =
185 × 103/μL, MPV = 8.5 fL.
O1 Complete the definitive diagnosis information.
02 No other questions
Diff- #14 PATH
2065
The patient is a 72 y/o female. WBC =
161,600/μL, RBC = 3.24 × 106/μL, Hgb =
10.6 g/dL, Hct = 28.6%, RDW = 15.4%, Plt Ct = 28 × 103/μL, MPV =
7.4 fL.
01 Complete the definitive diagnosis information.
02 What is the primary diagnosis?
Diff - #15 PATH 2075
The patient is a adult male. WBC = 9,200/μL,
RBC = 4.53
× 106/μL,
Hgb = 13.7 g/dL, Hct =
11.8%, RDW = 21.7%, Plt. Ct. = 9,900/μL,
MPV = 7.9 fL.
01 Complete the definitive diagnosis information.
02 No other questions.
Diff- #16
PATH 2078
The patient is a young adult female. . WBC =
36,300/μL, RBC = 4.98 × 106/μL, Hgb =
13.5 g/dL, Hct = 4-/4%, RDW =
13.0%, Plt Ct = 208 × 103/μL, MPV
= 7.5 fL.
QUESTIONS
01. Complete the definitive diagnosis information.
02. No other questions.
Diff- #17
PATH 2090
The patient is a very young female. WBC = 9,200/μL,
RBC = 4.08 × 106/μL, Hgb = 11.8 g/dL,
Hct = 36.8%, RDW = 14.0%, Plt Ct
= 264 × 103/μL, MPV = 5.5 fL.
Examine the stained blood film carefully and pay attention to the lymphocytes.
QUESTIONS.
01. Complete the definitive
diagnosis information.
02. Is this a leukemic condition or something else?
DIFF- #18 (Bonus slide) PATH
2093
The patient is a 17 y/o male. WBC = 12,150/μL, RBC
= 4.67 × 106/μL, Hgb = 14.5 g/dL, Hct
= 42.3%, RDW = 13.3%, Plt Ct =
145 × 103/μL, MPV = 7.0 fL
QUESTIONS.
01. Complete the definitive diagnosis information.
02. What is a probable primary diagnosis?
DIFF -- #19 (Bonus slide) NS 103
The patient is a 17 y/o male. WBC = 7,700/μL, RBC
= 4.05 × 106/μL, Hgb = 12.7 g/dL, Hct
= 37.6%, RDW = 13.1%, Plt Ct =
214 × 103/μL, MPV = 14.3 fL
No questions.
