EMQs in Clinical Medicine.pdf - Peshawar Medical College

54 Haematology and oncology
22 The peripheral blood film
A
B
C
D
E
F
vitamin B 12 deficiency anaemia
thalassaemia
hypothyroidism
haemophilia B
uraemia
sickle-cell anaemia
G
H
I
J
K
L
hyposplenism
hypersplenism
bone marrow failure
iron deficiency anaemia
anaemia of chronic disease
none of the above
For each finding from a peripheral blood film below, suggest the most likely cause
for the result observed. Each option may be used only once.
1 Presence of Burr cells in a patient being treated in the intensive care unit (ICU)
with multiple organ failure.
2 Howell–Jolly bodies in a patient with coeliac disease.
3 Neutrophil hypersegmentation in a patient with paraesthesia in the fingers and
toes.
4 Microcytic hypochromic film in a 24-year-old woman presenting with lethargy.
5 Film of a 3-month-old baby boy shows a hypochromic microcytic anaemia with
target cells and nucleated red blood cells. There are markedly high HbF levels.
Answers: see page 63.