Megaloblastic anemia is a subgroup of macrocytic anemia which is characterized by defective nuclear maturation. Though a lot of studies have been done to assess the efficacy and significance of red blood cell parameters in different hematological conditions fewer efforts have been made to standardize the visual examination of peripheral blood smears for diagnosing anemias. A Peripheral Blood Smear Examination is a procedure, which involves spreading a drop of blood thinly onto a glass slide. The diagnosis is established by reticulocytosis, increased unconjugated bilirubin and lactate dehydrogenase, decreased haptoglobin, and peripheral blood smear findings. A blood film or peripheral blood smear is a thin layer of blood smeared on a microscope slide .Peripheral blood smear are usually examined to investigate hematological problems and occasionally, to look for parasites within the blood. Pathophysiology. An atlas of instructive blood smears is included as a set of slides. Usually microscopic examination of the red cells shows them to be much like normal cells. THE ASH IMAGE BANK, a reference and teaching tool, is continually updated with new atlas images and images of case studies. Many disorders such as malaria, anemia, leukemia, thrombocytopenia, sickle cell anemia etc., can be diagnosed by evaluating blood cells. Can take blood in the EDTA. History and physical examination are followed by laboratory testing with a complete blood count and peripheral smear. The majority of the nonhemolytic anemias have a chronic and stable course. Objecves This study was done to evaluate RBC morphology on peripheral blood smear examinaon in paents of anemia and to compare these findings with cell counter generated Careful review of the peripheral blood smear can provide invaluable information in diagnosing the underlying disorder. Your doctor uses a CBC to check the different types of blood cells in your body. The blood smear test or peripheral smear test is a type of blood test that is done to procure detailed information about the number and shape of blood cells.This test focuses on the red blood cells, white blood cells and platelets. PERIPHERAL SMEAR – RBC . Peripheral Blood Smear. This is a microscopic pathology image showing Iron-deficiency Anemia. The peripheral smear will contain schistocytes, which are fragments of red blood cells (Black arrows). It can be acquired or inherited. It is then treated with a special stain and studied under a microscope to examine the blood cells. Peripheral blood smear. - Blood smear too thick - Blood smear too thin - ATL peripheral blood smear - Normal blood smear - Rouleaux in myeloma - CAD blood smear - Hypertriglyceride milky plasma - Macro-ovalocytes - Elliptocytes - Schistocytes on peripheral smear - Helmet cells - Waring blender syndrome - Tear drop cells - Spherocytes - Blood smear, iron deficiency - Polychromatophilia - Lymphocyte and monocyte The peripheral smear and reticulocyte count are the most important tests to diagnose hemolysis. Anemia (also spelled anaemia) is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood, or a lowered ability of the blood to carry oxygen. What are the uses of peripheral smear examination. (A) Long, thin, deeply stained cells with pointed ends are irreversibly sickled. Powerpoint on peripheral blood smear (B) Small, round, dense cells are hyperchromic because a part of the membrane is lost during sickling. Also, make a direct fresh blood smear. Bone marrow examination may be needed. An expert examination of the blood smear can identify errors, establish a diagnosis, or lead to a useful fortuitous finding. (C) Target cell with a concentration of hemoglobin on its centre. Note the macro-ovalocytes with tailed forms characteristic of vitamin B 12 or folate deficiency states. This test provides information about the number and shape of these cells. For a blood smear, the lab professional looks for blood cell problems that may not be seen on a computer analysis. This is a peripheral blood smear from a patient with iron deficiency anemia. An examination of the blood smear may be requested by physicians or initiated by laboratory staff. Blood smear in which the red cells show variation in size and shape typical of sickle cell anemia. A diagnosis is suspected in the setting of microangiopathic anemia (based on smear review) and thrombocytopenia and confirmatory testing with an ADAMTS13 assay. Peripheral blood smear analysis was key in this case, linking microangiopathic hemolytic anemia to a megaloblastic process. Discussion. When anemia comes on slowly, the symptoms are often vague and may include feeling tired, weakness, shortness of breath, and a poor ability to exercise. A blood smear, also referred to as a peripheral smear for morphology, is an important test for evaluating blood-related problems, such as those in red blood cells, white blood cells, or platelets.It has a wide range of uses, including distinguishing viral infections from bacterial infections, evaluating anemia, looking for causes of jaundice, and even diagnosing malaria. Occasionally they are referred to as “helmet cells” due to their shape. Prepare the peripheral blood smears. Diagnosis is usually based on peripheral smear. Normal lymphocyte for comparison purposes is seen at the edge of the smear. The smear shows macro-ovalocytosis, anisocytosis (variation in RBC size), and poikilocytosis (variation in RBC shape). View large Download PPT. A peripheral blood smear is often performed along with a complete blood count (CBC). Other names: peripheral smear, peripheral blood film, smear, blood film, manual differential, differential slide, blood cell morphology, blood smear analysis Context: Manual examination of peripheral blood smear in diagnosis of anemia has taken a backseat with the advent of automated counters. Peripheral Blood Smear - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. Take blood for the study of Vit. Blood Smear Examination in the Evaluation of Anemia. The presence of teardrop cells (dacrocytes) (Figure below) in the peripheral blood, named for their tear drop shape, is a prominent feature of myelophthisic (marrow infiltrative) conditions, including myelofibrosis, hematologic malignancies, cancer metastatic to the bone marrow, and granulomatous diseases. History and physical examination are followed by laboratory testing with a complete blood count and peripheral smear. A peripheral smear may demonstrate spherocytes, suggesting congenital spherocytosis or autoimmune hemolytic anemia (AIHA); see the image below. Blood disease - Blood disease - Normocytic normochromic anemias: Forms of anemia in which the average size and hemoglobin content of the red blood cells are within normal limits are called normocytic normochromic anemias. Peripheral blood smear with anemia, increased polychromatphilic RBCs, numerous target cells and rare HbC crystals. In microcytic anemia the curve was shifted to left, in macrocytic anemia the shift was towards right side, and dimorphic anemia shows bimodal peak. Spherocytes. Iron deficiency is the most common cause of microcytic anemia. Hemoglobin C disease is an intrinsic red cell disorder caused by Hemoglobin C (Hb C). Routine diagnostic evaluation includes: CBC, reticulocyte count, peripheral smear, BUN/Cr, bilirubin, LDH, and direct antiglobuluin test (DAT; and direct Coombs). In hemolytic disorders, however, the severity of the hemolysis can also create life-threatening emergencies. Many blood tests use computers to analyze results. Microcytic anemia is defined as the presence of small, often hypochromic, red blood cells in a peripheral blood smear and is usually characterized by a low MCV (less than 83 micron 3). Blood indices. Keywords: Histogram, RBC, Anemia, Peripheral Smear. but peripheral blood smear (PBS) study of red blood cells (RBCs) morphology is important along with study of red blood cell indices in the classificaon of anemia. Peripheral blood smear analysis is a common practice to evaluate health status of a person. Cytologic examination of peripheral blood is important in determining the cause, treatment, and prognosis of a patient’s anemia. The differential diagnosis (and cause of anemia) can then be further refined based on the results of testing. ... After blood transfusion (normocytes and microcytes) ... Aplastic anemia is a condition where there is bone marrow failure of producing sufficient number of blood cells due to decrease in hematopoietic precursors. When fully developed, the anemia is macrocytic, with MCV > 100 fL/cell in the absence of iron deficiency, thalassemia trait, or renal disease. Significant hypochromia and microcytosis is seen, as well as moderate variation in size and shape of the red cells Routine workup of the patient with anemia, advise: Clinically for diagnosis, ask the patient’s history, physical examination, signs, and symptoms with the following lab workup. View large Download PPT. peripheral blood smear, pernicious anemia. If hemolysis is suspected, a peripheral smear is examined and serum bilirubin, LDH, haptoglobin, and ALT are measured. Hemoglobin and hematocrit. Peripheral blood for RBC morphology. Red blood cell count. B12 and folic acid. Conclusion: For diagnosis of anemia peripheral smear findings were definitive and histogram can be used as supplementary tool. 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