haemato pathofe
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haemato
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Erythropoiesis
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IDAIDA
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Iron deficiency anaemia
•hypochromic (pale color-2/3rd of the central concave) •microcytic (small in size), •anisopikolocyte (different shape and sizes) such as1. pencil cells,2. microcytes, 3.cigar shaped cells, 4.tear drop cells.
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B12 & folate deficiency
•show macrocytic cells- the red cells are enlarged in size, •the neutrophils are hypersegmented, because nucleus has more than the normal 5 lobes.
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Thalassemia-hb defect
anisopoikilosis-hypochromic microcytic cells, fragments, nucleated red cells (reticulocyte),target cells.tear drop cell,polychromatic cell,contracted cell
•Howeljolly body
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Blood smear & HbH Preparation
Golf ball appearance- Hb H inclussion
Target cell
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Thalassemia Trait:beta
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Thalassemia Major:
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ß Thalassemia Major (post splenectomy):
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Sickle cell disease-hb defect
In sickle cell, u can see the RC sickles when exposed to oxidation stress.
•Howeljolly body
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Elliptocytosis-membrane defect(hemolysis)
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G6PD-enzyme defeciency(hemolysis after oxidant stress)
•Heinz bodies
•Bite cell
•Blister cell
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Anaemia; Reduced bone marrow erythroid
• Marrow failure• Marrow infiltration
Trephine biopsy (AplasticAnemia)
Marrow infiltration Normal trephine
hypocellular
hypercellular
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HemolysisHemolysis
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These are the matured white cells. 1.E=eosinophil -orangy granules within the cytoplasm2.B=basophil -coarse basophilic granules that they obscure the nucleus3.N=neutrophil-contain granules in the cytoplasm
-nucleus has between 2-5 segments4.L =lymphocyte-large nucleus with scanty cytoplasm5.M=monocyte-has nuclues and plenty sky-blue cytoplasm6.Band-form cell is the immatured neutrophil.7.P=platlet
Band
P
L
M
N
B
E
Leucocytes
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Morphology
• Lymphoblast– Blast size :small– Cytoplasm: Scant– Chromatin: Dense– Nucleoli :Indistinct– Auer-rods: Never
present
• Myeloblast– Large– Moderate– Fine, Lacy– Prominent– Present in 50%
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Morphology
Acute lymphoblastic leukemia
Acute myeloid leukemia
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ALL
contains more than 20% blast cells in the full blood picture.
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CLL
mixture of blast and cells at various stages of maturation.
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AML
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FAB Acute Myeloid Leukemia
M0 Minimally differentiated AML
M1 Myeloblastic without maturation
Few granules
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AMLM2 AML with maturation
Multiple cytoplasmic granules
M3 Acute Promyelocytic Leukemia (APML) 10-15%
prominent granules, multiple Auer rods
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AML
Acute Myelomonocytic Leukemia M4-monocytoid differentiation
Acute Monoblastic Leukemia M5>80% are monoblasts
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AML
M6 Erythroleukemia (Di Guglielmo)
Preponderance of erythroblasts
M7 Acute Megakaryoblastic Leukemia
Cytoplasmic blebs on blasts.
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CML
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• Reticulocytosis is a feature of increased red cell production.
• New methylene blue is used to stain the reticulocytes
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• Fragmented cells, and bitten cells are sings of damaged cells occurring in haemolysis
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Maa’ttaufeeq wannajah fi haza al ikhtibar
“…..berdoalah nescaya akan Kuperkenankan”…
Ad dua’ silahulmu’min…
Tawakkal…innallaha ma’na…
“ALLAHUGHOYATUNA”