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peripheral blood smear

Microscopic examination of blood obtained from a peripheral vein or capillaries. Indications: 1) examination of cell morphology a) erythrocytes b) leukocytes c) platelets 2) identification of parasites a) malaria b) microfilaria Clinical significance: erythrocyte findings - microcytosis & anisocytosis -> iron deficiency - spherocytes -> warm autoimmune hemolytic anemia, hereditary spherocytosis - macrocytes -> megaloblastic anemia, myelodysplasia, use of antimetabolite (nucleoside reverse transcriptase inhibitor) - schistocytes -> microangiopathy - schistocytes & thrombocytopenia -> TTP - schistocytes & prosthetic heart valve -> heart valve leak - RBC agglutination -> cold agglutinin hemolysis (Mycoplasma) - rouleaux -> paraproteinemia (multiple myeloma) - target cells -> thalassemia, hemoglobinopathy, liver disease - sickle cells -> sickle cell anemia - nucleated RBC -> marrow stress - tear drop cells -> myelofibrosis, bone marrow granuloma, bone marrow infiltration - bite cells -> G6PD deficiency - burr cells -> kidney disease - spur cells -> severe liver disease - elliptocytes -> hereditary elliptocytosis - stomatocytes -> hereditary stomatocytosis, artifact Procedure: - Wright stain is commonly used for peripheral smears

General

clinical hematology test smear for microscopy

References

  1. Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 574-86
  2. Medical Knowledge Self Assessment Program (MKSAP) 16, American College of Physicians, Philadelphia 2012
  3. Blevins SM, Greenfield RA, Bronze MS Blood smear analysis in babesiosis, ehrlichiosis, relapsing fever, malaria, and Chagas disease. Cleve Clin J Med. 2008 Jul;75(7):521-30 PMID: 18646588

Component-of

anemia panel DIC panel

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