Hemolytic anemia

Hemolytic anemia

实验目的 :

掌握溶血性贫血的诊断思路及骨髓象的主要特点。

Hemolytic anemia

Clinical Findings:

A 44-year-old female complained of fatigue and weaknessd,frequency and urgency of micturition over the last 2 weeks,she had noticed that her urine was pinkish red in colour.

On physicial examination,icteric scera and splenomegaly were found.

Hemolytic anemia

Laboratory Findings:

RBC: 2.6×1012/L Hb:85 g/L Ret:10%WBC: 4.7×109/L N:82% L:17% Mo:1%PLT: 164×1012/L Urobilinogen(+) urine bilirubin(++) icteric index:20URous test(-) Hams(-) coombs(+)

Hemolytic anemia

Questions:

1 what is the most probable diagnosis in this case?2 what are the diagnostic bases?3 what additional tests are need to establish the diagnosis?

Hemolytic anemia

骨髓涂片观察及骨髓报告

IDA

实验目的 :

掌握 IDA 的诊断思路及骨髓象的主要特点。

IDA

Clinical Findings:

A ten-year-old boy who came from city gave

chief complaint of having no energy. The

physician found his nail spoon-shaped.

IDA


Hb 56g/L, RBC 3.5×1012, WBC 10.5×109/L, PLT 200×109/L MCV 68.6fl, MCH 23pg, MCHC 23% Ret 0.5%Serum iron 7.5umol/L TIBC 73umol/L

The peripheral blood smear revealed marked anisocytosi

s, microcytosis hypochromia and poikilocytosis.

IDA

Questions:


IDA


IDA

骨髓涂片观察及骨髓报告 Ring cell

IDA

骨髓涂片观察及骨髓报告 basophilic stipping

IDA

骨髓涂片观察及骨髓报告 Howell-Jolly bodies

Megaloblastic anemia(MA)

实验目的 :

掌握 MA 的诊断思路及骨髓象的主要特点。


Clinical Findings:

A 50-year-old female had seen the physician with complaints of having no energy and feeling tired all of the time. She also reported experiencing a mild pain in the abdominal region and having impairment of sensation to pin prick and touch.



RBC: 1.7×1012/L Hb:62 g/L Ret:0.4%WBC: 4.0×109/L N:62% L:37% Mo:1%PLT: 200×1012/L The peripheral blood smear revealed anisocytosis, poikilocytosis two nucleated RBCs, rare Howell-Jolly bodies and basophilic stipping.


Questions:



骨髓涂片观察及骨髓报告大红细胞


骨髓涂片观察及骨髓报告红系改变


骨髓涂片观察及骨髓报告粒系改变

Aplastic anemia

实验目的 :

掌握 AA 的诊断思路及骨髓象的主要特点。

Aplastic anemia

Clinical Findings:

A 22-year-old female gave chief complaint of severe menstrual bleeding recently, and numerous petechiae and some purpura. She told the doctor she had a severe respiratory infection six months age and had taken chloramphenicol for five months. the physical examination revealed no hepatomegaly, splenomegaly and lymphadenopathy.

Aplastic anemia


RBC: 1.85×1012/L Hb:55 g/L MCV 89fL,MCH 29.7fL,MCHC 31%Ret:0.5%WBC: 2.2×109/L N:38 % L:62%PLT: 35×1012/L

Aplastic anemia

Questions:


Aplastic anemia

骨髓涂片观察及骨髓报告有核细胞增生极度低下

Aplastic anemia

骨髓涂片观察及骨髓报告非造血细胞增多

Acute lymphocytic leukemia

实验目的 :

掌握 ALL 的诊断思路及骨髓象的主要特点。


Clinical Findings:

A 5-year-old girl was taken to the emergency roomby her mother,because of an elevated temperture that could not be controlled by aspirn.the patient complained of a sore throat and ear for the last several days.Physical examination revealed a well-nourished but listless child,the tympanic membrane was inflamed.the child had both lymphadenopathy and hepatosplenomegaly.



RBC: 1.7×1012/L Hb:62 g/L WBC: 40×109/L lymphoblasts and prolymphocytes:80%L:12% N:8%PLT: 200×1012/L


Questions:



骨髓涂片观察及骨髓报告 ALL-L1

AML-M2a

实验目的 :

掌握 M2a 的诊断思路及骨髓象的主要特点。

AML-M2a

Clinical Findings:

A 32-year-old female patient complained of fatigue for two days. The doctor noticed that she looked pale and weakness and found some unexplained large bruises on her skin. Hepatomegaly and sternal tenderness was present, but lymphadenopathy was absent.

AML-M2a


RBC: 3.3×1012/L Hb:70 g/L WBC: 21×109/L DC: Immature cells :91% N:7% L:1% E:1%PLT: 45×109/L

AML-M2a

Questions:


AML-M2a


AML-M3 (APL)

实验目的 :

掌握 M3 的诊断思路及骨髓象的主要特点。

AML-M3 (APL)

Clinical Findings:

A female paitient , 36-year-old, complained of fatigue and weakness for more than half a month, and bleeding gums for five days. The physical examination revealed sternal tenderness, without hepatosplenomegaly.

AML-M3 (APL)


RBC: 3.6×1012/L Hb:86 g/LWBC: 2.8×109/L DC: Immature cells 73% ; Bands 3% ; Seg. 6%; E 1%; L 17%PLT: 30×1012/L

AML-M3 (APL)

Questions:


AML-M3 (APL)

骨髓涂片观察及骨髓报告 AML-M3a

AML-M3 (APL)

骨髓涂片观察及骨髓报告 AML-M3b

AML-M3 (APL)

骨髓涂片观察及骨髓报告 Faggot cell

AML-M3 (APL)

骨髓涂片观察及骨髓报告 t(15;17)

AML-M5

实验目的 :

掌握 M5 的诊断思路及骨髓象的主要特点。

AML-M5

Clinical Findings:

A 38-year-old female patient came to the hospital because she had been suffering from swollen, bleeding gums for several weeks. The physician noticed that she was pale and febrile, and had hepatomegaly, splenomegaly and lymphodenopathy.

AML-M5


Hb 90g/L, RBC 3.0×1012 WBC 32×109/L, DC: Immature cells 95% ; Monocytes 4.0% ; L 1.0%PLT 35×109/L

AML-M5

Questions:


AML-M5 (APL)

骨髓涂片观察及骨髓报告 ( AML-M5a)

AML-M5 (APL)

骨髓涂片观察及骨髓报告 ( AML-M5b)

Chronic Myeloid Leukemia

实验目的 :

掌握 CML 的诊断思路及骨髓象的主要特点。


Clinical Findings:

A 65-year-old male give chief complaint of feeling tired for 2 years. The physician noticed found the spleen enlarged and others were negative.



RBC: 3.0×1012/L Hb:86 g/LWBC: 145×109/L DC: Immature cells 60% ; Bands 15% ; Seg. 13%; B 6%; E 5% ; M 1 %PLT: 400×1012/L


Questions:



骨髓涂片观察及骨髓报告 t(9;22)

Multiple Myeloma (MM)

实验目的 :

掌握 MM 的诊断思路及骨髓象的主要特点。


Clinical Findings:

a 58-year-old male gave chief complaint of increasing fatigue and pain in his lower back when he walked .



Hb 85g/l RBC 3.2×1012/l WBC 5.6×109/l PLT 300×109/l ESR 50mm/hour X-ray indicated bone lesions in various sites


Questions:



骨髓涂片观察及骨髓报告 Myeloma cell


骨髓涂片观察及骨髓报告 Flame cell


骨髓涂片观察及骨髓报告 Mott cell


骨髓涂片观察及骨髓报告 Rouleaus—like formationRouleaus—like formation

Idiopathic Thrombocytopenic purpura (ITP)

实验目的 :

掌握 ITP 的诊断思路及骨髓象的主要特点。


Clinical Findings:

A 35-year-old women was admitted with complaint of bleeding of gum, purpura of the legs for 15 years, becoming severe in the last 10 days accompained with nasobleed recurrent and macroscropic hematuria. The patient was consciousness and pale, scattered hemorrhagic spots occur anywhere on the skin .The spleenmegaly was present.



RBC:3.1×10 12/L Hb 125g/L PLT 32×109/LBT ＞ 10min CT 8min WBC 8×109/L Neutrophils:77% Eosinophils: 2% Lymphocytes:16% Monocytes: 5%


Questions:


Hemolytic anemia

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