10 Questions
What is the primary purpose of bone marrow aspirate and biopsy?
To diagnose blood disorders and cancers
Which staining technique is commonly used in the examination of bone marrow aspirate and biopsy?
Wright stain
In which condition would a hypercellular bone marrow be expected?
Acute Megakaryoblastic Leukemia
What is the relevance of hypocellular bone marrow in disease diagnosis?
It may indicate conditions like aplastic anemia
Which type of disease is often diagnosed using bone marrow aspirate and biopsy?
Leukemia
What is the significance of a bone marrow trephine biopsy?
It provides information about the bone marrow's structure and cellularity
Which stain would be most useful in evaluating the architecture of bone marrow tissue?
H&E stain
What can a bone marrow aspirate reveal about the patient's condition?
Abnormal cell types
'BM' in 'BM Trephine' stands for:
Bone Marrow
What is the primary purpose of examining the bone marrow with Wright stain?
To visualize cellular components in the bone marrow
Study Notes
Laboratory Tests for Hematological Disorders
- Complete Blood Count (CBC):
- Components: Red Blood Cell (RBC) Indices, White Blood Cell (WBC) Count and Differential, Platelet Count
- RBC Indices: Red Cell Count, Hemoglobin (Hb), Hematocrit (HCT), Mean Cell Volume (MCV), Mean Cell Hemoglobin (MCH), Mean Cell Hemoglobin Concentration (MCHC), Red Cell Distribution Width (RDW)
- WBC Count and Differential: White Blood Cell Count, Lymphocyte, Monocyte, Segmented Neutrophil, Eosinophil, and Basophil counts
- Platelet Count: Platelet Count and Mean Platelet Volume (MPV)
- Peripheral Blood Smear (PBS):
- Evaluates: RBC size, shape, hemoglobin concentration, inclusion bodies, WBC differential count, abnormal cell morphology, platelet presence and number
- Normal Adult PBS: RBCs, WBCs, and Platelets
- Other lab tests:
- Hemoglobin Electrophoresis
- Iron Panel
- Serum B12 and Folate levels
- Bone Marrow Examination (BME), if indicated
Complete Blood Count (CBC)
- RBC Indices:
- Red Cell Count: 4.2-5.9 x 10^12/L
- Hemoglobin (Hb): 14-18 g/dL (males), 12-16 g/dL (females)
- Hematocrit (HCT): 40-54% (males), 37-47% (females)
- Mean Cell Volume (MCV): 80-100 fL
- Mean Cell Hemoglobin (MCH): 25.4-34.6 pg
- Mean Cell Hemoglobin Concentration (MCHC): 31-36 g/dL
- Red Cell Distribution Width (RDW): 11.5-15.4%
- WBC Count and Differential:
- White Blood Cell Count: 4-10 x 10^9/L
- Lymphocyte: 25-33%
- Monocyte: 3-7%
- Segmented Neutrophil: 54-62%
- Eosinophil: 1-3%
- Basophil: 0-1%
- Platelet Count:
- Platelet Count: 150-400 x 10^9/L
- Mean Platelet Volume (MPV): 8-12 fL
Peripheral Blood Smear (PBS)
- Evaluation of RBC size, shape, hemoglobin concentration, and inclusion bodies
- Evaluation of WBC differential count and abnormal cell morphology
- Evaluation of platelet presence and number
- Normal Adult PBS: RBCs, WBCs, and Platelets
- Abnormal PBS:
- Microcytic (MCV < 80 fL), e.g., iron-deficiency anemia
- Macrocytic (MCV > 100 fL), e.g., megaloblastic (B12- and folate-deficiency) anemia
- Hypochromic (MCHC < 31 g/dL), e.g., iron-deficiency anemia
- Spherocytes (sphere-shaped RBCs), e.g., hereditary spherocytosis and immune hemolytic anemia
Bone Marrow Examination (BME)
- Indications: evaluation of unexplained CBC results, diagnosis of malignancy, evaluation of iron stores, and evaluation of disseminated infection
- Procedures: bone marrow aspiration and trephine biopsy
- Sites: sternum, anterior iliac crest, and posterior iliac crest
- Techniques: aseptic technique, local anesthesia, and informed consent
- Results: evaluation of bone marrow cells, iron stores, and presence of infection or malignancy
This quiz focuses on recognizing and interpreting the characteristics evaluated in a peripheral blood smear related to the variation in red blood cell (RBC) size, specifically anisocytosis related to mean corpuscular volume (MCV). It includes identifying normocytic, normochromic, microcytic, hyperchromic, and macrocytic RBCs.
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