EXERCISE NO.

2
EXAMINATION OF PERIPHERAL BLOOD SMEAR AND DIFFERENTIAL COUNT

Date: March 23, 2021

Name: Hinlo, Czar Clidwyn R.
Group No. : 2
Preceptor: Dr. Auxiliadora R. Abanilla

1. How does the following red cell indices in complete blood count correlate with the eval-
uation of red blood cells in peripheral smears?
a. MCV- provides the average RBC volume.
b. MCH- provide the average hemoglobin volume in a single RBC
c. MCHC- provides on how well the red blood cells are filled with hemoglobin.
d. RDW- provides information about the presence and degree of anisocytosis (vari-
ation in RBC volume).
2. Give two conditions wherein the MCH and MCHC may vary. What are the expected ap-
pearances of the red cells in peripheral smears in those conditions?
• Hereditary Spherocytosis- Small, round, dense RBC with no central pallor.
• Sickle Cell Anemia- Thin, dense, elongated RBC pointed at each end; may be curved.
3. In what clinical conditions can you find the following ?
a. Neutrophilia- Bacterial Infection
b. Lymphocytosis- Acute Viral infections
c. Eosinophilia- Parasitic Infection
d. Basophilia- Hypersensitivity Reactions
e. Monocytosis- Tuberculosis
f. Neutropenia- Lupus
g. Lymphopenia- Hodgkins Disease
4. What are the reasons why platelet counts could be falsely low in automated complete
blood count but are assessed as adequate in peripheral smears?
Ans: Because there are large clumps of platelets induced by EDTA, that are counted as
WBCs and not as platelets.
5. In what condition/s nucleated red blood cells or normoblasts are seen in peripheral
smears?
• Severe hemolysis, hemorrhage or hypoxia
• Infiltrative disorders such as myelofibrosis, leukemia and metastatic carcinoma
• Megaloblastic anemia
6. In what conditions can you find anisochromia?
• Acquired Sideroblastic Anemia

7. Refer to Activity Slides no.1 to 5 considering that the slides come from a similar sam-
ple. Give your Differential Count (NOTE: count all the WBCs in five slides).

WBCs IDENTIFIED Percentage

Neutrophils/PMN 58%
Lymphocytes 30%
Monocytes 8%
Eosinophils 2%
Basophils -
Stab 2%

8. Refer to Activity Slides No.6 and No. 7. Give your red blood cell evaluation.
6. Predominantly microcytic and hypochromic. No nucleated red blood cells seen.
7. Predominantly normocytic and hyperchromic with mild poikilocytosis. Several
burr cells seen. Four (4) Nucleated red blood cells seen.

9. Refer to Activity Slide No.8. Give your platelet size evaluation. In what condition it
could be found?
Ans: Giant platelet seen in conditions such as Bernard Soulier Syndrome.

- End-