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Blood smear examination (100X (RBC morphology (Poikilocytosis (Target…

- - - - 7-20 / field
  - - - Autoimmune hemolytic anemia (AIHA)
    - - Multiple myeloma
      - Liver disease
- - - - เริ่มนับจากปลาย adequate area นับ Zig zag 100 ตัว
      - Type of WBC
        
        Atypical lymphocyte
        
        Blasts cell
        
        Lymphocytes,neutrophils,eosinophils,basophils,monocytes
    - - Inclusion
        
        Dohle body
        
        Chemotherapy
        
        RNA
        
        Toxic granulation
        
        Infection
        
        Activated primary granules ติดสีเข้มหยาบ
        
        Vacuolization
      - Nucleus
        
        Nuclear chages in neutrophils
        
        Hyposegmentation
        
        <3 lobes
        
        Pelge huet anomaly
        
        Leukemia
        
        Hypersegmentation
        
        Megaloblastic anemia
        
        3 lobes
      - Cytoplasm
        
        Auer rods
        
        Primary granules in myeloblasts
        
        Acute myeloblastic leukemia (AML)
  - - - Microcytosis
        
        MCV <80 fL
      - Macrocytosis
        
        MCV >100 fL
    - - Target cells (codocytes)
        
        Microcyte
        
        Thalassemia
        
        HbE
        
        Normocyte, macrocyte
        
        Obstructive liver disease
      - Spur cells (acanthocytes)
        
        หนามแหลมไม่เท่ากัน
        
        Alcoholic liver cirrhosis
        
        Abetalipoprroteinemia
      - Burr cells (Echinocytes)
        
        หนามแหลมเท่ากัน
        
        Artifact
        
        เก็บ collecting นานเกิน / รีบย้อม
        
        Homogenous echinocytes >80%
        
        Hyperosmolarity
      - Teardrops (dacrocytes)
        
        Thalassemia
      - Spherocytes
        
        No central pallor
        
        Cong. Spherocytosis
        
        AIHA
      - Ovalocytes (Elliptocytes)
        
        Iron def,
      - Bite cells/ Hb leak cells (Defected spherocytes)
        
        G6PD def.
      - Schistocytes
        
        เศษ RBC
        
        MAHA
        
        DIC
      - Sickle cells
    - - Normochromia
        
        Central paloor 1/3
      - Hypochromia
      - Spherocyte
        
        Hyperchromia
      - Polychromasia
        
        Reticulocyte
        
        Thalassemia major
    - - Wright’s stain
        
        NRBCs
        
        Thalassemia
        
        Hemolytic anemia
        
        Howell-jolly bodies
        
        Post-splenectomy
        
        Basophilic stippling
        
        Lead poisoning
        
        Thalassemia
      - Supravital stain
        
        Heinz bodies
        
        G6PD def.
  - - - Ref value
        
        7-20/ oil field
        
        140,000-400,000 /mm^3
      - Estimated Plt (/mm^3) = average no. of Plt /10 field x 20,000
    - - Giant platelet
        
        ขนาดมากกว่าครึ่งของ RBC
        
        Essential thrombocythemia (ET)
      - Plae stained platelet
        
        Acquired platelet dysfunction with eosinophilia (APDE)