May 7, 2011 (Saturday) - Female Smoker Syndrome

An e-HEMATimage case – last time I did one I said “Overall I’m satisfied with my result, but do feel I could have done better. However I shall put that down to unfamiliarity with the software. Now I’ve found the zoom function I’m intrigued to see how much better I’ll do next time…

Today I got to do my second on-line exercise. I was presented with a screen of various blood cells and had to determine the nature of all of the cells, identify all abnormalities present, suggest further testing which should be carried out, and a possible diagnosis.
Having made my judgements I got immediate feedback on how well I’d done.

Last time I wasn’t impressed with my diff counting ability, but put that down to not having found the zoom function. Now I can zoom I’m quite happy with the diff I got compared to the reference answer..
I spotted all of the significant abnormalities and correctly identified all the further testing that needed to be done. I got the diagnosis wrong though. Given the clinical symptoms and the blood picture, my first thought was Hodgkin’s disease. This wasn’t actually the case. The patient had my second choice of diagnosis: polyclonal B lymphocytosis with binucleated lymphocytes (or female smoker syndrome).
Seeing how I’m (relatively) familiar with Hodgkin’s disease, and I’ve barely heard of female smoker syndrome, I’m quite pleased with how I did.

On reflection I’m warming to the whole idea of e-HEMATimage. I do similar morphology exercises at work, and only ever get feedback when I’ve made a serious error, and that comes a month after the error and once the blood film has been safely lost. e-HEMATimage gave me feedback within a day of my submitting my answer. I really would like to continue with it. I hope I can afford to…

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