26 January 2023 (Thursday) - White Cells

Section 3.1 was an overview of white cells... Nothing new... perhaps? Every day I look down the microscope -  a treated iron deficiency, a mild neutropenia, completely normal, CLL, macrocytic... what I get is utterly random.
With this Coursera course I'm seeing that which I see every day, but with a structure to what I'm learning. A revision of what I know, and approaching what I know from a different angle.

THis is perhaps one of the best bits of CPD I have found in a long while...

 

25 January 2023 (Wednesday) - BTLP Exercise

I had one case – a ninety-seven year-old chao in the out-patients department needing group & save.

 

He grouped as A Rh(D) Positive with a negative antibody screen 

 

I got the green light.

 

23 January 2023 (Monday) - NEQAS 2208 BF

 

A month ago I did the NEQAS morphology exercise 2208BF. The results came in today

 

2208 BF1

 

I said   Rbc Acanthocytes Malaria (P. falciparum)   Wbc Left shift neuts Early myeloid cells (meta/myelo) smear cells   Plts Giant plts Thrombocytopenia

Consensus Top Ten Features   Plasmodium falciparum Thrombocytopenia Echinocytes/Crenated Cells Large/Giant Platelets Band Form Neutrophils Left Shift Reactive/Plasmacytoid Lymphocytes Atypical/Suspect Reactive Lymphocytes Nucleated RBCs Cytoplasmic Vacuolation

 

I said this was “Malaria Infection, P, falciparum. Parasitaemia 11%. When reporting

malaria would normally use different pH to the one supplied”

 

It was indeed malaria, but reported parasitaemias ranged from five to thirty per cent…

 

2208 BF2

 

I said   Rbc   hypochromia microcytosis pencil cells   Wbc Neutropenic   Plts Clumps

Consensus Top Ten Features   Platelet Clumps Hypochromic Cells Elliptocytes Microcytes Neutropenia Pencil Cells Rouleaux Poikilocytes Echinocytes/Crenated Cells Ovalocytes

 

I said this was either an iron deficiency or thalassemia. It was thalassemia.

I’m quite pleased about these two…

23 January 2023 (Monday) - NEQAS 2204DF

A month ago I did the NEQAS manual diff exercise 2204DF. The results came in today

 

I said

 

  WBCM     N     L     M     E     B   MET   MYE   PRO BLAST   NUC

        (3)   (2)   (1)   (.)   (0)   (4)   (5)   (6)   (9)  #(7)

  100    80    15     5     0     0     0     0     0     0     0

   8.2   6.6   1.2   0.4   0.0   0.0   0.0   0.0   0.0   0.0   0.0

 

Consensus:

 

  WBCM     N     L     M     E     B   MET   MYE   PRO BLAST   NUC

        (3)   (2)   (1)   (.)   (0)   (4)   (5)   (6)   (9)  #(7)

  100    75    15     6     0     0    2.5   1.0     0     0     0

   8.2   6.1   1.2   0.5   0.0   0.0   0.2   0.1   0.0   0.0   0.0

 

I didn’t count metamyelocytes or myelocytes in my diff, but I did comment on them in my observations on the film for NEQAS 2208BF

That’ll do…