March 6, 2010 (Sunday) - CML Again

On Feb 18th I mentioned that I’d joined an on-line morphology scheme. Today I got to do my first 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.

At first I wasn’t impressed with my differential – 38% neuts as opposed to 13% neuts on the reference. But the reference had 25% baso and I’d put 4%. Bearing in mind the appearance of the cells on my VDU, I think I saw those cells as neuts rather than basos. My staging of immature myeloid cells was also somewhat at odds with the reference answer. I shall again blame the appearance on my VDU. Having submitted the answer I then discovered how to use the zoom / high magnification function.
Perhaps next time my differential will be closer to the reference.

However I spotted all of the abnormalities, correctly identified all the further testing that needed to be done, and diagnosed a CML in transformation correctly.

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…

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