The results of the most recent digital morphology NEQAS exercise are available. I did the thing a month ago and can’t really remember much about it. My notes at the time said ” echinocytes, polychromasia, helmet cells, target cells, Howell Jolly bodies, blister cells, basophilic stippling, nucleated red cells, raised platelet count,?? toxic granulation (probably the staining) ??? rbc enzyme deficiency”
The case was actually one of pyruvate kinase deficiency post-splenectomy. Well… I got the enzyme deficiency bit right. But I’d seen the post splenectomy changes… and I’ll go out on a limb here.
This
exercise was utterly unrealistic. Cases of red cell enzyme deficiency do
present from time to time. In forty years I’ve seen four. Which is double the
amount that my lecturers told me to expect (these things are rather obscure).
And
a patient who has had their spleen out is going to be known to the laboratory.
Yet
again we are presented with an unrealistic case with absolutely no laboratory
or clinical data whatsoever.
(Going
to lie down now…)
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