Iron deficiency anemia

Chronic hemolytic anemia

Immune thrombocytopenic purpura

Aplastic anemia
Bacterial infection
Viral infection

A)Microcytic hypochromic anemia ( Hb)

Iron deficiency anemia:
MCV + MCH + Normal Reticulocytic count
Chronic hemolytic anemia:
MCV + MCH + Reticulocytic count

B) Thrombocytopenia ( Platelets)
Immune thrombocytopenic purpura:
Isolated thrombocytopenia ( mild anemia)
Aplastic anemia:
Pancytopenia

C) Infection (Leukocytosis = WBCs)

Bacterial infection:
PNLs + Band count (> 2 %)
+ Shift to left
Viral infection:
Lymphocytes + Normal Band count (< 2 %)
+ No Shift to left

Parameter

WBCs (X1.000)
HB (g/dl)
MCV (fl)
MCH (pg)
Platelet (X1,000)
Reticulocytes

Patients value

Normal Value

10
8
65
22
450
1.5%

4 -11
11.5 13.5
75 86
27 33
150 450
0.5- 2%

Serum iron is usually elevated.F

Serum ferritin is low.T
TIBC is markedly decreased.F
Stool analysis may be of help.T
This child may present with easy

Hair-on-end appearance in skull X-ray is

characteristic.F
Iron chelation therapy is indicated .F
Pica may occur in such patient.T
Nail changes are not uncommon.T
Macrocytic hypochomic anemia is present .F
This CBC may be due to folic acid deficiency.F
Serum bilirubin is usually elevated.F
Regular blood transfusion is the main line of
treatment.F
Splenectomy may improve the clinical
picture.F
.Splenomegaly may be found . T

Parameter

Patients value

Normal Value

WBCs (X1.000)

10

4 -11

HB (g/dl)
MCV (fl)

6
66

11.5 13.5
75 86

MCH

23

27 33

Platelet (X1,000)

420

150 450

Reticulocytes

8%

0.5- 2%

(pg)

Hb electrophoresis is of diagnostic value.T

This condition is genetically transmitted.T
Iron chelation therapy is indicated .T
Target cell may be seen in the blood film.T
X-ray bones shows thin medulla & wide cortex.

This type of anemia is not common in

Mediterranean area.F
Indirect bilirubin is usually elevated.T
Wide skull diploe is seen in X-ray film
.T
.Direct bilirubin is usually increased.F

Parameter

WBCs (X1.000)
HB (g/dl)
MCV (fl)
MCH (pg)
Platelet (X1,000)
Reticulocytes

Patients value

Normal Value

10
10.4
80
29
25
1%

4 -11
11.5 13.5
75 86
27 33
150 450
0.5- 2%

This disorder is usually inherited.F

Splenomegaly is constant finding.F
Organomegaly is constant.F
BM picture shows aplasia of all cell
lines.F

Blast cells are typical in blood film.F

Fever is common in such patient.F
Recurrent bacterial infection is
common.F
Bone marrow examination is helpful in
diagnosis.T
Epistaxis may occur.T
This condition may be drug-induced.T
Megakaryoctes are decreased with
defective budding.F

Parameter

WBCs (X1.000)
HB (g/dl)
MCV (fl)
MCH (pg)
Platelet (X1,000)
Reticulocytes

Patients value

Normal Value

2
5.3
80
29
25
0.1%

4 -11
11.5 13.5
75 86
27 33
150 450
0.5- 2%

This disorder may be inherited.T

Thumb anomalies may be present.T
Fever is common in such patient.T
Chloramphenicol Rx may be the
cause.T

Bleeding never occur in such

patient.F
Bone marrow analysis is indicated.T
Hepatomegaly is a constant finding.F
BM transplantation may be
indicated.T
Blood transfusion is curative.F

Parameter

WBCs (X1.000)
HB (g/dl)
MCV (fl)
MCH (pg)
Platelet (X1,000)
Band count
Polymorph: 70%

Patients value

Normal Value

35
9
78
27
250
25%

4 -11
11.5 13.5
75 86
27 33
150 450
< 2%

Lymphocytes: 25%

The anemia is normocytic normochromic.T

Band cells decreased.F
Urine culture may help in diagnosis.T
High fever is common in such patient.T
Antibiotics are of great impotance.T
There is shift to right .F
Bandemia is present.T
Immature forms of neutrophils are
increased.T
Neutrophilia can be detected.T
This child may be toxic.T
CRP is usually increased.T
Meningitis () may be associated with such
CBC.T

Blood culture may be a useful test.T

This type needs iron therapy.F
Home Rx is sufficient (Single antibiotic).F

Parameter

WBCs (X1.000)
HB (g/dl)
MCV (fl)
MCH (pg)
Platelet (X1,000)
Band count
Polymorph: 35%

Patients value

Normal Value

14.5
10.4
82
30
300
2%

4 -11
11.5 13.5
75 86
27 33
150 450
< 2%

Lymphocytes: 65%

Urine culture may show an organism.F

Antibiotics are strongly indicated.F
There is shift to left .F
Bandemia is evident.F
This anemia is normocytic as the MCH is
normal.F
Lymphocytosis is evident.T

Comment On Blood Picture and

Mention Confirmatory Test
Patients
Value

Normal
Value

Comment

WBCs(x103/mm3)

5.6

4 - 11

Normal

HB(g/dl)

7.8

11.5 - 13.5

Anemia

MCV(Fl)

66

75 - 86

Microcytic

MCH(pg)

24.5

27 - 33

Hypochromic

Plateletes(x103/mm3)

300

150 450

Normal

0.5 - 2

Normal

Parameter

Reticulocytes(%)

The Blood Picture shows Microcytic Hypochromic

Anemia with Normal Reticulocytic count, most
probably iron deficiency anemia.
Iron studies (Serum iron, TIBC & serum Ferretin) are
recommended

Comment On Blood Picture and

Mention Confirmatory Test
Parameter

Patients
Value

Normal
Value

Comment

WBCs(x103/mm3)

6.3

4 - 11

Normal

HB (g/dl)

3.2

11.5 - 13.5

Anemia

MCV (Fl)

54

75 - 86

Microcytic

MCH (pg)

20

27 - 33

Hypochromic

Plateletes(x103/mm3)

600

150 - 450

Thromboctosis

0.5 - 2

Reticulocytosis

Reticulocytes (%)

The Blood Picture shows Microcytic Hypochromic

Anemia with Reticulocytosis, most probably chronic
hemolytic anemia (Thalassemia).
Iron studies (Serum iron, TIBC & serum Ferretin) and
hemolytic profile are recommended .

Comment On Blood Picture and

Mention Confirmatory Test
Parameter

Patients
Value

Normal
Value

Comment

WBCs(x103/mm3)

5.5

4 - 11

Normal

HB (g/dl)

10.5

11.5 - 13.5

Mild Anemia

MCV (Fl)

81

75 - 86

Normocytic

MCH (pg)

30

27 - 33

Normochromic

Plateletes (x103/mm3)

15

150 - 450

Thrombocytpenia

Reticulocytes (%)

0.5 - 2

Normal

The Blood Picture shows severe thrombocytpenia

with mild anemia, most probably ITP.
Bone Marrow Aspirate is Recommended.

Comment On Blood Picture and

Mention Confirmatory Test
Parameter

Patients
Value

Normal
Value

Comment

4 - 11

Leukopenia

HB (g/dl)

5.2

11.5 - 13.5

Anemia

MCV (Fl)

78

75 - 86

Normocytic

MCH (pg)

28.9

27 - 33

Normochromic

Plateletes (x103/mm3)

25

150 - 450

Thrombocytpenia

Reticulocytes (%)

0.1

0.5 - 2

Reticulocytopenia

WBCs (x103/mm3)

The Blood Picture shows Pancytopenia, most probably

aplastic anemia.
Bone Marrow Aspirate and Biopsy are Recommended.

Comment On Blood Picture and

Mention Confirmatory Test
Parameter

Patients
Value

Normal
Value

Comment

WBCs(x103/mm3)

20

4 - 11

Leukocytosis

HB(g/dl)

9.5

11.5 - 13.5

Anemia

MCV(Fl)

82

75 - 86

Normocytic

MCH(pg)

30

27 - 33

Normochromic

Plateletes(x103/mm3)

300

150 - 450

Normal

Polymorph :70%

Lymphocytes :25%

Band Count 12%

There is Leukocytosis, with predominant neutrophilia (PolymorphNuclear Leukocytosis) with increase in the band count (Bandemia)
& shift to the left most probably bacterial infection.
ESR, CRP, proper cultures from possible infection focus or from
blood are recommended.

Comment On Blood Picture and

Mention Confirmatory Test
Parameter

Patients
Value

Normal
Value

Comment

14.5

4 - 11

Leukocytosis

HB(g/dl)

11

11.5 - 13.5

Mild Anemia

MCV(Fl)

82

75 - 86

Normocytic

MCH(pg)

30

27 - 33

Normochromic

Plateletes(x103/mm3)

300

150 - 450

Normal

WBCs(x103/mm3)

Polymorph : 35%

Lymphocytes :65%

Band Count 3 %

There is Leukocytosis, with predominant Lymphocytosis

with No bandemia & No shift to the left most probably
viral infection.
ESR & CRP recommended.