Reading the Blood Film: Size and Colour

What this deck covers

Reading the Blood Film: Size and Colour in twelve illustrated clinical cases with worked explanations – case presentations built around clinical images, radiology, teaching illustrations and real laboratory data, with the reference range beside every value a case quotes. This visual, data-interpretation style of practice suits candidates preparing for MRCPCH AKP in particular, alongside Saudi and Gulf licensing examinations such as the Arab Board, DHA and OMSB. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong.

The twelve cases, in order

1. One size, or more than one
2. Cells that vary more than they should
3. Why the average came back normal
4. The cells with a bluish cast
5. Deciding that a cell is large
6. What shape the large cells are
7. Large cells in a baby of two days
8. Small cells of entirely normal colour
9. When the pale centre grows
10. Cells with no pale centre at all
11. Counting the youngest cells
12. Reporting the two things apart

What this deck teaches

• Describe the population before the cells. One size or several. A film of cells all much alike is a different finding from one carrying two populations, whatever the average says.
• An index is an average and a film is not. Two populations, one large and one small, average to a normal mean cell volume. Only the film shows that there were two.
• Judge size against the lymphocyte nucleus. The ruler from episode 1, used rather than re-taught: cells clearly larger than that nucleus are macrocytic.
• Round and oval macrocytes are different findings. Both are large. Reporting the shape of the large cell costs nothing and is the part that narrows anything.
• Large cells are normal in a newborn. The range starts high and falls over the first months, so a size is read against the age before it is called anything.
• Size and colour do not always move together. Small cells with entirely normal colour is a real and different finding from small pale ones, so the two are reported separately.

Exam pearls from this deck

• A uniform population is the baseline the rest of this episode is read against.
• Variation in size appears while the average is still normal.

The twelve worked cases in this deck, with the images and the full explanation of every option, are part of Pediatric Case Review membership. See what is included, or start with the free Pediatric Exam Review Sets.

More from this system: all haematology illustrated case decks · haematology board questions for bank-style drilling · the free Pediatric Exam Review Sets · pediatric reference values.