Examination of a Blood film
You are provided with 2 blood films prepared from peripheral blood. The first prior to treatment and the second post treatment. Examine the blood film initially under lower power magnification and then under high power magnification noting any abnormal findings in order to aid diagnosis of the patient.
In order to aid you in your examination of the blood film a normal blood film is also included and should be viewed initially in order for you to make appropriate observations of the patient’s blood film.
Examine the blood film with a scan of the slide using the low-power objective. This step is necessary to assess the overall quality of the blood film, including abnormal distribution of RBCs, suggesting the presence of rouleaux or autoagglutination and/or the presence of a disproportionate number of large nucleated cells, such as monocytes or neutrophils. In addition, the low power magnification examination allows for the rapid detection of large abnormal cells such as blasts, reactive lymphocytes, and parasites.
Using high power magnification and oil immersion find an area of the blood film in which the RBCs are evenly distributed and barely touching one another (two or three cells may overlap). Scan 8 to 10 fields in this area note the RBC, WBC and platelet morphology and estimate the numbers in relation to the normal blood film.
Evaluation of the RBC morphology is an important aspect of the smear evaluation and is used in conjunction with the RBC indices to describe cells as normal or abnormal in size, shape, and colour.
Make a note of your observations.
