PERIPHERAL BLOOD SMEAR REPORT


Andy Nguyen,M.D./ UT-Medical School at Houston, Pathology/ Last Revision on: 2/14/2012
Interface design by Alex Nguyen
Enter Data on RBC: Enter Data on Hemolysis:
Anemia of chronic disease: A cold agglutinin:
Anemia in response to Epogen treatment: A sickling disease:
B12/folate deficiency: DIC:
Beta-thalassemia trait and hemoglobinopathies: Hemolytic disease of the newborn (HDN):
Increased erythropoiesis in response to anemia: Hereditary elliptocytosis cannot be ruled out:
Iron deficiency anemia: Hereditary spherocytosis/stomatocytosis/pyropoikilocytosis:
Iron deficiency anemia in response to iron treatment: Microangiopathic hemolysis:
Macrocytosis secondary to medication: Microangiopathic hemolysis cannot be ruled out:
Polycythemia: No evidence of microangiopathic hemolysis:
    Non-microspherocytic hemolysis:
Enter Data on PLT: Sickle cell disease:
ITP vs. HIT vs. neonatal allo-immune thrombocytopenia vs. congenital thrombocytopenia: TTP/HUS:
ITP and blood loss with increased erythropoiesis: Warm auto-antibody/ Hemolytic transfusion reaction:
Marked thrombocytosis (cannot r/o ET): Warm auto-antibody cannot be ruled out:
Reactive thrombocytosis:    
Spurious thrombocytopenia or hypersplenism:    
       
Enter Data on WBC: Enter Data on OTHERs:
Acute leukemia vs. Refractory anemia with excess blasts: Hypothyroidism:
CLL / other lymphoproliferative disorders: Liver disease:
CML: No pathological changes:
Eosinophilia: Normal/Premature-Newborn:
Immature leukocytes: Pancytopenia due to inadequate hematopoiesis or metastasis:
Myeloproliferative disorder/ Myelodysplastic syndrome: Renal disease:
Leukocytosis with reactive PMNs: Rouleaux formation:
Leukemoid reaction: Rouleaux formation due to monoclonal gammopathy:
Leukopenia: Malaria:    
Positive/Negative for organisms:    
Reactive lymphocytosis:    
Reactive neutrophilia:    

DRAFT FOR PERPHERAL BLOOD REPORT:



FINAL DRAFT: