6. History
Duration of symptom
Long (MDS)
Short (aplastic anemia)
History of transfusion
History of hemoglobinurea
Dietary history
Exposure to drugs : anti cancer , Abs , anti
thyroid (aplastic anemia)
Barbiturates , phenytoin ( B12, Folic acid)
Chemotherapy , radiation ( MDS , AML)
7. Weight loss , fever ( Inflammatory or
malignancy)
Jaundice ( Hepatitis B or C)
Joint pain (SLE)
History of blood loss
11. Pancytopenia + Back pain +
Hypercalcemia
(multiple myeloma)
Pancytopenia + Malar rash or GN = SLE
pancytopenia + HSM = Leukemia
12. Blood Film
1.RBC morphology ( size & shape)
2.WBC and RBC precursor
3.Platelets count & size
4.Abnormal increase or decrease
granulation in Neutrophil
5. Hypo / hypersegmented Neutrophil
13. Other evaluating test may be
included
ESR
Reticulocyte count
Serum LFTs
Hepatic serology
Serum coagulation profile, bleeding
time, fibrinogen, and D-dimer
Serum B12 and folate
HIV test
17. The characteristic peripheral blood
morphologic feature in multiple
myeloma is:
A. Cytotoxic T cells
B. Rouleaux formation
C. Spherocytosis
D. Macrocytosis
18.
19. True or false?
In blood film normal platelets count
rules out aplastic anemia
True
20. Bone Marrow Examination
Almost always indicated in case
pancytopenia unless cause is apparent.
Both aspiration and biopsy are indicated.
Specifically, bone marrow aspirate permits
examination of:
• Cytology (megaloblastic change,
dysplastic changes, abnormal cell
infiltrates)
• Immunophenotyping : antigen or marker
on cells surfaces e.g ( leukemias,
lymphoproliferative disorders)
• Cytogenetics : structure of chromosome
(myelodysplasia, leukemias,
lymphoproliferative disorders).
21. True or false?
Bone marrow examination is required
in diagnosis of Megaloblastic anemia
False
22. The differential diagnosis of pancytopenia
are based on cellularity of bone marrow :
Hypocellular: excessive amount of fat
cells
Normocellular: 50-70% hematopoietic
cells & 30-50% fat
Hypercellular: 80-100% cells with little