PERIPHERAL BLOOD SMEAR REPORT
Andy Nguyen,M.D./ UT-Medical School at Houston, Pathology/
Last Revision on: 6/3/09
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 cannot be ruled out:
Hemolytic disease of the newborn (HDN):
Increased erythropoiesis in response to anemia:
Hereditary elliptocytosis cannot be ruled out:
Iron deficiency anemia:
Hereditary spherocytosis:
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:
TTP/HUS:
ITP and blood loss with increased erythropoiesis:
Warm auto-antibody:
Marked thrombocytosis (cannot r/o ET):
Warm auto-antibody cannot be ruled out:
Reactive thrombocytosis:
Spurious thrombocytopenia:
Enter Data on WBC:
Enter Data on OTHERs:
Acute leukemia:
Hypothyroidism:
CLL / other lymphoproliferative disorders:
Liver disease:
CML:
No pathological changes:
Eosinophilia:
Normal/Premature-Newborn:
Immature leukocytes:
Pancytopenia due to inadequate hematopoiesis by bone marrow:
Myeloproliferative disorder:
Renal disease:
Leukocytosis with reactive PMNs:
Rouleaux formation:
Leukemoid reaction:
Rouleaux formation due to monoclonal gammopathy:
Leukopenia:
Positive for fungal organisms:
Reactive lymphocytosis:
Reactive neutrophilia:
DRAFT FOR PERPHERAL BLOOD REPORT:
FINAL DRAFT: