{"id":5438,"date":"2021-05-17T13:51:00","date_gmt":"2021-05-17T11:51:00","guid":{"rendered":"https:\/\/meddists.com\/learn\/clinical\/hematology\/investigations\/blood-smear\/"},"modified":"2022-01-13T21:28:15","modified_gmt":"2022-01-13T19:28:15","slug":"blood-smear","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/hematology\/investigations\/blood-smear\/","title":{"rendered":"Blood smear"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">A blood smear is used for the investigation of the various cells in the peripheral circulation and for the detection of parasites.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Done by placing a drop of blood on the top of a glass slide, using another slide to smear it at a 45-degree angle, staining and fixating it.<\/li><li><strong>RBCs<\/strong><ul><li>Morphology<ul><li>Size (macro\/micro\/normocytic)<\/li><li>Color (hypo\/normochromic)<\/li><li>Shape (normal\/sickle\/target\/spherocyte\/bitten)<\/li><\/ul><\/li><li>Inclusions<ul><li><strong>Howell-Jolly bodies<\/strong> (presence of DNA; seen in asplenism or hyposplenism, severe hemolytic anemia)<\/li><li><strong>Basophilic stippling<\/strong> (presence of RNA; seen in thalassemias, hemolytic anemias, MDS, alcoholism, lead poisoning)<\/li><li><strong>Heinz bodies<\/strong> (presence of denatured hemoglobin; seen in G6PD)<\/li><li><strong>Pappenheimer bodies<\/strong> (clumps of ferritin; the cells are known as <strong>siderocytes<\/strong>; seen in MDS, sideroblastic anemia, lead poisoning)<\/li><\/ul><\/li><\/ul><ul><li><strong>Rouleaux\u00a0formation<\/strong> (RBCs piling on top of each other; seen in infections, multiple myeloma, Waldenstr\u00f6m&#8217;s macroglobulinemia)<\/li><li><strong>Darcocytes<\/strong> (teardrop RBCs) appear in myelodysplastic syndrome and myelofibrosis.<\/li><\/ul><\/li><li><strong>WBCs<\/strong><ul><li>Left-shift (presence of immature WBCs; seen in infections)<\/li><li>Presence of nucleolus (always pathologic in peripheral cells)<\/li><li>Hypersegmented nuclei (in neutrophils; seen in megaloblastic anemia)<\/li><li>Pelger-Huet anomaly (bilobed\/dumbbell-shaped nucleus in neutrophils; seen in MDS)<\/li><li>Toxic granulation (in neutrophils; seen in severe infections)<\/li><li>Nuclear-cytoplasmic\u00a0ratio (increased ratio suggests dysplastic changes)<\/li><li>Presence of vacuoles (seen in storage diseases)<\/li><\/ul><\/li><\/ul>\n<div id=\"the_titles\" style=\"display:none;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>A blood smear is used for the investigation of the various cells in the peripheral circulation and for the detection of parasites. Done by placing a drop of blood on the top of a glass slide, using another slide to smear it at a 45-degree angle, staining and fixating it. RBCs Morphology Size (macro\/micro\/normocytic) Color [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":5392,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-5438","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Blood smear &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/hematology\/investigations\/blood-smear\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/hematology\\\/investigations\\\/blood-smear\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/hematology\\\/investigations\\\/blood-smear\\\/\",\"name\":\"Blood smear &#8211; 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