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Difficulty: EasyPediatric Hematology and Oncology

Match each pediatric hematologic or oncologic diagnosis with its most characteristic peripheral blood smear finding.

  • Sickle cell disease (in a school-aged child)Howell-Jolly bodies
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiencyHeinz bodies and bite cells
  • Iron deficiency anemiaMicrocytic, hypochromic red blood cells
  • Acute lymphoblastic leukemia (ALL)Lymphoblasts with a high nuclear-to-cytoplasmic ratio

Answer

Sickle cell disease pairs with Howell-Jolly bodies; G6PD deficiency pairs with Heinz bodies and bite cells; Iron deficiency anemia pairs with Microcytic, hypochromic red blood cells; Acute lymphoblastic leukemia pairs with Lymphoblasts.
Each diagnosis has a classic morphological hallmark on the peripheral blood smear driven by its underlying pathophysiology: autosplenectomy in sickle cell disease (Howell-Jolly bodies), oxidative damage in G6PD deficiency (Heinz and bite cells), reduced hemoglobin synthesis in iron deficiency (microcytic, hypochromic cells), and marrow infiltration by immature cells in ALL (lymphoblasts).

Step-by-Step Solution

1
Identify the underlying pathophysiologic mechanism of each condition.
Sickle cell disease leads to functional asplenia; G6PD deficiency leads to oxidative hemoglobin damage; iron deficiency impairs hemoglobin synthesis; ALL involves bone marrow replacement by malignant progenitor cells.
Understanding the mechanism is essential for predicting the cellular appearance on a blood smear.
2
Correlate the mechanism with the classic peripheral blood smear description.
Asplenia leads to retained nuclear remnants (Howell-Jolly bodies); oxidative damage leads to precipitated hemoglobin and subsequent macrophage clearance (Heinz bodies and bite cells); impaired hemoglobin synthesis yields small, pale cells (microcytic/hypochromic); and malignant progenitors appear as immature blasts (lymphoblasts).
This establishes the correct clinical associations required for diagnosis.

Key Concept

Peripheral blood smear findings in pediatric hematologic conditions
Estimated Time:45s
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Topics

Pediatric Hematology and Oncology

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