Blue Simple Medical Clinic Presentation 5Blue Simple Medical Clinic Presentation 5

Blood Smear

Blood Smear, A blood smear is a test performed in the lab to assess red blood cells’ (RBCs’) features and appearance under a microscope. It offers crucial diagnostic data regarding the size, structure, and color of red blood cells, which can aid in the diagnosis of some illnesses.

How to Make a Blood Smear:

Sample Collection: Although a finger-prick blood sample can also be utilized, blood is usually drawn from a vein.
Preparing a Smear: On one end of a sanitized glass slide, insert a little drop of blood. To spread the drop, insert the edge of a second slide into the blood drop and quickly push it across the first slide to create a thin, equal layer.

Staining: To distinguish the various cell types and anatomical features in the blood sample, the smear is stained, typically using Wright’s or Giemsa stain.

RBC Morphology:

The following characteristics of RBC shape are usually evaluated while analyzing a blood smear:

Normocytic: RBCs of a normal size.
Microcytic: RBCs that are smaller than usual; frequently observed in thalassemia and iron deficient anemia.
Macrocytic: Larger than normal red blood cells, caused by deficiencies in vitamin B12 or folate.

Typical: Disc form is biconcave.
Poikilocytosis: RBCs with an irregular form are present. Particular forms consist of:

Spherocytes: Spherical cells that are observed in immunological hemolytic anemia and hereditary spherocytosis.
Elliptocytes are oval-shaped cells linked to a genetic condition called elliptocytosis.
Target cells: RBCs that resemble targets and are observed in thalassemia and liver illness.
Schistocytes: Broken red blood cells that are a sign of hemolytic anemia with microangiopathy.
Teardrop-shaped cells known as dacrocytes are linked to severe iron deficiency anemia and myelofibrosis.

Normochromic RBCs: These have a normal color and a sufficient amount of hemoglobin.
Pale red blood cells, or hypochromic RBCs, are a common sign of iron deficiency anemia and indicate decreased hemoglobin.

Polychromasia: bluish-colored red blood cells that indicate immature cells (reticulocytes) in environments where red blood cell synthesis is elevated.

Nuclear remains observed in hyposplenic or asplenic situations are known as Howell-Jolly bodies. Small, dark blue granules known as basophilic stippling are linked to lead toxicity and some anemias.

Heinz bodies: Some hemoglobinopathies and G6PD deficiency are characterized by denatured hemoglobin.
Pappenheimer bodies: Granules containing iron that are observed following a splenectomy and in sideroblastic anemia.

Clinical Importance: 

Crucial hints to the underlying disease are provided by RBC morphology:

Anaemia: Different forms of anemia can be identified by differences in size (anisocytosis) and shape (poikilocytosis).
Hemolysis: Schistocytes or spherocytes may indicate the presence of hemolytic processes.
Nutritional Deficiencies: Microcytic and hypochromic RBCs indicate an iron shortage, whereas macrocytic RBCs may indicate a vitamin B12 or folate insufficiency.
Bone Marrow abnormalities: Myeloproliferative illnesses and myelodysplastic syndromes are two examples of bone marrow abnormalities that may be indicated by abnormal RBC inclusions and morphologies.


An invaluable diagnostic tool in hematology, a blood smear can reveal the underlying causes of a wide range of hematologic diseases. Healthcare practitioners can successfully detect and monitor disorders by looking at the shape of red blood cells (RBCs), which in turn helps guide proper treatment choices.

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