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Section 4 of 6 · Open sections

Required section · Section 4 of 6

Guided example: a normal background supports the count

K2-EDTA blood was delivered within 30 minutes. The smear was prepared within 15 minutes of receipt and stained the same shift. WBC is 6.8 × 10^9/L with a reference interval of 4.0 to 11.0 × 10^9/L, hemoglobin is 14.1 g/dL, hematocrit is 41.8 percent, and platelet count is 238 × 10^9/L. The displayed platelet interval of 150 to 450 × 10^9/L is representative and must be verified locally.

In the monolayer, RBCs are round discocytes with central pallor about one-third of diameter. Anisocytosis is minimal, and there is no significant poikilocytosis or more than occasional polychromasia. Platelets occur singly and in small loose groups; none approach RBC diameter, the descriptive giant-platelet threshold.

Multiple fields, including edge areas, show no clumping or satellitism. A local-policy smear estimate using the laboratory's validated oil-field factor is concordant with 238 × 10^9/L. The estimate supports the automated result because the smear does not show a visible mechanism for a falsely low count. A normal smear estimate corroborates an analyzer count only after the field and distribution have been checked.

Illustrative drawing — this picture was drawn rather than captured.

Worksheet lists platelet counts of 12, 11, and 13 in three oil fields, average 12, then states that a local validated factor yields a concordant estimate for the analyzer count of 238 × 10^9/L.
Figure 1The worksheet uses a local validated factor and corroborates the automated count.
CBC and smear review data
ItemResultReference or observation
Platelet count238 × 10^9/LRepresentative adult interval 150-450 × 10^9/L
WBC6.8 × 10^9/L4.0-11.0 × 10^9/L
RBC morphologyDiscocytesCentral pallor about one-third
Platelet distributionSingles and loose groupsNo clumps or satellitism
Oil-field platelet worksheet
FieldPlatelets counted
112
211
313
Average12

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Knowledge check 1

Which interpretation best fits the guided case?

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Knowledge check 2

Which observations support the guided-case platelet result?

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