Required section · Section 5 of 6

Choose the defensible review action

For this case, the evidence that changes interpretation is the broad, bimodal histogram plus two discernible populations in the representative monolayer. High RDW-CV supports variation but cannot establish dimorphism. The in-range MCV remains an average, not a reason to dismiss film evidence.

Report approved morphology when film and analyzer agree: anisocytosis with microcytic hypochromic cells and a discrete normocytic population, consistent with dimorphism. Do not add a disease label, transfusion statement, or treatment history that is not available.

When film and analyzer do not agree, do not force a morphology conclusion. Review relationships, flags, specimen appearance, and original film for interference; complete the validated verification path. Release a reconciled result or use recollection, suppression, consultation, or escalation when the discrepancy remains unresolved.

Ordering exercise

Put the case-correlation steps in the order that supports a bounded release decision.

1. Apply local reporting action

Use approved terms, review relevant history under procedure, and escalate only if criteria apply.
2. Reconcile histogram and film

Relate bimodal volume evidence to the observed cells.
3. Review indices and flags

Identify the in-range MCV, low MCHC, high RDW-CV, and distribution flag.
4. Inspect the monolayer

Confirm representative morphology and distinguish populations from clumps.

Knowledge checks

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Knowledge check 1

Select the evidence-based actions supported by the case before release.

Choose at least 3 options.

Release only approved local morphology terms for the observed populations.

Review available transfusion and treatment history under local procedure.

When the representative film and analyzer agree, report approved dimorphic morphology; when they do not, begin the interference pathway.

Assign a cause of dimorphism from the CBC and smear alone.

Apply a universal morphology grade from a published cutoff.

Section status

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The module finishes after every required section is marked done and every check in those sections is correct.