ABPath Hematopathology case studies
ABPath Hematopathology · Put your knowledge to work in context.
The ABPath Hematopathology subspecialty examination is a one-day, computer-based certification exam for pathologists seeking subspecialty board certification in hematopathology. It combines Written/Practical sections with Virtual Microscopy sections and uses no glass slides; all microscopy is virtual. The Written/Practical portion contains 220 multiple-choice, one-best-answer questions allotted 4 hours 25 minutes. The Virtual Microscopy portion contains 45 questions allotted 2 hours 39 minutes. Topics on this exam: Methodology, Hematopoiesis, Erythrocyte disorders, Leukocyte disorders, Lymphoid disorders, Blood, bone marrow, and related disorders, Platelets and platelet disorders, Hemostasis and thrombosis, and Patient care decision making and consultation. The ABPath Hematopathology case studies are 5 cases and about 1,896 words.
1Schistocytes, Thrombocytopenia, and a Pending ADAMTS13
A 34-year-old woman presents with 3 days of confusion, petechiae, and fatigue. She is not pregnant and has no diarrhea. Labs: Hb 8.1 g/dL, platelets 14 ×10^9/L, WBC 9.2 ×10^9/L, LDH 1,200 U/L, haptoglobin <10 mg/dL, creatinine 1.0 mg/dL, total bilirubin 3.1 mg/dL indirect, PT/INR 1.0, aPTT 28 s, fibrinogen 320 mg/dL. Peripheral smear shows 3% schistocytes and no platelet clumps.
399 words, about 2 min2Marked Leukocytosis With Basophilia and a Low LAP Score
A 55-year-old man reports fatigue and early satiety. The spleen is 6 cm below the costal margin. CBC: WBC 68 ×10^9/L, Hb 10.5 g/dL, platelets 450 ×10^9/L. Differential: neutrophils 60%, bands 8%, metamyelocytes 10%, myelocytes 8%, promyelocytes 2%, basophils 4%, eosinophils 2%, lymphocytes 6%.
357 words, about 2 min3Incidental Monoclonal B-Cell Lymphocytosis in an Older Woman
A 68-year-old woman has incidental lymphocytosis of 18 ×10^9/L on a routine CBC. Hb is 12.5 g/dL, platelets 180 ×10^9/L, and she has no lymphadenopathy or hepatosplenomegaly. The smear shows small lymphocytes and smudge cells. Flow cytometry shows CD19+, CD5+, CD23+, dim CD20, dim surface kappa, FMC7 negative, and CD200 positive.
410 words, about 2 min4Platelet Fall After Cardiac Surgery With New Thrombosis
A 64-year-old man is postoperative day 7 after coronary artery bypass grafting. Platelets fell from 250 ×10^9/L preoperatively to 85 ×10^9/L today. He has no bleeding, but Doppler ultrasound shows a new popliteal vein thrombosis. He is receiving unfractionated heparin prophylaxis.
394 words, about 2 min5Macrocytosis With Mild Cytopenias: Marrow Now or Later?
A 72-year-old woman has Hb 10.2 g/dL, MCV 104 fL, WBC 3.4 ×10^9/L, and platelets 130 ×10^9/L. She has no alcohol use, no B12 or folate deficiency, normal TSH, and no new medications. The smear shows oval macrocytes and rare five-lobed neutrophils but no clear hypogranularity. Reticulocyte count is 1.2%.
336 words, about 2 min