| Course | PA 512 CCM Hematology/Oncology |
|---|---|
| Week | 3 |
| Paper type | Peripheral smear correlation |
| Length | About 750 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 512 Week 3
Peripheral Smear Correlation: Spherocytes and Polychromasia on K.B.'s Film, Tied to an MCHC of 36.5 and a Reticulocyte Count of 9.2%, and the One Place They Disagree
Student Name
Chamberlain University
PA 512: CCM Hematology/Oncology
Instructor Name
Month Day, Year
Peripheral Smear Correlation: Spherocytes and Polychromasia on K.B.'s Film, Tied to an MCHC of 36.5 and a Reticulocyte Count of 9.2%, and the One Place They Disagree
The Vocabulary of the Field
Film from the same sample as last week's count, Wright stain, examined in the monolayer area at 100 times oil immersion. Written description supplied by the laboratory and confirmed on review of the image provided:
Red cells vary in size and color. Many cells are small, round and densely stained, with no central pale area: spherocytes, estimated at about one in six red cells across ten fields. Larger cells with a blue-gray tint are frequent: polychromatophilic cells, the stained appearance of young red cells. No fragmented cells, no bite or blister cells, no target cells, no sickle cells and no red cell clumping. Occasional nucleated red cell, fewer than one per 100 white cells. White cells normal in number and appearance. Platelets adequate in number with normal size.
Terms Tied to Figures
Spherocytes and the MCHC. Spherocytes have lost membrane and become smaller and denser, which raises the hemoglobin concentration inside each cell. The MCHC of 36.5 g/dL is the count's measurement of what the film shows directly (Perrotta et al., 2008).
Polychromasia and the reticulocyte count. Polychromatophilic cells are reticulocytes seen on an ordinary stain. Their frequency on the film agrees with the reticulocyte count of 9.2% and the absolute count of about 267 × 10^9/L.
Variation in size and the RDW. Small spherocytes and large polychromatophilic cells on the same film explain the RDW of 17.9%: the spread is wide in both directions.
Normal white cells and platelets on the film agree with their counts.
Where the Two Disagree
The film shows many small cells, yet the MCV is 84 fL, in the normal range. Read alone, that looks like a contradiction. It is resolved by the two populations: spherocytes pull the average volume down, and the large reticulocytes pull it up. The disagreement is named here because a reader comparing the film and the count would otherwise wonder whether one was wrong. Neither is; the average simply hides both ends.
What the Picture Added
The film added three things the count could not. First, it confirmed that the raised MCHC is real: spherocytes are visible, so an artifact is less likely. Second, it showed what is absent: no fragmented cells, which argues against destruction in small vessels, and no bite cells, which argues against oxidative damage. Third, it narrowed the cause to one of two main groups. Spherocytes are seen in hereditary spherocytosis and also in warm autoimmune hemolytic anemia, and the film cannot separate them (Bolton-Maggs et al., 2012). A direct antiglobulin test is the step that does.
Captions on the Image
The image supplied with the assignment is annotated with three labels: an arrow to a spherocyte, captioned "small, dense, no central pallor"; an arrow to a polychromatophilic cell, captioned "large, blue-gray, young red cell"; and a box around a normal red cell for comparison, captioned "normal size and central pallor." Each caption states a visible feature rather than a diagnosis.
How the Estimate Was Made
The proportion of spherocytes, about one in six, was estimated by counting 100 consecutive red cells in each of ten monolayer fields and marking those that were small, round and lacked central pallor. Cells at the thick and thin edges of the film were not counted, because red cells there can look falsely round or falsely flat. The estimate is recorded as an estimate. It is not a test result, and a second reader might count a few more or fewer, but the method lets them repeat it. Laboratories differ in how they grade spherocytes, often as few, moderate or many, and the count gives a reader something firmer than a grade.
Summary
The film and the count agree on spherocytes, a strong marrow response and normal white cells and platelets. They disagree only in appearance on the MCV, and the two cell populations explain that. The film narrows the field to spherocytic hemolysis and leaves the immune question to the antiglobulin test. Since the last visit, that test has come back negative, and K.B.'s parent's history of splenectomy fits a hereditary cause.
References
Bolton-Maggs, P. H. B., Langer, J. C., Iolascon, A., Tittensor, P., & King, M. J. (2012). Guidelines for the diagnosis and management of hereditary spherocytosis: 2011 update. British Journal of Haematology, 156(1), 37-49. https://doi.org/10.1111/j.1365-2141.2011.08921.x
Perrotta, S., Gallagher, P. G., & Mohandas, N. (2008). Hereditary spherocytosis. The Lancet, 372(9647), 1411-1426. https://doi.org/10.1016/S0140-6736(08)61588-3
Reading the PA 512 Week 3 instructions
The third week asks you to describe a peripheral blood smear and correlate it with the complete blood count from the same sample. Keep the description in the vocabulary of the field of view: cell size, shape, staining, inclusions, what is present in numbers and what is absent. Then tie each term to a figure in the count, such as spherocytes to the MCHC or polychromatophilic cells to the reticulocyte count. Where the film and the indices seem to point in different directions, name the disagreement and explain it rather than smoothing it over. Say what the film added that the count could not, including what it ruled out. If an image is supplied, caption it with visible features. Explain how any estimates were made. Stop short of a final diagnosis unless the film alone settles it.
Inside the PA 512 Week 3 example
The description records a Wright-stained film read in the monolayer at oil immersion: spherocytes about one in six cells, frequent polychromatophilic cells, no fragments, bite cells, target cells or sickle cells, an occasional nucleated red cell and normal white cells and platelets. The correlation section ties spherocytes to the MCHC of 36.5, polychromasia to reticulocytes of 9.2% and the mix of small and large cells to the RDW of 17.9%. A section on disagreement explains that the MCV of 84 fL sits in the normal range because spherocytes and reticulocytes pull the average in opposite directions. What the film added follows: confirmation that the MCHC is real, the absence of fragments and bite cells, and a narrowing to two causes of spherocytes. A section describes counting 100 cells in ten fields, the image captions are listed and the summary notes the negative antiglobulin test.
Reading the PA 512 Week 3 grading rubric
Points drain fastest from a description that is complete and joined to nothing, pages of terms with no figure attached to any of them. Almost as damaging is a conflict passed over in silence: where the film and the indices seem to point different ways, rubrics want the disagreement named and explained. Further deductions follow for descriptions that use diagnostic labels instead of features, for absent findings left out, for estimates given without a method, for captions that name a disease rather than a visible feature and for a correlation that claims the film settles a question it cannot. Full credit goes to a description in the vocabulary of the field, every term tied to a number, any disagreement named and resolved, a clear statement of what the film added or ruled out and a note on which test settles what remains.
PA 512 Week 3 help: mistakes that cost points
Smear correlations ask you to move back and forth between a picture and a table, and most drafts stay on one side. Bring the film or written description and the count from your case, and we will tie each finding to its figure in short, checkable sentences. Finding and explaining an apparent disagreement, such as a normal MCV beside many small cells, is where a correlation shows understanding, and we can work through yours. Describing what is absent from the film, and why that matters, is another step drafts tend to skip. The observations and conclusions remain yours. If your section supplies an image, the custom sample captions it with visible features only and keeps the caption wording consistent with the description.
Get a PA-512 Week 3 example written to your instructions
Send the image or description your section supplied, along with the count it belongs to and any list of terms the assignment names, and a custom example comes back written to them inside 24 to 48 hours, the first one free. Where only an image is given, the correlation is built from whatever figures you send with it.
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PA 512 Week 3 questions, answered
Does the assignment need a real image?
Sections differ. Many supply the image or a written description, some allow a labeled image from the course text, and a few accept neither and want the correlation built from a description alone. Whichever applies, the marked object is the join between the picture and the figures rather than the picture itself. Send whatever your classroom posted.
How many terms belong in the description?
Enough to cover what is actually visible and no more. Sections mark whether each term was applied to this sample rather than recited from a glossary, so five terms that are all tied to figures score above fifteen that are not. If your assignment names a term list, the example works through that list in order.
Can the correlation name a condition?
In most sections it may name the possibilities the film narrows to, provided each one is reached from a term and a figure rather than announced. What this week marks is the reasoning between the two documents. Send the wording your assignment uses, since a few sections ask for the narrowing and stop short of any named condition.
Where can I find a free PA 512 Week 3 sample paper?
This page carries the full PA 512 Week 3 smear correlation tying spherocytes and polychromasia to the count, with the disagreement explained.
Why is the MCV normal in the PA 512 Week 3 sample despite many small cells?
Because small spherocytes and large reticulocytes pull the average volume in opposite directions, so the mean lands in the normal range while the RDW widens.