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Haem Exam
Haem Exam
When examining a patient's haematologic system, remember the three key cell lines and the major manifestations that can result from their derangement: anaemia, infection and bleeding / bruising. The haematology exam is also used to identify signs of malignancy, such as lymphadenopathy and splenomegaly.



Conjunctival Pallor

    • How to Elicit

    • Pull the lower eyelid downward and inspect the inner eyelid. Conjunctival pallor is present if there is loss of the normal redness of the anterior rim of the conjunctiva.
    • Significance

    • A sign of severe anaemia.

Subconjunctival Haemorrhage

    • Look For

    • Redness beneath the conjuncctiva due to bleeding
    • Significance

    • May be a sign of coagulopathy.
    • Causes of Subconjunctival Haemorrhage

    • Idiopathic
    • Ocular damage - trauma, contact lens use, surgery
    • Vascular damage - hypertension, diabetes, atherosclerosis
    • Conjunctivitis
    • Conjunctival tumour

Scleral Icterus

    • Look For

    • Yellowness of the conjunctiva overlying the sclera.
    • Significance

    • A relatively sensitive indicator of jaundice, occurring prior to the development of colour change in the skin.
Last updated on January 1st, 2017

Associated Diseases

Nutritional Anaemias
Aplastic Anaemia