So we have our first update.
Our 20 year old lady who is now 32 weeks pregnant attended with a rash. This is her first pregnancy.
She has been increasingly tired over the last 6 weeks, but has put this down to her pregnancy.
She had not been taking folic acid, but has been taking some iron tablets for the last 2 weeks. She does not take any other regular medication and has nkda. She does not smoke and only very occasionally drinks alcohol.
We have repeated her bloods.
Hb 78
Plt 40
Wcc 24
Neut 0.90
Na 136
K 4.0
Urea 5.4
Creatinine 78
LFT normal
The lab have made the blood film (shown below)
What does this show?
What would you do next?
TeamHaem 
Blast cells
? Leukemia lymphoma
For immunophentyping
Thanks for all of your useful comments. We try to do most of the discussion via Twitter – next time reply to us and use #teamhaem! Thanks!
PB blasts
Normoblastemia
Polychromasia
BM aspiration, immunophenotyping and cytogenetics are recommended