Diamond-Blackfan Anemia

Macrocytic anemia with normal DNA synthesis

Enlarged skull and DNA helix etched on the forehead = large cells, intact DNA replication.

Without hypersegmented neutrophils

No neutrophil markings; clean red blood cells float nearby — indicating non-megaloblastic morphology.

Causes: chronic alcohol use, liver disease

Wears a belt flask and has skin mottled with hepatic stigmata — visualizing cirrhosis and toxicity.

Congenital pure red cell aplasia

Childlike face and skeletal arm emerging from abdomen = early-onset marrow failure.

Intrinsic defect in erythroid progenitor cells

Cracked red cell symbol on chest = erythroid lineage shutdown.

↑ HbF (but ↓ total Hb)

Wears a glowing fetal-face medallion = compensatory increase in HbF.

Short stature, craniofacial abnormalities

Small torso, hunched posture, and twisted facial structure = classic malformative phenotype.

Triphalangeal thumbs

One hand has three long, finger-like claws, exaggerated and misplaced — visual cue for malformed thumbs.