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Compendium Hematopathology > Blood Cells Atlas > Flashcards

Blood Cells Atlas Flashcards

1
Q

Changes induced by hyperlipidemia

A
  • Dissolution of granulocyte cell wall (can be alleviated with additional of albumin)
  • Pale/smudged red cells (can be alleviated with additional of albumin)
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2
Q

Pyknotic WBCs

A

Occur more frequently with increased interval between collection and prep of smear and in atypical lymphocytes

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3
Q

Excess EDTA can cause

A
  • Platelet clumping (collect sample in blue tube - citrate - to fix this; need to multiply by 1.1 because of dilution)
  • Platelet satellitosis
  • White cell clumping
  • Shrunken white cells
  • Echinocytes
  • Target cells
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4
Q

Platelet satellitosis associated with?

A

Behcet disease

EDTA exces

Thromboembolism

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5
Q

Artifacts caused by excessive delay in preparing smear

A

Pseudo toxic granulation and vacuoles

Echinocytes

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6
Q

Artifacts in smears that dry slowly or in excessive humidity

A

Echinocytes

Vacuolated red cells (watermark artifact)

Target cells

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7
Q

Erythophagocytosis associated with?

A

Immune hemolytic anemia

Infection

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8
Q

Apoptotic bodies in granulocytes associated with?

A

MDS

Chemotherapy

AIDS

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9
Q

White cell clumping associated with?

A

Bacterial infections

Viral infections

Autoimmune disorders

Usually seen at the edges of the smear

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10
Q

Lymphocyte clumping associated with?

A

Lymphoproliferative disorders

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11
Q

Hypochromia associated with

A

IDA

ACD

Thalassemia

Hemoglobin Lepore (trait and disease)

Hemoglobinopathy-thalassemia syndromes

Lead poisoning

Sideroblastic anemia

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12
Q

Examples of hyperchromic red cells

A

Spherocytes

Acanthocytes

Irreversible sickled red cells

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13
Q

Normocytic hypochromic red cells

A

ACD

Early IDA

Sideroblastic anemia

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14
Q

Microcytic normochromic red cells associated with?

A

ACD

Early IDA

Thal minor

Hemoglobin C (trait and disease)

Hemoglobin E (trait and disease)

Rarely seen in Hemoglobin H disease

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15
Q

Microcytic hypochromic red cells associated with

A

IDA

Thal major

Thal minor

ACD

Hemoglobin E-thal

Hemoglobin E disease

Hemoglobin Lepore (trait and disease)

Lead poisoning

Sideroblastic anemia

Hemoglobin H disease

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16
Q

Normochromic round macrocytic red cells

A

Acute blood loss

Aplastic anemia

Postsplenectomy state

Hemolytic anemia

Alcoholism

Liver disease

AIDS

AIDS therapy

Hyperthyroidism

Hypothyroidism

Hypopituitarism

Malaria (P vivax)

MDS

17
Q

Normocytic ovala macrocytic/macro-ovalocytes associated with?

A
  1. Vitamin B12 deficiency
  2. Folate deficiency
  3. Postchemotherapy
  4. Inherited abnormalities of DNA synthesis (e.g., orotic aciduria, MTHF transferase deficiency, transcobalamin II deficiency)
  5. MDS
  6. Chronic infections
18
Q

Polychromasia is seen in

A

Newborns

Acute blood loss

Hematinic therapy

Homeostatic recovery of bone marrow after chemo or other suppressive factors

19
Q

Target cells occur as a result of

A

Increased surface membrane to volume ratio (e.g.,

  • excess lipid as in liver disease or
  • decreased lipid loss during maturation in postsplenectomy state or
  • by decreased and/or abnormal hemoglobin content as in thalassemia and hemoglobinopathies
20
Q

Microcytic, normocytic, and macrocytic target cells associated with

A
  • Microcytic
    • thalassemia
      • E thal
      • C thal
    • hemoglobinopathies (hemolgobin E disease and hemoglobin Lepore)
  • Normocytic
    • Hb SS
    • Hb CC
    • Hb SC
    • LCAT deficiency
    • Postsplenectomy
  • Macrocytic
    • liver diease
21
Q

Microspherocytes are associated with?

A

burns

MAHA

Feather edge of many smeres

Transfused cells

22
Q

Acanthocytes are associated with?

A
  1. Lutheran blood group
  2. McLeod phenotype
  3. Postsplenectomy
  4. Abetalipoproteinemia
  5. Hypobetalipoproteinemia
  6. Vitamin E deficiency
  7. Amyotrophic chorea
  8. Myxedema
  9. Panhypopituitarism
  10. malnutrition
  11. MPN

Occur as a result of disproportionate cholesterol: sphingomyelin ratio (should be 1:1)

23
Q

Echinocytes occur as a result of?

A
  1. Excess EDTA
  2. Slow drying
  3. Aged blood
  4. Increased pH
  5. Decreased albumin concentration
  6. “glass effect” which elevates pH
  7. Uremia
  8. Liver disease
  9. Vitamin E deficiency
  10. Pyruvate kinase deficiency
  11. Burns
  12. Heparin therapy
  13. GI disorders (peptic ulcer, carcinoma, Crohn)
  14. MPN
24
Q

Stomatocytes

A
  • Associated with
    • Hereditary stomatocytosis (deficient somatin)
    • acute alcoholism
    • alcoholic cirrhosis
    • obstructive liver disease
    • Rh null disease
    • Tangier disease
    • cardiovascular disease
    • Stewart syndrome
    • acidic pH
    • cationic detergents
    • phenothiazine
  • Artifactual causes of stomatocytes
    • Humidity
    • Slow air drying
    • addition of albumin (prevents smudging, but causes stomatocytes)
  • There is an abnormal cationic transport leading to increse in intracellular sodium and water with loss of potassium causing cells to swell and volume increases as MCHC decreases
25
Q

Blister cells and blister-like cells

A
  • Blister cells form as a result of oxidant stress (e.g., G6PD deficiency with bitten Heinz bodies) or from fibrin strands that disrupt the red cell membrane which then reattaches to itself
  • Blister-like cells occur in acute chest syndrome in sickle cell disease
26
Q

Heinz bodies

A

Denatured hemoglobin often on inner surface of RBC membrane

  • not visible in Wright stain
  • Seen on supravital stain with crystal violet, brilliant cresyl blue, or new methylene blue
  • Associated with
    • Hereditary Heinz body hemolytic anemia
    • Dapsone, other oxidant drugs
    • Chemicals (naphthalene, phenazopyridine)
    • thalassemia major
    • some hemolgobinopathies
    • liver disease
    • G6PD deficiency (mature red cells affected, whereas other conditions have bodies in mature and immature red cells)
27
Q

Hemoglobin H inclusions

A
  • Seen with supravital stain
  • Looks like golf ball
  • beta tetramers that occur in
    • alpha thal
    • MPN
    • sideroblastic anemia
    • MDS
28
Q

Teardrop cells associated with

A
  • Small number are seen in
    • pernicious anemia
    • hemolytic anemia
    • IDA
    • thalassemia
    • anemia of renal disease
  • More are seen in PMF or myelophthisic diseases
29
Q

Basophilic stipling

A
  • Fine stippling is an artifact from slow air drying
  • Coarse stippling occurs with imparied RNA degradation (impaired Hb synth)
    • lead poisoning
    • pyrimidine 5’-nucleotidase deficiency
    • thalassemia
    • hemoglobinopathies
    • sideroblastic anemia
    • MDS
    • congenital dyserythropoietic anemias
30
Q

Cabot ring

A

Remnant of mitotic spindle often seen with basophilic stipling and associated with

  • congenital dyserythropoietic anemias
  • megaloblastic anemia
  • MDS
  • other severe anemias
31
Q

Howell-Holly bodies

A
  • Nuclear remnant
  • Associated with
    • postsplenectomy state
    • hypofunctioning spleen
    • severe hemolytic anemia
    • megaloblatic anemia
    • congenital dyserythropoietic anemias
32
Q

Vacuolated cytoplasm may occur in cytoplasm of a pronormoblast or its progeny under what conditions?

A
  • chloramphenicol
  • ethanol abuse
  • hyperosmolar coma
  • deficiency of copper, phenylalanine, riboflavin

Compendium Hematopathology (8 decks)

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