RBCs

Question 1

Erythrocyte

Answer 1

Anucleate
Biconcave and flexible – spectrin
Rely on glucose for energy
-90% anaerobic -> lactate
10% HMP shunt

deficiency in pyruvate kinase -> hemolysis

120 day lifespan

Question 2

Anisocytosis

Answer 2

RBC of varying sizes

Question 3

Poikilocytosis

Answer 3

RBC of varying shape

Question 4

Polycythemia/erythrocytosis

Answer 4

Too many RBCs

Question 5

Reticulocytes

Answer 5

Immature RBCs

Question 6

Basophilic stippling

Answer 6

RNA or ribosome clumping
Lead poisoning MC cause

Thalassemias
Anemia of chronic dz
Alcohol abuse

Question 7

Echinocyte – burr cell

Answer 7

Regular spikes on surface

Uremia, renal failure

Pyruvate kinase deficiency

Question 8

Acanthocyte – spur cell

Answer 8

Irregularly spiked
Liver dz
-abetalipoproteinemia

Question 9

Spherocytes

Answer 9

Lose biconcave shape

Hereditary spherocytosis

Question 10

Schistocytes

Answer 10

Fragmented RBCs
Left over pieces chopped up

DIC, TTP – US -> microangiopathic hemolytic anemia
-blood cells sliced as forced through fibrin mesh -> sheared off

Question 11

Target cells

Answer 11

Bulls eye
“THAL”
thalassemia
hemoglobin C dz
asplenia
liver disease

Question 12

Sickle cell

Answer 12

Sickle shaped

Sicke cell anemia

Question 13

Howell-Jolly body

Answer 13

Basophilic remnant of nucleus – only 1 per cell

Asplenic patients – sickle cell

Question 14

Heinz bodies

Answer 14

Oxidized hemoglobin precipitates out of solution – denatured

Splenic MO remove -> bite cell

G6PD deficiency

Many possible in a cell – “Heinz 57”

Question 15

Degmacyte

Answer 15

Bite cell

Question 16

Tear drop cell

Answer 16

Myelofibrosis

Question 17

Elliptocyte

Answer 17

Hereditary elliptocytosis
“pencil cell”
“cigar cells”

Question 18

Sideroblast

Answer 18

Nucleated red cell precursor

Granules of iron in M0

Normal in bone marrow

Question 19

Ringed sideroblast

Answer 19

Found in disorders of heme synthesis
-unutilized iron -> excess iron granules around nucleus

abnl
found in bone marrow

Question 20

Sideoblastic anemia

Answer 20

Defective heme synthesis
Not a dx, sign of underlying dz

Causes:
Genetic conditions
Drugs – seizure, INH, Chloramphenicol
Chronic etOH use
Myelodysplastic sn

Elevated serum iron
Elevated ferritin

Tx: B6 supplements

Question 21

Erythroblastosis fetalis

Answer 21

Maternal Ab to fetal RBC antigen
MC ab is anti-Rh-D
-only after exposed, develops in 1st pregnancy -> subsequent pregnancies w/ problems

Rh- mom: dose anti-Rh-D Ig at 28 weeks, at any traumatic event (MVA) and w/in three days of delivery

Neonate features:
Anemia d/t hemolysis of RBC by maternal Ab
Jaundice -> possible kernicterus
Hydrops fetalis – generalized fetal edema
Intrauterine death

Question 22

G6PD deficiency

Answer 22

Can’t go through HMP shunt -> no reduced glutathione -> hemoglobin oxidized -> Heinz body -> removed by splenic MO -> bite cells

Question 23

Transfusion of incompatible blood type

Answer 23

-> Ab mediated type II HSR
#1 cause of transfusion rxns: clerical error