Abnormal Red Blood Cells

Question 1

What are the 5 things we evaluate RBCs to determine normal from abnormal?

Answer 1

Arrangement
Size
Color
Shape
Inclusions/Parasites

Question 2

What do normal RBCs look like in a cat?

Answer 2

They have more central pallor

Question 3

Which species have natural elliptical RBCs?

Answer 3

Camelids

Question 4

What does the RBC of birds and reptiles naturally have?

Answer 4

They have nucleated red blood cells

Question 5

Rouleaux formation

Answer 5

Stacking of erythrocytes

Question 6

What species is Rouleaux formation normal?

Answer 6

Horses

Question 7

Agglutination

Answer 7

Cells are coated with antibodies, resulting in bridges and clumps

Question 8

What cell arrangement is never normal?

Answer 8

Agglutination

Question 9

What are the causes of agglutination?

Answer 9

Immune disorders
Transfusion with the wrong blood type
Neonatal Isoerythrolysis

Question 10

How do you tell the difference between Rouleaux and Agglutination?

Answer 10

With one drop of saline, the Rouleaux will disperse

Question 11

-cytic

Answer 11

Size

Question 12

-chromic

Answer 12

Color

Question 13

Anisocytosis

Answer 13

Variation in red blood cell size

Question 14

Macrocytes

Answer 14

Large cells

often reticulocytes

Question 15

Microcytes

Answer 15

Decreased cell size
Seen in iron deficiency
Spherocytes

Question 16

What species is Anisocytosis normal?

Answer 16

Cattle

Question 17

Normochromic

Answer 17

Normal cell color

Question 18

Polychromasia

Answer 18

Varying color

increased bluish tint

Question 19

Hypochromasia

Answer 19

Decreased color
Insufficient hemoglobin
Have a very pale central region
Iron deficiency

Question 20

Is the term Hyperchromic used commonly to describe darker stained cells?

Answer 20

No. Oversaturation cannot occur because the cell has a fixed capacity for hemoglobin

Question 21

What are the cells called instead of hyperchromic?

Answer 21

Spherocytes

Question 22

What are Spherocytes?

Answer 22

They have lost the biconcave disk shape
Perfectly round
Stain intensely because they are not flat anymore

Question 23

Poikilocytosis

Answer 23

Abnormally shaped blood cells

Question 24

What are the five categories of morphological changes?

Answer 24

Regenerative responses
Immune-mediated damage
Oxidative injury
Membrane/metabolic disorder
Mechanical fragmentation

Question 25

What morphological changes are seen in Immune-mediated damage?

Answer 25

Spherocytes Agglutination Ghost Cells

Question 26

Ghost Cells

Answer 26

remnant cell membranes | Due to intravascular lysis

Question 27

Oxidative Injury

Answer 27

Areas of red blood cells with denatured hemoglobin

Question 28

What does denatured hemoglobin mean?

Answer 28

The hemoglobin is pushed aside

Question 29

What causes an oxidative injury?

Answer 29

Ingestion of garlic and onions in dogs | Ingestion of Tylenol in cats

Question 30

If an oxidative injury has occurred, what are the cells unable to carry?

Answer 30

Oxygen

Question 31

What changes are seen in the cells with an oxidative injury?

Answer 31

Heinz bodies | Eccentrocytes

Question 32

Heinz bodies

Answer 32

Small round projection, sometimes blue, dependent on the stain

Question 33

What are the small round projections on Heinze bodies?

Answer 33

Denatured hemoglobin

Question 34

What do increased amounts of Heinz bodies indicate?

Answer 34

Lymphosarcoma Hyperthyroidism Diabetes mellitus

Question 35

Eccentrocytes

Answer 35

Hemoglobin gets pushed over to one side

Question 36

What do increased amounts of Eccentrocytes indicate?

Answer 36

Diabetic ketoacidosis Neoplasia Babesia canis

Question 37

Metabolic/ Membrane Disorders: | Echinocytes

Answer 37

Burr cells Renal disease multiple, small, delicate, regular-shaped spines distributed evenly

Question 38

Burr Cells

Answer 38

Projections similar to Echinocytes but oval to elongated

Question 39

How do you tell the difference between Echinocytes and crenation?

Answer 39

Crenation is a drying artifact and happens in vitro | Echinocytes occurs because of renal disease ( in vivo)

Question 40

Metabolic/ Membrane Disorders: Acanthocytes

Answer 40

Multiple, large, irregular shaped, blunt, finger-like projections Spur cells Liver disease Hemangiosarcoma

Question 41

Metabolic/ Membrane Disorders: Keratocytes

Answer 41

Blister, bite, Helmet cells Area of cell membrane damage Two fairly uniform hornlike projections Hemangiosarcoma, neoplasia, glomerulonephritis, liver disease

Question 42

Metabolic/ Membrane Disorders: Torocytes

Answer 42

Punched out cells An abrupt transition between the outer and central zones an artifact of spreading the blood

Question 43

Metabolic/Membrane Disorders: Stomatocytes

Answer 43

Central pallor is oval, elongated | resembles a mouth

Question 44

In what circumstances will stomatocytes be present?

Answer 44

Inherited Lead poisoning Drying artifact

Question 45

Metabolic/ Membrane Disorders: Ovalcytes (elliptocytes)

Answer 45

Cells that are oval with an oval region of central pallor | Normal in camelids

Question 46

In what situations will you see ovalcytes in species where it is not normal?

Answer 46

Lymphoblastic leukemia Hepatic lipidosis Portosystemic shunts Glomerulonephritis

Question 47

Metabolic/Membrane Disorders: Lepatocytes

Answer 47

Codocytes and Bar cells | The cell membrane is too large for the quantity of hemoglobin

Question 48

Lepatocytes: Codocytes

Answer 48

Target cells Could be a change in polychromatophil Liver disease

Question 49

Lepatocytes: Bar cells

Answer 49

Knizocytes | Bar-shaped or line near central pallor

Question 50

Mechanical Fragmentation

Answer 50

Caused by intravascular trauma or myelofibrosis Schistocytes (Schizocytes) Dacryocytes

Question 51

Mechanical Fragmentation: Schistocytes or Schizocytes

Answer 51

Sheared off RBC Caused by intravascular trauma Irregularly shaped RBC Seen with Disseminated intravascular coagulation (DIC)

Question 52

Mechanical Fragmentation: Dacryocytes

Answer 52

Happens in the bone marrow while they are developing Tear-drop shaped cells Caused by myelofibrosis

Question 53

What does it mean if the points of the Dacryocytes are facing the same way?

Answer 53

It is an artifact of spreading

Question 54

What is myelofibrosis?

Answer 54

Scarring of the bone marrow | The cause is unknown but may be secondary to lymphoma or leukemia

Question 55

What are the six pseudoparasites?

Answer 55

Stain Precipitate, Basophilic stippling Pappenheimer bodies, Refractile bodies Platelets, Howell-Jolly bodies

Question 56

Anaplasma marginale

Answer 56

Parasite seen in ruminants

Question 57

What bacteria is Anaplasma marginal caused by?

Answer 57

Rickettsia spp

Question 58

What happens to ruminants that are infected with Anaplasma marginal?

Answer 58

They get anemia quickly and the RBC break apart

Question 59

Viral inclusions: Distemper

Answer 59

Inclusions are larger than Howell-Jolly bodies Stain pink to red (sometimes blue) Smooth glassy appearance

Question 60

Mycoplasma haemocanis

Answer 60

Coccoid or rod-shaped blue structures forming chains on RBC | Seen in dogs who have had their spleens removed

Question 61

Babesia Canis

Answer 61

Large intracellular, pear-shaped parasite Protozoan Cause the RBC to break apart, anemia and icterus

Question 62

Mycoplasma haemofelis

Answer 62

A common cause of feline infectious anemia Passed via vectors or from queen to kitten Small, blue, coccoid, rod, or ring-shaped organisms on the surface of RBC