Blood fillms

Question 1

What conditions might cause the appearance of target cells?

Answer 1

Sickle cell anaemia

Thalassaemia

Iron deficiency anaemia

Hyposplenism

Liver disease

Target cells arise because of the red cell’s surface area increasing disproportionatly to its volume, either because of increased red cell surface area or decreased haemoglobin content

Question 2

What condition might cause the appearance of ‘tear drop’ poikilocytes (aka dacrocytes)?

Answer 2

Myelofibrosis (myeldodysplastic syndromes, rare forms of acute leukaemias, or myelofibrosis associated with autoimmune conditions, toxins, post-irradiation, inborn haemolytic anaemias, iron deficiency or beta thalassaemia)

Question 3

What conditions might cause the appearance of spherocytes?

Answer 3

Hereditary spherocytosis

Autoimmune haemolytic anaemia

Spherocytes - sphere-shaped rather than biconcave RBCs. Found in all haemolytic anaemias to some degree, however only the above two are characterised by only having spherocytes)

Question 4

What conditions might case the appearance of basophilic stippling?

Answer 4

Lead poisoning

Thalassaemia

Sideroblastic anaemia

Myelodysplasia

Question 5

What condition might cause the appearance of Howell-Jolly bodies?

Answer 5

Hyposplenism (damaged or absent)

Howell-Jolly bodies are erythrocytes that contain a small amount of remnant DNA that would usually be removed from the circulation

Question 6

What conditions might cause the appearance of Heinz bodies?

Answer 6

G6PD deficiency

Alpha thalassaemia

Heinz bodies are inclusions within red blood cells composed of denatured haemoglobin, and appear usually as a result of oxidative damage to haemoglobin component molecules

Question 7

What conditions might cause the appearance of schistocytes (‘helmet cells’)?

Answer 7

Intravascular haemolysis

Mechanical heart valves

DIC

Schistocytes are created by trying to move past areas of intravascular blockage, with red cells becoming damaged by fibrin strands created by the above conditions. Think “putting on a helmet to protect yourself from damage!”

Question 8

What condition might cause the appearance of pencil poikilocytes?

Answer 8

Iron deficiency anaemia

Question 9

What conditions might cause the appearance of Burr cells (echinocytes)?

Answer 9

Uraemia

Pyruvate kinase deficiency

Question 10

What condition might cause the appearance of hypersegmented neutrophils?

Answer 10

Megaloblastic anaemia

Question 11

What condition might cause the appearance of bite cells (“degmacytes”)?

Answer 11

G6PD deficiency

Bite cells result from denatured haemoglobin being removed by macrophages in the spleen