(F) L1.2: RBC Morphology Flashcards
(107 cards)
1
Q
Normal distribution of RBCs
a. Slightly separated from one another
b. Not overlapping
c. Both
d. Neither
A
Both
2
Q
Shape of normal RBC
A
Circular (with smooth edge)
3
Q
Color of the cytoplasm of a normal RBC
A
Reddish-pink
4
Q
T or F: When we read a PBS under a microscope, we should read the feathery edge
A
False (near the feathery edge)
5
Q
- RBCs resembling “stack of coins”
- The entire outline of each cell is NOT VISIBLE
- CANNOT EVALUATE the cell size and shape
A
Rouleaux formation
6
Q
Roulaux formation is characteristic to which two disorders?
A
- Hyperproteinemia
- Multiple myeloma
7
Q
Rouleaux formation
a. Increased amount of serum gamma globulin and increased fibrin
b. Producing functional antibodies
c. Both
d. Neither
A
D
A. Should be plasma and fibrinogen
B. Should be non-functional
8
Q
T or F: If one of the zetapotentials of the RBC are INCREASED, they will CLUMP forming a rouleaux formation
A
False (reduced)
9
Q
Happens when RBCs clump together forming AGGREGATES when exposed to various red cell antibodies
A
Agglutination
10
Q
- In ______________, you can observe AGGREGATES OR MASSES OF RED BLOOD CELLS when exposed to various red cell antibodies
- In __________, they are forming a STACK OF COINS
A
- Agglutination
- Rouleaux formation
11
Q
- An individual’s RBCs agglutinate in their own plasma or serum that contain no specific agglutinins
- Presence of cold agglutinin IgM antibodies directed against RBC antigens
A
Autoagglutination
12
Q
Agglutination has (elevated/decreased) MCV and (elevated/decreased) RBC count
A
- Elevated MCV
- Decreased RBC count
13
Q
Refers to increased number of red blood cells with a variation in size
A
Anisocytosis
14
Q
- NORMAL RBC
- 7–8µm
- MCV is 80–100fL
A
Normocytes
15
Q
- LARGER than normal RBCs
- > 8µm
- MCV is > 100fL
A
Macrocytes
16
Q
- SMALLER than normal RBCs
- MCV is < 80fL
A
Microcytes
17
Q
What are macrocytes associated with?
A
Impaired DNA synthesis
18
Q
What are microcytes associated with?
A
Defective Hgb formation
19
Q
- General term for a VARIATION IN THE NORMAL COLORATION
- It is often noted DURING THE MICROSCOPIC EXAMINATION of the blood smear
A
Anisochromia
20
Q
The degree of ________ can provide diagnostic information about the underlying cause of the disease
A
Anisochromia
21
Q
- RBCs that LACK A CENTRAL PALLOR even though they lie in the desirable area for evaluation
- These RBCs are actually caused by a shape change such as those found in spherocytes
A
Hyperchromic cells
22
Q
TRUE HYPERCHROMIA occurs when MCHC is (HIGH/LOW)
A
High
23
Q
The ONLY DISEASE in which the MCHC is high above the reference
A
Hereditary spherocytosis
24
Q
3 clinical manifestations of Hereditary Spherocytosis
A
- Splenomegaly
- Anemia
- Jaundice
25
Supply the missing values for Hereditary Spherocytosis
DAT:
MCV:
MCH:
MCHC:
- DAT (Direct Antiglobulin Test): Negative
- MCV: Normal to low
- MCH: Normal
- MCHC: Slightly increased
26
T or F: **Immune disorders** that have spherocytes are also usually characterized by a positive result on DAT
True
27
Supply the grading for hypochromia:
1. Thin rim of hemoglobin
2. Area of central pallor - 2/3
3. Area of central pallor - 3/4
4. Area of central pallor - 1/2
4+, 2+, 3+, 1+
28
The gradng of hypochromia depends on which two factors?
1. Degree of paleness
2. Amount of hemoglobin distribution
29
In hypochromia, the RBC is (paler/darker) in color
Paler
30
- Aka DIFFUSELY CHROMATOPHILIC ERYTHROCYTES
- LARGER than normal red cells with BLUISH TINGE (Wright’s stain)
Polychromatophilic Erythrocytes
31
What causes the bluish tinge in polychromatophilic RBCs?
Residual RNA
32
Increased number of red blood cells with a VARIATION IN SHAPE
Poikilocytes
33
Description:
- SPHERICAL in shape
- LACKS CENTRAL PALLOR
- The staining intensity is increased
- The only RBC that can be called hyperchromic due to increased MCHC
Spherocytes
34
Associated conditions of this abnormal RBC:
- Hereditary Spherocytosis
- Autoimmune Hemolytic Anemia
- Burns
- ABO HDN
Spherocytes
35
Description:
- Aka MOUTH CELL
- ELONGATED RBCs with a SLIT-LIKE CENTRAL PALLOR
Stomatocyte
36
- The cause of this type of variation is due to the MEMBRANE DEFECT causing HIGH CELLULAR SODIUM and LOW POTASSIUM
- The ABNORMAL SODIUM POTASSIUM TRANSPORT RATIO causes the production of this
Stomatocyte
37
Associated conditions of this abnormal RBC:
- RH Deficiency Syndrome
- Alcoholism
- Electrolyte imbalance
- Overhydration
Stomatocytes
38
Description:
- Aka SPUR CELLS
- RBCs with an IRREGULARY SPICULATED SURFACE
Acanthocyte
39
Lack central pallor
a. Spherocyte
b. Acanthocyte
c. Both
d. Neither
C
40
The RBCs are IRREVERSIBLY THORNY and they have irregularly shape spicules with various lengths and some of the SPICULES ARE BENT plus they DO NOT HAVE A CENTRAL PALLOR
Acanthocytes
41
Associated conditions of this abnormal RBC:
- Abetalipoproteinemia (Aka Bassen-Kornzweig Syndrome)
- Lecithin-cholesterol acyltransferase (LCAT) Deficiency
- Liver disease
- Post-splenectomy
- Pyruvate Kinase (PK) deficiency
Acanthocyte
42
Description:
- Aka ECHINOCYTES OR CRENATED CELLS
- RBCs with a REGULAR SURFACE but SPICULATED
- Resembles a HEDGEHOG or SEA URCHIN
Burr cells
43
Associated conditions of this abnormal RBC:
- Seen in uremia
- Pyruvate kinase deficiency
Burr cells
44
Description:
Red blood cells that are OVAL OR EGG SHAPED
Ovalocytes
45
Associated conditions of this abnormal RBC:
- Hereditary Ovalocytosis (Southeast Asian Ovalocytosis)
- Megaloblastic Anemia (Macroovalocytes)
Ovalocytes
46
Description:
ELLIPTICAL or CIGAR-SHAPED RBC
Elliptocyte
47
- The hemoglobin is still concentrated at both ends hence the presence of a central pallor
- The formation is involved in the alteration of the RBC membrane skeleton
Elliptocyte
48
Associated conditions of this abnormal RBC:
- Hereditary Elliptocytosis
- Thalassemia
Elliptocyte
49
Description:
- Aka TEAR DROP CELL
- TEAR-DROP SHAPED or PEAR SHAPED RBC
Dacrocyte
50
This is produced when RBCs with rigid inclusions try to pass through the splenic sinuses
Dacrocyte
51
Associated conditions of this abnormal RBC:
- Primary Myelofibrosis
- Megaloblastic Anemia
Dacrocyte
52
Description:
- Aka SCHIZOCYTE
- FRAGMENTED RBCs
Schistocyte
53
HALLMARK OF Microangiopathic Hemolytic Anemia (MAHA) wherein the cells attempt to pass through the fibrin strands, and when a cell passes through a narrow vessel, the RBCs are damaged
Schistocyte
54
Associated conditions of this abnormal RBC:
- Artificial heart valves
- Uremia
- Severe burns
- Microangiopathic hemolytic anemia (MAHAs)
Schistocyte
55
Description:
- Aka SICKLE CELL OR MENISCOCYTE
- SICKLE OR CRESCENT-SHAPED RBCs
Drepanocyte
56
- The morphology is usually elongated and crescent shaped
- The RBC with pointed ends are usually with an S, V, or L configuration
Drepanocyte
57
Due to the polymerization of hemoglobin S because of decreased oxygen (are also irreversible)
Drepanocyte
58
Associated conditions of this abnormal RBC:
- Sickle Cell Anemia
- Hemoglobin SC disease
Drepanocyte
59
Description:
- Aka CODOCYTE, PLATYCYTE, GREEK HELMET CELL, MEXICAN HAT CELL, BULL’S EYE CELL, and TARGET CELL
Leptocyte
60
- Caused by an increased membrane surface due to increased cholesterol and phospholipids
- RBCs show a centrally stained area with a thin outer rim of hemoglobin
Leptocyte
61
Associated conditions of this abnormal RBC:
- Liver disease
- Thalassemia
- Lecithin-cholesterol acyltransferase (LCAT) Deficiency
Leptocyte
62
Description:
- A.K.A DEGMACYTE
- Demonstrates a semi-circular defect on the edge of the RBCs
- Resembles a bite mark
Bite cell
63
The spleen doesn't kill which two types of RBCs?
| The killing process is aka "culling" or "splenic sequestration"
- Microcytic hypocritical RBCs
- G6PD RBC with Heinz bodies
64
Associated condition of this abnormal RBC:
G-6-PD Deficiency
Bite cell
65
Description:
- AKA PUNCTATE BASOPHILIA
- Irregular dark blue to purple granules evenly distributed within an RBC
Basophilic stippling
66
Content of basophilic stippling
Aggregated RNA
67
Associated conditions with this inclusion body:
- LEAD POISONING a.k.a PLUMBISM (Arsenic poisoning)
- Pyrimidine-5-nucleotidase deficiency
- Refractory Anemia
- Alcoholism
- Megaloblastic Anemia
- Thalassemia
Basophilic stippling
68
Description:
- AKA PAPPENHEIMER BODIES
- Described as multiple dark blue irregular granules in PRUSSIAN BLUE IRON STAINING
Sideroblastic granules
69
Content of sideroblastic granules
Pappenheimer bodies
70
Associated conditions of this inclusion body:
- Sideroblastic Anemia
- Thalassemia
- Hemochromatosis or Hemosiderosis
Sideroblastic granules
71
Description:
- Appears singly in a cell (only one per cell)
- Round and < 1 um in diameter
- Blue to purple in color
Howell-jolly bodies
72
Content of Howell-jolly bodies
Remnants of Nuclear Chromatin (DNA)
73
Associated conditions of this inclusion body:
- Megaloblastic Anemia
- Thalassemia
Howell-jolly bodies
74
Description:
Threadlike structures that appear as purple-blue loops or rings
Cabot rings
75
Content of Cabot rings
Mitotic spindle remnants
76
Associated conditions of this inclusion body:
- Megaloblastic Anemia
- Refractory Anemia
- Lead Poisoning
Cabot rings
77
Description:
- Appears eccentrically along the inner RBC membrane
- Large, round, and blue to purple materials
- Cannot be seen in Wright's stain so you have to use Supravital stains
Heinz bodies
78
Content of Heinz bodies
Denatured and Precipitated Hemoglobin
79
Associated conditions of this inclusion body:
- Glucose-6-PD deficiency
- Drug-induced hemolytic anemia
- Unstable hemoglobin disease
Heinz bodies
80
Description:
- Small multiple, evenly distributed throughout the red cell
- Granular, greenish-blue bodies
Hemoglobin H inclusion bodies
81
Content of Hgb H inclusion bodies
Precipitated Hgb H
82
Associated condition of this inclusion body:
- Hemoglobin H Disease (subtype of Alpha Thalassemia)
Hemoglobin H inclusion bodies
83
Associated condition of this inclusion body:
- Malaria (Schuffner's dots aka eosinophilic stipplings)
- Babesia spp. (Maltese cross)
Parasite
84
Type of anemia according to MCV and MCHC found in:
- IDA
- Thalassemia
- Sideroblastic anema
- Lead poisoning
- Anemia of chronic disease
Microcytic, hypochromic anemia
85
Causes of Microcytic-Hypochromic anemia
Most common cause and is often due to
insufficient dietary iron, poor iron absorption, and chronic blood loss.
IDA
86
Causes of Microcytic-Hypochromic anemia
Group of inherited disorders that affect the production of hemoglobin
Thalassemia
87
Causes of Microcytic-Hypochromic anemia
Rare genetic or acquired condition that affects iron utilization with the red blood cell precursor leading to abnormal hemoglobin production
Sideroblastic anemia
88
Causes of Microcytic-Hypochromic anemia
Exposure to lead
Lead poisoning
89
Causes of Microcytic-Hypochromic anemia
Certain chronic conditions like chronic inflammation or infection that can disrupt the body’s ability to use iron effectively
Anemia of Chronic Disease
90
Normocytic-Normochromic anemia
State whether normal-low reticulocyte count or increased reticulocyte count
Renal disease
Normal-low
91
Normocytic-Normochromic anemia
State whether normal-low reticulocyte count or increased reticulocyte count
Aplastic anemia
Normal-low
92
Normocytic-Normochromic anemia
State whether normal-low reticulocyte count or increased reticulocyte count
PNH
Increased
93
Normocytic-Normochromic anemia
State whether normal-low reticulocyte count or increased reticulocyte count
PCH
Increased
94
Normocytic-Normochromic anemia
State whether normal-low reticulocyte count or increased reticulocyte count
Sickle cell
Increased
95
Normocytic-Normochromic anemia
State whether normal-low reticulocyte count or increased reticulocyte count
Enzyme disease
Increased
96
Normocytic-Normochromic anemia
- This happens when the kidneys are still able to release erythropoietin, the normal EPO production will help maintain the stable reticulocyte count
- There are advanced stages wherein there is impaired production of EPO which leads to low reticulocyte count and anemia
Renal disease
97
Normocytic-Normochromic anemia
- A failure of the bone marrow to produce an adequate number of blood cells
- Low reticulocyte count because the bone marrow’s ability to produce RBC is severely impaired
Aplastic anemia
98
Normocytic-Normochromic anemia
The RBCs are more susceptible to destruction by the immune system due to a deficiency of a certain protein on their surface
PNH
99
Normocytic-Normochromic anemia
An autoimmune hemolytic anemia where antibodies attach to RBCs leading to destruction especially in cold temperatures
PCH
100
Normocytic-Normochromic anemia
Certain deficiencies like G6PD and PK deficiency can make RBCs more susceptible to oxidative damage when exposed to certain triggers
Enzyme disease
101
Two types of Macrocytic-Normochromic anemia
1. Megaloblastic
2. Nonmegaloblastic
102
Type of Macrocytic-Normochromic anemia caused by Vitamin B12 and folate deficiency
Megaloblastic anemia
103
Type of Macrocytic-Normochromic anemia caused by liver disease, alcoholism, and BM failure
Non-megaloblastic anemia
104
Type of Macrocytic-Normochromic anemia with hypersegmented neutrophils (≥ 6 lobes)
Megaloblastic anemia
105
Shape
Megaloblastic anemia:
Nonmegaloblastic anemia:
Oval
Round
106
Type of Macrocytic-Normochromic anemia with the presence of megaloblasts in BM
| Note: It is a result of impaired DNA synthesis
Megaloblastic anemia
107
Type of Macrocytic-Normochromic anemia with the absence of megaloblasts in BM
Non-megaloblastic anemia
