HEMA LEC - Erythrocytic Morphology and Assoc Disease Flashcards Preview

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Flashcards in HEMA LEC - Erythrocytic Morphology and Assoc Disease Deck (47):
1

are normal erythrocytes that are approximately the same size as the nucleus of a small lymphocytes.

Normocytes (discocytes)

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a. RBCs greater than 8um in diameter;

2. Macrocytes

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MCV greater than 100 fL

2. Macrocytes

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Seen in megaloblastic anemias, such as B12/folate deficiency

2. Macrocytes

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Seen in non-megaloblastic anemia of liver disease or accelerated erythropoiesis; also seen in normal newborns

2. Macrocytes

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a. RBCs less than 6um in diameter;

Microcytes

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MCV less than 80 fL

Microcytes

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Seen in iron-deficiency anemia, thalassemias, sideroblastics anemia, and anemia of chronic disease

Microcytes

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a. Variation in RBC size, indicating a heterogeneous RBC population (dimorphism)

anisocytosis

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heterogeneous RBC population (dimorphism)

(dimorphism)

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b. Correlates with RDW (red blood cell distribution width), especially when the RDW exceeds 15.0%

anisocytosis

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c. Seen post-transfusion, post-treatment for a deficiency (e.g., iron), presence of two concurrent deficiencies (e.g., iron and vitamin B12), and idiopathic sideroblastic anemia

anisocytosis

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a. General term to describe variation in shape
b. Associated with a variety of pathologic conditions

5. Poikilocytosis

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include crenated, and burr cells (sea urchin cells)

Echinocytes

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Have evenly spaced round projections; central pallor area present

Echinocytes

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Seen in liver disease, uremia, heparin therapy, pyruvate kinase deficiency, anemia associated with renal insufficiency (burr cells) or as artifact in improper air drying

Echinocytes

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Caused by changes in osmotic pressure due to depletion of ATP which supports the cation pump, exposure to hypertonic solution

Echinocytes

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Have unevenly space pointed projection; lack a central pallor area

Acanthocytes (spur cells/thorn cells)

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Associated with alcoholic liver disease, post-splenectomy, and abetalipoproteinemia, malabsoprtion states, hepatitis of the newborn, severe haemolytic anemia associated with cirrhosis and in metastatic liver disease

Acanthocytes (spur cells/thorn cells)

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Caused by excessive cholesterol in the membrane

Acanthocytes (spur cells/thorn cells)

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a. Show a central area of hemoglobin surrounded by a colorless ring and a peripheral ring of hemoglobin; cells have an increased surface-to-volume ratio

Target cells (codocytes or Mexican hat cells)

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Seen in liver disease, hemoglobinopathies SS SC CC DD EE, thalassemia, iron-deficiency anemia, obstructive liver disease, postsplenectomy states

Target cells (codocytes or Mexican hat cells)

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Caused by excessive cholesterol in the membrane or a hemoglobin distribution imbalance

Target cells (codocytes or Mexican hat cells)

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thinner variant of codocytes

Leptocyte

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Disk-shaped cell with a smaller volume than a normal erythrocytes; cells have decreased surface-to-volume ratio
Lack a central pallor area
c. Associated with defects of the red cell membrane proteins

Spherocytes (ball shaped cells)

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MCHC may be >37%; increased osmotic fragility

Spherocytes (ball shaped cells)

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Damaged RBC; seen in hereditary spherocytosis (HS), G6PD deficiency, and isoimmune and autoimmune hemolytic anemias, blood banked stored blood for a long time

Spherocytes (ball shaped cells)

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are frequently seen in severe thermal injury (burns).

Microspherocytes (

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After splenectomy in a patient with HS, spherocytes ____ indicating that the abnormality involves the red blood cell membrane itself rather than splenic damage to the cells.

persist

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a. Pear-Shaped cell with one blunt projection
b. Seen in megaloblastic anemias, thalassemia, and extramedullary hematopoiesis (myelofibrosis, myelophthisic anemia)

Teardrops (dacryocytes)

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a. Shapes vary but show thin, elongated, pointed ends and will appear crescent shaped; usually lack a central pallor area; described as having a holly leaf appearance

Sickle cells (drepanocytes)

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Contain polymers of abnormal hemoglobin S

Sickle cells (drepanocytes)

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Seen in hemoglobinopathies SS, SC, SD, and S/B-thalassemia

Sickle cells (drepanocytes)

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Cell Shape is caused by cell membrane alterations due to an amino acid substitution

Sickle cells (drepanocytes)

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a. Interior portion of cell is hollow, resembling a horn or helmet
c. Seen in microangiopathic hemolytic anemias

Helmet cells (horn cells or keratocytes)

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b. Basically a schistocyte with a hornlike projections (Gr. Keras: horn)

Helmet cells (horn cells or keratocytes)

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a. Damaged RBC; fragment of various sizes and shapes are present, often with pointed projection

Schistocytes/schizocyte (RBC fragments)

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Seen in microangiopathic hemolytic anemias (e.g., DIC, HUS, TTP), thermal injury, renual transplant rejection, and G6PD deficiency

Schistocytes/schizocyte (RBC fragments)

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a. Characterized by an elongated or slit-like area of central pallor

Stomatocytes (mouth cells)

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Caused by osmotic changes due to cation imbalance (Na+/K+)

Stomatocytes (mouth cells)

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Seen in obstructive liver disease, Alcoholism, cirrohosis, hereditary stomatocytosis, RH NULL DISEASE, or as artifact

Stomatocytes (mouth cells)

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a. Cigar- to – egg-shaped erythrocytes

Elliptocytes (ovalocytes)

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Seen in hereditary elliptocytosis, iron-deficiency anemia (pencil forms), megaloblastic anemia (macro-ovalocytes), thalassemia major

Elliptocytes (ovalocytes)

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Associated with defects of the red cells membrane proteins specifically in membrane protein 4.1

Elliptocytes (ovalocytes)

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– a transitional variant of Hereditary elliptocytosis.

Hereditary pyropoikilocytosis

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has the same appearance as elliptocytes and usually occur at the first 6 months of life.

Pyropoikilocytes

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To differentiate from normal red blood cells, it usually lyses at 45-460C while normal red blood cells lyses at 490C

Pyropoikilocytes

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