HEMATOLOGY (RBC ABNORMALITIES) Flashcards
(169 cards)
1
Q
Variation in cell size
A
ANISOCYTOSIS
2
Q
RBC abnormalities can be differentiated through: (5)
A
- Cell size
- Hgb content
- Cell shape
- Inclusions
- Miscellaneous
3
Q
An index of variation of cell volume in a red blood cell population reported in automated hema analyzers. Correlates with the degree of anisocytosis
A
RDW (Red cell distribution width )
4
Q
Normal range of RDW
A
11.5% to 14.5%
5
Q
Formula of RDW
A
RDW = (SD ÷ MCV) × 100
6
Q
RDW:
Homogenous in character
Exhibits very little anisocytosis in PBS
A
NORMAL RDW
7
Q
RDW:
Heterogenous in character
High degree of anisocytosis
A
Increased RDW
8
Q
LOW RDW
A
NO SIGNIFICANCE
9
Q
Average volume of RBC
A
MCV (Mean Corpuscular Volume)
10
Q
Formula for MCV
A
Hct(%) x 10 / RBC(x10^12/L)
11
Q
MCV NORMAL reference range
A
80-100 fL
12
Q
Used to classify anemias
A
MCV
13
Q
Normal MCV (80-100fL)
A
Normocytic
13
Q
MCV<80fL
A
microcytic
14
Q
MCV>100fL
A
macrocytic
15
Q
Normal sized RBC 6-8 um in diameter, MCV 80-100fL
A
normocytic RBC
16
Q
Small RBC (<6um in diameter) MCV<80fL
A
microcytic RBC
17
Q
Large RBC (>8um in diameter), MCV >100fL
A
macrocytic RBC
18
Q
AHA
Acute blood Loss
Hemolytic anemia
Aplastic anemia
A
Normocytic RBC
19
Q
ATIS
Anemia of chronic inflammation
Thalassemia
IDA
Sideroblastic anemia
A
Microcytic RBC
20
Q
Megaloblastic anemia
Myelodysplastic anemia
Chronic liver disease
Bone marrow failure
Reticulocytosis
A
Macrocytic RBC
21
Q
Megaloblastic anemia caused by VIT. B12 DEFICIENCY
A
- D. latum
- Malabsorption caused by gastric resection, gastric carcinoma, and some forms of CELIAC disease or SPRUE
- Nutritional deficiency/ diminished supply of V. B12
- Pernicious anemia
22
Q
Megaloblastic anemia caused by FOLIC ACID DEFICIENCY
A
- Abnormal absorption caused by celiac disease or sprue
- increased utilization caused by pregnancy
- Tx with antimetabolites that act as folic acid antagonists
- Dietary deficiency
- Won’t involve CNS
23
Q
Vit. B12 or Folic Acid Deficiency
A
Megaloblastic anemia
24
Variation of the color of erythrocyte due to unequal hemoglobin concentration
ANISOCHROMIA
25
Central pallor does not exceed 1/3 red cell's diameter, MCHC 31-36%
Normochromic RBC
26
Normal MCHC value
32 to 36% or 32 to 36 g/dL
27
Central pallor > 1/3 red cell's diameter, MCHC <31%
Hypochromic RBC
28
IDA: Most common cause
Chronic blood loss (e.g. hookworms)
29
Normochromic RBCs: diseases
AHA
Acute blood Loss
Hemolytic anemia
Aplastic anemia
30
Hypochromic RBCs: diseases
ATIS
Anemia of chronic inflammation
Thalassemia
IDA
Sideroblastic anemia
31
HYPOCHROMIA GRADING
Area of central pallor is ONE-HALF of cell diameter
1+
32
HYPOCHROMIA GRADING
Area of central pallor is TWO-THIRDS of cell diameter
2+
33
HYPOCHROMIA GRADING
Area of central pallor is THREE-QUARTERS of cell diameter
3+
34
HYPOCHROMIA GRADING
THIN RIM of hemoglobin
4+
35
Indirect measure of transferrin
TIBC
36
serum TIBC increased, serum iron significant decreased
Iron deficiency
37
serum IRON increased
Sideroblastic anemia
38
serum IRON & TIBC decreased
Anemia of Chronic disease
39
No central pallor, MCHC >36%
Hyperchromic RBC
40
SPHEROCYTE (Bronze cell)
Hyperchromic RBC
41
Hyperchromic RBC: disease
Hereditary Spherocytosis
42
Confirmatory test for Hereditary spherocytosis
Increased OFT
43
Alternative confirmatory test for Hereditary spherocytosis
EMA dye (Flow cytometry)
44
Blue-gray tint to the red cells
Reticulocytes / Polychromatophilic RBCs
45
Stain for Reticulocytes
Supravital stain (brilliant cresyl blue)
46
Uses Supravital stain (3)
1. Reticulocytes
2. Hgb H
3. Heinz bodies
47
Polychromatophilic RBC: diseases
Hemolysis
Hemorrhage
48
POLYCHROMASIA GRADING:
1+
3%
49
POLYCHROMASIA GRADING:
2+
5%
50
POLYCHROMASIA GRADING:
3+
10%
51
POLYCHROMASIA GRADING:
4+
>11%
52
The average concentration of Hemoglobin per dL of RBCs
MCHC (Mean Corpuscular Hemoglobin Concentration)
53
MCHC >37%
May indicate problem with the specimen (HYPERLIPIDEMIA, COLD AGGLUTININS) or instrument
54
MCHC Formula
Hgb (g/dL) x 100 / Hct (%)
55
NORMOCYTIC NORMOCHROMIC
AHA
Acute blood loss
Hemolytic anemia
Aplastic anemia
56
MICROCYTIC HYPOCHROMIC
ATIS
Anemia of chronic inflammation
Thalassemia
IDA
Sideroblastic anemia
57
HEREDITARY SPHEROCYTOSIS:
indications
increased MCHC
increased OFT
(-) DAT
58
AUTOIMMUNE HEMOLYTIC ANEMIA: indications
increased MCHC
increased OFT
(+) DAT
59
Presence of NORMOCHROMIC & HYPOCHROMIC cells in the same film
DIMORPHIC ANEMIA
60
Causes of DIMORPHIC ANEMIA
- Sideroblastic anemia
- Weeks of IRON THERAPY for IDA
- Hypochromic anemia AFTER TRANSFUSION with normal cells
61
Alterations or variations in SHAPE of erythrocytes
POIKILOCYTOSIS
62
POIKILOCYTOSIS are classified as to:
Poikilocytosis secondary to:
1. Developmental Macrocytosis
2. Membrane defects
3. Trauma
4. Abnormal hemoglobin content
63
Poikilocytosis secondary to Developmental macrocytosis
Oval macrocytes (MEGALOCYTES)
64
Oval macrocytes (MEGALOCYTES)
Oval or Egg-like in appearance
65
Poikilocytosis seen in Vitamin B12 and folate deficiency
Oval macrocytes (MEGALOCYTES)
66
Poikilocytosis secondary to MEMBRANE DEFECTS
1. Acanthocyte
2. Echinocyte
3. Codocyte, Leptocyte
4. Spherocyte
5. Stomatocyte
6. Elliptocyte, Ovalocyte
67
Irregularly spaced projections of varying length
Acanthocytes (spur, thorn cell)
68
Increase in sphingomyelin over lecithin
Acanthocyte
69
Acanthocytes are seen in:
McLeod Syndrome
Abetalipoproteinemia
Neuroacanthocytosis
Severe liver disease
70
RBC with blunt or pointed, short projections that are usually evenly spaced over the surface of cell
Echinocyte/ Burr Cell (Crenated, sea urchin)
71
_______ can occur as the result of the physical loss of intracorpuscular water (OSMOTIC IMBALANCE)
Crenation
72
Diseases associated with Echinocytes
Heparin therapy
Uremia
Liver disease
Pyruvate kinase
73
Other term for echinocytes
Crenated, sea urchin, BURR CELL
74
Equal length and distribution cell
Echinocyte/burr cell
75
RENAL INSUFFICIENCY
Burr cell/Echinocytes
76
Echinocytes as artifact
1. Drying artifact = H2O artifact
2. Stored blood (decreased ATP)
3. Hypertonic solution (cells shrink and crenate)
77
Mexican hat
Codocyte
78
Target cell
Codocyte
79
Excessive cholesterol and phospholipid in the membrane or a hemoglobin distribution imbalance
CODOCYTE
80
Diseases associated with codocytes
Hemoglobinopathies
Thalassemia
Liver disease
81
Thinner variant of codocyte
Leptocyte
82
no central pallor, decreased surafce to volume ratio; associated with defects of the red cell membrane proteins (SPECTRIN)
SPHEROCYTES
83
diseases associated with spherocyte
HIS (Hereditary spherocytosis)
Immune Hemolytic Anemia
Extensive burns (along with schistocytes)
84
bowl-shaped RBC
Stomatocyte
85
mouth cell
stomatocyte
86
RBC with slit like area of central pallor
Stomatocyte
87
caused by osmotic changes due to CATION IMBALANCE
Stomatocytes
88
Diseases associated to stomatocyte
Hereditary stomatocytosis
RH NULL SYNDROME
Acquired (liver disease, alcoholism)
89
Defects in CYTOSKELETON. Decreased in membrane protein band 4.1
Elliptocytes
90
Hereditary elliptocytosis
Anemia associated with malignancy
Hb C disease
Hemolytic anemias
IDA, Sickle cell trait, thalassemia
Pernicious anemia
Elliptocytosis
91
Egg-shaped RBC, wider than elliptocyte
Ovalocyte
92
Thinner variant of ovalocyte
Pencil/oat cell
93
Megaloblastic anemia
Ovalocyte
94
REDUCTION IN MEMBRANE CHOLESTEROL
Ovalocyte
95
Elliptocytes are seen in what blood phenotype?
Leach phenotype (Gerbich null) Ge -2 -3 -4
96
Cigar-shaped RBC
Elliptocytes
97
POIKILOCYTES SECONDARY TO TRAUMA
1. Schistocytes
2. Dacrocytes
3. Microspherocytes
4. Semilunar bodies/Half-moon, Crescent cell
98
Fragmented RBC due to the rupture in the peripheral circulation (rupturing of a blister cell)
Schistocytes
99
Also called as HELMET CELLS
Schistocytes
100
Pinched cell (triangular with 2 pallor areas)
Knizocytes
101
Disease associated with Schistocytes
MICROANGIOPATHIC HEMOLYTIC ANEMIA
Traumatic cardiac hemolysis
Extensive burns
102
seen in MMM: Myelofibrosis with Myeloid Metaplasia
Dacrocytes
103
Squeezing and fragmentation during splenic passage. Resembles a teardrop or pear
Dacrocyte/Dacryocyte/Teardrop cell
104
Defective cells exhibiting heat sensitivity
Microspherocytes/Pyropikilocyte
105
Normal RBCs fragment at what temp?
49 degrees C
106
RBCs fragment @ 45-46 degrees Celsius:
Hereditary pyropoikilicytosis
Hereditary microspherocytosis
107
Poikilocyte seen in MALARIA
Semilunar bodies, halfmoon or crescent
108
What is the poikilocyte secondary to abnormal hemoglobin content?
Drepanocyte (sickle cells)
109
Holly-leaf shape
Drepanocyte (sickle cells)
110
Results from the gelation of polymerized deoxygenated hemoglobin S
Drepanocyte (sickle cells)
111
Folded cell: RBC with membrane folded over are seen in
Hb C disease & Hb SC disease
112
Nuclear fragments of DNA
Howell-Jolly bodies
113
Poikilocyte inclusion testing positive in Feulgen's reaction
Howell-Jolly bodies
114
Howell-Jolly bodies are seen in
MEGALOBLASTIC ANEMIA
115
Deep blue to purple granules. Aggregation of ribosomes
Basophilic stippling
116
Basophilic stippling is seen in
Lead and arsenic intoxication
Pyrimidine-5-nucleotidase deficiency
117
Type of basophilic stippling seen when there is increased polychromatophilia, increased production of red cells
FINE STIPPLINE
118
Type of basophilic stippling seen in LEAD POISONING
COARSE STIPPLING
119
Reference range for LEAD
<3.5 ug/dL or <5 ug/dL
120
lead: >0.5 mg/day
lead accumulation and toxicity
121
lead: 0.5g absorbed
fatal dose
122
normal lead in children
5 ug/dL
123
normal lead in adults
25 ug/dL
124
Supravital stain used in Reticulum
New Methylene Blue
125
Supravital stain used in Hgb H
Brilliant Cresyl blue
126
Supravital stain used in Heinz bodies
Crystal violet
127
BEST vital dye
Neutral red
128
6th GLU --> VAL
Hgb S
129
6th GLU--> LYS
Hgb C
130
Basophilic stippling may resemble
Pappenheimer bodies
131
To differentiate Basophilic stippling from Pappenheimer bodies
Basophilic stippling - uniform and homogenous distribution
Pappenheimer bodies - distribution is in periphery
132
Ring/Figure of 8 inclusion. Remnants of microtubules from the mitotic spindle
CABOT RINGS
133
Cabot rings are seen in
DYSERYTHROPOIESIS, lead poisoning, pernicious anemia
134
PITTED GOLF BALL
Heinz bodies
135
Denatured hemoglbin
Heinz bodies
136
Heinz bodies are seen in
G6PD deficiency
Unstable hemoglobins
FAVISM
Splenectomized pxs
Congenital hemolytic anemia
Child with ingested mothball
137
Precipitate of Beta chains of hemoglobin
Hgb H bodies
138
Alpha thalassemia with a deletion of 3/4 alpha chains
Hgb H disease
139
glove or pistol-like in shape
Hemoglobin SC
140
WASHINGTON MONUMENT
Hemoglobin SC
141
Clam shell/gold bar shape
Hemboglobin C
142
Nucleated RBC that contains nonheme iron particles
Ringed sideroblast (immature cell)
143
Non-nucleated cell containing iron granules
Siderocyte
144
Due to excessive IRON OVERLOAD; and defective heme synthesis
Sideroblastic Anemia
145
Appears in:
Sideroblastic anemia
Hemoglobinopathies
Hyposplenism
Megaloblastic anemia
Pappenheimer bodies
146
Inclusions composed of ferric iron on PRUSSIAN BLUE
Pappenheimer bodies
147
Stain for hemosiderin
Perl's prussian blue
148
Component of Perl's Prussian Blue
1% aqueous potassium ferrocyanide
2% aqueous hydrochloric acid
149
What spp. of Plasmodium makes RBC size ENLARGED
P. vivax, P. ovale
150
What spp. of Plasmodium makes RBC size NORMAL
P. malariae, P. falciparum
151
P. vivax contains what type of RBC inclusions?
Schuffner's dots
152
P. ovale contains what type of RBC inclusions?
Schuffner's dots & James dots
153
P. malariae contains what type of RBC inclusions?
Ziemann stippling
154
P. falciparum contains what type of RBC inclusions?
Maurer dots
155
To quantify malaria parasites against RBCs
THIN SMEAR
% PARASITEMIA
= (parasitized rbc / total rbc) x 100
156
To quantify malaria parasites against WBCs
THICK SMEAR
PARASITES/MICROLITER OF BLOOD
= (parasites/WBCs) x WBC count per microliter (or 8,000)
157
NANTUCKET FEVER / most common cause of babesiosis
B. microti
158
MALTESE CROSS
Babesiosis
159
P. vivax and ovale attacks:
YOUNG RBCs (RETICS)
160
P. falciparum attacks:
All stages of RBCs
161
P. malariae attacks:
Mature RBCs
162
Clumping of RBCs
AGGLUTINATION
163
Occurs when an individual's red cells agglutinate in his own plasma or serum that contains specific known agglutinins
AUTOAGGLUTINATION
164
Agglutination occurs in:
Cold agglutinin disease (Cold Ab = Anti-I)
Primary Atypical Pneumonia
165
GRADING OF AGGLUTINATION
1+ 25%
2+ 50%
3+ 75%
4+ 100%
166
Represents erythrocytes arranged in rolls or stacks
Rouleaux formation
167
Rouleaux formation occurs in:
(INCREASED ESR)
Multiple myeloma
Macroglobulinemia
168
Due to the presence of concentrations of abnormal globulins or fibrinogen
Rouleaux formation
