Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

AMT MLS Exam - Hematology > Hematology - RBC Morphology, Inclusions, & Stains > Flashcards

Hematology - RBC Morphology, Inclusions, & Stains Flashcards

(102 cards)

Start Studying
1
Q

What diseases are macrocytes associated with?

A
  1. megaloblastic anemias (B12/folate deficiency)
  2. liver disease
  3. accelerated erythropoiesis (reticulocytosis)

-normal in newborns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What diseases are associated with microcytes?

A
  1. iron deficiency anemia
  2. thalassemias
  3. sideroblastic anemia
  4. anemia of chronic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is anisocytosis?

A

variation in RBC size - indicating a dimorphic population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What RBC parameter does anisocytosis correlate with?

A

RDW - esp. when it exceeds 15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What diseases are associated with anisocytosis?

A
  1. post-transfusion
  2. post-treatment (B12, iron, folate)
  3. presence of 2 concurrent deficiencies (e.g., iron and B12)
  4. idiopathic sideroblastic anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is poikilocytosis?

A

variation in the shape of RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
A

Echinocyte (Burr cell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the clinical significance of echinocytes (burr cells)?

A

-membrane defect

  1. liver disease
  2. uremia
  3. hemolytic anemias
  4. TTP
  5. DIC
  6. carcinoma of stomach
  7. pyruvate kinase deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the clinical significance of crenated RBCs?

A

-osmotic imbalance

-if seen in most cells in thin part of smear, do not report = probably artifact due to excess anticoagulant or slow drying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can crenated RBCs be differentiated from burr cells?

A

Burr cells have more pointed projections as compared to the knobby projections of crenated cells.

-if the abnormality is seen in nearly all cells in the thin part of the smear, it is most likely artifact (crenation) due to slow drying of the smear or over-anticoagulation
-burr cells are seen in variable number throughout the smear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is hypochromia?

A

the are of central pallor is greater than 1/3 the diameter of the RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
A

spur cells (acanthocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the clinical significance of acanthocytes (spur cells)?

A

-membrane defect (excessive cholesterol)

  1. alcoholic liver disease
  2. post-splenectomy
  3. abetalipoproteinemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How are echinocytes and acanthocytes differentiated on a smear?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
A

target cells (codocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What causes target cells (codocytes)?

A

-excessive cholesterol in membrane
-hemoglobin distribution imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the clinical significance of target cells (codocytes)?

A
  1. liver disease
  2. hemoglobinopathies (sickle cell, hemoglobin C)
  3. thalassemia
  4. iron-deficiency anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
A

teardrops (dacrocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the clinical significance of dacrocytes (tear drop)?

A
  1. anemias (megaloblastic)
  2. thalassemia
  3. extramedullary hematopoiesis (myelofibrosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
A

sickle cells (drepanocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
A

schistocyte (RBC fragments)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the clinical significance of schistocytes?

A

-RBCs split by fibrin strands

  1. microangiopathic hemolytic anemias (DIC, TTP, HUS)
  2. prosthetic heart valves
  3. burns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are spherocytes?

A

small, dark-staining RBCs without central pallor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q
A

spherocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the clinical significance of spherocytes?
membrane defect -hereditary spherocytosis -autoantibodies -burns -hemoglobinopathies -hemolysis -ABO HDFN -incompatible blood transfusion -transfusion of stored blood -a few are normal due to aging of RBCs
26
How are the MCV and MCHC affected in hereditary spherocytosis?
MCV: normal to low MCHC: slightly increased
27
On a blood smear spherocytes appear small in comparison to normal RBCs. Explain how their MCV may be normal.
Although spherocytes are small in diameter, their volume is normal because they are spherical rather than biconcave.
28
What are stomatocytes?
RBCs with a slit-like central pallor (mouth cells)
29
What is the clinical significance of stomatocytes?
-hereditary stomatocytosis -hereditary spherocytosis -thalassemia -alcoholic cirrhosis -Rh null disease -may be artifact in parts of the smear that are too thin or too thick
30
stomatocyte
31
What is the clinical significance of marked polychromasia?
it is a sign of accelerated erythropoiesis -acute blood loss -hemolytic anemia -following anemia treatment -supravital stain = retics
32
polychromasia
33
Describe rouleaux.
RBCs resemble a stack of coins
34
What is the clinical significance of rouleaux?
serum protein abnormality - increased globulin or fibrinogen -multiple myeloma -macroglobulinemia -may be artifact = delay in spreading drop of blood OR smear is too thick
35
What is the clinical significance of agglutination on a blood smear?
RBCs in irregular clumps - RBCs coated with IgM antibodies and complement -autoantibodies -cold autoagglutination
36
Rouleaux vs. agglutination
37
Why is it important to report oval macrocytes?
because of their association with megaloblastic anemia
38
What is the clinical significance of hypochromic microcytic RBCs?
-iron deficiency anemia -sideroblastic anemia -thalassemia -anemia of chronic inflammation
39
In what ways will the RBC morphology of a newborn differ from that of an adult?
-macrocytic and polychromatophilic -a few nucleated RBCs (3-10 per 100 WBCs) -Reference ranges are higher for newborns: WBCs, RBCs, hematocrit, hemoglobin, retics
40
What effect does chronic alcoholism have on RBC morphology?
-MCV is elevated -target cells -stomatocytes
41
How would you correct agglutination?
-warm the blood to 37*C
42
How does agglutination affect indices when using an automated cell counting instrument?
-RBC count and hematocrit = falsely LOW -MCHC = falsely high (>37 g/dL)
43
If a patient has an MCV of 110 fL and marked polychromasia, what other hematology test would be abnormal?
-the reticulocyte count would be increased -the polychromatophlic RBCs would be retics if stained with new methylene blue - they are slightly larger than a mature RBC, which is why the MCV is elevated
44
What changes occur in a blood specimen stored at room temperature?
-RBCs swell = increasing MCV and hematocrit -MCHC and ESR decrease -Platelets and WBCs decrease
45
What stain is used for basophlic stippling?
Wright & new methylene blue -stain dark blue with Wright's stain
46
basophilic stippling
47
What RBC inclusion is described below? -multiple, irregular purple inclusions evenly distributed in the cell
basophilic stippling
48
What is basophilic stippling composed of?
aggregation of RNA (ribosomes)
49
What is the significance of basophilic stippling?
coarse: exposure to lead fine: young RBC
50
What conditions are associated with basophilic stippling?
-exposure to lead -accelerated or abnormal hemoglobin synthesis -thalassemia
51
Which RBC inclusion is associated with lead poisoning?
coarse basophilic stippling
52
What stain is used for Howell-Jolly bodies?
Wright & new methylene blue -stain dark purple to black with Wright's stain
53
Howell-Jolly bodies
54
What RBC inclusion is described below? round, purple, 1-2 um in diameter; usually only 1 per cell
Howell-Jolly bodies
55
What are Howell-Jolly bodies composed of?
nuclear remnants (DNA)
56
What is the clinical significance of Howell-Jolly bodies?
-usually pitted by the spleen -seen with accelerated or abnormal erythropoeisis
57
What conditions are associated with Howell-Jolly bodies?
-post-splenectomy -thalassemia -hemolytic & megaloblastic anemias -sickle cell anemia
58
What stain is used for Cabot rings?
Wright -appear dark violet
59
Do Cabot rings stain with Perl's Prussian blue stain?
yes
60
Cabot rings
61
What RBC inclusion is described below? reddish purple rings or figure-8s
Cabot rings
62
What are Cabot rings composed of?
-part of mitotic spindle -remnant of microtubules -fragment of nuclear membrane
63
What is the clinical significance of Cabot rings?
-rapid blood regeneration -abnormal erythropoiesis
64
What conditions are associated with Cabot rings?
-megaloblastic anemia -thalassemia -post-splenectomy -myelodysplastic syndromes -lead poisoning
65
What stain is used for Pappenheimer bodies?
Wright (siderotic granules with Prussian blue stain)
66
What RBC inclusion is described below? small purplish blue granules that vary in size, shape, and number; are usually in clusters at the periphery
Pappenheimer bodies
67
Pappenheimer bodies
68
What are Pappenheimer bodies composed of?
unused iron particles
69
What is the clinical significance of Pappenheimer bodies?
faulty iron utilization during hemoglobin synthesis
70
What conditions are associated with Pappenheimer bodies?
-sideroblastic anemias -post-splenectomy -thalassemia -sickle cell anemia -hemochromatosis
71
What stain is used for siderotic granules?
Prussian blue
72
What RBC inclusion is described below? blue granules of varying size and shape that stain with Prussian blue
siderotic granules
73
What are siderotic granules composed of?
aggregates of iron particles
74
What is the clinical significance of siderotic granules?
faulty iron utilization in hemoglobin synthesis
75
siderotic granules
76
What conditions are associated with siderotic granules?
-sideroblastic anemias -post-splenectomy -thalassemia -sickle cell anemia -hemochromatosis
77
What stains are used for reticulocytes?
new methylene blue or brilliant cresyl blue (polychromasia on Wright stain)
78
Reticulocytes
79
What are reticulocytes composed of?
residual RNA (ribosomes)
80
What is the clinical significance of reticulocytes?
>2%: increased erythropoiesis <0.1%: decreased erythropoiesis
81
What conditions are associated with reticulocytes?
-hemolytic anemia -blood loss -following treatment for iron deficiency or megaloblastic anemia
82
What stain is used for Heinz bodies?
supravital stain (e.g., crystal violet, brilliant cresyl blue, methylene blue)
83
What RBC inclusion is described below? round blue inclusions, varying sizes, close to cell membrane; may be >1
Heinz bodies
84
Heinz bodies
85
What are Heinz bodies composed of?
precipitated, oxidized, denatured hemoglobin
86
What is the clinical significance of Heinz bodies?
normal during aging but pitted by spleen
87
What conditions are associated with Heinz bodies?
-G6PD deficiency -unstable hemoglobins -chemical injury to RBCs -drug-induced hemolytic anemia
88
Do Heinz bodies stain with Wrights stain?
NO
89
Which of the following conditions is associated with basophilic stippling? A. sideroblastic anemia B. lead poisoning C. G6PD deficiency D. none of the above
B. lead poisoning
90
Which of the following conditions is associated with Howell-Jolly bodies? A. DIC B. G6PD deficiency C. post-splenectomy D. none of the above
C. post-splenectomy
91
Which of the following conditions is associated with Heinz bodies? A. G6PD deficiency B. post-splenectomy C. multiple myeloma D. none of the above
A. G6PD deficiency
92
Which of the following conditions is associated with Pappenheimer bodies? A. lead poisoning B. sideroblastic anemia C. post-splenectomy D. none of the above
B. sideroblastic anemia
93
Which of the following conditions is associated with rouleaux? A. sideroblastic anemia B. multiple myeloma C. DIC D. none of the above
B. multiple myeloma
94
Which of the following conditions is associated with schistocytes? A. sideroblastic anemia B. multiple myeloma C. DIC D. all of the above
C. DIC
95
What is a supravital stain?
a stain that stains unfixed cells in the living state -new methylene blue -brilliant cresyl blue -crystal violet
96
Where are reticulocytes found after centrifugation of whole blood?
just below the buffy coat -they are less dense than mature RBCs
97
What other RBC inclusions are seen on a reticulocyte smear?
-Howell-Jolly bodies -Heinz bodies -Pappenheimer bodies -they are all stained by supravital stains
98
Staining of RBC inclusions - reticulum: Wright stain? New Methylene blue? Prussian blue?
Wright stain: cell appears polychromatophilic New methylene blue: yes Prussian blue: NO
99
Staining of RBC inclusions - Howell-Jolly bodies: Wright stain? New Methylene blue? Prussian blue?
Wright stain: yes New methylene blue: yes Prussian blue: NO
100
Staining of RBC inclusions - Pappenheimer bodies: Wright stain? New Methylene blue? Prussian blue?
Wright stain: yes New methylene blue: yes Prussian blue: yes
101
Staining of RBC inclusions - siderotic granules: Wright stain? New Methylene blue? Prussian blue?
Wright stain: yes, but called Pappenheimer bodies New methylene blue: yes Prussian blue: yes
102
Staining of RBC inclusions - Heinz bodies: Wright stain? New Methylene blue? Prussian blue?
Wright stain: NO New methylene blue: yes Prussian blue: NO

AMT MLS Exam - Hematology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions