Peripheral Blood films

Question 1

What are ‘Acanthocytes’

Answer 1

Also known as spike or spur cells

RBCs with many spicules

Question 2

In which conditions are acanthocytes seen?

Answer 2

LIVER DISEASE
hyposplenism

rare: alpha-betalipoproteinemiaa

Question 3

What is ‘basophilic RBC stippling’

Answer 3

Accelerated erythropoiesis or defective Hb synthesis, small dots at the periphery are seen = these are rRNA

Question 4

In which conditions is basophilic RBC stippling seen?

Answer 4

** Lead poisoning

pyrimidine 5’ nucleotidase **

megaloblastic anaemia

myelodysplasia

Question 5

What are Burr cells?

Answer 5

Like a sea urchin with regular spicules

Question 6

When are Burr cells seen?

Answer 6

Often an artefact if blood has sat in EDTA prior to film being made

Question 7

What are Heinz bodies?

Answer 7

Inclusions on very edge of RBCs due to denatured Hb

Question 8

When are heinz bodies seen?

Answer 8

Glucose 6 phosphate deficiency

Question 9

What are howell Jolly bodies?

Answer 9

Basophilic nuclear remnants in RBCs

Question 10

When are howell jolly bodies seen?

Answer 10

Post splenectomy or hyposplenism

e.g. sickle cell disease

Question 11

What is leucoerythroblastic?

Answer 11

A phrase to denote the presence of nucleated red blood cells and myeloid precursors in peripheral blood

Question 12

When is leucoerythroblastic state seen?

Answer 12

Bone marrow infiltration e.g. myelofibrosis or malignancy

Question 13

What is Pelger huet cells?

Answer 13

Hyposegmented neutrophil with 2 lobes like a dumbell

Question 14

When are pelger huet cells seen?

Answer 14

Myelodysplastic syndromes

Question 15

What is polychromasia?

Answer 15

Bluish red blood cells due to presence of DNA.

usually immature reticulocytes

Question 16

When is polychromasia seen?

Answer 16

Usually increased naturally in response to shortened RBC life

Also in haemolytic anaemias

Question 17

What is right shift?

Answer 17

Hypermature white cells with hypersegmented polymorphs

= 5 + lobes

Question 18

When is right shift / hypersegmented wbc seen

Answer 18

Megaloblastic anaemia
(pernicious anaemia)

Question 19

What is rouleax formation?

Answer 19

Red cells stacked on eachother

Question 20

When is rouleaux formation seen?

Answer 20

Multiple myeloma

Question 21

What are shistocytes?

Answer 21

Fragmented RBC parts, irregular shapes with sharp edges

Question 22

When are schistocytes seen?

Answer 22

Microangiopathic anaemia:

DIC , haemolytic uraemia syndrome, TTP, Pre-eclampsia

Question 23

What are spherocyteS?

Answer 23

Sphere shaped RBC, often a bit smaller

Question 24

When are spherocytes seen?

Answer 24

Hereditary spherocytosis

Autoimmune haemolytic anaemia

Question 25

What are stomatocytes?

Answer 25

Central pallor is straight, curved or rod like shape RBC can look like smiley, or fish mouth

Question 26

When are stomatocytes seen?

Answer 26

Can be artefact or hereditary stomatocytosis high alcohol intake

Question 27

What are target cells?

Answer 27

Also known as codocyte Bulls eye apperance in central pallor

Question 28

when are target cells seen?

Answer 28

Liver disease hyposplenism thalassaemia

Question 29

What are bite cells and hemighosts seen in?

Answer 29

G6PD deficiency