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HEMA > RBC ABNORMALITIES > Flashcards

RBC ABNORMALITIES Flashcards

1
Q

DEVELOPMENTAL ORGANELLES

1.______-________
Small, __-__ um in size; nuclear fragments of _____
Normally pitted by ______ ______ and are (seen/not seen) in normal RBCs Develop in periods of accelerated or abnormal _________ because the _______ cant keep up with pitting of the remnants
______ ____; (Light/Dark) blue-purple with Wright’s stain
Positive in _______ reaction (DNA stain)

  1. ___________/_____________
    Multiple, tiny, fine or coarse ______inclusions (precipitated _____)> inclusions aggregates in _____ & ______
    Hemoglobin appears (homogeneous/heterogenous) ________ ____ appearance
    _____-_____ to ______ with Wright’s stain
3.\_\_\_\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_
 ● Aggregates of mitochondria, ribosomes, and\_\_\_\_\_\_
PARTICLES
● Appears in the \_\_\_\_\_\_\_ of
the erythrocytes
● Small, irregular, (light/dark) blue to
purple staining \_\_\_\_\_.
● \_\_\_\_\_\_\_\_ with Wright’s stain
● \_\_\_\_\_\_\_\_ GRANULES: iron
(ferritin) aggregates
●\_\_\_\_ \_\_\_\_\_\_\_\_ blue iron stain
● \_\_\_\_\_\_\_\_\_: RBC with siderotic granules
● \_\_\_\_\_\_\_\_\_\_: Normoblast with siderotic granules

4._______ ___________
Numerous siderotic ________ found within mitochondria and forms a ______ around the nucleus

________ ________
Thin ring like structure, circular and may form figure of ______, (complete/incomplete) rings
Represent remnants of ________ from the mitotic spindle
Stains _______ _____ in Wright’s stain
Associated with _____________ in the same RBC

________ _________
(Old/Young) cells with no nucleus but contains ______ remnants
Wright’s stain: _______ _____ throughout cytoplasm; also called polychromasia/polychromatohilia
Suprvital stains: ____ ______ _____ remnants in the cytoplasm (called reticulocytes)
Supravital stain:
______ ________ ______→ CLSI recommended
Brilliant Cresyl blue
_____ ________→ for Heinz bodies preparation

A
  1. Howell-Jolly bodies
    - 1-2, DNA, splenic macrophages, not seen, erythropoiesis, splenic
    - Reddish blue, Dark blue
    - Feulgen reaction
  2. Basophilic stippling/Punctuate Basophilia
    - rRNA inclusions(RNA), homogenous, blueberry gel appearance
    - dark blue-purple
  3. Pappenheimer bodies/Siderotic granules
    - IRON particles, periphery, light-blue-purple staining IRON
    - GRANULES (W/S)
    - Siderotic granules (iron aggregates)
    - Siderocyte; Sideroblast
  4. Ringed sideroblast
    - numerous siderotic granules, ring (nucleus)
  5. Cabot ring
    - - 8, incomplete, microtubules(mitotic spindle)
    - reddish violet
    - associated with howell/jolly bodies
  6. Diffuse Basophilia
    - young, no nucleus, RNA
    - Bluish tinge (cytoplasm): Polychromasia/Polychromatophilia
    - Supravital stains: Dark blue RNA remnants (reticulocytes)
    - New Methylene blue, brilliant cresyl blue, Crystal violet
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2
Q

ABNORMAL HGB PRECIPITATION

1._____ _________
Precipitated/denatured ______ due to destruction of _____
_____-____ um in size, that can be seen with a stain such as _______ _____ or ________ _____ ________
_______ ____ ball appearance
_____CELL/________ RBC with pitted Heinz bodies
(VISIBLE/NOT VISIBLE) ON WRIGHT’S STAIN

2.__________________
Small,(color) _____ OR _____ granules ; Precipitated (alpha/beta)-globin chains of hemoglobin
Failure of synthesizing three _____ globin chains (Hgb H disease)
Results to unstable, easily oxidized and easily precipitated hemoglobin
Can be mistake as _________
Retics: ________ pattern
Hb H inclusions: _____ body
Seen after -__ drops of blood incubated with 0.5ml __% BCB for ____ minutes at ___C

A

Heinz bodies

  • globin, hgb, 0.2-2.0, crystal violet, brilliant cresyl blue
  • Pitted golf ball appearance
  • BITE CELL/DEGMACYTE RBC
  • not visible

Hemoglobin H inclusions

  • dark blue or greenish, beta-globin, alpha (Hgb H disease)
  • retics( granulofilamentous); hgb h inclusions(single body)
  • 4 drops of blood, 0.5 ml 1% BCB for 20 mins at 37C
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3
Q

SICKLE CELL ANEMIA/ Hgb S
Hgb SC disorder
Hgb C-Harlem disorder Hgb S-Memphis disorder

HGB CC DISEASE

HGB SC DISEASE

A

Sickle cell/drepanocytes/menisocytes

Hgb cc crystal

Hgb Sc crystal

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4
Q

Post splenectomy
Congenital absence of spleen Splenic atrophy Sickle cell anemia
Alcoholism
Megaloblastic anemia

Megaloblastic anemia Alcoholism
Thalassemia
Lead & arsenic toxicity Pyrimidine-5’-nucleotidase deficiency

Sideroblastic anemia Hemoglobinopathies Thalassemias
Megaloblastic anemia
Myelodysplastic syndromes Hyposplenism Post-splenectomy

Sideroblastic anemia

Megaloblastic anemia
Myelodysplastic syndromes

Increased RBC production
Increased EPO stimulation of the marrow

A

Howell-Jolly bodies

Basophilic stippling/Punctuate basophilia

Papenheimer bodies/siderotic granules

Sideroblastic anemia

Cabot ring

Diffuse basophilic

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5
Q

POIKILOCYES CAUSED BY TRAUMA OR PHYSICAL DAMAGE- RBC may fragment and lyse when subjected to excessive physical trauma in cardiovascular system (CVS)

  1. ________/________/__________
    Characterized by ________, ______ RBC
    Are fragments of erythrocytes that are small and irregularly shaped; these cells -are produced as the result of the______ _____ of an erythrocyte, the schistocyte is about ____ the size of a normal erythrocyte and may have a ______ ____appearance
    -Includes ____, triangular, variety of small, irregular shapes with few pointed extremities
FRAGMENTATION IS CAUSED BY: 
\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_
Presence of fibrin (\_\_\_\_\_\_) 
Prosthetic \_\_\_\_ \_\_\_\_
\_\_\_\_\_ transplant \_\_\_\_\_\_\_\_\_
  1. ________/________ ______
    - Type of schistocyte with one or more _______ projections, (shallow/hollow) interior portion of cell; resembling helmet or horn
    - Are usually the larger ______ _____ part of the cell that remains after the rupturing of a _______ cell and are formed as a result of the physical process of fragmentation
    - Formed in the _______ and _______ ______ _____

3.___________ ________
RBC containing one or more ________ that resemble a ____ on the skin
Has a significantly (thicked/thinned) area at the periphery or outer border of the cell membrane
The vacuoles may _______. If it does occur, distorted cells (_________) and cell fragments (_________) are produced

4.____________
Resemble a pinched bottle ; can be _______ in shape
RBC has ___ pallor area
This abnormality is associated with hemolytic anemias, including hereditary spherocytosis

5.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
 disk shaped cells with smaller volume
Due to \_\_\_\_\_\_\_ damage to cell membrane protein \_\_\_\_\_\_\_, no pallor area
Laboratory:
\_\_\_-\_\_\_um in diameter MCV = \_\_\_fL

6.________________
_____ drop, _____ drop shaped with (blunt/unblunt) pointed projection
Due to ________ of red cells through small openings or ____ ____ and remains behind

7.___________
Half ____ cell, half _____ cell Large, pale _____ staining ______ of red cell
Causing overt _______
ASSOCIATED WITH _______

A

Shistocyte/Schizocyte/Fragmented RBC

  • cleaved, breaking apart, half, deeper red
  • helmet, triangular

-altered vessel wall, fibrin (CLOTS), prosthetic heart valves, renal transplant rejection

Keratocytes/Helmet Cells

  • hornlike projections, hollow, helmet or horn resemble
  • larger scooped out part, blister cell rupturing
  • spleen and intravascular fibrin clots

Blister cell

  • one or more vacuoles, thinned area (periphery/outer)
  • vacoules rupturing –> keratocyte, shistocyte

Knizocyte
-pinched, triangle, 2 pallor area

Microspherocytes/Pyropoikilocyte

  • disk shape, smaller vol
  • thermal damage, NO PALLOR area
  • 2-3 um, <60 fl

Dacrocyte

  • tear drop,pear drop, blunt pointed
  • squeezing, splenic sinuses

Semilunar bodies

  • moon, crescent, large pale pink staining ghost of red cell
  • overt hemolysis
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6
Q

POIKILOCYTES CAUSED BY MEMBRANE ABNORMALITIES

1._______________
SMALL, ROUND, RBC (with/without) central pallor (increased MCHC) ; may appear as _____ if a slide is examined at the ____ ___ of a normal blood smear
Hereditary spherocytosis→ Deficiency in either ____, ____ 3, _____ and ____ 4.2 (vertical/horitzontal)
*Laboratory findings:
-MCHC____g/dL ; can be microcytic RBCs
-Increased/Decreased OFT
-(Increased/Decreased) surface area:volume ratio

  1. _________
    Have a ___, _____, _____, pencil shape
    Hemoglobin are concentrated @(how many) ends of the cell with (no/normal) pallor area
    Hereditary elliptocytosis → Due to deficiency in either _____ and/or Protein ___(vertical/horitzontal)
    ________ - deficiency in Gerbich antigens/Gerbichnal antigen (elliptocytosis)
    _________- in cases of megaloblastic anemia (oval macrocyte) IDA, myeliphistic anemia
  2. __________/_______ RBC/______ CELLS
    _________: evenly distributed blunt serrated edges/short projections
    ______ ____: not evenly distributed blunt serrated edges/short projections
    -IN-VIVO: Due to _____ abnormalities,
    ______ changes
    -IN-VITRO: prolonged standing of ____ ____.
    (with/without) AC, _____ slide, and stored blood (Pyruvate kinase deficiency
    -Can be an _____
  3. _____________
    are ______, ______ erythrocytes that are similar to burr cells
    may be seen in small numbers during the first ___to ___ months of life as infantile pyknocytes
  4. ________/_________/_______
    - Contains uneven spaced, pointed projections (with/without) central pallor -Fewer ______ than echinocytes
    - Due to the changes in the _____ of plasma lipids ; decreased ______ and _____ ______ _____ (_____ and ________)

6.___________
-Characterized by elongated or slit like pallor area instead of circular pallor (_____ like central pallor)
-Can appear as an _______ in blood film
-Can be seen with _______ hemoglobin at the periphery of cells with ____
-_______ _________: increased membrane permeability to sodium and potassium leading to water influx
-__________ _______: increased membrane permeability to potassium leading to loss of water from cell
_________- inc. in intracellular potassium

___________/_________/__________
Central area of hemoglobin surrounded by (colored/colorless) ring and a peripheral ring of hemoglobin, resembles a _____
-Due to increased membrane surface after of the membrane with ________ and _________ (_________)
-In some instances, such as abnormal hemoglobins, the defect is related to a __________ of hemoglobin
-____________: THINNER VARIANT OF A TARGET CELL
-Target cell in one portion targets ann ______(fixed w/ m

A 
Spherocytes
- increased MCHC, artifacts (thin end)
-akyrin, band 3, protein 4.2 (vertical)
-37g/dl
increased
-decrease

Elliptocytes

  • cigar, elliptical, egg; two ends, normal pallor area
  • spectrin, protein 4.1 (horizontal)
  • Leach phenotype
  • Ovalocyte

Echinocytes/Crenated/Burr

  • echinocytes, burr
  • iN VIVO: plasma ab., osmolatic changes
  • IN VITRO- prolonged standing of blood film, w/ AC, moist slide, stored blood

Pyknocytes

  • distorted contracted,
  • 2-3 months

Acanthocytes/Spurr cells/Thorn cells
-uneven spaced, pointed projections, WITHOUT central pallor
-fewer projections-
-ratio=dec. plama, rbc membrane lipids (lecithin, sphingomyelin)
-Piezo type
Stomatocytes
- elongated, or slit like, WITHOUR central pallor , MOUTH like
-artifact
-Overhydrated stomatocytosis- influx; Dehydrated stomatocytosis: loss(RHAG protein deficiency)

Target cell/Codocyte/Mexican hat cell

  • colorless/peripheral ring of hgb
  • INC. MEMBRANE SURFACE
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7
Q
  • HEREDITARY SPHEROCYTOSIS -Pre & Post splenectomy
  • HDN- Hemolytic disease of the newborn
  • WAIHA (Warm autoimmune hemolytic anemia), MAHA (microangiopathic hemolytic anemia)
  • Severe burns or thermal injury -Jaundice
  • HEREDITARY ELLIPTOCYTOSIS -Iron deficiency anemia -Thalassemia major
  • Sickle cell anemia
  • Pernicious anemia -Myelofibrosis
  • Renal insufficiency
  • Liver disease
  • Uremia
  • Pyruvate kinase deficiency
  • Acute, severe hemolytic anemia -Glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Hereditary lipoprotein deficiency

-ABETALIPOPROTENEMIA
-Alcoholic cirrhosis w/ HA -Malabsorption states
-Post splenectomy
-Hepatitis of newborn
-Pyruvate kinase deficiency
-Lipid metabolism disorders
-McLeod phenotype→ absence of Kx
gene ; absence of Kell antigens

  • RH NULL DISEASE
  • Acute alcoholism, alcoholic cirrhosis -Glutathione deficiency
  • Hereditary spherocytosis
  • Infectious mononucleosis
  • Lead poisoning
  • Malignancies
  • Thalassemia minor
  • Transiently accompanying hemolytic
  • Hemoglobinopathies (Hb C disease, S-C and S-S disease, sickle cell thalassemia, and thalassemia)
  • Hemolytic anemias
  • Hepatic disease with or without jaundice -Iron deficiency anemia -Post-Splenectomy
A

Spherocytes

Elliptocytes

echinocytes/Crenated/ burr

pyknocytes

acanthocytes/spurr/thorn cells

stomatocytes

target cell/codocyte/mexican hat

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8
Q
  • Severe burns -Glomerulonephritis -MAHA
  • TTP- Thrombotic Thrombocytopenic purpura
  • DIC- Disseminated intravascular coagulation

-Pulmonary emboli in sickle cell anemia -Microangiopathic hemolytic anemia -Heinz body hemolytic anemia

hemolytic anemias
hereditary spherocytosis

Severe burns
Hereditary pyropoikilocytosis→ Fragmented cells increases when heated in vitro at 450C (normal fragmentation: 490C)

  • Myeloid metaplasia -Primary myelofibrosis -Myelopthisic anemia -Pernicious anemia -Beta thalassemia -Tuberculosis
  • Heinz body formation

ASSOCIATED WITH MALARIA

A

schistocytrd/schizocyte/fragmented rbc + keratocyte

blister cell

knizocyte

microspherocyte/pyropoikilicoytes

dacrocyte

semilunar bodies

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HEMA (4 decks)

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