RBC ABNORMALITIES

Question 1

T/F: it provides an experienced observer with valuable information about morphology

Answer 1

TRUE

Question 2

T/F: rbc abnormality importance suggests a particular disease, aids in diagnosis

Question 3

what are of RBCs should be slightly separated from one another or barely touching without overlapping; should represent 1/3 of the entire film

Answer 3

thin area

Question 4

what are of RBCs may overlap or lie on top of one another, making them unsuitable

Answer 4

thicker portions

Question 5

what is the ideal distribution of rbc

Answer 5

thin portion adjacent to the feather end of the film

Question 6

not separated with each other; appear in short/long stacks resembling coins

Answer 6

rouleaux

Question 7

cells are in clusters or masses when exposed to antibodies

Answer 7

agglutination

Question 8

normal or in disease state (atypical pneumonia or hemolytic anemia)

Answer 8

autoagglutination

Question 9

clumping at below 25 celsius; increased mcv in automated machine- (artifactual) since clumps are counted as one

Answer 9

cold agglutinin disease

Question 10

T/F: central pallor of rbc should be more than 1/3 of the cell

Answer 10

FALSE dapat not more than 1/3

Question 11

clear central pallor (1/3)

Answer 11

normochromic

Question 12

• increasing central pallor, decreasing hgb concentration
• caused by impaired hb synthesis
• associated most often with microcytosis; (e.g. IDA, thalassemia,sideroblastic anemia)

Answer 12

hypochromic

Question 13

• lack of central pallor associated with macrocytosis
• mchc is elevated in true hyperchromia
• hemolytic anemia including hemolysis caused by burns

Answer 13

hyperchromic

Question 14

premature released cells occurs as a result of stimulated erythropoiesis

Answer 14

shift cells

Question 15

rbc size that is correlated with MCV:
- if diameter exceeds 8.5-9um and MCV exceeds 100fL
- low vitamin b12, alcoholism with or without liver disease, cancer chemotheraphy, chronic HA with reticulocytosis, myeloma etc.
- diffusely basophilic occurs as a result of stimulated erythropoiesis

Answer 15

normocytic
macrocytic

Question 16

rbc size that is correlated with MCV:
- small rbc, occurs when mcv is below 80fL
- characteristic of IDA

Answer 16

microcytic

Question 16

lack central pallor and appear to have increased Hb seen in hemolytic anemia

Answer 16

spherocytes

Question 17

thinner than normal and have a colorless center; increased surface area that is out of the proportion to the volume

Answer 17

leptocytes

Question 17

• describes red blood cells that are of different sizes.
• shows variation in population size or diameter in the blood

Answer 17

anisocytosis

Question 18

T/F: red cell distribution width is an estimate of erythrocyte variation in sizes, calculated in most automated analyzers, and is used as index of red cell population homorogeneity

Answer 18

FALSE - dapat heterogeneity

Question 19

• large oval shaped cells with marked increased mcv
• occur due to nuclear maturation defect in the early marrow cells caused by vit b12 or folate deficiency; strongly suggest MEGALOBLASTIC ANEMIA
• > 125fL ; size: > 7 Hg

Answer 19

oval macrocytes

Question 19

• elliptical egg-shaped/oval to sausage shaped
• seen in hereditary elliptocytosis, IDA, MMM

Answer 19

elliptocytes

Question 20

• round, small redcells, lacks central pallor, showing an intense staining affinity
• h or a, seen in HS, acquired HA, burned patient

Answer 20

spherocyte

Question 20

• central area of Hb surrounded by a relatively colorless ring, appear like a bell or tall hat shaped, or mexican hat shell
• membrane surface is increased after loading of the membrane with cholesterol and phospholipids

Answer 20

codocytes

Question 21

having many uniform tiny spicules on their surfaces; represent artifact on films; should not be reported

Answer 21

echinocytes

Question 22

- having irregularly sized and unevenly spaced spicules, that differs from echinocytes, and should be reported when seen - related to increase in bun

Answer 22

burr cells

Question 23

- small, densely stained rbcs having few irregular, large pointed spicules or thorn like projections - caused by changes in ratio of plasma lipids - abetalipoproteinemia, alcoholic cirrhosis with HA

Answer 23

acanthocytes

Question 24

- having an elongated or slit like area of central pallor (mouth shaped) - H or A membrane defect in the Na+: K+ transport ratio and a greatly increased rate of active cation trn - alcoholism, cirrhosis, obstructive liver disease, Rh null disease

Answer 24

stomatocytes

Question 25

T/F: poikilocytes are primary to trauma

Answer 25

FALSE - secondary

Question 26

- aka helmet cells - undergoes cleavage and fragmentation - process is associated with either small blood vessel disease or fibrin in small blood vessel and results in intravascular fragmentation - MAHA, severe burns, renal graft rejection, glumerulonephritis, vasculitis

Answer 26

schistocytes

Question 27

- a schistocyte with one or more horn like projections; a rare phenomenon; should be reported as schistocyte - a result of rbc being caught on a fibrin strand w/c could cut it to two. when this escapes, it may have a vacoule like area (blister cell) - associated with g6pd

Answer 27

keratocyte

Question 28

- teardrop or pear shaped cells - rbc containing heinz bodies that squeeze through the spleenic sinuses, hence, will have its original shaped stretched - seen in MMM, heinz body anemia, myelophthisic anemia

Answer 28

dacrocytes

Question 29

- usually seen in severe burns as small, round cells, as a result of thermal damage to the membrane - rare hereditary HA associated with heat sensitivity at 45 celsius

Answer 29

microspherocytes

Question 30

- large fragments of red cell membrane with their contents being extruded, and stain pale pink forming a half moon or crescent shape cell - frequently seen in malaria

Answer 30

drepanocytes

Question 30

intracellular hexagonal crystals with blunt ends and strains darkly; forms within the red cell membrane when hb c crystallizes

Answer 30

hemoglobin cc crystals

Question 30

small round fragments of a metarubricyte and stain reddish blue in wright's; result from kharyorrhexis or from incomplete extrusion of nucleus during mitosis, give positive feulgen reaction

Answer 30

howell-jolly bodies

Question 31

- dark-hued crystals of condensed hb that distorts rbc membrane - one or more fingerlike blunt pointed projections, that protrude from the cell membrane in different directions

Answer 31

hemoglobin sc crystals

Question 32

two forms of basophilic stippling

Answer 32

fine stippling granular stippling

Question 33

irregularly shaped basophilic granules; represents aggregates of ribosomes

Answer 33

basophilic stippling

Question 34

stippling due to increased red cell population, seen with increased polychromatophilia

Answer 34

fine stippling

Question 35

stippling due to abnormal instability of RNA in the young cells, seen in lead poisoning, thalassemia, megaloblastic anemia, and severe anemia

Answer 35

granular stippling

Question 35

small irregular dark staining granules located in the periphery; positive with prussian blue

Answer 35

pappenheimer bodies

Question 36

heinz bodies is best stained with

Answer 36

supravital stain

Question 36

- round refractile bodies of denatured hemoglobin precipitates, not visible in wrights stain; pitted golf apperance if multiple - seen in hereditary g6pd deficiency

Answer 36

heinz bodies

Question 37

- small greenish-blue inclusion bodies - precipitated hb h - a-thalassemia

Answer 37

hemoglobin H inclusions

Question 37

an oxidant used in heinz bodies for a long period induces heinz body formation

Answer 37

acetylphenylhydrazine

Question 38

plasmodium spp transmitted to man by anopheles mosquito

Answer 38

malaria

Question 39

schuffner's stippling, four maturation stages infects the rbc-enlarged

Answer 39

p. vivax

Question 39

protozoan inclusion that is the same but rbc is not enlarged

Answer 39

p. malariae

Question 40

small delicate ring froms, gametocytes are banana shaped

Answer 40

p. falciparum

Question 41

rbc is oval, schuffners stippling is present

Answer 41

p. ovale

Question 42

- rare transmission to humans by tick bites - resemble ring stages of malarial parasites - tiny rings 1-5um - tetrad formation - rbc not enlarged

Answer 42

babesia microti