RBC Cell Morphology

Question 1

variation in red cell shape

Answer 1

poikilocytosis

Question 2

Answer 2

target cell (codocytes/mexican hat)

Increased surface to volume ratio

Question 3

Answer 3

Spherocytes

Sphere with no central pallor (hyperchromia)
May have have high MCHC
Dysfunction in RBC cytoskeleton

Question 4

Answer 4

Stomacyte (mouth in greek = stoma)

cause → RBC membrane cation permeability abnormality

Conditions → Alcoholism, hereditary stomacytosis, Rh null disease

Question 5

Answer 5

ovalocyte

Cause → weakened RBC cytoskeleton that deforms under stress

Megaloblastic anemia + iron deficiency anemia

Question 6

Answer 6

Elliptocytes

Appearance → pencil, rod with blunt ends. May stain bipolar (Hgb appears concentrated on ends)

cause → weakened RBC cytoskeleton that deforms under stress

Conditions → Hereditary elliptocytosis, iron deficiency anemia

Question 7

Answer 7

Sickle cells (Drepanocytes)

Shape→ moon or sickle shape with sharp projecti9ons

cause→ hemoglobin S forming tactoids

Conditions → hemoglobinopatheis

Question 8

Answer 8

Helmet cell (bite cell)

Cause → pitting

Clinical → G6PD deficency

Question 9

Answer 9

Keratocyte (blister cells)

cause → RBC caught on fibrin in circulation ad fused around strand forming a vacuole

Clinical → DIC

Question 10

Answer 10

Schistocyte

• extreme forms of red cell fragments
• trauma to the RBC membrane
  
  • conditions → burns, DIC, TTP, renal graft rejections

Question 11

Answer 11

Burr Cells

crenated cell in vitro

condition → dehydration

Question 12

Answer 12

Achanthocyte

membrane cholesterol increased

Question 13

Answer 13

Teardrop

Question 14

Answer 14

Leptocyte

Question 15

Answer 15

Howell Jolly Bodies

• single or double circles in periphery
• DNA remnants → Karyorrhexis
• Accelerated erythropoiesis (spleen cannot keep pitting pace up)

Question 16

Answer 16

Basophilic Stippling

Homogenous stippling → cytoplasm filled with evenly distributed dots. RNA and mitochondrial remants

Condition → accelerated erythopoiesis

Question 17

Answer 17

Pappenheimer bodies

Cause → Iron not in heme.

Condition → Iron overload

Question 18

Wright stain - Pappenheimer bodies

Answer 18

pappenheimer bodies

Question 19

Prussian Blue stain

Answer 19

siderotic granules

Question 20

Answer 20

Heinz bodies → requires supra vital stain (brilliant cresyl/crystal violet)

appearance → single, pairs or more circules gathering around periphery.

cause → denatured hemoglobin

conditions → G6PD deficiency

Question 21

Answer 21

Cabot rings

condition → megaloblastic anemia

Question 22

Answer 22

Hemoglobin C crystals

appearance → finger like blunt pointed projections

cause → side effects from Hgb S and HgB C

Clinical →Hgb SC disease

Question 23

Answer 23

Agglunation

cause → antigen/antibody reactions resulting in clumps

Lab → falsely elevated MCV

Clinical → cold antibody/agglutinin syndromes

Question 24

Answer 24

Rouleaux - stack of coins

cause → increased globulin or fibrinogen in plasma -lowering zeta potential (net negative charge that repel each other)

Clinical → hyperpoteinemia

solution - saline

Question 25

Increased ESR

Answer 25

**RBCs clump together and fall faster** ex: Rouleaux and Inflammatory conditions Bacterial infections Malignant conditions

Question 26

Decreased ESR

Answer 26

RBC settle slower Sickle cell anemia morphology Increased RBC: polycythemia , newborn, dehydration

Question 27

Answer 27

toxic granulation in WBC medium to large granules evenly scattered throughout PMN cause → persistence of primary granules through maturation (neutrophils)

Question 28

Answer 28

A-granulation / Hypogranulation Lack of granules in the cytoplasm of granulocytes **Pelger Huet Anomaly** **Myelodysplastic syndromes**

Question 29

Answer 29

Hypersegmentaion Megaloblastic anemia

Question 30

Answer 30

Hyposegmentation (pelger huet anomaly) LBR gene

Question 31

Answer 31

Toxic vacuolization * Round, clear unstained areas randomly dispersed in PMN * cause → phagocytosis * Clinical → overwhelming bacterial infection

Question 32

Answer 32

Döhle bodies oval, blue single, multiple inclusions in PMN cause → RNA remnants

Question 33

Answer 33

Auer rods → myeloblast or promyelocyte Cause → fusion of primary grnaules clinical → acute myelogenous leukemia (AML). acute monocytic leukemia

Question 34

Answer 34

Charcot Leyden Crystals Cytoplasmic granules of disintegrated eosinophil (secondary) inflammatory conditions + hematologic malignancies with eosinophilia

Question 35

Answer 35

Chicken drumstick (barr body) ## Footnote **INACTIVATED X CHROMOSOMES IN FEMALES - neutrophil**

Question 36

Answer 36

Necrobiotic neutrophils Pyknotic nuclei that are not connected. Cause → **asynchronous** development. Nucleus keeps developing without cytoplasm clinical → deficiency