RBC Morphology

Question 1

Anisocytosis

Answer 1

Abnormal variation in RBC size

Question 2

Poikliocytosis

Answer 2

Abnormal variation in RBC shape

Question 3

Normocytic parameters

Answer 3

7-8 um, MCV 80-100 fl

Question 4

Microcytic parameters & causes

Answer 4

<7 um, MCV <80 fl

Hemoglobin production problem

Question 5

Microcytic diseases

Answer 5

iron deficiency, hemoglobinpathies, thalassemias, sideroblastic anemias (lead poisoning), anemia of inflammation (chronic disease)

Question 6

Macrocytic parameters & causes

Answer 6

> 8 um, MCV >100 fl

DNA synthhesis defect

Megaloblastic changes (asynchronism)

Question 7

Macrocytic diseases

Answer 7

Megaloblastic anemias, megaloblastoid (chemo), increased reticulocyte count

Question 8

Hypochromic cause

Answer 8

RBCs lack normal amount of hemoglobin

Question 9

Hypochromic diseases

Answer 9

Irong deficiency, thalassemia

Question 10

Polychromasia causes

Answer 10

Young RBC that has just spit out its nucleus, pale lavendar due to remnant RNA

Question 11

Polychromasia diseases

Answer 11

Increased levels normal due to compensating for blood loss, hemolysis

Decreased/insufficient increase indicative of bone marrow not responding properly

Question 12

Oval/Elliptocyte Diseases

Answer 12

Lateral spectrin-ankyrin juction defect

Myelodysplastic syndroms

Question 13

Target cell cause

Answer 13

Increase in lipid membranes result in increased surface area or reduced hemoglobin

Question 14

Target cell diseases

Answer 14

HgB abnormality

Liver disease, anemias, IDA

Question 15

Sickle Cells (Drepanocytes) cause

Answer 15

Presence of abnormal Hgb S in reduced oxygen tension cells will sickle

Question 16

Sickle cell diseases

Answer 16

HgB SC disease
HgB S - thalassemia
Sickle cell anemia

Question 17

Crystal cells (HgB C)

Answer 17

Condensation of abnormal HgB C into “washington monument” shaped crystal, one or both ends pointed

Question 18

Crystal cells (HgB SC)

Answer 18

Bird shaped crystal

Needs to be confirmed with electrophoresis

Question 19

Envelope cause

Answer 19

Associated with Hgb C

Question 20

Burr Cells (Echinocytes) cause

Answer 20

change in tonicity of intravascular fluid

Question 21

Burr cells (echinocytes) diseases

Answer 21

Uremia, liver disease, burns, microangiopathic hemolytic anemia (MAHA)

Question 22

Acanthocyte causes

Answer 22

abnormal lipid membranes

Question 23

Acanthocyte diseases

Answer 23

abetalipoproteinemia, liver disease

Question 24

Schistocytes diseases

Answer 24

Dic, ttp, hem, HUS, MAHA, Aprol

Question 25

Tear Drop (Dacryocytes) cause/disease

Answer 25

Inclusions being removed, myelofibrosis

Question 26

Spherocyte cause

Answer 26

Defect/lack of cell membrane (they can't deform, so they lose membrane over time and can't keep biconcave shape)

Question 27

Spherocytes diseases

Answer 27

Defect in vertical spectrin ankyrin interactions

Question 28

Stomatocyte diseases

Answer 28

Liver disease Rh deficiency syndrome -Rh null (absent) -Rh-mod (reduced)

Question 29

Stomatocyte causes

Answer 29

Failure of Na/K pumps, increased cellular H2O and cells swell

Question 30

Agglutination causes

Answer 30

RBC antibody (cold agglutinin, immune hemolytic anemia)

Question 31

Rouleaux cause

Answer 31

increase in plasma proteins/antibodies, coat RBCs, masking zeta potential/sialic acid fix with saline replacement

Question 32

Rouleaux diseases

Answer 32

Multiple myeloma, Waldenstom's, macroglobulinemia

Question 33

Howell-Jolly Bodies description

Answer 33

Bit of nucleus left behind, small dense blue dot at RBC periphery

Question 34

Howell-Jolly Body diseases

Answer 34

Occasional is normal. High amounts indicate busy bone marrow (hemolysis, megaloblastic nemias, thalassemias) Splenectomy!

Question 35

Basophilic stippling description

Answer 35

Remnant RNA

Question 36

Basophilic stippling diseases

Answer 36

Coarse = lead poisoning Blood loss, hemolysis, thalassemia

Question 37

Pappenheimer bodies description

Answer 37

Iron granules (too much, or ineffective use) Use Prussion Blue stain to confirm

Question 38

Pappenheimer diseases

Answer 38

Sideroblastic anemias, hemochromatosis, hemoglobinopathies, thalassemias

Question 39

Cabot ring description

Answer 39

Very fine, single or double loop Nuclear membrane remnant, indicative of busy bone marrow

Question 40

Heinz Bodies

Answer 40

Requires supravital stain Precipitated, denatured hemoglobin due to oxidative injury (G6PD deficiency, looking at you Hexose monophosphate pathway)

Question 41

Hemoglobin H inclusions

Answer 41

Requires supravital stain Precipitated Beta-Hgb chains