RBC Morphology Flashcards

(28 cards)

1
Q

What is the normal morphology of red blood cells?

A
  • 7.5 micrometres (roughly the size of a lymphocyte nucleus).
  • Central pallor (central pale area) takes up approximately 1/3rd of the cell.
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2
Q

What is anisoscytosis?

A

Red blood cells that are of different sizes. Normal red blood cells are generally the same size.

Having red blood cells of unequal sizes may be a sign of anemia

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3
Q

What is poikilocytosis?

A

An increase in abnormal red blood cells of any shape that makes up 10% or more of the total population

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4
Q

What is microcytosis?

A

Red blood cells smaller than 7-7.2 micrometres.

Indicates microcytic anaemia.

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5
Q

What are the causes of microcytic anaemia (TAILS)?

A

Thalassaemia

Anaemia of chronic disease

Iron deficiency

Lead poisoning

Sideroblastic anaemia

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6
Q

How is microcytosis identified on a blood film?

A

Comparing the RBC diameter to the nucleus of the lymphocyte. If the RBC is smaller, this indicated microcytosis.

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7
Q

What is macrocytosis?

A

Red blood cells larger than 7-7.2 micrometres.

Indicates macrocytic anaemia.

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8
Q

What are the causes of non-megaloblastic macrocytic anaemia (HAND LAMP)?

A

Hypothyroidism

Aplastic anaemia

Neonate

Drugs e.g. azathropine

Liver disease

Alcohol

Myelodysplasia

Pregnancy

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9
Q

What are elliptocytes?

A

Thin, elongated RBC’s

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10
Q

What are the causes of elliptocytes?

A

Iron deficiency

Myelodysplastic syndrome

Hereditary elliptocytosis

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11
Q

What are schistocytes?

A

RBC fragments. These are fragmented red cells resulting from sheer stress (mechanical damage).

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12
Q

What are the causes of schistocytes?

A

Microangiopathic haemolytic anaemia

Mechanical e.g. metallic cardiac valve haemolysis

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13
Q

What are spherocytes?

A

Cells that lack central pallor and are spherical in shape (lost their membrane without losing their cytosol).

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14
Q

What are the causes of spherocytes?

A

Hereditary spherocytosis

Warm and cold AIHA

Immediate and delayed haemolytic transfusion reaction

ABO haemolytic disease of the newborn

Drug-induced haemolytic anaemia i.e. ceftriaxone.

Burns

Cold agglutination disease

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15
Q

What are stomatocytes?

A

RBC’s with a slit like area of central pallor. Occurs as a result of a decreased surface area to volume ratio in RBC’s.

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16
Q

Causes of stomatocytes?

A

Hereditary stomatocytosis

Liver disease

17
Q

What are “target” cells?

A

RBC’s that have areas of increase staining due to redundant RBC membrane in relation to the cytoplasm.

18
Q

Causes of “target” cells (Mnemonic: LOTSS)?

A

Liver disease

Obstructive jaundice

Thalassaemia

Splenectomy

Sideroblastic anaemia

19
Q

Characteristic feature of “target” RBC’s?

A

Contains a characteristic “bullseye” appearance

20
Q

What are “tear drop” cells?

A

RBC’s that are round at one side and tapered at the other.

Arises from conditions that affect the bone marrow architecture and resulting in RBC’s exiting the bone marrow

21
Q

Causes of “tear drop” cells?

A

Bone marrow fibrosis

Bone marrow infiltration

22
Q

What are Howell-Jolly bodies?

A

Normal RBC nuclear DNA remnants which are normally removed by the spleen.

23
Q

Causes of Howell-Jolly bodies?

A

Splenectomy

Hyposplenism (impaired spleen function)

Neonates with functionally immature spleens

24
Q

How does a Howell-Jolly body appear on blood film?

A

Dark purple spot within the RBC.

25
What are Pappenheimer bodies?
Small aggregates of ferritin. Such debris is normally removed by the spleen.
26
Causes of Pappenheimer bodies?
Post-splenectomy Lead poisoning Sideroblastic anaemia
27
How do Pappenheimer bodies appear on blood film?
Usually presents as smaller faint dots inside the RBC's.
28
What are the indications for splenectomy?
ITP AIHA Thalassaemia intermedia (old indication) Congenital RBC membrane defects - Hereditary spherocytosis - Hereditary elliptocytosis Lymphoproliferative disorders - Splenic marginal zone lymphoma - Hairy cell leukaemia (old indication) Myelofibrosis (old indication) Trauma