Section 7: RBC Morphology Flashcards
(63 cards)
What is anisocytosis?
Variation in RBC size
What can be used as comparison for RBC side when screening for anisocytosis?
Nucleus of a small lymph
What is normal RBC size in microns?
7 microns
What does microcytosis indicate? Seen in which diseases?
Indicates hemoglobin production problem, so often see hypochromasia too
Diseases: Iron deficiencies, thalassemias (hemoglobin deficiencies), anemia of inflammation, hemoglobinopathy, sideroblastic anemias (lead poisoning)
What does macrocytosis indicate? Seen in which abnormal conditions?
Indicates DNA synthesis defect. Asynchronism (slow nucleus maturation but normal cytoplasmic growth)
Diseases: Megaloblastic anemias, high reticulocyte count, tumors, fish tapeworm, hemodialysis, normal in newborns
What is hypochromasia? What traits do you look for?
RBCs lack normal hemoglobin amount
Look for: More central pallor (more than 1/3 of cell) and often microcytic
What trait(s) do you look for in polychromasia?
Diffuse pale blue/gray/or lavender due to remnant RNA. Often Macrocytic and lack central pallor. Macrocytosis
*These are young RBCs (reticulocytes)
What does increase or decrease in polychromasia (aka young RBCs) indicate?
Increase: body’s normal attempt to compensate for RBC loss such as in blood loss or hemolysis
Decrease: Bone marrow not responding properly to generate enough young RBCs
Define poikilocytosis. What are some specific types of poikilocytosis?
It’s variation in RBC shape. Ovalocytes and elliptocytes are types.
What are target cells? What trait(s) are you looking for?
They are cells with increased membrane lipids, thus increasing surface area OR decreasing Hgb
Look for bullseye appearance
What are sickle cells? What trait(s) are you looking for?
They’re cells that have abnormal Hgb S such that decreased oxygen environments will cause enough tension to deform RBCs to a sickle or crescent shape.
What are crystal cells? What trait(s) are you looking for you?
Cells with abnormal Hgb C condensed into a crystal shape. Look for super dark crystal shape either by itself or attached to RBC
What are envelope cells? Are they diagnostic? What trait(s) are you looking for?
These cells have Hgb pushed to one side with clear “flap” area. NOT DIAGNOSTIC bc can be artifact. See red color on just one side of cell and pallor on the other side.
What are Burr cells (echinocytes)? What trait(s) are you looking for?
They’re cells that underwent change in tonicity of intravascular fluid. Look for small blunt and evenly spaced projections. Don’t mistake for crenated cells, which have more spiky projections
What are acanthocytes? What trait(s) are you looking for?
They’re cells with abnormal membrane lipids. Look for long, irregular, spiny/spiky uneven projections
What are schistocytes? What types of schistocytes are there?
They’re fragmented RBCs.
Types: Bite cells, blister cells, helmet/horn cells, or triangle fragments
What trait(s) do you look for in blister cells?
See giant clear pocket within RBC
What’s another name for a teardrop cell? Causes? What trait(s) are you looking for?
Dacryocyte caused by macrophage biting it and myelofibrosis (squeezing through microvasculature or fibrous tissue and not bouncing back)
Look for tear or pear-shaped cells
What are spherocytes? What trait(s) are you looking for?
They’re cells with a defect in or loss of cell membrane. Vertical spectrin-ankyrin interaction defect
Look for microcytic, dark, very round cells that lack central pallor
What are stomatocytes? What trait(s) are you looking for?
They’re cells that may exist due to hereditary defect in sodium/potassium pump.
Look for coin slot or mouth shaped pallor
What causes agglutination? Trait to look for?
RBC antibody causes it. Look for RBC clumps
What are Rouleaux cells? What trait(s) are you looking for? How do you fix the problem?
They’re cells with increased plasma proteins or immunoglobulins, which mask the overall negative charge that sialic acid gives and thus causes the appearance of stacked coins.
Fix by saline replacement
What are Howell-Jolly bodies? What trait(s) are you looking for?
They’re cells caused by a busy bone marrow so see leftover nuclear components in RBCs
Look for small, dense, round nuclear remnant in cell (usually found in periphery but not every time)
What is basophilic stippling? What trait(s) are you looking for? Which stain do you use for reticulocyte (young RBC) counts?
Reticulocytes with remnant precipitated RNA showing up as a bunch of dots. Thick dots indicate lead poisoning.
Look for lots of fine to course blue dots evenly dispersed throughout cytoplasm. Use supra vital stain to do reticulocyte count
