10.08.18 Peripheral Blood

Question 1

What is the thin edge we’re interested in looking at of the smear called?

Answer 1

Feathered edge

Question 2

What are the peripheral smear slides stained with?

Answer 2

Wright Giemsa stain

Question 3

RBC size should be about the size of _____

Answer 3

lymphocyte nucleus

Question 4

The area of central pallor in RBC should be ____ of total RBC diameter

Answer 4

1/3

Question 5

refers to RBC which vary widely in size

Answer 5

Anisocytosis

Question 6

mathematically measures the range of RBC sizes

Answer 6

RDW

Question 7

refers to red cells that are small

Answer 7

Microcytosis

Question 8

What lab value helps determine microcytosis/macrocytosis?

Answer 8

MCV

Question 9

What does the differential diagnosis of microcytosis include?

Answer 9

1. Iron deficiency
2. Thalassemias
3. Lead poisoning
4. Sideroblastic anemia
5. Anemia of chronic disease (usually normocytic)
6. Hemoglobin C disease and trait

Question 10

refers to large RBC

Answer 10

macrocytosis

Question 11

What does the differential diagnosis for macrocytosis include?

Answer 11

1. B12/folate deficiency
2. Liver disease
3. Thyroid disease
4. Chemotherapy
5. Anti-retrovirals
6. Aplastic anemia
7. MDS
8. Elevated reticulocyte count

Question 12

refers to RBC that have too little hemoglobin

Answer 12

Hypochromasia

Question 13

How can you measure hypochromasia?

Answer 13

MCH

Question 14

refers to RBC that have a bluish tinge

Answer 14

Polychromasia

Question 15

What are blue cells in polychromasia usually?

Answer 15

reticulocytes

Question 16

RBC that vary widely in shape

Answer 16

Poikilocytosis

Question 17

look like bulls-eyes

Answer 17

Target cells

Question 18

What does the differential diagnosis of target cells include?

Answer 18

1. Liver disease
2. Thalassemias
3. Hemoglobin C
4. After splenectomy

Question 19

have a loss of central pallor

Answer 19

Spherocytes

Question 20

When would you see spherocytes?

Answer 20

1. Hereditary spherocytosis

2. Autoimmune hemolysis

Question 21

red cell fragments with sharp edges

Answer 21

Schistocytes

Question 22

Schistocytes are the hallmark for which disease?

Answer 22

Microangiopathic Hemolytic Anemia (MAHA)

Question 23

These cells are seen in sickle cell anemia

Answer 23

Sickle cells

Question 24

What cells are included with sickle cell smears?

Answer 24

Target cells

Question 25

have small, regular projections

Answer 25

Echinocytes or burr cells

Question 26

This disorder of RBC shape is seen in renal disease where as this one is seen in liver disease

Answer 26

Renal- echinocytes Liver- acanthocytes

Question 27

have larger, irregular projections

Answer 27

acanthocytes or spur cells

Question 28

seen in myelophthisic processes, which are diseases of marrow infiltration

Answer 28

Teardrop cells

Question 29

In what diseases can you see teardrop cells?

Answer 29

1. Myelofibrosis 2. Tumor metastatic to marrow 3. Granulomatous diseases 4. Leukemias and lymphomas 5. Sometimes in massive splenomegaly

Question 30

peripheral, small round, purple inclusions within red cells that represent nuclear remnants;

Answer 30

Howell-Jolly Bodies

Question 31

What kind of cells can we see after a splenectomy?

Answer 31

1. Target cells 2. Achantocytes 3. Schistocytes 4. Nucleated red cells 5. Howell-Jolly Bodies

Question 32

linear arrangements of red cells typically described as "piles of coins on a plate"

Answer 32

Rouleaux

Question 33

this is typically seen in disorders with increased levels of immunoglobulin (multiple myeloma, Waldenstrom's macroglobulinemia) and severe hypo-albuminemia

Answer 33

Rouleux

Question 34

occrus when the red cells are coated with IgM, which is large enough to bridge two red cells

Answer 34

Agglutination

Question 35

What is the difference between agglutination and rouleux?

Answer 35

Rouleux is linear and orderly

Question 36

Hypchromic, microcytic cells; increased numbers of platelets can be seen with this anemia

Answer 36

iron deficiency anemia

Question 37

In this type of anemia, red cells are macrocytic and hypersegmented neutrophils can be seen

Answer 37

Megaloblastic anemia

Question 38

What types of cells are seen in autoimmune hemolytic anemia (AIHA)

Answer 38

polychromasia and microspherocytes