10.08.18 Peripheral Blood Flashcards
What is the thin edge we’re interested in looking at of the smear called?
Feathered edge
What are the peripheral smear slides stained with?
Wright Giemsa stain
RBC size should be about the size of _____
lymphocyte nucleus
The area of central pallor in RBC should be ____ of total RBC diameter
1/3
refers to RBC which vary widely in size
Anisocytosis
mathematically measures the range of RBC sizes
RDW
refers to red cells that are small
Microcytosis
What lab value helps determine microcytosis/macrocytosis?
MCV
What does the differential diagnosis of microcytosis include?
- Iron deficiency
- Thalassemias
- Lead poisoning
- Sideroblastic anemia
- Anemia of chronic disease (usually normocytic)
- Hemoglobin C disease and trait
refers to large RBC
macrocytosis
What does the differential diagnosis for macrocytosis include?
- B12/folate deficiency
- Liver disease
- Thyroid disease
- Chemotherapy
- Anti-retrovirals
- Aplastic anemia
- MDS
- Elevated reticulocyte count
refers to RBC that have too little hemoglobin
Hypochromasia
How can you measure hypochromasia?
MCH
refers to RBC that have a bluish tinge
Polychromasia
What are blue cells in polychromasia usually?
reticulocytes
RBC that vary widely in shape
Poikilocytosis
look like bulls-eyes
Target cells
What does the differential diagnosis of target cells include?
- Liver disease
- Thalassemias
- Hemoglobin C
- After splenectomy
have a loss of central pallor
Spherocytes
When would you see spherocytes?
- Hereditary spherocytosis
2. Autoimmune hemolysis
red cell fragments with sharp edges
Schistocytes
Schistocytes are the hallmark for which disease?
Microangiopathic Hemolytic Anemia (MAHA)
These cells are seen in sickle cell anemia
Sickle cells
What cells are included with sickle cell smears?
Target cells
have small, regular projections
Echinocytes or burr cells
This disorder of RBC shape is seen in renal disease where as this one is seen in liver disease
Renal- echinocytes
Liver- acanthocytes
have larger, irregular projections
acanthocytes or spur cells
seen in myelophthisic processes, which are diseases of marrow infiltration
Teardrop cells
In what diseases can you see teardrop cells?
- Myelofibrosis
- Tumor metastatic to marrow
- Granulomatous diseases
- Leukemias and lymphomas
- Sometimes in massive splenomegaly
peripheral, small round, purple inclusions within red cells that represent nuclear remnants;
Howell-Jolly Bodies
What kind of cells can we see after a splenectomy?
- Target cells
- Achantocytes
- Schistocytes
- Nucleated red cells
- Howell-Jolly Bodies
linear arrangements of red cells typically described as “piles of coins on a plate”
Rouleaux
this is typically seen in disorders with increased levels of immunoglobulin (multiple myeloma, Waldenstrom’s macroglobulinemia) and severe hypo-albuminemia
Rouleux
occrus when the red cells are coated with IgM, which is large enough to bridge two red cells
Agglutination
What is the difference between agglutination and rouleux?
Rouleux is linear and orderly
Hypchromic, microcytic cells; increased numbers of platelets can be seen with this anemia
iron deficiency anemia
In this type of anemia, red cells are macrocytic and hypersegmented neutrophils can be seen
Megaloblastic anemia
What types of cells are seen in autoimmune hemolytic anemia (AIHA)
polychromasia and microspherocytes
