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HEMA1 > 3 - HEMA > Flashcards

3 - HEMA Flashcards

1
Q

CRITERIA FOR PATHOLOGIC RBC

A

 Size (7-8 um)
 Variation in size (80-100 fL)
 Area of Central Pallor (1/3 & clear)
 Cytoplasm (clear w/out inclusion)

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2
Q

increase in variation in size thus increasing RDW a measure of variation in size

A

ANISOCYTOSIS

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3
Q

Refers to variation in color after staining which is related to the hemoglobin content of the cell, since it is the
hemoglobin that takes up the stain wherein the appearance of the cell after staining is directly proportional to
the hemoglobin content

A

ANISOCYTOSIS

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4
Q

Biconcave disc

A

NORMOCYTE

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5
Q

 Not all cells are normal there is a classification
known as normocytic anemia which are normal
in size (MCV: 80-100) but there is anemia which
is related to the decrease in production

A

NORMOCYTE

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6
Q

 Smaller RBCs
 Diameter: <7 µm
 MCV= <80 fL

A

MICROCYTE

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7
Q

Note: It is efficient to use MCV because diameter depends on the smear prepared.

A

MICROCYTE

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8
Q

Main cause: Any defect in heme or globin that
results in IMPAIRED HB SYNTHESIS thus cells
undergo extra division & the cells hardly
reached its optimum MCHC

A

MICROCYTE

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9
Q

Main cause: Any defect in heme or globin that
results in IMPAIRED HB SYNTHESIS thus cells
undergo extra division & the cells hardly
reached its optimum MCHC

A

MICROCYTE

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10
Q

Develops from:
o ineffective iron utilization, absorption, or release
o decreased or defective globin synthesis

A

Microcyte

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11
Q

Microcyte disease:

Affects the heme

A

IRON DEFICIENCY ANEMIA

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12
Q

Microcyte diseases:

iron precipitate due to protoporphyrin 9
deficiency leading to siderotic granules
& its occurrence in RBC appears as
sideroblast

A

Sideroblastic anemia

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13
Q

Microcyte diseases:

iron precipitate due to protoporphyrin 9
deficiency leading to siderotic granules
& its occurrence in RBC appears as
sideroblast

A

Sideroblastic anemia

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14
Q

inhibits enzymes (heme synthase) in heme
synthesis

A

Lead poisoning

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15
Q

 Larger than 10 µm diameter due to failure of mitosis
 Diameter: >9 µm
 MCV= >100 fL

A

Macrocyte

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16
Q

fast RBC prod. Until faster release of reticulocyte in circulation as a compensation to blood loss or
lysis. If patient suffers from blood loss or lysis,
blood cell count decreases causing hypoxia &
the kidneys will produce increase erythropoietin causing acceleration of erythropoiesis thus the bone marrow will release even immature reticulocytes (stress/shift reticulocytes) thus it is larger in size

A

Accelerated erythropoiesis

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17
Q

MACROCYTE DISEASE:
affects nuclear maturation resulting to nuclear arrest which is prolonged mitosis due to immaturity of nucleus which is the central control of the cell due to deficiency in DNA synthesis thus it undergoes slow maturation & mitosis leading to large cells; failure of division

A

Defective DNA synthesis

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18
Q

bone marrow compensates for the blood loss or lysis by producing immature RBC thus high
reticulocyte count

A

Hemolytic anemia and acute blood lose

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19
Q

Macrocyte disease:

affected by impaired DNA synthesis because cells fail to divide or suffer from long mitosis resulting to oval macrocytes

A

Megaloblastic anemia

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20
Q

Macrocyte disease:

the chemical infused to destroy the malignant cells often target the DNA of cell thus affecting DNA

A

Chemotheraphy

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21
Q

increase cholesterol lipids causing loading to phospholipid bilayer

A

Liver disease

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22
Q

Presence of 2 distinct populations of red cells that may differ in size, shape or hemoglobin content thus it may be a mixture of hypochromic cell & normochromic cell or a microcytic cell or macro

A

Dimorphic RBC

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23
Q

Dimorphic RBC is seen in

A

ANEMIA AFTER TRANSFUSION

IRON DEFICIENCY DURING THERAPY

IRON DEFICIENCY & VIT. B12

COMBINED VIT. B12 /FOLATE

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24
Q

ANEMIA AFTER TRANSFUSION

after transfusion, on the examination of
patient’s blood smear, there is 2 population of cell, the patient RBC & transfused RBC, the cells are pale (______________) & ____________, mixed w/ the
transfused blood _________________________

A

Hypochromic and microcytic, normocytic & normochromic

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25
Q

 variation in the hemoglobin concentration
 absence of uniformity of color
 directly relates to Hb
 Color of cells when stained depends on the Hb

A

ANISOCHROMASIA

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26
Q

Normochromic measures what?

A

MCHC

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27
Q

RBCs show central pallor (exceeds 1/3 of the diameter of the red cell)

A

Hypochromic

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28
Q

Very hypochromic cells

A

ANULOCYTE/ GHOST CELLS

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29
Q

Thin & poorly hemoglobinized cells.

A

Ghost cells or anulocyte

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30
Q

Cells that lack central pallor and with reduced diameter

A

Spherocytic

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31
Q

 Defects in the cytoskeletal proteins

A

Spherocytosis

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32
Q

Central pale area is filled with hemoglobin
resulting to bulls eye & further surrounded by thin rim of Hb

A

Target cells

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33
Q

there is protrusion on the center

A

Target cells

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34
Q

PROBLEM: difference in RNA & Hb among RNA & Hb

A

Polychromasia

35
Q

Polychromasia:

Refers to the display of different shades of color which is _____________ of RBCs & is not directly related to Hb content

A

Diffused bluish-gray tint

36
Q

Polychromasia:

Exemplified by the fifth stage of erythropoiesis: reticulocytes which is the first non-nucleated stage but it has ______________ & is fully hemoglobinized

A

remnants of RNA

37
Q

Polychromasia:

_________ precipitate the RNA thus they appear as ___________ against ___________. The granules appear in a network or reticulum thus called ___________.

A

Supravital stains, dark blue precipitate, pale blue cytoplasm, reticulocytes

38
Q

increase variation in shape ; named after their shape

A

Poikilocytosis

39
Q

maintain shape & size of the cell, preventing it from collapsing

A

Proteins

40
Q

main fluid barrier

A

Lipids

41
Q

 Range from egg-shape, slightly oval to sausage, rod, or pencil forms
 Despite of their shape they function normally depending on their hemoglobin content, flexibility & deformability

A

Ovalocytes

42
Q

Ovalocytes:

Some are ovals and macrocytic which is a significant observation in _____________.

A

Megaloblastic anemia

43
Q

A disease characterized by a decrease in skeletal membrane CHON band 4.1

A

Hereditary elliptocytosis

44
Q

Hereditary elliptocytosis is characterized by a decrease in skeletal membrane _____________.

A

CHON band 4.1

45
Q

A disease characterized by an increase heat sensitivity of spectrin.

A

Hereditary elliptocytosis

46
Q

Diseases that causes ovalocytes.

A

 Myelodysplastic syndrome
 Thalassemic syndrome
 Megaloblastic syndrome – megaloblastic

47
Q

Hb appears to be concentrated at the two ends of the cell, leaving a normal central pallor area.

A

Ovalocytes

48
Q

____________ can be found on the surface or inner surface underlying the phospholipid layer, these proteins are connected to the transmembrane proteins & phospholipid bilayer which adds on the integrity thus deficiency in _________________ will alter the membrane thus deformed.

A

Peripheral proteins, spectrins, protein 4.1, 4.2

49
Q

Smaller in diameter than normal RBC & w/ smaller volume because it is fully distended due to increase hb

A

Spherocytes

50
Q

Spherocytes indicates a ____________ thus it cannot enter onto the microcirculation & as they enter they immediately burst or lyse

A

hemolytic process

51
Q

Hereditary spherocytosis is characterized by __________________________________.

A

protein or spectrin abnormality, deficiency in ankyrin or protein band 3.

52
Q

In hereditary spherocytosis, ___________ is
connected to the integral protein, ___________ underlies the phospholipid bilayer, these add to the integrity of phospholipid bilayer thus a deficiency in these protein will make the phospholipid bilayer, weaker, & some of portion of phospholipid will be easily detached into the form of microvesicles.

A

Spectrin dimer, ankyrin

53
Q

In spherocytosis, a deficiency of this leads to uncoupling of phospholipid layer and some lipids will be easily detached into the form of _______________.

A

Spectrin, ankyrin, protein band 3, microvesicles

54
Q

Another cause of spherocytes is ______________. Ab to the red cell will attached to the red cell w/ their FC portion exposed which will be recognized by macrophages that have Fc receptors on their receptors & they pit off. Macrophages pull off Ab attached on RBC but as it pulls off, it removes portion of RBC. The remaining fragment of RBC will reseal to form a smaller cell w/ a filled volume. Repeated pitting may occur resulting to microspherocyte.

A

Autoimmune hemolytic anemia

55
Q

Spherocytosis:

NORMAL AGING PROCESS:
lose enzymatic properties & will lack ATP caused by decreased in enzymatic activity of enzymes involve in Embden Meyerhof pathway resulting to lack of ability to maintain their shape & size. Na/K ATPase needs ATP for activity thus when cell lacks ATP, this can no longer be maintained & transport of Na/K is compromised & as an effect the cell can be ________________.

A

crenate or distorted.

56
Q

No abnormality but shows a lot of spherocytes.

A

Storage phenomenon

57
Q

Resembles sea urchin.

A

Echinocyte

58
Q

Crenation occurs in vitro and an artifact and insignificant which may be seen on thinner part of the cells.

A

Echinocytes

59
Q

Echinocyte has an evenly distributed, uniformly sized ___________ blunt spicules or bumps.

A

10-30 blunt spicules

60
Q

Both cells are reversible.

A

Echinocyte and burr cell

61
Q

Clinically significant which indicates a change in the plasma tonicity.

A

Burr cell

62
Q

Crenation occurs in VIVO.

A

Burr cell

63
Q

Burr cell is reversible in formation, when patient underwent _______ thus _______ is cleared out from the plasma maintaining the normal tonicity of plasma.

A

dialysis, NPN

64
Q

BURR CELL
1. Occur in situations that cause a change in tonicity (hypertonic) of the intravascular fluid plasma seen in ______________________________.

A

dehydration & azotemia related to uremia

65
Q

In renal insufficiency the kidneys cannot function, resulting to non-removal of metabolic products such as the non-protein nitrogenous substances, blood urea nitrogen & creatinine, these substances builds up in the blood altering the tonicity thus cells will crenate while still in the intravascular fluid. What cell will be produced?

A

Burr cell

66
Q

RULE: The ___________ indicates the severity of _________.

A

no. of burr cell, renal damage

67
Q
  1. Several hours old anticoagulant blood stored at room temperature causing an artefactual effect due to prolonged storage at prolonged temperature
  2. Stored blood causes crenation of cell due to depletion of ATP & biochemical activities
A

Echinocytes

68
Q

Irreversible formation which Indicates permanent
membrane damage, some are long & short thus it
indicates that the cell can no longer regain its normal shape

A

Acanthocytes

69
Q

What causes acanthocytes?

A

Changes in cholesterol, lecithin & sphingomyelin

70
Q

Cell that is associated with end stage liver disease.

A

Acanthocytes

71
Q

Congenital abetalipoproteinemia is a condition wherein there is an absence of betalipoprotein which is related to the inability of the liver to metabolize it. What cell is related to this disease?

A

Acanthocytes

72
Q

Vit. E is needed for preventing ______________ of the cell membrane

A

peroxidase oxidation

73
Q

fully hydrated cell due to defect in the transport of Na/K ATPase ans is swollen cell due to increase water content.

A

Stomatocytes

74
Q

Membrane defect that results in high cellular sodium and low potassium content

A

Stomatocytes

75
Q

Common cause of stomatocytes.

A

Hereditary

76
Q

main problem in the transport of Na/K. Due to defect in the transport of Na/K, there is high cellular Na thus water enters into the cell & the cell becomes hydrated & low K.

A

HEREDITARY STOMATOCYTOSIS

77
Q

This is characterized by the absence of this specific component which is located in the cell membrane which also affects the maintenance of RBC thus transport of Na/K is altered leading to
stomatocytosis.

A

RH Null disease

78
Q

Has a bulls eye, w/ a button or concentrate Hb thus a dark center followed by clear Hb area & followed by thin rim of Hb

A

Target cells

79
Q

 bell-shaped (codon) or tall hat shaped on SEM
 resembles a tall Mexican hat cell on SEM

A

Target cells (codocytes)

80
Q

 Increase in cholesterol & phospholipids
 Excess surface area to volume ratio

A

Target cells (codocytes)

81
Q

Codocytes can be seen in blood smear due to slow drying due to humid environment causing Hb to crystallize at the center & dissolve forming a
concentrated Hb at the center resulting to a target cell. What do you call this?

A

Drying artefact

82
Q

PLATICYTES - On front view, it appears as a flat cell
LEPTOCYTE – remains connected w/ the peripheral Hb but clinical significance is the same

A

Platicytes, Leptocyte

83
Q

ACANTHOCYTE:
TEARDROP CELL:
BURR CELL:
TARGET CELL: non-specific

A

abetalipoproteinemia, myelofibrosis, renal disorder,

84
Q

Very significant
finding indicating a
hemolytic anemia

A

Schistocytes

HEMA1 (3 decks)

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