49/50: Pathology of RBC I & II - Fang Flashcards
immature RBC =
reticulocyte
before reticulocyte= normoblast
after reticulocyte = mature erthyrocyte
marker of effective erythropoiesis
reticulocyte
normal below 3%
reticulocyte count is falsely increased in…
anemia
corrected retic count = patient Hct/45 x retic count
normal RBC size =
nucleus of lymphocyte
normal MCV
80- 100 fL
components of CBC
Hb Hct PCV (packed cell volume) RBC count including: MVC, MCH (mean corpuscular hemoglobin), MCHC (mean corpuscular hemoglobin concentration) RDW (red cell distribution width) WBC count including TLC (total leukocyte count) and Diff Platelet count PBS (peripheral blood smear)
normal hemoglobin
11-15 female
12-16 male
MCV less than 80
microcytic anemia
iron deficiency (most common)
sideroblastic anemia (least common)
anemia of chronic disease (ex: renal failure)
thalassemia
most common microcytic anemia
iron deficiency
lab tests in microcytic anemia
serum iron
TIBC
% saturation
serum ferritin
single best test for iron studies
serum ferritin
circulating fraction of storage iron
most common type of auto-immune hemolytic anemia
SLE
warm v. cold auto-immune hemolytic anemias
warm - IgG
cold- IgM and complement
hemolytic transfusion reaction and hemolytic disease of newborn =
allo-immune
difference between direct and indirect coombs test *****
direct - use pt RBC
used to determine whether pt with hemolysis have an immune etiology
indirect - use pt serum
used to identify clinically significant red cell alloantibodies that are important in choosing compatible blood products
DAT and IAT are used to detect red cell antibodies on _____ and in the _________, respectively
RBC
serum
decreased RBC mass affecting tissue oxygenation
anemia
- low Hb or low Hct
sign on underlying disease rather than a specific diagnosis
zone of central pallor =
1/3 diameter of RBC
variation in size =
variation in shape =
anisocytosis
poikilocytosis
polychromasia
alteration of color of the RBC
sign of cellular IMMATURITY
large size and bluish hue due to their RNA content
nucleated RBC in PBS?
normoblastemia –> hemolytic anemia
spherocytes (not biconcave) = (2) reasons
hereditary spherocytosis
OR
autoimmune hemolytic anemia
schistocytes =
- microangiopathic hemolytic anemias (DIC, TTP, HUS)
or other hemolytic anemias
coarse smaller purple dots in the RBC =
basophilic stippling/ punctate basophilia
cause: severe anemia caused by lead poisoning sever infection drug exposure alcoholism
child eats lead paint, feels lethargy, etc…
severe anemia caused by lead poisoning
PBS will show basophilic stippling
howell-jolly bodies =
red cell inclusion which are residual nuclear fragments
see in hemolysis, megaloblastic anemia, post splenectomy
indicate absence of spleen or hemolysis
howell-jolly bodies
defects in heme synthesis microcytic anemias
iron deficiency
anemia of chronic disease
sideroblastic anemias
defects in synthesis of globin chains microcytic anemias
a and b thalassemias
microcytotic hypochromic anemia
iron deficiency anemia
common causes of macrocytic anemia (MCV > 100)
Vit B12/folate deficiency
alcohol use
liver disease
retiuclocytosis
uncommon causes: myelodysplastc syndrome, HYPOTHYROIDISM
pathogenesis of macrocytic anemias
- defective DNA synthesis
- increased RBC membrane
