ANISOCHROMASIA

Question 1

1. very hypochromic cells which has thin and poorly hemoglobinized cells
   - aka
2. not all ____ are ______ but all _____ are ______
3. cells that lack central pallor
   - aka
4. central pale area is filled with hemoglobin resulting to bulls eye
5. cells have high affinity to dyes
   - hemoglobin takes up the _____ dye
   - rRNa takes up the the ____ dye
6. two supravital stains that is appropriate staining of living reticulocyte & the cells will appear as larger cells w/ granules (RNA)

Answer 1

1. ANULOCYTE
   - GHOST/ SHADOW CELLS
2. not all hypochromic cells are microcytic but all microcytic cell are hypochromic
3. SPHEROCYTIC
   - HYPERCHROMIC
4. TARGET CELLS
5. POLYCHROMASIA
   - ACIDIC DYE
   - BASIC DYE
6. new methylene blue & brilliant cresyl blue

Question 2

HYPOCHROMIA GRADING
1+
2+
3+
4+

POLYCHROMASIA GRADING
Slight
1+
2+
3+
4+

Answer 2

HYPOCHROMIA GRADING
1/2 of cell diameter
2/3 of cell diameter
3/4 of cell diameter
thin rim of Hgb

POLYCHROMASIA GRADING
1%
3%
5%
10%
>11%

Question 3

POIKILOCYTES & CRYSTALS SECONDARY TO ABNORMAL HEMOGLOBIN CONTENT

1. most insoluble of the Hb variants
   - aka
2. w/ one or more
   fingerlike, blunt-pointed projections
3. both ends are blunt and & rectangular ; hexagonal
   - formed within ____ but does not deform rbc
   - crystals when hb is ___ or _____

Answer 3

1. SICKLE CELL
   - DREPANOCYTES
2. HB SC CRYSTAL
3. HB CC CRYSTAL
   - RBC MEMBRANE
   - OXYGENATED or DEHYDRATED

Question 4

INCLUSIONS: ABNORMAL HEMOGLOBIN PRECIPITATION

1. inclusions on RBC periphery (distorts the membrane) depending on the oxidation
   - most common disorder associated w/ this cell
   - chemical that causes accumulation of oxidized Hb
   - abnormal Hb prone to precipitation & oxidation, unstable Hb
2. golf ball w/ pits
   when numerous in RBC which is small greenish blue
   - abnormal hb has 4 polypeptide chains as B occurs when __ chain is not completely synthesize
   - so its thalassemia is ___

Answer 4

1. HEINZ BODIES
   - G-6-PDH DEFICIENCY ANEMIA
   - sulfonamides
   - ZURICH & KOLN HB
2. HB H INCLUSIONS
   - ALPHA CHAIN
   - ALPHA THALASSEMIA

Question 5

INCLUSIONS: ABNORMAL HEMOGLOBIN PRECIPITATION

1. an nuclear fragment which appears singly & is off the center but not at the periphery
   - tiny inclusion w/ __um
   - stains for DNA (2)
   - seen when there is increase of _____
   - spleen w/ decreased function thus unable to remove inclusion
   - caused by abnormal nuclear dissolution
2. Reddish-violet thread- like that assumes a loop, or an incomplete ring or a figure of 8
   - remnants of ___ of Mitotic spindle
   - this is a ___ finding

Answer 5

1. HOWELL-JOLLY BODY
   - <1um
   - Feulgen & Methyl Green Pyronin stains
   - karyorrhexis
   - FUNCTIONAL HYPOSPLENIA
   - megaloblastic anemia
2. CABOT RING
   - microtubules
   - non-specific

Question 6

INCLUSIONS: ABNORMAL HEMOGLOBIN PRECIPITATION

_____: faint blue coccoid bodies that aggregate in small clusters at the periphery of the cell
1. stained w/ _____ = _____
2. stained w/ _____ = _____
3. sometimes appear as ____
4. diseases associated with this
- red cell cannot make use of iron due to deficiency in protoporphyrin 9 thus iron precipitate & becomes siderotic granules
- affects enzymes in heme synthesis

_____: granules, multiple, uniform and evenly distributed as fine dots or large granules

1. often confused with _____
   - their difference is that ___ is positive in Prussian blue but _____ is not
2. appearance:
   - granules are much more outlined and easily distinguished & larger
   - coalescing into smaller forms
   - granules are fine blue dusting
3. aggregates of ___ & ____ remnants thus acidic in component due to they took the basic dye
4. deficiency in what enzyme

Answer 6

PAPPENHEIMER BODIES
1. Perl’s Prussian Blue = Siderotic granules
2. Wright/Giemsa = Pappenheimer bodies
3. Ringed sideroblast
4.
- SIDEROBLASTIC ANEMIA
- ALCOHOLISM

BASOPHILIC STIPPLING
1. PAPPENHEIMER BODIES
- pappenheimer is positive in Prussian blue but basophilic stippling is not
2. appearance:
- COARSE
- PUNCTATE
- DIFFUSE
3. ribosomes & mitochondrial
4. PYRAMIDINE-5 NUCLEOTIDASE DEFICIENCY

Question 7

ABNORMAL RED CELL DISTRIBUTION

1. Clumping of RBCs
   - indication of ___ rxn
   - presence of Abs on RBC surface produced by patient (____) or from different person (____)
2. Linear alignment of RBCs appearing as stack of coin
   - due to destruction of ____
   - increased conc of _____
   - plasma protein component is altered resulting to alteration of the negative charges surrounding the RBC
   - which is seen in (2)
   - most affected plasma cell in multiple myeloma will produce excessive ___

Answer 7

1. AGGLUTINATION
   - Ag-Ab reaction
   - patient (autoAb; different person (isoAb
2. ROULEAUX
   - zeta potential_
   - globulin
   - HYPERPROTEINEMIA’S
   - Multiple myeloma & Waldenstrom’s macroglobulinemia
   - IgM

Question 8

PROTOZOAN INCLUSIONS
1. Obligate intraerythrocytic parasites
- w/ ___ stage
- leaves behind a pigment called
**pigments inside the infected rbc
- P. vivax
- P. falcifarum
- P. malariae
- P. ovale
2. Parasite of cattle’s causing red fever on cattle’s
- w/ ___ in RBC

Answer 8

1. MALARIAL INCLUSION
   - hepatic stage (liver)
   - hematin or hemozoin pigment
   **pigments inside the infected rbc
   - P. Schuffners dots
   - P. Maurer’s dots
   - P. ziemann’s dots
   - P. james dots
2. BABESIA PARASITE
   - ring forms

Question 9

ARTIFACTS:

FIXATIVE
1. When fixative is contaminated w/ water which must be ______
2. effects
- ___ in red cells
- ____: caused by blowing leading to spicules

HEAT
1. Red cell bud off into vesicles which might be reported _____
2. ___ disintegrate
3. Proteins coagulate producing small weak basophilic particles which are similar to _____

Answer 9

FIXATIVE
1. water free methanol
2. effects
- Refractile rings
- Mouth eaten cells

HEAT
1. microspherocytes
2. WBC
3. Platelets