Blood films Flashcards

1
Q

What are acanthocytes?

A

Spikes on RBCs due to unstable membrane

Caused by splenectomy, alcoholic liver disease, abetalipoproteinemia and spherocytosis

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2
Q

What is anistocytosis?

A

Variation in RBC size

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3
Q

Basophilic RBC stipling

A

Denatured RNA found in RBCs indicating accelerated erythropoesis or defective Hb synthesis.

Seen in lead poisoning, megaloblastic anaemia, myelofibrosis and malignant marrow infiltration

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4
Q

What are blasts in a blood film?

A

Nucleated precursor cells that should not normally appear in the peripheral blood film but do in leukaemia, myelofibrosis and malignant marrow infiltration

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5
Q

What are cabot rings?

A

Seen in pernicious anaemia, lead poisoning and bad infections

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6
Q

What are burr cells/ echinocytes?

A

RBC projections, less marked than acanthocytes

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7
Q

What are Howell-Jolly bodies?

A

DNA nuclear remnants in RBCs which are usually removed by the spleen, seen post splenectomy and in hyposplenism

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8
Q

What is a leukoerythroblast film?

A

Immature cells ± tear drop RBCs from haemolysis or marrow infiltration

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9
Q

What are pappenheimer bodies?

A

Granules of siderocytes containing iron

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10
Q

What is poikilocytosis?

A

Variation in RBC shape

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11
Q

What is olychromasia?

A

RBCs of different ages stain differently - young cells are more blue

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11
Q

What is rouleaux formation?

A

Stacks of RBCs, caused by infections, multiple myeloma, Waldenstrom’s macroglobulinemia, inflammatory and connective tissue disorders, and cancers. It also occurs in diabetes mellitus and is one of the causative factors for microvascular occlusion in diabetic retinopathy

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12
Q

What are schistocytes?

A

Fragmented RBCs - formed by mechanical destruction of RBCs by fibrin bands following clot formation

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13
Q

What is neutrophilia?

A

Increased neutrophils

  • Bacterial infections
  • Inflammation
  • Steroids
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14
Q

What causes neutropenia?

A
  • Viral infections
  • Drugs
  • Severe sepsis
  • Hypersplenism
  • Smoking
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15
Q

What causes lymphocytosis (increased lymphocytes)

A
  • Leukaemia and lymphoma (especially CLL)
  • EBV
  • Chronic infections e.g. TB
16
Q

What is hypereosinophilic syndrome?

A

Raised eosinophils for >6weeks, leads to organ damage

Treated with imatinib

17
Q

What is the function of a neutrophil?

A

Bacterial or fungal infection

Most common first responders to microbial infection

18
Q

What is the function of an eosinophil?

A

Parasitic infections and allergic reactions

19
Q

What is the function of basophils?

A

Allergic and antigen response (release histamine causing vasodilation)

20
Q

What is the function of lymphocytes?

A

Subtypes of white blood cell

Includes B cells, CD4+ T helper cells, CD8+ cytotoxic T cells

Primarily operate in the lymphatic system

21
Q

What is the function of monocytes?

A

Phagocytosis of pathogens, presentation of antigens to T cells

Eventually become tissue macrophages

Kidney shaped nucleus

22
Q

Which WBCs have bi or tri-lobed nuceli?

A

Basophils

23
Q

Which WBCs have multi-lobed nuclei?

A

Neutrophils

24
Q

What is haematopoiesis?

A

Production of the blood

25
Q

Where does haematopoiesis most commonly occur in adults?

A

Bone marrow

AKA medullary haematopoiesis

26
Q

What is extra-medullary haematopoeisis?

A

Haematopoiesis that occurs outside of the bone marrow e.g.liver, thymus and spleen

27
Q

Which bones are the most common sites of haematopoiesis?

A

Flat bones

  • Pelvis
  • Cranium
  • Sternum
  • Vertebrae
28
Q

Where does haematopoiesis occur in children?

A

Marrow of the long bones e.g. tibia and femur

29
Q

Where does haematopoiesis occur before birth?

A

Liver (mainly) and spleen

30
Q

What causes an increase in extramedullary haematopoiesis?

A

Infection - can promote liver, spleen and LNs to take part in haematopoiesis because of the need for more blood

Hence hepatomegaly and splenomegaly during periods of infection

31
Q

What do haematopoietic stem cells differentiate into?

A
  1. Common lymphoid progenitor cells
  2. Common myeloid progenitor cells
32
Q

What cells do common lymphoid cells differentiate into?

A

Lymphoblasts - become lymphocytes

Large lymphocytes = natural killer cells

Small lymphocytes = T and B cells

33
Q

Where do plasma cells come from?

A

B cells

34
Q

What do common myeloid progenitor cells differentiate into?

A
  • Myeloblasts e.g. neutrophils, eosinophils, basophils and monocytes
  • Megakaryocytes (in response to thrombopoietin from the liver and kidneys)
  • Erythroblasts (in response to EPO from the kidneys)
35
Q

Where do platelets come from?

A

Budding of megakaryocytes

36
Q

What appears on a full bloof count?

A
37
Q
A