Bloodfilm Review Flashcards
Stats of a Normal RBC
- Diameter: 6 - 8 µ
- Volume: 90 fL
- Biconcave disk
- Area of central pallor: 1/3 of cell
What does RBC morphology include?
- Size
- Color
- Shape
- Inclusions
- Distribution
Anisocytosis
Variation in cell size (look at MCV & MCHC)
- Normocytic
- Macrocytic
- Microcytic
Macrocytic
- Impaired DNA synthesis (B12/folate deficiency)
- Accelerated erythropoiesis (hemolysis)
- Increased cholesterol and lecithin (liver disease)
Microcytic
- Ineffective Fe utilization
- Decreased or defective globin synthesis
RBC Color morphology names
- Normochromic
- Hypochromic
- Hyperchromic
- Polychromasia
Hypochromic
Too little hemoglobin, large central pallor.
Grading Scale
1+ - Area of central pallor is ½ of cell diameter.
2+ - Area of central pallor is 2/3 of cell diameter.
3+ - Area of central pallor is ¾ of cell diameter.
4+ - Thin rim of hemoglobin
Hyperchromic
Too much hemoglobin. no central pallor
Polychromasia
Bigger, bluer. Follow up with reticulocyt count Grading scale:
Percentage of RBC that are Polychromatophilic
1+ - 3%
2+ - 5%
3+ - 10%
4+ - >10%
Grading Scale for Anisocytosis/ Poikilocytosis
Percentage of cells that differ in size or shape
Normal – 5%
Slight – 5-10%
1+ - 10-25%
2+ - 25 – 50%
3+ - 50 – 75%
4+ - >75%
Poikilocytosis
RBC Shape -Target cells -Spherocytes -Elliptocytes and ovalocytes -Stomatocytes -Sickle cells -Acanthocytes and echinocytes -Fragmented cells (schistocytes) -Teardrop cells
RBC Inclusions (seen via Wright stain)
-Howell-Jolly bodies -Basophilic stippling -Siderotic granules and Pappenheimer bodies -Nucleated RBC -Cabot rings -Hemoglobin C crystals -Parasites (malaria, etc.)
Examination of Peripheral Blood Smear
Low Power Scan (10x)
- stain quality
- distribution (agglutination/routeau)
- optimal area for differential and morphology
High Power Exam (40x)
- WBC estimate
- scan for abnormal
WBC Oil Immersion Examination (100x)
- 100 WBC differential count (WBC morphology, nucleated RBC correction)
- RBC morphology -platelet estimate
Target Cell
- look like targets or bulls eye
- disfunction in membrane (too much membrane)
Spherocytes
- hyperchromic (can’t see central palor)
- are more sperical, so they look smaller but they are actually the same volume as normal cell.
Elliptocytes
-elongated shape, two parellel sides
Ovalocytes
- oval (kinda egg shaped)
Stomatocytes
-mouth cells
Sickle Cells
Abnormal hemoglobin (Hem s) stretches the RBC membrane.
Acanthocytes
- Irregular spicules cells, looks like bart simpson hair on ONE side
Burr Cells (Echinocytes)
Regular spiculated, crenated cells. It might be artifact if the slide was prepared incorrectly.
Schistocytes
Red cell fragments. Seen in clotting, red blood cells go through a chain link fence and get shredded.
Teardrop
Howell Jolly Bodies
-nuclear fragments
Basophilic Stippling
Increased RNA precipitation. Looks like an equal distribution of inclusions.
Pappenheimer Bodies
AKA siderotic granules (iron). Grape like clusters of iron inclusions.
Nucleated RBC
should nnot be in peripheral blood, unless its a new borne baby.
Hb C Crystals
Crystals that are flat. You would see this in a person who has their spleen removed because the spleen takes care of these.
Malaria
malarial parasite = the dot with the ring around it
Agglutination
Rouleaux
