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pathology > CBC and Peripheral Blood Cell Morphology > Flashcards

CBC and Peripheral Blood Cell Morphology Flashcards

1
Q

What are the specimen requirements for a CBC?

A

EDTA anti coagulated blood (purple cap)

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2
Q

What cells are counted in a CBC?

A

WBCs; RBCs; platelets

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3
Q

In a CBC, the WBC count is reported in what unit?

A

thousands of cells/microliter ( x 10^3 / uL)

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4
Q

In a CBC, the RBC count is reported in what unit?

A

millions of cells/microliter (x 10^6 / uL)

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5
Q

In a CBC, the platelet count is reported in what unit?

A

thousands of cells/microleter (x 10^3 / uL)

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6
Q

In a CBC, Hemoglobin is reported in what unit?

A

grams per deciliter (g/dl)

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7
Q

In a CBC, Hematocrit is reported in what unit?

A

%

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8
Q

In a CBC, Mean cellular volume (MCV) is reported in what unit?

A

femtoliters, fl

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9
Q

In a CBC, Red cell distribution width (RDW) is reported in what unit?

A

RDW-CV is in %; RDW-SD in in fl

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10
Q

How do hematology analyzers sort RBC, WBC, and platelets?

A

by size, via electrical impedence or light scattering

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11
Q

When are manual methods of hematology analyzation used?

A

only when there is an abnormality flagged by the instrument as needing review (ex: platelet clump) or when the lab values don’t match the clinical situaiton

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12
Q

Hemoglobin uses ____ method for measurement

A

cyanmethemoglobin

note: gives the total hemoglobin concentration in a give volume of blood

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13
Q

____ is the percentage of the volume of whole blood that is comprised of RBCs

A

hematocrit

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14
Q

What is the equation for Hematocrit calculation?

A

Hct = MCV x RBC

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15
Q

In normal individuals with normal cell morphology, hematocrit is roughly ___X the hemoglobin, which is roughly __X the RBC count

A

3; 3

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16
Q

Mean cell volume (MCV) is the average volume of the RBCs. What is the equation for MCV?

A

MCV = Hct x 1000/RBC

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17
Q

In what evaluation is MCV useful

A

anemia

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18
Q

Mean cellular hemoglobin (MCH) is the weight of hemoglobin in the average RBC. What is the equation for MCH?

A

MCH = Hgb/RBC

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19
Q

Mean cellular hemoglobin concentration is the concentration of hemoglobin in the average RBC. What is the equation for this?

A

[MCH] = (Hgb/Hct) x 100

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20
Q

Red blood cell distribution width (RDW) is a measurement of what?

A

variation in size of the RBCs

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21
Q

Mean platelet volume is a measurement of what?

A

variation in size of platelets - indirect measure of the age of platelets

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22
Q

Differential (percentages) give you relative numbers, not absolute. Absolute cell counts are what matter. How are they calculated?

A

by multiplying % on the manual differential by the total WBC count

ex: Total WBC is 10.0 with 65% neutrophils, 10% lymphocytes, and 25% monocytes

absolute cell count: 6.5 (normal); 1.0 (normal), 2.5 (high)

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23
Q

What is thrombocytosis?

A

increased platelets

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24
Q

What is polycythemia?

A

increased RBCs

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25
Q

What is leukocytopenia?

A

decreased WBCs

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26
Q

What is anemia?

A

decreased RBCs

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27
Q

What does microcytic mean? macrocytic?

A

smaller than normal; larger than normal

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28
Q

What does Anisocytosis mean?

A

variation in size

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29
Q

What does Poikilocytosis mean?

A

variation in shape

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30
Q

What does anisopoikilocytosis mean?

A

variation in size AND shape

31
Q

What does normocytic mean?

A

normal amount of hemoglobin

32
Q

What does hypochromic mean?

A

decreased hemoglobin with pale staining

33
Q

What does polychromasia mean?

A

increased immature RBC; blue-gray cytoplasm due to residual RNA; normal amount of hemoglobin

34
Q

Each RBC has how many hemoglobin molecules?

A

650 million

35
Q

What is the purpose of the disc shape of the RBC?

A

to be able to pass through capillaries

36
Q

These cells are small and pale. Their zone of central pallor is > 1/3 the diameter of the cell. They are seen in iron deficiency, anemia, lead poisoning, and thalassemia.

A

microcytic hypochromic cells

37
Q

These cells are larger than normal (>8.5 um); well hemoglobinized; seen with young cells and in abnormal maturation states like megaloblastic anemia (B12 deficiency) and meylodysplastic syndromes

A

macrocytic cells

38
Q

These cells are smaller in diameter than normal, but spherical, with loss of central pallor. Bone marrow produces normal biconcave red cells, but these lose membrane during passage through the spleen. These cells have a shortened life span and are destroyed prematurely in the spleen.

A

spherocytes

note: can be caused by heredity or acquired through hemolytic anemia, burns, and post-transfusion

39
Q

What causes the hereditary and acquired forms of elliptocytosis/ovalocytosis?

A

heriditary: cytoskeleton abnormalities (defects in ankyrin, spectrin)
acquired: iron deficiency, thalassemia, megaloblastic anemia, myelodysplastic syndromes

40
Q

These are large, floppy cells with redundant cytoplasmic membrane compared to the volume of the cell. May be thinner than normal. Bell-shaped in bloodstream

A

target cells

41
Q

What are the causes of target cells?

A

macrocytic: liver disease
microcytic: thalassemia, iron deficiency
normocytic: sickling disorders, hgbE

42
Q

These are amoeboid cells with unevenly distributed spicules over the RBC surface, of unequal length

A

acanthocytes

43
Q

What causes acanthocytes? (inherited and acquired causes)

A

inherited: abetalipoproteinemia
acquired: liver disease, myelodysplastic syndromes, malnutrition

44
Q

These cells have evenly distributed spicules over the entire RBC surface, which are short and blunt. Resemble the echinoderms (sea urchins) with spiny projections.

A

echinocytes

45
Q

What causes echinocytes?

A

storage artifact
liver disease or renal failure
enzyme deficiencies

46
Q

These are “mouth cells”. Central zone of pallor is narrow, not round. Occasionally seen in healthy patients. Commonly associated with alcohol excess and alcoholic liver disease.

A

Stomatocytes

47
Q

These are RBC fragments formed as a result of mechanical disruption in the microvasculatrue by fibrin strands, platelet strands, toxins, burns, vasculitis, or mechanical heart valves.

A

schistocytes

48
Q

Homozygosity for hemoglobin S variant of beta chain of hemoglobin with a point mutation at position 6 (valine is substituted for glutamate) causes what disease?

A

SCA

49
Q

In regards to sickle cells, the spleen is ___ early in childhood but by adulthood is ____

A

enlarged; small

50
Q

Homozygosity for hemoglobin C variant of beta chain of hemoglobin with a point mutation at position 6 (glutamate replaced by lysine) causes what?

A

hemoglobin C disease

51
Q

Bite cells have the appearance of having a bite taken out of them. They are formed after ___ bodies are “plucked” out of the RBCs by the reticuloendothelial cells of the spleen

A

heinz

52
Q

Bite cells are typical of what type of deficiency?

A

Glucose-6-phosphate DH

note: doesn’t result in anemia unless the person is introduced to oxidant stress

53
Q

These cells are seen as a result of marrow fibrosis

A

teardrop cells

54
Q

This indicates reticulocytosis. Blue-gray color of RBCs is due to residual ribosomal material within the cytoplasm. seen in any condition that induces premature release of immature cells from the marrow.

A

polychromasia

55
Q

RBC inclusion: has small nuclear remnants, typically single, seen in post-splenectomy states, hemolytic anemias, megaloblastic anemia

A

Howell-Jolly bodies

56
Q

RBC inclusion: iron-containing mitochondrial remnants, seen in sideroblastic anemias, post-splenectomy states, lead poisoning, and reticulocytes, occur in small clusters near the periphery of the cell

A

pappenheimer granules

57
Q

RBC inclusion: composed of RNA, aggregates of ribosomes, seen in thalassemia, megaloblastic anemia, liver disease, lead poisoning, hemolytic anemia, dyserythropoietic states

A

basophilic stippling

58
Q

RBC inclusion: nuclear remnant versus microtubules, seen in post-splenectomy states, hemolytic anemias, megaloblastic anemia

A

cabot ring

59
Q

RBC abnormality: stacking of RBCs like coins, seen in high profile states like multiple myeloma

A

rouleaux

60
Q

Leukocyte: most abundant, multi lobular, fights bacterial infection

A

neutrophil

61
Q

leukocyte: largest, blue-gray cytoplasm, bilobed (horseshoe), seen in chronic inflammatory states

A

monocytes

62
Q

Leukocyte: spectrum of sizes, cytoplasm is agranular

A

lymphocytes

note: most peripheral are T cells

63
Q

Leukocyte: granulocyte, seen in parasitic infections, large round, bilobed

A

eosinophils

64
Q

Leukocyte: least abundant, dark cytoplasmic granules, seen in neoplastic conditions

A

basophils

65
Q

Abnormal leukocyte: inherited benign anomaly of failure of normal nuclear segmentation, bilobed nuclei, normal neutrophilic function

A

pelger-huet anomaly (hyposegmented neutrophil)

66
Q

Abnormal leukocyte: acquired abnormality seen in myelodsysplastic syndromes with bilobed or monologged nuclei, do not usually function as normal neutrophils

A

pseudo-pelger-huet (hyposegmented neutrophil)

67
Q

Abnormal leukocyte: seen with megaloblastic anemia, myelodysplastic syndromes, in some infections, and effects of some medications

A

hypersegmented neutrophils

68
Q

Abnormal leukocyte: coarse cytoplasmic granules seen in neutrophils in response to infection; due to presence of primary granules in cytoplasm

A

toxic granulation

69
Q

Abnormal leukocyte: inconspicuous geryish-blue areas in the cytoplasm that represent residual ribosomes; seen in infections

A

Dohle bodies

70
Q

Abnormal leukocyte: most commonly seen in response to acute viral infections; large lymphocytes with abundant blue pale cytoplasm, occasional fine red cytoplasmic granules

A

atypical lymphocytes

71
Q

rare autosomal dominant condition with abnormal condensations of RNA appearing as pale blue cytoplasmic inclusions in neutrophils, resemble Dohle bodies; large/giant platelets and thrombocytopenia, usually with no bleeding problems

A

May-Hegglin anomaly

72
Q

austosomal recessive disorder with abnormally large granules within leukocytes; partial oculocutaneous albinism, photophobia, immune deficiency, frequent pyogenic infections, and neurologic defects

A

Chediak-Higashi

73
Q

austosomal receissve disorder with no significant clinical abnormalities in most; deep purple granules in granulocytes, monocytes, and lymphocytes

A

Alder-Reily

74
Q

Autosomal recessive deficiencies of enzymes involved in breakdown of acid mucopolysaccharides; abnormal granulation of blood granulocytes and monocytes with lymphocyte vacuolation

A

Mucopolysacharidosis

pathology (10 decks)

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