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Final Exam > Chap 16 > Flashcards

Chap 16 Flashcards

RBC Morphology

1
Q

RBC morphology is examined via?

A

Wright stained blood smear.

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2
Q

What are the 5 morphological features of RBCs examined?

A

Size
Color
Shape
Inclusions
Distribution

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3
Q

What 2 morphological features correlate W/ red cell indices?

A

Size and Color

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4
Q

A normal mature RBC is?

A

Normochromic-normal color 1/3 of RBC empty

Normocytic- Normal Size 7-8um (MCV=80-100fL)

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5
Q

Discocyte

A

normal RBC survival of 120 days, depending upon maintaining the RBC shape.

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6
Q

What is the main Hgb type in normal RBCs?

A

Hgb A

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7
Q

(T or F) Normal RBC morphology is not quantitated?

A

True

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8
Q

Normocytic RBCs MCV?

A

82.0-98.0 fL

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9
Q

Normocytic RBCs RDW?

A

< or = 14.0%

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10
Q

A uniform RBC size would indicate the the RBC population is?

A

Homogeneous

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11
Q

Anisocytosis

A

Heterogenous RBC population

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12
Q

Anisocytosis has a high?

A

RDW >14.0%

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13
Q

Dimorphic RBC Population means?

A

The RBC population is heterogeneous or is made of 2 different cell populations.

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14
Q

A dimorphic RBC population would cause what RBC indice to be falsely normal?

A

MCV

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15
Q

Anisocytosis is classified as being w/?

A

Microcytic or Macrocytic

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16
Q

Normal Color of RBCs is called?

A

Normochromic

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17
Q

Normochromic MCHC is?

A

32-36%

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18
Q

Hypochromic

A

less Hgb coloring the cell, MCHC <32.0%

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19
Q

Poikilocytosis

A

Abnormal RBC shape, Rigid RBCs.

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20
Q

Spherocyte

A

No longer biconcave discs, slightly smaller, Hyperchromic, Little to no are of central pallor due to being overfilled w/ Hgb.

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21
Q

Spherocyte MCHC is?

A

> 36%

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22
Q

Spherocyte MCV is?

A

Within normal range

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23
Q

Hereditary Spherocytosis

A

Red cell membrane defect due to deficiency of Spectrin, Ankyrin, or Band 3 protein.

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24
Q

What happens to the membrane of an RBC, in a PT W/ Hereditary Spherocytosis?

A

The skeletal lipid bilayer is uncoupled, resulting in membrane loss.

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25
Q

Autoimmune Hemolytic Anemia

A

end result of the coating of RBCs W/ IgG and/or Complement proteins.

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26
Q

Acanthocytes (Spur Cells)

A

Between 3-12 thorny projections of uneven length along cell membrane.

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27
Q

What is the specific mechanism for the formation of acanthocytes?

A

Unknown

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28
Q

What is increased in acanthocytes?

A

Cholesterol to Phospholipid ratio.

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29
Q

What are the possible pathologies of a PT W/ Acanthocytes?

A

Alcohol Intoxication
Pyruvate Kinase (PK) deficiency
Congenital Abetalipoproteinemia
Vitamin E Deficiency
Post-Splenectomy

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30
Q

Echinocytes (Burr Cell, Crenated Cells)

A

Sea-urchin cells that can develop as a result of allowing blood to stand for prolonged time.

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31
Q

When a freshly made blood film has the presence of Burr Cells what could it indicate?

A

Renal Disease
Dehydration as a result of severe gastroenteritis.
In larger #s, are a artifact of sample contamination.

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32
Q

“True” Burr Cells (Echinocytes) occur in small numbers in what pathologies?

A

Uremia
Heart Disease
Stomach Cancer
Bleeding Peptic Ulcers
PTs W/ untreated Hypothyroidism
Liver Disease
Renal Disease
Burn PTs

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33
Q

When can Burr Cells appear in any situation?

A

Changes in tonicity of the intravascular fluid (Dehydration).

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34
Q

What separates spherocytes and acanthocytes from Burr cells, in appearance only?

A

Spherocytes and Acanthocytes have no pallor.

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35
Q

Codocytes (Target Cells)

A

Bell-shaped, thin-walled cells W/ increased surface area compared to volume.

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36
Q

Pathologies associated W/ Target Cells?

A

Liver Disease
Thalassemias
Hyposplenism
Some abnormal Hgb (Hgb S)

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37
Q

Drepanocyte (Sickle Cells)

A

Deoxygenated RBC that becomes a crescent or sickle-shaped.

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38
Q

Which pathology are Sickle cells seen in?

A

Abnormal Hb S
SCD
Sickle Cell Trait

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39
Q

What causes Hb S?

A

Replacement of glutamic acid W/ valine @ the 6th position on the Hgb B-chain.

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40
Q

What deforms the RBC?

A

Precipitation of polymerized Hb S.

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41
Q

Characteristic of SCD is?

A

Double-Heterozygote disorder

42
Q

C Crystals?

A

RBCs contain Hb C

43
Q

SC Crystals?

A

RBCs contain Hb S and Hb C

44
Q

Sickle Cells?

A

RBCs contain Hb S.

45
Q

What cell is always present W/ sickle cells?

A

Target Cells

46
Q

What is the shape of SC Crystals?

A

Bizarre

47
Q

Elliptocytes (Cigars, Ovalocytes)

A

Oval or cylindrical shaped, biconcave disc.

48
Q

Both oval and cylindrical shaped elliptocytes, have quantitative and qualitative abnormality of which 2 major membrane proteins?

A

Skeletal proteins Spectrin and Protein 4.1.

49
Q

Incidence of Elliptocytes seen in a normal PB smear?

A

5%

50
Q

Percentage of Elliptocytes seen in Hereditary Elliptocytosis?

A

Between 30-100%

51
Q

What type of anemia are Elliptocytes a feature of?

A

Iron Deficiency Anemia (IDA)

52
Q

Dacryocytes (Teardrops)

A

Single, elongated extremity.

53
Q

Characteristic feature of which disorders?

A

Leukoerythroblastic Disorders
(I.E. Myelofibrosis or Metastatic Carcinoma)
Thalassemias
Megaloblastic Anemia

54
Q

Stomatocytes (The mouth, Stomas)

A

Bowl-shaped RBCs W/ a slit-like area of pallor.

55
Q

Stomas are associated W/?

A

Alcoholism
Hereditary Stomatocytosis
S.E. Asian Ovalocytosis

56
Q

What is the cause of Hereditary Stomatocytosis?

A

A membrane deficiency of protein 7.2b or stomatin, resulting in sodium influx into cell and potassium exiting the cell.

57
Q

The MCV of a PT W/ Hereditary Stomatocytosis is?

A

High, about 130 fL

58
Q

(T or F) Stomas can occur as an artifact?

A

True

59
Q

Schistocytes (Schistos)

A

Fragmentation due to a loss of a piece of the cell membrane, may or may not contain Hgb.

60
Q

Schistocytes include?

A

Burr Cells
Helmet Cells
Schistos

61
Q

How many pathways can lead to fragmentation for Schistocytes?

A

2 pathways

62
Q

1 Pathway of schistocytes fragmentation?

A

Alteration of normal fluid in circulation
(Vasculitis, Malignant Hypertension, Heart Valve replacement).

63
Q

What is the intrinsic pathway of fragmentation in Schistocytes?

A

Defects of RBCs that make it less deformable (Spherocytes and Antibody-covered RBCs).

64
Q

Dangocytes (Bite Cells)

A

Formed when Heinz Bodies (HBs) are removed from cell.

65
Q

Bite cells are characteristic of what?

A

Oxidant Hemolysis

66
Q

What pathologies are bite cells seen it?

A

G6PD Deficiency
Oxidative Drug use (Dapsone, Salazopyrin, Anti-malarial Drugs)

67
Q

Keratocytes ( Blister Cell, Helmet Cell)

A

Appear W/ horns or helmet W/ chin straps.

68
Q

What pathologies are associated W/ Helmet Cells?

A

Trauma, especially cellular damage from contact with fibrin strands.

69
Q

(T or F): RBC inclusion reduce RBC deformity?

A

True

70
Q

Basophilic Stippling

A

Fine, medium, or coarse blue granules W/ uniform distribution w/n the RBC.

71
Q

Basophilic Stippling represents ribosomal RNA which is precipitated during?

A

Staining

72
Q

Conditions/diseases Basophilic Stippling is found in?

A

Thalassemias
Hemoglobinopathies
Sideroblastic Anemia (SA)
Heavy Metal Poisoning (Lead)
Myelodysplastic Syndrome

73
Q

Howell-Jolly Bodies (HJBs)

A

Spherical blue-black inclusions of RBCs seen on a Wright-stained smear.

74
Q

What are HJBs made of?

A

Nuclear fragments of condensed DNA (1-2um), that are normally removed by the spleen.

75
Q

What conditions/diseases do we find HJBs in?

A

Severe Hemolytic Anemias
PTs W/ dysfunctional spleens
PTs who’ve had a Splenectomy
Megaloblastic Anemia
Thalassemia
Myelodysplastic Syndrome
Hyposplenism

76
Q

Pappenheimer Bodies (PHBs)

A

Iron-containing granules in RBCs (Siderotic Granule).

77
Q

Why are PHBs seen in RBCs?

A

The iron aggregated W/ the mitochondria and ribosomes.

78
Q

What is the appearance of PHBs?

A

Faint violet or magenta specks, often in small clusters.

79
Q

What conditions/diseases are associated W/ PHBs?

A

Sideroblastic Anemia
Thalassemias
Hemoglobinopathies
Megaloblastic Anemia
Hyposplenism
Post-Splenectomy

80
Q

Siderocytes

A

A mature erythrocyte containing siderotic granules.

81
Q

Siderotic Granules

A

Iron-containing granules

82
Q

To verify RBC inclusions containing Iron, what stain should be used?

A

Iron stain, such as Prussian Blue.

83
Q

Heinz Bodies (HBs)

A

small, round inclusions of denatured Hgb.

84
Q

HBs are associated W/ what conditions/diseases?

A

Congenital Hemolytic Anemias, resulting in Hb precipitates (G6PD Deficiency).
Unstable Hgbs
Oxidant drugs/chemicals

85
Q

Cabot Rings

A

Thin, Red-violet stained strands.

86
Q

Cabot Rings shape?

A

Rings, Figure 8, Shapes of the letter B.

87
Q

Cabot ring incidence?

A

Rare

88
Q

What is the possible cause of Cabot rings?

A

Microtubules remaining from a mitotic spindle.

89
Q

Cabot rings are associated W/ what conditions?

A

Megaloblastic Anemia
Lead poisoning
Disorders of Erythropoiesis
Splenectomy
Myelodysplastic Syndromes

90
Q

Diffuse Basophilia (Polychromasia)

A

RNA inclusion of bluish tinge throughout the plasm of an erythrocyte.

91
Q

What cell is polychromasia commonly seen in?

A

Retics under supravital stain

92
Q

Diseases/Conditions associated W/ polychromasia?

A

Hemolytic Anemia
Treatment of Iron, Vitamin B-12, or Folate deficiency.

93
Q

Which type of Hb is seen W/ golf ball looking, dispersed, dark blue granules?

A

Hb H

94
Q

(T or F): Hb H is visible on Wright’s Stain?

A

False

95
Q

What is the composition of the Hb H inclusion?

A

Precipitated B- globin chains of Hgb.

96
Q

Polychromasia under Wright’s Stain and Supravital Stain?

A

Bluish tinge T/O plasm under Wright’s.

Dark blue granules & filaments in the plasm under Supravital.

97
Q

Basophilic stippling W/ Wright’s and Supravital?

A

SVS & Wright’s- Dark blue-purple W/ punctate grans T/O plasm.

98
Q

HJBs under wright’s and SVS?

A

The same, dark blue-purple, dense, round granules, usually 1 per cell, but can have multiples.

99
Q

HBs W/ SVS and Wright’s?

A

SVS- Round, dark blue-purple granule, attached to inner RBC membrane.

Wright’s- Not visible

100
Q

PHBs on Wright’s and SVS?

A

The same, irregular clusters, small, light to dark blue granules, near the periphery of cell.

101
Q

Cabot Rings on SVS and Wright’s?

A

SVS- Rings or figure 8s

Wright’s- Blue rings or figure 8s

102
Q

Hb H W/ Wright’s and SVS?

A

SVS- Fine evenly dispersed dark blue granules, “Golf Ball appearance.

Wright’s- Not visible

Final Exam (27 decks)

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