Class Information

Question 1

Young neutrophils

Answer 1

Young neutrophils in the blood have not yet acquired the “polymorphonuclear” phenotype that the cell type is associated with. Instead it looks more like an elongated bean-shape. These are neutrophils that are still differentiating and are not pathological.

Question 2

Reticulocyte

Answer 2

Appears like an erythrocyte with a nucleus, and that is effectively what it is. It has not yet lost its nuclear material.

Reticulocyte counts may be used as a proxy for estimating the rate of hematopoiesis. Usually 1-2 per 1,000, higher counts may indicate anemia.

Question 3

Your patient is an 18 month old boy. His parents tell you that he has met all his developmental milestones, but recently has been inconsolable and appears in constant pain.

Answer 3

Sickle Cell Anemia

Associated with both general and localized hypoxia. The pain comes from localized, acute hypoxia and associated muscle acidosis.

Sickle Cell Crisis is when a local clogging of capillaries leads to acute tissue hypoxia.

Question 4

Your patient is a 5 year old girl who has come in for her prekindergarten physical. She feels fine, but her parents have noticed that her skin and eyes look a bit yellow.

Answer 4

Spherocytosis

Yellow skin indicates jaundice, which here is a sign of hemolysis. Notice the loss of central palor on the erythrocytes.

This particular case was caused by a homozygous deletion of ankyrin, a protein vital to maintaining the erythrocyte shape.

Question 5

Where do you always see jaundice first?

Answer 5

The eyes

Then look for an enlarged spleen to see if it is hemolytic jaundice.

Question 7

Test typically used to look for autoantibodies

Answer 7

Immunofluorescence with a green anti-IgG

Subsequent tests can try to look for the specific antigen