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HEMATOLOGY LAB > DIFFERENTIAL LEUKOCYTE COUNT / RBC MORPHOLOGY > Flashcards

DIFFERENTIAL LEUKOCYTE COUNT / RBC MORPHOLOGY Flashcards

1
Q

● _________, _______, ________
● Have _____________
● Diameter: ____________
● Have _________
● Whole cell is filled with
____________

A

● Fragile, biconcave, disk-like
structure
● Have smooth round surface
● Diameter: 7.5-7.8 um
● Have no nucleus.
● Whole cell is filled with
hemoglobin

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2
Q

TOP VIEW:__________
SIDE VIEW:_________

A

TOP VIEW: 7.5 MICROMETERS
SIDE VIEW: 2.0 MICROMETERS

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3
Q

The term used to express RBCs of
normal size

A

Normocytic

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4
Q

Mature RBCs will also have
appropriate hemoglobin content, giving them a red-orange appearance on Wright-stained smears.These cells will display a central pallor no larger than 3 microns in diameter

A

Normochromic

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5
Q

ABNORMALITIES OF RED CELLS
3 types of abnormalities may occur in RBCs:

A
  1. Anisocytosis
  2. Poilkilocytosis
  3. Inclusions in RBC
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6
Q

If the size of RBC varies, in the same
blood film, beyond normal limits

A

Anisocytosis

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7
Q

When the shapes of RBCs vary more
than expected in normal individuals

A

Poikilocytosis

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8
Q

Abnormal structures present in
RBC having certain staining characteristics

A

Inclusions in RBC:

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9
Q

ANISOCYTOSIS
Variations in size are as follows:

A
  1. Macrocytosis
  2. Microcytosis
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10
Q

When the average size of RBC is more than normal.

A

Macrocytosis

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11
Q

When the average size of RBC is less than normal.

A

Microcytosis:

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12
Q

Causes of macrocytosis (2)

A

Megaloblastic anemia, Aplastic anemia

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13
Q

Causes of Microcytosis (2)

A

IDA, Thalassemia

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14
Q

small densely staining
spherical RBC with no central pallor
area

A

Spherocytes

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15
Q

Causes of Spherocytes (4)

A

(HDSA)
Hemolytic anemia,
drug-induced,
snake venom,
ABO HDN

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16
Q

oval-shaped RBC

A

Ovalocytes

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17
Q

Causes of Ovalocytes (2)

A

(IM)
IDA,
megaloblastic anemia

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18
Q

Elongated narrow
red cells. Feature of IDA.

A

Eliptocytes

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19
Q

Hypochromic red cells showing
central spot of Hb.

A

Codocyte/Target Cells:

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20
Q

Causes of codocytes (4)

A

(TSLO)
Thalassaemia syndrome,
sickle cell disease,
liver disease,
obstructive jaundice

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21
Q

are thin crescent shaped, or boat-shaped cells elongated, deeply staining red cells with pointed ends.

A

Sickle cells

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22
Q

Causes of sickle cell (3)

A

(SST)
Sickle cell disease,
including sickle cell anemia (S/S)
sickle cell/ thalassemia

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23
Q

also called pear shaped cell.

A

Dacrocyte/Tear drop

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24
Q

Causes of Dacrocytes (1)

A

IDA (Iron deficiency anemia)

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25
Q

fragmented RBCs of various shaped and sizes.

A

Schistocytes

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26
Q

Causes of Schistocytes (4)

A

(SDTD)
severe burns,
drugs,
toxins
and DIC

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27
Q

echinocytes with
evenly distributed blunt spicules
of uniform size on their surface

A

Crenated cells

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28
Q

are also echinocytes
but their spicules are reversible

A

Burr cells

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29
Q

Causes of Burr cells (3)

A

(UAP)
uremia,
acute blood loss and
Pyruvate Kinase deficiency

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30
Q

central biconcave area
appears slit-like.

A

Stomatocytes

31
Q

Causes of Stomatocytes (3)

A

(HLA)
Hereditary stomatocytosis,
liver disease,
alcoholism

32
Q

RBCs which are
deficient in Hb. Appear ring-shaped
because the central palor in increased

A

Hypochromasia

33
Q

Causes of Hypochromasia (3)

A

(ITS)
IDA,
Thalassemia,
Sideroblastic
anemia

34
Q

Abnormal structures that are present in red cells are called ________

A

Inclusions

35
Q

small, rounded fragments of the nuclear material staining
reddish-blue to blue-black. These usually occur singly in RBC. During maturation in the bone marrow erythrocytes normally expel
their nuclei, but in some cases, a small
portion of DNA remains

A

Howell-Jolly bodies

36
Q

Causes of Howell-Jolly Bodies (4)

A

(SASM
splenectomy,
alcoholism,
sickle cell anemia,
megaloblastic anemia

37
Q

contains
non hemoglobin iron
granules. Granules
appear bright blue.

A

Siderocytes

38
Q

Causes of Siderocytes (1)

A

Hemolytic anemia

39
Q

fine to
coarse, deep blue to purple,
small but multiple inclusions
of varying sizes

A

Basophilic Stippling

40
Q

Causes of Basophilic Stippling (5)

A

(TMLLI)
thalassemia,
megaloblastic anemia, liver
disease, lead poisoning and
infections

41
Q

A stack-like arrangement of RBCs in blood or in diluted suspensions of blood in which their biconcave surfaces are next to each other.

A

ROULEAUX FORMATION

42
Q

Rouleaux formation - It happens with ___________, particularly _______and ________

A

Increased serum proteins
fibrinogen and globulins.

43
Q

An appropriately prepared and
stained blood film is systematically
scanned microscopically to:

A
  • estimate leukocyte count
  • identify morphologic erythrocyte
    abnormalities
  • estimate platelet number
  • classify leukocytes into group types
44
Q

DIFFERENTIAL LEUKOCYTE
COUNT
* Counting ________ leukocytes
E
-
-
L
-
P
-

A

100-200
* ERYTHROCYTES
- Morphology and hemoglobin content
- IDA
* LEUKOCYTES
- Leukemias, infections
* PLATELETS
- Morphology and estimation

45
Q

WHAT TO OBSERVE?

A

(CNC)
* CELL SIZE
* NUCLEAR
CHARACTERISTICS
*CYTOPLASMIC
CHARACTERISTICS

46
Q
  • Compared with RBCs
A
  • CELL SIZE
47
Q
  • Shape, size, color, structure
A
  • NUCLEAR
    CHARACTERISTICS
48
Q
  • Color, amount, inclusions
A

*CYTOPLASMIC
CHARACTERISTICS

49
Q

HOW TO OBSERVE?

A

(ORE)
* Oil immersion
objective
*RBCs should barely
touch each other
* Examine near the
feathered edge

50
Q

WHAT TO IDENTIFY?
ERYTHROCYTES

A

(MPN6C)
- Most numerous
- Pink-tan
- No nucleus
- 6-8 um in diameter
- Central pallor

51
Q

RBC MORPHOLOGY

A

Hypochromic,
normochromic
* Normocytic,
microcytic,
macrocytic
* Poikilocytosis and
anisocytosis

52
Q

WHAT TO IDENTIFY?
PLATELETS

A

(S2NFR)
- Smallest
- 2-4 um in diameter (1/3
dm of RBC)
- No nucleus
- From MEGAKARYOCYTE
- Round, oval, spiny
projections

53
Q

ESTIMATION of PLATELETS

A
  • Abnormality in morphology
  • Counted in 10 OIO fields
  • Average plt per field
  • Multiplied by 20,000
54
Q

WHAT TO IDENTIFY?
LEUKOCYTES

A

(L5NEBLM)
Largest among blood
components
* 5 types
- NEUTROPHILS
- EOSINOPHILS
- BASOPHILS
- LYMPHOCYTES
- MONOCYTES

55
Q
  • Largest among blood
    components
A

LEUKOCYTES

56
Q
  • 5 types of leukocytes
A
  • NEUTROPHILS
  • EOSINOPHILS
  • BASOPHILS
  • LYMPHOCYTES
  • MONOCYTES
57
Q

Criteria for Leukocyte Identification
(4)

A

(CNCN)
1. Cell size
2. Nucleus-Cytoplasm Ratio
3. Cytoplasm Characteristics
4. Nuclear Characteristics

58
Q

Nucleus-cytoplasm ratio (2)

A
  • High ratio
  • Low ratio
59
Q

Cytoplasm characteristics (3)

A
  • Color of background cytoplasm
  • Presence or absence of granules
  • Color and size of granules
60
Q

Nuclear characteristics (4)

A

(SCCP)
- Shape
- Color
- Chromatin pattern
- Presence of absences of nucleoli

61
Q

Neutrophil (segmented)
Segmented, PMN
Nucleus:
Cytoplasm:

A

Segmented, PMN
Diameter: 10-15 um
Nucleus:
2-5 lobes (connected by threadlike
filaments)
Dark blue
Cytoplasm:
Light pink with numerous specific or
secondary granules (too small)
Grainy appearance

62
Q

Neutrophil (band)
Nonsegmented, stab
Diameter:
Nucleus:
Cytoplasm:

A

Nonsegmented, stab
Diameter: 10-15 um
Nucleus
Elongated, curved, sausage shaped
With rounded ends and areas of dense
clumping at each pole
Filaments: absent
Cytoplasm
Light pink with numerous specific or
secondary granules (too small)
Grainy appearance

63
Q

Eosinophil
Acidophil
Diameter:
Nucleus:
Cytoplasm:

A

Acidophil
Diameter: 12-17 um
Nucleus:
Dark purple
Usually band shaped or segmented into 2
Cytoplasm:
Bright-orange pink
Filled with large, spherical, refractive
granules

64
Q

Basophil
Diameter:
Nucleus:
Cytoplasm:

A

Diameter: 10-14 um
Nucleus:
Light purple
Round, indented band shaped or
lobulated
Difficult to see
Cytoplasm:
Filled with densely stained, dark violet
to purple black granules

65
Q

Lymphocyte (normal)
Diameter:
Nucleus:
Cytoplasm:

A

Diameter: 6-8 um (small); 8-12 (medium to
large)
Nucleus:
Deep purple
Compact
Densely packed clumps of chromatin
Visible nucleoli
Shape: round, oval or indented
Cytoplasm:
pale to bright sky blue
Contain a few prominent reddish granules

66
Q

Lymphocyte (variant)
Diameter:
Nucleus:
Cytoplasm:

A

Diameter: highly variable, 10 – 22 um
Nucleus:
Extremely dense to pale
Immature-looking
Cytoplasm:
Abundant and ranges in staining
intensity
Deeply basophilic to pale blue

67
Q

Monocyte
Diameter:
Nucleus:
Cytoplasm:

A

Diameter: 12-20 um
Nucleus:
Highly variable in shape
Round, horseshoe or lobulated
Usually shows some degree of folding or convolutions
Chromatin: light purple, lacy
Cytoplasm:
Abundant
Low N:C ratio
Dull, pale, faded
Ground-glass appearance
Cell outline- irregular with occasional pseudopods and vacuoles

68
Q

REFERENCE VALUES of
DIFF COUNT
* Varies with age
* Neutrophil and lymphocytes
_______
* Eosinophils, basophils,
monocytes ______
* _______ normally have higher
lymphocyte count than _________

A
  • Varies with age
  • Neutrophil and lymphocytes
    (85%-95%)
  • Eosinophils, basophils,
    monocytes (5%-15%)
  • Children normally have higher
    lymphocyte count than adults
69
Q

FACTORS AFFECTING
LEUKOCYTE COUNTS
(6)

A

(VBVPAL)
* Varies according to disease state
* Bacterial infections
* Viral infections
* Parasitic infections
* Allergic reactions
* Leukemias

70
Q

FACTORS AFFECTING
RBCs (2)

A

(IV)
*Iron deficiency
* Vitamin B12 deficiency

71
Q

FACTORS AFFECTING
PLATELETS

A

(LDL)
* Leukemia
* Delay in capillary puncture
* Long-standing EDTA blood

72
Q

SIZES

NEUTROPHIL SEG:
NEUTROPHIL BAND:
EOSINOPHIL:
BASOPHIL:
LYMPHOCYTE NORMAL: (SMALL) (MEDIUM-LARGE)
LYMPHOCYTE VARIANT:
MONOCYTE:

A

NEUTROPHIL SEG: 10-15 um
NEUTROPHIL BAND: 10-15 um
EOSINOPHIL: 12-17 um
BASOPHIL: 10-14 um
LYMPHOCYTE NORMAL: 6-8 um / 8-12 um
LYMPHOCYTE VARIANT: 10-22 um
MONOCYTE: 12-20 um

73
Q
A

HEMATOLOGY LAB (4 decks)

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