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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
fragmented RBCs of various shaped and sizes.
Schistocytes
26
Causes of Schistocytes (4)
(SDTD) severe burns, drugs, toxins and DIC
27
echinocytes with evenly distributed blunt spicules of uniform size on their surface
Crenated cells
28
are also echinocytes but their spicules are reversible
Burr cells
29
Causes of Burr cells (3)
(UAP) uremia, acute blood loss and Pyruvate Kinase deficiency
30
central biconcave area appears slit-like.
Stomatocytes
31
Causes of Stomatocytes (3)
(HLA) Hereditary stomatocytosis, liver disease, alcoholism
32
RBCs which are deficient in Hb. Appear ring-shaped because the central palor in increased
Hypochromasia
33
Causes of Hypochromasia (3)
(ITS) IDA, Thalassemia, Sideroblastic anemia
34
Abnormal structures that are present in red cells are called ________
Inclusions
35
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
Howell-Jolly bodies
36
Causes of Howell-Jolly Bodies (4)
(SASM splenectomy, alcoholism, sickle cell anemia, megaloblastic anemia
37
contains non hemoglobin iron granules. Granules appear bright blue.
Siderocytes
38
Causes of Siderocytes (1)
Hemolytic anemia
39
fine to coarse, deep blue to purple, small but multiple inclusions of varying sizes
Basophilic Stippling
40
Causes of Basophilic Stippling (5)
(TMLLI) thalassemia, megaloblastic anemia, liver disease, lead poisoning and infections
41
A stack-like arrangement of RBCs in blood or in diluted suspensions of blood in which their biconcave surfaces are next to each other.
ROULEAUX FORMATION
42
Rouleaux formation - It happens with ___________, particularly _______and ________
Increased serum proteins fibrinogen and globulins.
43
An appropriately prepared and stained blood film is systematically scanned microscopically to:
* estimate leukocyte count * identify morphologic erythrocyte abnormalities * estimate platelet number * classify leukocytes into group types
44
DIFFERENTIAL LEUKOCYTE COUNT * Counting ________ leukocytes E - - L - P -
100-200 * ERYTHROCYTES - Morphology and hemoglobin content - IDA * LEUKOCYTES - Leukemias, infections * PLATELETS - Morphology and estimation
45
WHAT TO OBSERVE?
(CNC) * CELL SIZE * NUCLEAR CHARACTERISTICS *CYTOPLASMIC CHARACTERISTICS
46
- Compared with RBCs
* CELL SIZE
47
- Shape, size, color, structure
* NUCLEAR CHARACTERISTICS
48
- Color, amount, inclusions
*CYTOPLASMIC CHARACTERISTICS
49
HOW TO OBSERVE?
(ORE) * Oil immersion objective *RBCs should barely touch each other * Examine near the feathered edge
50
WHAT TO IDENTIFY? ERYTHROCYTES
(MPN6C) - Most numerous - Pink-tan - No nucleus - 6-8 um in diameter - Central pallor
51
RBC MORPHOLOGY
Hypochromic, normochromic * Normocytic, microcytic, macrocytic * Poikilocytosis and anisocytosis
52
WHAT TO IDENTIFY? PLATELETS
(S2NFR) - Smallest - 2-4 um in diameter (1/3 dm of RBC) - No nucleus - From MEGAKARYOCYTE - Round, oval, spiny projections
53
ESTIMATION of PLATELETS
* Abnormality in morphology * Counted in 10 OIO fields * Average plt per field * Multiplied by 20,000
54
WHAT TO IDENTIFY? LEUKOCYTES
(L5NEBLM) Largest among blood components * 5 types - NEUTROPHILS - EOSINOPHILS - BASOPHILS - LYMPHOCYTES - MONOCYTES
55
* Largest among blood components
LEUKOCYTES
56
* 5 types of leukocytes
- NEUTROPHILS - EOSINOPHILS - BASOPHILS - LYMPHOCYTES - MONOCYTES
57
Criteria for Leukocyte Identification (4)
(CNCN) 1. Cell size 2. Nucleus-Cytoplasm Ratio 3. Cytoplasm Characteristics 4. Nuclear Characteristics
58
Nucleus-cytoplasm ratio (2)
- High ratio - Low ratio
59
Cytoplasm characteristics (3)
- Color of background cytoplasm - Presence or absence of granules - Color and size of granules
60
Nuclear characteristics (4)
(SCCP) - Shape - Color - Chromatin pattern - Presence of absences of nucleoli
61
Neutrophil (segmented) Segmented, PMN Nucleus: Cytoplasm:
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
Neutrophil (band) Nonsegmented, stab Diameter: Nucleus: Cytoplasm:
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
Eosinophil Acidophil Diameter: Nucleus: Cytoplasm:
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
Basophil Diameter: Nucleus: Cytoplasm:
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
Lymphocyte (normal) Diameter: Nucleus: Cytoplasm:
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
Lymphocyte (variant) Diameter: Nucleus: Cytoplasm:
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
Monocyte Diameter: Nucleus: Cytoplasm:
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
REFERENCE VALUES of DIFF COUNT * Varies with age * Neutrophil and lymphocytes _______ * Eosinophils, basophils, monocytes ______ * _______ normally have higher lymphocyte count than _________
* Varies with age * Neutrophil and lymphocytes (85%-95%) * Eosinophils, basophils, monocytes (5%-15%) * Children normally have higher lymphocyte count than adults
69
FACTORS AFFECTING LEUKOCYTE COUNTS (6)
(VBVPAL) * Varies according to disease state * Bacterial infections * Viral infections * Parasitic infections * Allergic reactions * Leukemias
70
FACTORS AFFECTING RBCs (2)
(IV) *Iron deficiency * Vitamin B12 deficiency
71
FACTORS AFFECTING PLATELETS
(LDL) * Leukemia * Delay in capillary puncture * Long-standing EDTA blood
72
SIZES NEUTROPHIL SEG: NEUTROPHIL BAND: EOSINOPHIL: BASOPHIL: LYMPHOCYTE NORMAL: (SMALL) (MEDIUM-LARGE) LYMPHOCYTE VARIANT: MONOCYTE:
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

HEMATOLOGY LAB (4 decks)

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