ERYTHROCYTES & ANOMALIES Flashcards
1
Q
The RBC count, hemoglobin, and hematocrit values are _____ in people living a ______
A
Elevated ; higher altitude
2
Q
Normal rbc count in children
A
4.00 to 5.40 x 10^6/uL or x 10^12/L
3
Q
Adult male normal rbc count
A
4.60 to 6.00 x 10^6/uL or x 10^12/L
4
Q
Adult female rbc count normal
A
4.00 to 5.40 x 10^6/uL or x 10^12/L
5
Q
Glucose penetrates the red blood cell with no energy expenditure via _______(transmembrane protein)
A
Glut-1
6
Q
This pathway handles 90% of glucose utilization in red blood cells
Non oxidative, anaerobic pathway that produces 2 molecules of ATP
A
EMBDEN MEYERHOF PATHWAY
7
Q
An autosomal recessive disorder ; most common enzyme deficiency of he EMP and most common form of hereditary nonspherocytic hemolytic anemia
A
Pyruvate kinase deficiency
8
Q
Possible cells seen in PBS of PK deficiency
A
Acanthocytes, burr cells
9
Q
Recommended screening test for PK deficiency
A
PK fluorescent spot
10
Q
Also a screening test for PK deficiency
A
Auto hemolysis test
11
Q
A confirmatory test for PK deficiency
A
Quantitative PK assay
12
Q
Pattern of autohemolysis with PK deficiency : it is greatly ______ and glucose has _____
A
INCREASED ; NO EFFECT
13
Q
These are the three alternate pathways that branch from the glycolytic pathway
A
Glycolysis diversion pathways (Shunt)
14
Q
Pentose phosphate pathway to phosphogluconate pathway
A
Hexose monophosphate shunt (Aerobic glycolysis)
15
Q
This pathway prevents the desaturation of the GLOBIN by oxidation
A
Hexose monophosphate shunt
16
Q
Functionally dependent on G6PD
A
HEXOSE MONOPHOSPHATE SHUNT
17
Q
An x-linked recessive disorder ; most common deficiency in the pentose phosphate pathway a
A
G6PD DEFICIENCY
18
Q
Most common RBC enzyme defect
A
G6PD deficiency
19
Q
An autosomal recessive disorder in the embden-Meyerhof pathway
A
Pk deficiency
20
Q
An x-linked recessive disorder in the Hexose monophosphate shunt
A
G6PD deficiency
21
Q
Cells seen in the PBS of a ptx with G6PD deficiency
A
Heinz bodies and bite cells
22
Q
Recommended screening test for G6PD deficiency
A
G6PD fluorescent spot test
23
Q
Also a screening test for G6PD deficiency
A
Autohemolysis test
24
Q
Confirmatory test for G6PD
A
Quantitative G6PD assay
25
Chronic type of G6PD , hereditary nonspherocytic henmolytic anemia
Type 1
26
A severe type of G6PD, episodic acute hemolytic anemia associated with infections, certain drugs, and fava beans ; not self limited and may require transfusion during hemolytic episode
Type 2
27
Favism is mostly demonstrated in what type of G6PD deficiency
G6PD-Mediterranean
28
Episodic type of G6PD deficiency, acute hemolytic anemia associated with infections and certain drugs; self limited
Type III
29
G6PD-Serres
G6PD -Madrid
Type I
30
G6PD-Mediterranean
G6PD-Chatham
Type II
31
G6PD-A”
G6PD-Canton
Type III
32
G6PD-B (Wild type)
GPD-A= (May also manifest as class III)
Type IV
33
Most frequently encountered enzymopathies are deficiencies of
G6PD and PK
34
AKA cytochrome B5 reeducase
Methemoglobin reductase
35
For the production of 2,3-BPG
Rapoport-Luebering shunt
36
It binds to the hemoglobin and decreases the oxygen affinity of hemoglobin
2,3-BPG
37
Two variables affecting the degree of association or dissociation between oxygen and hemoglobin
Partial pressure of oxygen
Affinity of hemoglobin for oxygen
38
Affinity of hemoglobin for oxygen is depended on 5 factors
pH
Partial pressure of CO2
Concentration of 2,3-BPG
Temperature
Presence of other hgb species that are nonfunctional
39
The curve produced when the 2 variables (partial pressure of O2 and affinity of hgb for O2) are plotted in a graph (oxygen saturation of hgb vs partial pressure of O2)
Oxygen dissociation curve
40
OXYGEN DISSOCIATION CURVE: Shift to the left
⬆️ pH
⬇️ PCO2
⬇️2,3-BPG
⬇️TEMPERATURE
INCRESEAD AFFINITY
41
OXYGEN DISSOCIATION CURVE: Shift to the RIGHT
⬇️ pH
⬆️ PCO2
⬆️2,3-BPG
⬆️Temperature
Decreased affinity
42
A shift in the curve due to an alteration in pH
Bohr effect
43
Depict the occurrence by which the binding o2 to the hgb promotes the release of CO2
Haldane effect
44
Increased number of red cells with variation in size
Anisocytosis
45
Sized of RBC usually seen when MCV is 80-100 fL
6-8 um
46
Anisocytosis :
>8.0 um
>100 fl
Macrocytosis
47
Anisocytosis:
<6.0 um
<80 fL
Microcytosis
48
MCV formula
HCT/RBC CT X 10
49
A visual display of cell size (x-axis) and cell friquency is the number of cells (y-axis)
Blood cell histogram
50
Automated hematology analyzers produce histograms for
Rbcs, WBCs, and platelets
51
Automated hematology analyzers produce histograms for
Rbcs, WBCs, and platelets
52
Two parameters calculated from RBC histogram
MCV and RDW
53
If The rbcs are macrocytic, the curve will shift to the
Right
54
If the rbcs are microcytic , the curve will shit to the
Left
55
Shape of the histogram curve
Bimodal
56
Conditions that may cause a bimodal curve
Blood transfusion
Cold agglutinin disease
Hemolytic anemia with schistocytes present
57
Indicates more variation in the size of the cells
A wide or flattened curve on histogram
58
A calculated index given by hematology analyzers to help identify Anisocytosis and provide information about its degree
RDW
59
Based on both of the RBC distribution curve and the mean RBC size
RDW-CV
60
Based on the actual measurement of the width of the RBC distribution curve in fĻ
RDW-SD
61
RDW-CV reference range
11.5% to 14.5%
62
RDW-SD reference range
39-46 fL
63
EARLIEST METHOD provided by the hematology analyzers to measure the red cell variations
RDW-CV
64
Dependent on the width of the distribution curve and the MCV
RDW-CV
65
Width of the curve is measured at the point that is 20% above the baseline
RDW-SD
66
Better and more reliable measure of erythrocyte variability, specifically in highly abnormal conditions
RDW-SD
67
MCV and RDW in microcytic
Low MCV and high RDW
68
RDW Reference range for newborns
14.2 to 19.9%
69
RDW is markedly _____ in newborns but gradually, the value will ____ until it reaches adult levels by _____ (age)
Incresead ; decrease ; 6 months of age
70
RDW and MCV in Anemia of chronic inflammation
Low MCV and Normal RDW
71
MCV and RDW in iron deficiency anemia
Low MCV and high RDW
72
MCV and RDW IN G6PD deficiency
Normal MCV and normal RDW
73
MCV and RDW in sickle cell anemia
Normal MCV and high RDW
74
MCV and RDW in liver disease
High MCV and Normal RDW
75
MCV and RDW in megaloblastic anemia
High MCV High RDW
76
General term for a variation in the normal coloration
Anisochromia
77
Normally, RBCs have a central area of pillow approximately ____ the diameter
1/3
78
May also mean the occurrence of hypohromic cells and normochromic cells in the same blood smear
Anisochromia
79
May be found in Sideroblastic anemias, also in a hypochromic anemia after transfusion with normal cells and some weeks after iron therapy for IDA
ANISCHROMIA
80
Central pallor >1/3 of diameter
Hypochromic
81
Grading : central pallor 1/2
1+
82
Grading : central pallor 2/3
2+
83
Grading : central pallor 3/4
3+
84
Grading : 4+
Thin rim of hemoglobin
85
Anulocyte is also known as
Pessary cell, ghost cell
86
Rbc with a thin rim of hemoglobin and a large, clear center ; may be observed in IDA
Anulocyte
87
RBCs that lack central pallor even through they lie in desirable area for evaluation
Hyperchromic cells
88
Basically the only disease in which MCHC is high
Hereditary spherocytosis
89
3 clinical manifestations of Hereditary spherocytosis
Splenomegaly
Anemia
Jaundice
90
Immune disorders with spherocytes result on the DAT
POSITIVE
91
TEST INCREASED IN HEREDITARY SPHEROCHYTOSIS
MCHC (slightly)
AUTOHEMOLYSIS (greatly)
OFT (
92
Result of fluorescence in EMA binding test for HS
Low
93
Larger than normal red cell with bluish tinge in wright stain
Polychromatophilic erythrocytes
94
Bluish tinge in retics is caused by the presence of
Residual RNA
95
POLYCHROMASIA GRADING: 1%
Slight
96
POLYCHROMASIA GRADING: 3%
1+
97
POLYCHROMASIA GRADING: 5%
2+
98
POLYCHROMASIA GRADING: 10%
3+
99
POLYCHROMASIA GRADING: >11%
4+
100
Increased number of red cells with variation in SHAPE
POIKILOCYTES
101
Almost spherical in shape ; lacks central pallor
Spherocytes
102
Appearance of rbc in the feathered edge
Lack central pallor
103
It can also result to spherocytosis red cells
Natural cell death
104
Aka “mouth cell”
Stomatocytes
105
Elongated rbcs with a slit like central pallor
Stomatocytes
106
Rh deficiency , alcoholism, severe liver disease, Overhydrated and DEHYDRATED hereditary ____
Stomatocytes
107
A dehydrated form of a stomatocyte
Xerocyte
108
Appears to have puddled at one end (half-light, half dark)
Xerocyte
109
Aka “thorn cell or spur cell”
Acanthocytes
110
Rbcs with irregularly SPICULATED surface
Acanthocytes
111
Abetalipoproteinemia is associated with what type of red cells shape
Acanthocytes
112
Abetalipoproteinemia is also known as
Basset-kornzweig syndrome or hereditary acanthocytosis
113
Characterized by defective apo B synthesis ; VLDL, LDL, and chylomicron not found in plasma
Abetalipoproteinemia
114
Cells seen McLeo syndrome and PK deficiency
Acanthocytes
115
Aka “echinocytes”
Burr cell
116
RBs with REGULAR SPICULES
Burr cell
117
Rbc seen in uremia and PK deficiency
Burr cell/ echinocyte
118
Cigar shaped rbc
Elliptocyte
119
Thalassemia is associated with what rbc
Elliptocyte
120
Aka “Mediterranean anemia, hereditary leptocytosis”
Thalassemia
121
Aka “teardrop cell”
Dacryocyte
122
Pear shaped rbc
Dacryocte
123
Rbc seen in primary myelofibrosis and megaloblastic anemia
Dacryocyte
124
Aka “schizocytes”
Schistocytes
125
Fragmented rbcs
Schistocyte
126
MAHAs are associated with what rbc shape
Schistocytes (helmet cells)
127
Group of disorders characterized by RBC fragmentation and thrombocytopenia
MAHAs
128
Major MAHAs
Thrombocytopenia purpura
HELLP (hemolysis, elevated liver enzymes, low plt ct)
Hemolytic uremic syndrome
Dessimenated intravascular coagulation
129
Characterized by narrowing obstruction of small blood vessels by fibrin or platelet aggregates resulting in rbc fragmentation
MAHAs
130
Also known as defibrination syndrome, consumption coagulopathy
DIC
131
Generalized over-activation of the coagulation and fibrinolytic systems
DIC
132
TESTS for DIC
D-dimer
Prothrombin fragment 1 + 2
133
Related conditions to DIC
TISSUE TRAUMA
OBSTETRIC COMPLICATIONS
MUCUS-SECRETING TUMORS
ACUTE INFECTIONS
SNAKE BITES
ACUTE PROMYELOCYTIC LEUKEMIA
134
AKA sickle cell ; meniscocyte
Drepanocyte
135
Two forms of drepanocytes
Irreversible sickle cell
Oat shaped cells
136
Crescent shaped ; with long projection ; when deoxygenated they fragment
Irreversible sickle cell
137
Have less pronounced projections ; when reoxygenated they return to the original biconcave disks
Oat shaped cells
138
Aka codocyte, platycyte, Greek helmet cell, Mexican hat cell, bull’s eye cell, leptocyte
Target cell
139
Rbc seen in LCAT deficiency
Target cell
140
Rbcs with an increased cell membrane-to-volume ratio
Codocytes
141
In vivo and on electro microscopy, these cells appear bell shaped
CODOCYTES
142
AKA DEGMACYTE
BITE CELL
143
Demonstrate a semicircular defect in their edge (resembles a bite mark)
Bite cell
144
Heinz bodies are seen in this rbc
Bite cell
145
Rbcs seen in G6PD deficiency
Bite cell
146
Folded rbcs
Biscuit cell
147
Bipolar or central distribution of hgb
Bronze Elliptocyte
148
As large a leukocytes ; pale pink staining ghost of the red cell
Semilunar body
149
Frequently seen in malaria and other conditions causing overt hemolysis
Semilunar bodies
150
Aka punctuate basophilia
Basophilic stippling
151
Associated with lead poisoning , megaloblastic anemia, arsenic poisoning , pyrimidine-5 nucleotidase deficiency, thalassemia
Basophilic stippling
152
A basophilic stippling in which PLUMBISM may be observed , megaloblastic anemia , impaired Hb synthesis
Coarse stippling
153
Aka papenheimer bodies
Siderotic granules
154
Iron stains like Perl’s reagent through Prussian blue reaction stains what
Siderotic granules
155
New methylene and wrights stains stain what rbc inclusion
Papenheimer bodies
156
Characterized by a DIMORPHIC peripheral blood picture and hypochromic RBCs in the same blood smear
Sideroblastic Anemia
157
Described as multiple dark blue irregular granules in Prussian blue iron staining
Siderotic granules
158
Described as pale blue clusters in wrights staining
Siderotic granules
159
Frequently appears single in a cell usually round <1 um diameter blue to purple in color
Howell Jolly bodies
160
Remnants of nuclear chromatin (DNA)
Howell-Jolly bodies
161
Fuelgen reaction of Howell jolly bodies
Positive
162
Described as threadlike structures that appear as purple blue loops or rings
Cabot rings
163
Mitotic spindle Remnants
Cabot rings
164
Most of the time appear eccentrically along the inner RBC membrane large. Round blue to purple materials
Heinz bodies
165
Denatured and precipitated hemoglobin
Heinz bodies
166
Supravital stains used for staining Heinz bodies
Brilliant cresyl blue
New methylene blue
Methyl blue
Crystal violet
167
Inclusion bodies seen in G6PD deficiency (FAVISM), Drug induced hemolytic anemia
Heinz bodies
168
Described as SMALL , multiple, evenly distributed throughout the red cell, granular, GREENISH BLUE bodies
He H inclusion bodies e
169
An abnormal Hb composed of 4 beta globin chains
Hemoglobin H
170
A subtype of alpha thalassemia
Hb H disease
171
Schuffner dots is seen what protozoan
Malaria
172
Aka eosinophilia stippling
Schuffner dots
173
“Maltese cross”
Babesia spp.
174
Caused by a serum protein abnormality either increased globulin or fibrinogen
Rouleaux formation
175
Many be observed in multiple myeloma
Rouleaux
176
These are graded as POSITIVE ONLY
Sickle cells
Basophilic stippling
Papenheimer bodies
Howell Jolly bodies
177
Erythrocyte morphology grading : Slightly increased or few
1+
178
Erythrocyte morphology grading : moderately increased
2+
179
Erythrocyte morphology grading : Many
3+
180
Erythrocyte morphology grading : marked or marked increase
4+
