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Hematology 1 > (F) L1.2: RBC Morphology > Flashcards

(F) L1.2: RBC Morphology Flashcards

1
Q

Normal distribution of RBCs

a. Slightly separated from one another
b. Not overlapping
c. Both
d. Neither

A

Both

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2
Q

Shape of normal RBC

A

Circular (with smooth edge)

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3
Q

Color of the cytoplasm of a normal RBC

A

Reddish-pink

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4
Q

T or F: When we read a PBS under a microscope, we should read the feathery edge

A

False (near the feathery edge)

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5
Q
  • RBCs resembling “stack of coins”
  • The entire outline of each cell is NOT VISIBLE
  • CANNOT EVALUATE the cell size and shape
A

Rouleaux formation

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6
Q

Roulaux formation is characteristic to which two disorders?

A
  1. Hyperproteinemia
  2. Multiple myeloma
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7
Q

Rouleaux formation
a. Increased amount of serum gamma globulin and increased fibrin
b. Producing functional antibodies
c. Both
d. Neither

A

D

A. Should be plasma and fibrinogen
B. Should be non-functional

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8
Q

T or F: If one of the zetapotentials of the RBC are INCREASED, they will CLUMP forming a rouleaux formation

A

False (reduced)

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9
Q

Happens when RBCs clump together forming AGGREGATES when exposed to various red cell antibodies

A

Agglutination

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10
Q
  • In ______________, you can observe AGGREGATES OR MASSES OF RED BLOOD CELLS when exposed to various red cell antibodies
  • In __________, they are forming a STACK OF COINS
A
  1. Agglutination
  2. Rouleaux formation
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11
Q
  • An individual’s RBCs agglutinate in their own plasma or serum that contain no specific agglutinins
  • Presence of cold agglutinin IgM antibodies directed against RBC antigens
A

Autoagglutination

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12
Q

Agglutination has (elevated/decreased) MCV and (elevated/decreased) RBC count

A
  1. Elevated MCV
  2. Decreased RBC count
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13
Q

Refers to increased number of red blood cells with a variation in size

A

Anisocytosis

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14
Q
  • NORMAL RBC
  • 7–8µm
  • MCV is 80–100fL
A

Normocytes

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15
Q
  • LARGER than normal RBCs
  • > 8µm
  • MCV is > 100fL
A

Macrocytes

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16
Q
  • SMALLER than normal RBCs
  • MCV is < 80fL
A

Microcytes

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17
Q

What are macrocytes associated with?

A

Impaired DNA synthesis

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18
Q

What are microcytes associated with?

A

Defective Hgb formation

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19
Q
  • General term for a VARIATION IN THE NORMAL COLORATION
  • It is often noted DURING THE MICROSCOPIC EXAMINATION of the blood smear
A

Anisochromia

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20
Q

The degree of ________ can provide diagnostic information about the underlying cause of the disease

A

Anisochromia

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21
Q
  • RBCs that LACK A CENTRAL PALLOR even though they lie in the desirable area for evaluation
  • These RBCs are actually caused by a shape change such as those found in spherocytes
A

Hyperchromic cells

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22
Q

TRUE HYPERCHROMIA occurs when MCHC is (HIGH/LOW)

A

High

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23
Q

The ONLY DISEASE in which the MCHC is high above the reference

A

Hereditary spherocytosis

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24
Q

3 clinical manifestations of Hereditary Spherocytosis

A
  • Splenomegaly
  • Anemia
  • Jaundice
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25
Q

Supply the missing values for Hereditary Spherocytosis

DAT:
MCV:
MCH:
MCHC:

A
  • DAT (Direct Antiglobulin Test): Negative
  • MCV: Normal to low
  • MCH: Normal
  • MCHC: Slightly increased
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26
Q

T or F: Immune disorders that have spherocytes are also usually characterized by a positive result on DAT

A

True

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27
Q

Supply the grading for hypochromia:

  1. Thin rim of hemoglobin
  2. Area of central pallor - 2/3
  3. Area of central pallor - 3/4
  4. Area of central pallor - 1/2
A

4+, 2+, 3+, 1+

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28
Q

The gradng of hypochromia depends on which two factors?

A
  1. Degree of paleness
  2. Amount of hemoglobin distribution
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29
Q

In hypochromia, the RBC is (paler/darker) in color

A

Paler

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30
Q
  • Aka DIFFUSELY CHROMATOPHILIC ERYTHROCYTES
  • LARGER than normal red cells with BLUISH TINGE (Wright’s stain)
A

Polychromatophilic Erythrocytes

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31
Q

What causes the bluish tinge in polychromatophilic RBCs?

A

Residual RNA

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32
Q

Increased number of red blood cells with a VARIATION IN SHAPE

A

Poikilocytes

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33
Q

Description:
- SPHERICAL in shape
- LACKS CENTRAL PALLOR
- The staining intensity is increased
- The only RBC that can be called hyperchromic due to increased MCHC

A

Spherocytes

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34
Q

Associated conditions of this abnormal RBC:
- Hereditary Spherocytosis
- Autoimmune Hemolytic Anemia
- Burns
- ABO HDN

A

Spherocytes

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35
Q

Description:
- Aka MOUTH CELL
- ELONGATED RBCs with a SLIT-LIKE CENTRAL PALLOR

A

Stomatocyte

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36
Q
  • The cause of this type of variation is due to the MEMBRANE DEFECT causing HIGH CELLULAR SODIUM and LOW POTASSIUM
  • The ABNORMAL SODIUM POTASSIUM TRANSPORT RATIO causes the production of this
A

Stomatocyte

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37
Q

Associated conditions of this abnormal RBC:
- RH Deficiency Syndrome
- Alcoholism
- Electrolyte imbalance
- Overhydration

A

Stomatocytes

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38
Q

Description:
- Aka SPUR CELLS
- RBCs with an IRREGULARY SPICULATED SURFACE

A

Acanthocyte

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39
Q

Lack central pallor

a. Spherocyte
b. Acanthocyte
c. Both
d. Neither

A

C

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40
Q

The RBCs are IRREVERSIBLY THORNY and they have irregularly shape spicules with various lengths and some of the SPICULES ARE BENT plus they DO NOT HAVE A CENTRAL PALLOR

A

Acanthocytes

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41
Q

Associated conditions of this abnormal RBC:
- Abetalipoproteinemia (Aka Bassen-Kornzweig Syndrome)
- Lecithin-cholesterol acyltransferase (LCAT) Deficiency
- Liver disease
- Post-splenectomy
- Pyruvate Kinase (PK) deficiency

A

Acanthocyte

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42
Q

Description:
- Aka ECHINOCYTES OR CRENATED CELLS
- RBCs with a REGULAR SURFACE but SPICULATED
- Resembles a HEDGEHOG or SEA URCHIN

A

Burr cells

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43
Q

Associated conditions of this abnormal RBC:
- Seen in uremia
- Pyruvate kinase deficiency

A

Burr cells

44
Q

Description:
Red blood cells that are OVAL OR EGG SHAPED

A

Ovalocytes

45
Q

Associated conditions of this abnormal RBC:
- Hereditary Ovalocytosis (Southeast Asian Ovalocytosis)
- Megaloblastic Anemia (Macroovalocytes)

A

Ovalocytes

46
Q

Description:
ELLIPTICAL or CIGAR-SHAPED RBC

A

Elliptocyte

47
Q
  • The hemoglobin is still concentrated at both ends hence the presence of a central pallor
  • The formation is involved in the alteration of the RBC membrane skeleton
A

Elliptocyte

48
Q

Associated conditions of this abnormal RBC:
- Hereditary Elliptocytosis
- Thalassemia

A

Elliptocyte

49
Q

Description:
- Aka TEAR DROP CELL
- TEAR-DROP SHAPED or PEAR SHAPED RBC

50
Q

This is produced when RBCs with rigid inclusions try to pass through the splenic sinuses

51
Q

Associated conditions of this abnormal RBC:
- Primary Myelofibrosis
- Megaloblastic Anemia

52
Q

Description:
- Aka SCHIZOCYTE
- FRAGMENTED RBCs

A

Schistocyte

53
Q

HALLMARK OF Microangiopathic Hemolytic Anemia (MAHA) wherein the cells attempt to pass through the fibrin strands, and when a cell passes through a narrow vessel, the RBCs are damaged

A

Schistocyte

54
Q

Associated conditions of this abnormal RBC:
- Artificial heart valves
- Uremia
- Severe burns
- Microangiopathic hemolytic anemia (MAHAs)

A

Schistocyte

55
Q

Description:
- Aka SICKLE CELL OR MENISCOCYTE
- SICKLE OR CRESCENT-SHAPED RBCs

A

Drepanocyte

56
Q
  • The morphology is usually elongated and crescent shaped
  • The RBC with pointed ends are usually with an S, V, or L configuration
A

Drepanocyte

57
Q

Due to the polymerization of hemoglobin S because of decreased oxygen (are also irreversible)

A

Drepanocyte

58
Q

Associated conditions of this abnormal RBC:
- Sickle Cell Anemia
- Hemoglobin SC disease

A

Drepanocyte

59
Q

Description:
- Aka CODOCYTE, PLATYCYTE, GREEK HELMET CELL, MEXICAN HAT CELL, BULL’S EYE CELL, and TARGET CELL

60
Q
  • Caused by an increased membrane surface due to increased cholesterol and phospholipids
  • RBCs show a centrally stained area with a thin outer rim of hemoglobin
61
Q

Associated conditions of this abnormal RBC:
- Liver disease
- Thalassemia
- Lecithin-cholesterol acyltransferase (LCAT) Deficiency

62
Q

Description:
- A.K.A DEGMACYTE
- Demonstrates a semi-circular defect on the edge of the RBCs
- Resembles a bite mark

63
Q

The spleen doesn’t kill which two types of RBCs?

The killing process is aka “culling” or “splenic sequestration”

A
  • Microcytic hypocritical RBCs
  • G6PD RBC with Heinz bodies
64
Q

Associated condition of this abnormal RBC:
G-6-PD Deficiency

65
Q

Description:
- AKA PUNCTATE BASOPHILIA
- Irregular dark blue to purple granules evenly distributed within an RBC

A

Basophilic stippling

66
Q

Content of basophilic stippling

A

Aggregated RNA

67
Q

Associated conditions with this inclusion body:
- LEAD POISONING a.k.a PLUMBISM (Arsenic poisoning)
- Pyrimidine-5-nucleotidase deficiency
- Refractory Anemia
- Alcoholism
- Megaloblastic Anemia
- Thalassemia

A

Basophilic stippling

68
Q

Description:
- AKA PAPPENHEIMER BODIES
- Described as multiple dark blue irregular granules in PRUSSIAN BLUE IRON STAINING

A

Sideroblastic granules

69
Q

Content of sideroblastic granules

A

Pappenheimer bodies

70
Q

Associated conditions of this inclusion body:
- Sideroblastic Anemia
- Thalassemia
- Hemochromatosis or Hemosiderosis

A

Sideroblastic granules

71
Q

Description:
- Appears singly in a cell (only one per cell)
- Round and < 1 um in diameter
- Blue to purple in color

A

Howell-jolly bodies

72
Q

Content of Howell-jolly bodies

A

Remnants of Nuclear Chromatin (DNA)

73
Q

Associated conditions of this inclusion body:
- Megaloblastic Anemia
- Thalassemia

A

Howell-jolly bodies

74
Q

Description:
Threadlike structures that appear as purple-blue loops or rings

A

Cabot rings

75
Q

Content of Cabot rings

A

Mitotic spindle remnants

76
Q

Associated conditions of this inclusion body:
- Megaloblastic Anemia
- Refractory Anemia
- Lead Poisoning

A

Cabot rings

77
Q

Description:
- Appears eccentrically along the inner RBC membrane
- Large, round, and blue to purple materials
- Cannot be seen in Wright’s stain so you have to use Supravital stains

A

Heinz bodies

78
Q

Content of Heinz bodies

A

Denatured and Precipitated Hemoglobin

79
Q

Associated conditions of this inclusion body:
- Glucose-6-PD deficiency
- Drug-induced hemolytic anemia
- Unstable hemoglobin disease

A

Heinz bodies

80
Q

Description:
- Small multiple, evenly distributed throughout the red cell
- Granular, greenish-blue bodies

A

Hemoglobin H inclusion bodies

81
Q

Content of Hgb H inclusion bodies

A

Precipitated Hgb H

82
Q

Associated condition of this inclusion body:
- Hemoglobin H Disease (subtype of Alpha Thalassemia)

A

Hemoglobin H inclusion bodies

83
Q

Associated condition of this inclusion body:
- Malaria (Schuffner’s dots aka eosinophilic stipplings)
- Babesia spp. (Maltese cross)

84
Q

Type of anemia according to MCV and MCHC found in:
- IDA
- Thalassemia
- Sideroblastic anema
- Lead poisoning
- Anemia of chronic disease

A

Microcytic, hypochromic anemia

85
Q

Causes of Microcytic-Hypochromic anemia

Most common cause and is often due to
insufficient dietary iron, poor iron absorption, and chronic blood loss.

86
Q

Causes of Microcytic-Hypochromic anemia

Group of inherited disorders that affect the production of hemoglobin

A

Thalassemia

87
Q

Causes of Microcytic-Hypochromic anemia

Rare genetic or acquired condition that affects iron utilization with the red blood cell precursor leading to abnormal hemoglobin production

A

Sideroblastic anemia

88
Q

Causes of Microcytic-Hypochromic anemia

Exposure to lead

A

Lead poisoning

89
Q

Causes of Microcytic-Hypochromic anemia

Certain chronic conditions like chronic inflammation or infection that can disrupt the body’s ability to use iron effectively

A

Anemia of Chronic Disease

90
Q

Normocytic-Normochromic anemia

State whether normal-low reticulocyte count or increased reticulocyte count

Renal disease

A

Normal-low

91
Q

Normocytic-Normochromic anemia

State whether normal-low reticulocyte count or increased reticulocyte count

Aplastic anemia

A

Normal-low

92
Q

Normocytic-Normochromic anemia

State whether normal-low reticulocyte count or increased reticulocyte count

PNH

93
Q

Normocytic-Normochromic anemia

State whether normal-low reticulocyte count or increased reticulocyte count

PCH

94
Q

Normocytic-Normochromic anemia

State whether normal-low reticulocyte count or increased reticulocyte count

Sickle cell

95
Q

Normocytic-Normochromic anemia

State whether normal-low reticulocyte count or increased reticulocyte count

Enzyme disease

96
Q

Normocytic-Normochromic anemia

  • This happens when the kidneys are still able to release erythropoietin, the normal EPO production will help maintain the stable reticulocyte count
  • There are advanced stages wherein there is impaired production of EPO which leads to low reticulocyte count and anemia
A

Renal disease

97
Q

Normocytic-Normochromic anemia

  • A failure of the bone marrow to produce an adequate number of blood cells
  • Low reticulocyte count because the bone marrow’s ability to produce RBC is severely impaired
A

Aplastic anemia

98
Q

Normocytic-Normochromic anemia

The RBCs are more susceptible to destruction by the immune system due to a deficiency of a certain protein on their surface

99
Q

Normocytic-Normochromic anemia

An autoimmune hemolytic anemia where antibodies attach to RBCs leading to destruction especially in cold temperatures

100
Q

Normocytic-Normochromic anemia

Certain deficiencies like G6PD and PK deficiency can make RBCs more susceptible to oxidative damage when exposed to certain triggers

A

Enzyme disease

101
Q

Two types of Macrocytic-Normochromic anemia

A
  1. Megaloblastic
  2. Nonmegaloblastic
102
Q

Type of Macrocytic-Normochromic anemia caused by Vitamin B12 and folate deficiency

A

Megaloblastic anemia

103
Q

Type of Macrocytic-Normochromic anemia caused by liver disease, alcoholism, and BM failure

A

Non-megaloblastic anemia

104
Q

Type of Macrocytic-Normochromic anemia with hypersegmented neutrophils (≥ 6 lobes)

A

Megaloblastic anemia

105
Q

Shape

Megaloblastic anemia:
Nonmegaloblastic anemia:

106
Q

Type of Macrocytic-Normochromic anemia with the presence of megaloblasts in BM

Note: It is a result of impaired DNA synthesis

A

Megaloblastic anemia

107
Q

Type of Macrocytic-Normochromic anemia with the absence of megaloblasts in BM

A

Non-megaloblastic anemia

Hematology 1 (32 decks)

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