Haematology Flashcards
What are Acanthocytes?
RBCs that show many spicules
Associated with liver disease, hyposplenism, and abetalipoproteinaemia (rare)
What causes basophilic RBC stippling?
Accelerated erythropoiesis or defective Hb synthesis
Small dots at the periphery are seen (rRNA). Conditions include lead poisoning, megaloblastic anaemia, myelodysplasia, liver disease, and haemoglobinopathy such as thalassaemia.
What are Burr cells also known as?
Echinocytes
They resemble a sea urchin with regular spicules and can be artefacts if blood has sat in EDTA prior to film preparation.
What conditions are associated with the presence of Burr cells?
Uraemia, renal failure, GI bleeding, stomach carcinoma
Burr cells often appear as artefacts.
What are Heinz bodies?
Inclusions on the edge of RBCs due to denatured Hb
Associated with glucose-6-phosphate dehydrogenase deficiency and chronic liver disease.
What are Howell-Jolly bodies?
Basophilic nuclear remnants in RBCs
Much bigger purple spots are seen in nucleated RBCs. They occur post-splenectomy or in hyposplenism and conditions like sickle cell disease, coeliac disease, congenital issues, and myeloproliferative disease.
What does the term Leucoerythroblastic refer to?
Presence of nucleated red blood cells and myeloid precursors in peripheral blood
Indicates marrow infiltration such as myelofibrosis or malignancy.
What characterizes Pelger Huet Cells?
Hyposegmented neutrophil with 2 lobes like a dumbbell
Pseudo-pelger huet cells are hypogranular and can be congenital or acquired (e.g. myelogenous leukaemia and myelodysplastic syndromes).
What is Polychromasia?
Bluish red blood cells due to presence of DNA
Usually increased in response to shortened RBC life, prevalent in haemolytic anaemias, and decreased in aplastic anaemia and chemotherapy.
What does a right shift indicate in white blood cells?
Hypermature white cells with hypersegmented polymorphs
Specifically, more than 5 lobes to the nucleus; associated with megaloblastic anaemia, uraemia, and liver disease.
What is rouleaux formation?
Red cells stacked on each other
Associated with chronic inflammation, paraproteinaemia, and myeloma.
What are Schistocytes?
Fragmented parts of RBCs that are typically irregularly shaped with sharp edges and no central pallor
Common in microangiopathic anaemia, such as DIC, haemolytic uraemic syndrome, thrombotic thrombocytopenic purpura, and pre-eclampsia.
What are Spherocytes?
Sphere-shaped RBCs that are often smaller
Associated with hereditary spherocytosis and autoimmune haemolytic anaemia.
What do Stomatocytes look like?
RBCs appear as ‘smiling faces’ or ‘fish mouth’ with central pallor being straight or curved rod-like shape
Can be artefacts during slide preparation or indicative of hereditary stomatocytosis, high alcohol intake, or liver disease.
What is the appearance of Target cells?
Bull’s-eye appearance in central pallor
Associated with liver disease, hyposplenism, thalassaemia, and iron deficiency anaemia (IDA).
What are the causes of Microcytic Anemia?
- Iron deficiency 2. Anemia of chronic disease 3. Thalassaemia 4. Sideroblastic anaemia
What are the causes of normocytic anaemia?
- Blood loss 2. Anaemia of chronic disease 3. Hypothyroidism 4. Haemolysis 5. Renal failure 6. Bone marrow failure 7. Pregnancy
What are the causes of Macrocytic anaemia?
- B12 deficiency & folate deficiency 2. Anti-folate eg. phenytoin 3. Myelodysplastic syndromes 4. Cirrhosis
What is seen on the blood film in IDA?
Poikilocytosis (shape), anisocytosis (size), microcytosis, hypochromia, pencil cells
By what mechanisms does Anaemia of chronic disease induce anaemia?
- INF and TNF downregulate EPO receptors. 2. IL6 and Lipopolysaccharide induce hepcidin: causes reduced gut absorption and phagocytosis of iron by macrophage.
What is the mechanism, Chief cause and treatment of Sideroblastic anaemia?
Ineffective erythropoiesis causes iron loading and deposition (haemosiderosis in liver, heart, endocrine)
Cause: alcohol excess
Rx: pyridoxine
What is seen in the marrow of Sideroblastic anaemia?
Ring sideroblasts
