Haematology Flashcards
Polychromasia
Reticulocytes (blue cells)
Normoblast
Immature/nucleated RBC (precursor to reticulocyte)
High number is abnormal after first week of life
Poikilocytosis
Abnormal shaped RBC
Eliptocyte
severe iron deficiency, thalassaemia, hereditary eliptocytosis
Sphereocyte
Very round, uniform
Hereditary spherocytosis - splenomegaly. Diagnosed with osmotic fragility test, neg DCT
Autoimmune haemolytic anaemia - pos DCT, ABO incompatibility
Bite cell
G6PD deficiency
Blister cell
G6PD deficiency
Target cell
Thalassaemia, post splenectomy
Sickle cell
Sickle cell anaemia, Hb SS disease
Burr cell
Looks like stars
HUS
DIC
Anisocytosis
Unequal sized RBC
Microcytic
Small
Iron deficiency, thalassaemia, sideroblastic anaemia
Macrocytic
Big
B12/Folate deficiency
Schistocyte
Fragmented “helmet” RBC
Microangiopathic disease - DIC, TTP, HUS
Haemolytic anaemia, mechanical valve
Basophilic stippling
Blue dots on outer part of cell
Lead poisoning
Thalassaemia, myelodysplasia, B12 deficiency
Auer Rod
Small rod inside cell
AML
Heinz body
Small Hb inclusion on the edge of the cell
G6PD deficiency, oxidant drugs
Howell Jolly Body
DNA inclusion inside the cell
Asplenism e.g. sickle cell Dx - functional asplenia
Severe haemolytic anaemia
Haemoglobin J inclusion
Small inclusions throughout whole cell
Haemoglobin H disease
Reed Sternberg cell
Bilobed or multinucleate cells, owl eyes
Hodgkins lymphoma
Birbeck granule
Tennis racket cell - like Boris Becker
Langerhan cell histiocytosis
Red cell agglutinate
Red cells all clumped together
Cold autoimmune haemolytic anaemia, paroxysmal cold haemolytic anaemia, IgM associated lymphoma, multiple myeloma
Roulex
Red cells in a line
Lymphoma,. myeloma, chronic liver disease, chronic inflammatory disease
Hypersigmented neutrophils
B12/folate deficiency
Extrinsic pathway
Tissue injury - PT, INR, warfarin
Factor 7
WEPT7
Intrinsic pathway
APTT (heparin)
Factors 8, 9, 11, 12
Common pathway
Fibrinogen
Factors 1, 2, 5, 10
2 (prothrombin) –> 2a (thrombin) –> 1 (fibrinogen)
Other clotting cascade facts
Fibrin clot - factor 13a (fibrin)
Antithrombin activates - 2, 7, 9, 10, 11, 12
Vitamin K - TV channels - 2, 7, 9, 10, Protein C & S
vWF - carries factor 8
Indirect Antiglobulin Test
Detects antibodies AGAINST RBC in serum e.g. in pregnant women
Direct Antiglobulin Test
Detect antibodies COATING RBC in serum e.g. autoimmune haemolytic anaemia, haemolytic disease of the newborn, drug induced
Osmotic fragility test
Hereditary spherocytosis
Chromosomal fragility test
Fanconi anaemia
Bone marrow trephine
aplastic anaemia
Bone marrow aspirate
leukaemias
PT
Extrinsic pathway
Factor 7
APTT
Common and intrinsic pathway
All factors NOT 7, 13
Mixing studies (APTT)
Corrects on mixing: haemophilia/factor deficiency
Doesn’t correct on mixing: LSE/inhibitor present
Ristocetin factor
Low in vWB, normal in haemophilia
Haemoglobin alpha
From 6/40 remains steady
Haemoglobin beta
Small levels in foetus, rises 36/40, max by 12w
Haemoglobin delta
From birth, rises slowly, stays low
Haemoglobin gamma
High in foetus, drops 36/40, very low by 12 weeks
HbF
Foetal Hb = 2A 2G chains
HbF high in foetus
HbA
Adult Hb = 2A 2B chains
HbA high in adulthood
Birth 15-20% HbA, no HbA - major haemoglobinopathy
Hb A2
2A 2D chains
HbH
4B
Bart’s
4G
HbS
2A 2Bs