Hem & Onc - Pathology (RBC Pathologies)

Question 1

What is another name for acanthocytes? With what kinds of pathology should you associate acanthocytes?

Answer 1

Spur cells; (1) Liver disease (2) Abetalipoproteinemia (states of cholesterol dysfunction)

Question 2

How can you distinguish acanthocytes (spur cells) from echinocytes (burr cells)?

Answer 2

Acanthocytes = irregularly spaced spines; Echinocytes have more regularly spaced projections (also, seen in GP6D deficiency)

Question 3

With what kinds of pathology should you associate basophilic stippling?

Answer 3

(1) Anemia of Chronic Disease (2) Alcohol abuse (3) Lead poisoning (4) Thalassemias; Think: “BASically, ACiD Alcohol is LeThal.”

Question 4

With what kind of pathology should you associate bite cells?

Answer 4

GP6D deficiency

Question 5

With what kind of pathology should you associate elliptocytes?

Answer 5

Hereditary elliptocytosis

Question 6

With what kinds of pathology should you associate macro-ovalocytes?

Answer 6

(1) Megaloblastic anemia (2) Marrow failure

Question 7

What kinds of abnormal blood smear findings are associated with megaloblastic anemia?

Answer 7

(1) Macro-ovalocytes (2) Hypersegmented PMNs

Question 8

With what kind of pathology should you associate ringed sideroblasts? What do ringed sideroblasts signify?

Answer 8

Sideroblastic anemia; Excess iron in mitochondria = pathologic

Question 9

What is another name for shistocytes? With what kinds of pathology should you associate shistocytes?

Answer 9

Helmet cells; (1) DIC (2) TTP/HUS (i.e., microangiopathic hemolytic anemia) (3) Traumatic hemolysis (i.e., metal heart valve prosthesis?)

Question 10

With what kind of pathology should you associate sickle cells?

Answer 10

Sickle cell anemia

Question 11

With what kinds of pathology should you associate spherocytes?

Answer 11

(1) Hereditary spherocytosis (2) Autoimmune hemolysis

Question 12

With what major kind of pathology should you associate teardrop cells?

Answer 12

Bone marrow infiltration (e.g., myelofibrosis)

Question 13

With what kinds of pathology should you associate target cells? What is a good mnemonic to remember this?

Answer 13

(1) HbC disease (2) Asplenia (3) Liver disease (4) Thalassemia; HALT said the hunter to his TARGET

Question 14

What leads to the formation of bite cells?

Answer 14

Oxidation of hemoglobin sulfhydryl groups leads to denatured hemoglobin precipatation = Heinz bodies & damage to RBC membrane –> formation of bite cells (when spleen attempts to remove Heinz body)

Question 15

What are Heinz bodies? With what kinds of pathology should you associate Heinz bodies? In what condition are Heinz body-like inclusions seen?

Answer 15

Precipitation of denatured hemoglobin (due to oxidation of hemoglobin sulfhydryl groups); GP6D deficiency; Alpha-thalassemia

Question 16

What are Howell-Jolly bodies? How are they normally handles? In what kinds of patients do Howell-Jolly bodies occur?

Answer 16

Bsophilic nuclear remnants found in RBCs; Normally removed from RBCs by splenic macrophages; Patients (1) with functional hyposplenia or asplenia (2) after mothball ingestion (napthlene)