HEMA LEC - Erythrocyte Inclusions And Associated Diseases

Question 1

Usually orthochromic normoblasts (metarubricyte) but can appear in any erythrocytic stage of maturation

Answer 1

Nucleated RBCs (nRBCs, nucRBCs)

Question 2

Indicate bone marrow stimulation or increased erythropoiesis

Answer 2

Nucleated RBCs (nRBCs, nucRBCs)

Question 3

Associated with thalassemia major, sickle cell anemia, and other hemolytic anemias, erythroleukemia, and myeloproliferative disorders

Answer 3

Nucleated RBCs (nRBCs, nucRBCs)

Question 4

Normal newborns can have a few

Answer 4

Nucleated RBCs (nRBCs, nucRBCs)

Question 5

Healthy individuals should have none on a peripheral blood smear.

Answer 5

Nucleated RBCs (nRBCs, nucRBCs)

Question 6

Small, round DNA fragments (0.5-1.0um in diameter) usually one per cell, but can be multiple which results from karyorrhexis or nuclear disintegration

Answer 6

Howell-Jolly bodies

Question 7

Stain dark purple to black with Wright’s stain; positive (+) in Feulgen Reaction

Answer 7

Howell-Jolly bodies

Question 8

Not seen in normal erythrocytes; normally pitted by splenic macrophages

Answer 8

Howell-Jolly bodies

Question 9

karyorrhexis or nuclear disintegration

Answer 9

Howell-Jolly bodies

Question 10

d. Seen in sickle cell anemia, beta-thalassemia major, and other severe hemolytic anemias, MEGALOBLASTIC ANEMIA, alcoholism, post-splenectomy, accelerated erythropoiesis

Answer 10

Howell-Jolly bodies

Question 11

Multiple, tiny, fine, or coarse inclusion (ribosomal RNA remnants) evenly dispersed throughout the cell;

Answer 11

Basophilic stippling (punctuate basophilia)

Question 12

“blueberry bagel” appearance

Answer 12

Basophilic stippling (punctuate basophilia)

Question 13

Stain dark blue with Wright’s stain

Answer 13

Basophilic stippling (punctuate basophilia)

Question 14

Seen in in thalassemias, megaloblastic anemias, sideroblastic anemia, LEAD POISONING, pyrimidine-5-nucleotidase deficiency, and alcoholism

Answer 14

Basophilic stippling (punctuate basophilia)

Question 15

Small, irregular, dark-staining IRON granules usually clumped together at PERIPHERY of the cell

Answer 15

Pappenheimer bodies

Question 16

Stain with Perl’s Prussian blue stain; appear dark violet with Wright’s stain

Answer 16

Pappenheimer bodies

Question 17

Caused by an accumulation of ribosomes, mitochondria, and iron fragments

Answer 17

Pappenheimer bodies

Question 18

Seen in sideroblastic anemia, hemoglobinopathies, thalassemia megaloblastic anemia, myelodysplastic syndrome (RARS)!!!

Answer 18

Pappenheimer bodies

Question 19

Thin, red-violet, single to multiple ringlike structures that may appear in lip or figure-eight shapes

Answer 19

Cabot rings

Question 20

Seen in megaloblastic anemia, myelodysplastic syndromes, lead poisoning

Answer 20

Cabot rings

Question 21

Composed of fragments of nuclear material, specifically, remnants of microtubules of mitotic spindle

Answer 21

Cabot rings

Question 22

Condensed, intracellular, rod-shaped crystal, or hexagonal crystals with blunt ends and stains darkly

Answer 22

Hemoglobin C crystals

Question 23

Seen in hemoglobin C or SC disease, but not in trait

Answer 23

Hemoglobin C crystals

Question 24

1-2 blunt, fingerlike projection extending from the cell membrane

Answer 24

Hemoglobin SC crystals (Washington monument)

Question 25

Seen in hemoglobin SC disease

Answer 25

Hemoglobin SC crystals (Washington monument)

Question 26

Multiple inclusions ranging in size from 0.3 to 2.0um

Invisible with Wright’s stain; must use a supravital stain to visualize; usually crystal violet

Answer 26

Heinz bodies

Question 27

Seen in G6PD deficiency, beta-thalassemia major, Hgb H disease, unstable hemoglobinopathies, drug-induced anemias

Answer 27

Heinz bodies

Question 28

Represent denatured hemoglobin

Answer 28

Heinz bodies

Question 29

include P. vivax, P, falciparum, P. malariae and P. ovale

Answer 29

Malarial parasite

Question 30

protozoan inclusion (B. microti), transmitted from deer to humans by tick bite. RBC inclusion resembles that of P. falciparum rings which a characteristic “MALTESE CROSS” appearance

Answer 30

Babesia