HEMA LEC - Erythrocytic Morphology and Assoc Disease

Question 1

are normal erythrocytes that are approximately the same size as the nucleus of a small lymphocytes.

Answer 1

Normocytes (discocytes)

Question 2

a. RBCs greater than 8um in diameter;

Answer 2

2. Macrocytes

Question 3

MCV greater than 100 fL

Answer 3

2. Macrocytes

Question 4

Seen in megaloblastic anemias, such as B12/folate deficiency

Answer 4

2. Macrocytes

Question 5

Seen in non-megaloblastic anemia of liver disease or accelerated erythropoiesis; also seen in normal newborns

Answer 5

2. Macrocytes

Question 6

a. RBCs less than 6um in diameter;

Answer 6

Microcytes

Question 7

MCV less than 80 fL

Answer 7

Microcytes

Question 8

Seen in iron-deficiency anemia, thalassemias, sideroblastics anemia, and anemia of chronic disease

Answer 8

Microcytes

Question 9

a. Variation in RBC size, indicating a heterogeneous RBC population (dimorphism)

Answer 9

anisocytosis

Question 10

heterogeneous RBC population (dimorphism)

Answer 10

(dimorphism)

Question 11

b. Correlates with RDW (red blood cell distribution width), especially when the RDW exceeds 15.0%

Answer 11

anisocytosis

Question 12

c. Seen post-transfusion, post-treatment for a deficiency (e.g., iron), presence of two concurrent deficiencies (e.g., iron and vitamin B12), and idiopathic sideroblastic anemia

Answer 12

anisocytosis

Question 13

a. General term to describe variation in shape

b. Associated with a variety of pathologic conditions

Answer 13

5. Poikilocytosis

Question 14

include crenated, and burr cells (sea urchin cells)

Answer 14

Echinocytes

Question 15

Have evenly spaced round projections; central pallor area present

Answer 15

Echinocytes

Question 16

Seen in liver disease, uremia, heparin therapy, pyruvate kinase deficiency, anemia associated with renal insufficiency (burr cells) or as artifact in improper air drying

Answer 16

Echinocytes

Question 17

Caused by changes in osmotic pressure due to depletion of ATP which supports the cation pump, exposure to hypertonic solution

Answer 17

Echinocytes

Question 18

Have unevenly space pointed projection; lack a central pallor area

Answer 18

Acanthocytes (spur cells/thorn cells)

Question 19

Associated with alcoholic liver disease, post-splenectomy, and abetalipoproteinemia, malabsoprtion states, hepatitis of the newborn, severe haemolytic anemia associated with cirrhosis and in metastatic liver disease

Answer 19

Acanthocytes (spur cells/thorn cells)

Question 20

Caused by excessive cholesterol in the membrane

Answer 20

Acanthocytes (spur cells/thorn cells)

Question 21

a. Show a central area of hemoglobin surrounded by a colorless ring and a peripheral ring of hemoglobin; cells have an increased surface-to-volume ratio

Answer 21

Target cells (codocytes or Mexican hat cells)

Question 22

Seen in liver disease, hemoglobinopathies SS SC CC DD EE, thalassemia, iron-deficiency anemia, obstructive liver disease, postsplenectomy states

Answer 22

Target cells (codocytes or Mexican hat cells)

Question 23

Caused by excessive cholesterol in the membrane or a hemoglobin distribution imbalance

Answer 23

Target cells (codocytes or Mexican hat cells)

Question 24

thinner variant of codocytes

Answer 24

Leptocyte

Question 25

Disk-shaped cell with a smaller volume than a normal erythrocytes; cells have decreased surface-to-volume ratio
Lack a central pallor area
c. Associated with defects of the red cell membrane proteins

Answer 25

Spherocytes (ball shaped cells)

Question 26

MCHC may be >37%; increased osmotic fragility

Answer 26

Spherocytes (ball shaped cells)

Question 27

Damaged RBC; seen in hereditary spherocytosis (HS), G6PD deficiency, and isoimmune and autoimmune hemolytic anemias, blood banked stored blood for a long time

Answer 27

Spherocytes (ball shaped cells)

Question 28

are frequently seen in severe thermal injury (burns).

Answer 28

Microspherocytes (

Question 29

After splenectomy in a patient with HS, spherocytes ____ indicating that the abnormality involves the red blood cell membrane itself rather than splenic damage to the cells.

Answer 29

persist

Question 30

a. Pear-Shaped cell with one blunt projection

b. Seen in megaloblastic anemias, thalassemia, and extramedullary hematopoiesis (myelofibrosis, myelophthisic anemia)

Answer 30

Teardrops (dacryocytes)

Question 31

a. Shapes vary but show thin, elongated, pointed ends and will appear crescent shaped; usually lack a central pallor area; described as having a holly leaf appearance

Answer 31

Sickle cells (drepanocytes)

Question 32

Contain polymers of abnormal hemoglobin S

Answer 32

Sickle cells (drepanocytes)

Question 33

Seen in hemoglobinopathies SS, SC, SD, and S/B-thalassemia

Answer 33

Sickle cells (drepanocytes)

Question 34

Cell Shape is caused by cell membrane alterations due to an amino acid substitution

Answer 34

Sickle cells (drepanocytes)

Question 35

a. Interior portion of cell is hollow, resembling a horn or helmet
c. Seen in microangiopathic hemolytic anemias

Answer 35

Helmet cells (horn cells or keratocytes)

Question 36

b. Basically a schistocyte with a hornlike projections (Gr. Keras: horn)

Answer 36

Helmet cells (horn cells or keratocytes)

Question 37

a. Damaged RBC; fragment of various sizes and shapes are present, often with pointed projection

Answer 37

Schistocytes/schizocyte (RBC fragments)

Question 38

Seen in microangiopathic hemolytic anemias (e.g., DIC, HUS, TTP), thermal injury, renual transplant rejection, and G6PD deficiency

Answer 38

Schistocytes/schizocyte (RBC fragments)

Question 39

a. Characterized by an elongated or slit-like area of central pallor

Answer 39

Stomatocytes (mouth cells)

Question 40

Caused by osmotic changes due to cation imbalance (Na+/K+)

Answer 40

Stomatocytes (mouth cells)

Question 41

Seen in obstructive liver disease, Alcoholism, cirrohosis, hereditary stomatocytosis, RH NULL DISEASE, or as artifact

Answer 41

Stomatocytes (mouth cells)

Question 42

a. Cigar- to – egg-shaped erythrocytes

Answer 42

Elliptocytes (ovalocytes)

Question 43

Seen in hereditary elliptocytosis, iron-deficiency anemia (pencil forms), megaloblastic anemia (macro-ovalocytes), thalassemia major

Answer 43

Elliptocytes (ovalocytes)

Question 44

Associated with defects of the red cells membrane proteins specifically in membrane protein 4.1

Answer 44

Elliptocytes (ovalocytes)

Question 45

– a transitional variant of Hereditary elliptocytosis.

Answer 45

Hereditary pyropoikilocytosis

Question 46

has the same appearance as elliptocytes and usually occur at the first 6 months of life.

Answer 46

Pyropoikilocytes

Question 47

To differentiate from normal red blood cells, it usually lyses at 45-460C while normal red blood cells lyses at 490C

Answer 47

Pyropoikilocytes