hematology

Question 1

Answer 1

Plasmodium Falciparum: RBCs with multiple small rings representing developing Trophozoites

African species are typically resistant to Chloroquine and require Atovaquone and Proguanil

Question 2

Answer 2

Burton Line:

Blueish line along gingiva that indicates lead poinsoning

Question 3

Answer 3

Sideroblastic Anemia:

Microcytic Anemia due to defective Protoporphyrin synthesis

iron-laden mitochondria form a ring around the nucleus. Pappenheimer bodies

commonly caused by Alcoholism, Lead poisoning, or B6 Deficiency (Common in Isoniazid therapy)

Most commonly involves ALA-Synthase

S.T.I.C.

Question 4

Answer 4

Auer rods:

Associated with Acute Promyelocytic anemia (15:17 translocation)

Fused lysosomal granules that appear as azurophilic needle-shaped cytoplasmic inclusions

Question 5

Answer 5

Schistocytes:
Seen in Patients with Hemolytic Anenmias,
microangiopathic anemias, DIC, TTP/HUS, HELLP Syndrome.

Question 6

Answer 6

Howell-Jolly Bodies

Nuclear remnants within red cells that are normally removed by the Spleen. Suggests a non functioning or surgically removed spleen

Question 7

Answer 7

Heinz bodies:

inclusions of oxidized and denatured hemoglobin

Seen in G6PD, most common enzymatic disorder of RBCs (Decreased Glutathione)

Question 8

Answer 8

Bite Cells:

Result rom Phagocytic removal of Heinz bodies by Splenic Macrophages

Question 9

Answer 9

Thalassemia:

Some RBCs are moderately smaller and paler than normal. There is moderate variation in size and shape of RBCs. Target cells (dense staining area in center of RBC) and “pencil cells” are present

Question 10

Answer 10

Anemia of Chronic Disease:

Associated with chronic inflammation or cancer.

most common type of anemia in hospitalized patients.

Chronic disease results in release of Hepcidin which is an acute phase reactant.

Hepcidin: limits tranfer of iron (to pprevent bacteria) and supresses EPO = anemia

Free protoporphyrin will be found, unattached to iron

Question 11

Answer 11

Basophilic Stippling:

Lead poisoning

Basophilic stippling on a background of Hypochrominc, Microcytic anemia

Stippling the result of abnormal degredation of ribosomal RNA

young children/paint chips , industrial workers/lead particle inhalation

Question 12

Answer 12

Cavernous Hemangioma:

Collection of Diliated blood vessel malformations (hemangioma) that form a benign tumor that slowly leaks blood.

DO NOT BIOPSY: risk of intracerebral hemorrhage

Question 13

Answer 13

absent thymic shadow:

DiGeorge syndrome, Failure to develope 3rd and 4th Pharyngeal pouches. No thymus (T-cells) or Parathyroid glands (decr. Calcium)

22q deletion, FISH test

Recurrent infections that T-cells fight, hypocalcemia, Truncus arteriosus, tet of Fallot, dysmorphic facial features

B-cells: Cortex, T-cells: Paracortex

Question 14

Answer 14

Reed-Sternberg Cells:

Owl’s eye inclusions, Lacunar cells

Giant binucleate/ Bilobed cells

Hodgekin Lymphoma

Question 15

Answer 15

Koilonychia (Spoon nails):

Iron deficiency anemia, Microcytic Hypochromic

Question 16

Answer 16

Spur Cells:

(Acanthocytes)

Assoc with Liver disease, abetalipoproteinemia

due to abnormal lipoproteins forming in the cell wall