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HEMATOLOGY (RBC ABNORMALITIES) Flashcards

1
Q

Variation in cell size

A

ANISOCYTOSIS

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2
Q

RBC abnormalities can be differentiated through: (5)

A
  1. Cell size
  2. Hgb content
  3. Cell shape
  4. Inclusions
  5. Miscellaneous
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3
Q

An index of variation of cell volume in a red blood cell population reported in automated hema analyzers. Correlates with the degree of anisocytosis

A

RDW (Red cell distribution width )

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4
Q

Normal range of RDW

A

11.5% to 14.5%

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5
Q

Formula of RDW

A

RDW = (SD ÷ MCV) × 100

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6
Q

RDW:
Homogenous in character
Exhibits very little anisocytosis in PBS

A

NORMAL RDW

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7
Q

RDW:
Heterogenous in character
High degree of anisocytosis

A

Increased RDW

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8
Q

LOW RDW

A

NO SIGNIFICANCE

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9
Q

Average volume of RBC

A

MCV (Mean Corpuscular Volume)

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10
Q

Formula for MCV

A

Hct(%) x 10 / RBC(x10^12/L)

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11
Q

MCV NORMAL reference range

A

80-100 fL

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12
Q

Used to classify anemias

A

MCV

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13
Q

Normal MCV (80-100fL)

A

Normocytic

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13
Q

MCV<80fL

A

microcytic

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14
Q

MCV>100fL

A

macrocytic

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15
Q

Normal sized RBC 6-8 um in diameter, MCV 80-100fL

A

normocytic RBC

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16
Q

Small RBC (<6um in diameter) MCV<80fL

A

microcytic RBC

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17
Q

Large RBC (>8um in diameter), MCV >100fL

A

macrocytic RBC

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18
Q

AHA
Acute blood Loss
Hemolytic anemia
Aplastic anemia

A

Normocytic RBC

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19
Q

ATIS
Anemia of chronic inflammation
Thalassemia
IDA
Sideroblastic anemia

A

Microcytic RBC

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20
Q

Megaloblastic anemia
Myelodysplastic anemia
Chronic liver disease
Bone marrow failure
Reticulocytosis

A

Macrocytic RBC

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21
Q

Megaloblastic anemia caused by VIT. B12 DEFICIENCY

A
  • D. latum
  • Malabsorption caused by gastric resection, gastric carcinoma, and some forms of CELIAC disease or SPRUE
  • Nutritional deficiency/ diminished supply of V. B12
  • Pernicious anemia
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22
Q

Megaloblastic anemia caused by FOLIC ACID DEFICIENCY

A
  • Abnormal absorption caused by celiac disease or sprue
  • increased utilization caused by pregnancy
  • Tx with antimetabolites that act as folic acid antagonists
  • Dietary deficiency
  • Won’t involve CNS
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23
Q

Vit. B12 or Folic Acid Deficiency

A

Megaloblastic anemia

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24
Q

Variation of the color of erythrocyte due to unequal hemoglobin concentration

A

ANISOCHROMIA

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25
Q

Central pallor does not exceed 1/3 red cell’s diameter, MCHC 31-36%

A

Normochromic RBC

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26
Q

Normal MCHC value

A

32 to 36% or 32 to 36 g/dL

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27
Q

Central pallor > 1/3 red cell’s diameter, MCHC <31%

A

Hypochromic RBC

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28
Q

IDA: Most common cause

A

Chronic blood loss (e.g. hookworms)

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29
Q

Normochromic RBCs: diseases

A

AHA
Acute blood Loss
Hemolytic anemia
Aplastic anemia

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30
Q

Hypochromic RBCs: diseases

A

ATIS
Anemia of chronic inflammation
Thalassemia
IDA
Sideroblastic anemia

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31
Q

HYPOCHROMIA GRADING
Area of central pallor is ONE-HALF of cell diameter

A

1+

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32
Q

HYPOCHROMIA GRADING
Area of central pallor is TWO-THIRDS of cell diameter

A

2+

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33
Q

HYPOCHROMIA GRADING
Area of central pallor is THREE-QUARTERS of cell diameter

A

3+

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34
Q

HYPOCHROMIA GRADING
THIN RIM of hemoglobin

A

4+

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35
Q

Indirect measure of transferrin

A

TIBC

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36
Q

serum TIBC increased, serum iron significant decreased

A

Iron deficiency

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37
Q

serum IRON increased

A

Sideroblastic anemia

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38
Q

serum IRON & TIBC decreased

A

Anemia of Chronic disease

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39
Q

No central pallor, MCHC >36%

A

Hyperchromic RBC

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40
Q

SPHEROCYTE (Bronze cell)

A

Hyperchromic RBC

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41
Q

Hyperchromic RBC: disease

A

Hereditary Spherocytosis

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42
Q

Confirmatory test for Hereditary spherocytosis

A

Increased OFT

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43
Q

Alternative confirmatory test for Hereditary spherocytosis

A

EMA dye (Flow cytometry)

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44
Q

Blue-gray tint to the red cells

A

Reticulocytes / Polychromatophilic RBCs

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45
Q

Stain for Reticulocytes

A

Supravital stain (brilliant cresyl blue)

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46
Q

Uses Supravital stain (3)

A
  1. Reticulocytes
  2. Hgb H
  3. Heinz bodies
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47
Q

Polychromatophilic RBC: diseases

A

Hemolysis
Hemorrhage

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48
Q

POLYCHROMASIA GRADING:
1+

A

3%

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49
Q

POLYCHROMASIA GRADING:
2+

A

5%

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50
Q

POLYCHROMASIA GRADING:
3+

A

10%

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51
Q

POLYCHROMASIA GRADING:
4+

A

> 11%

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52
Q

The average concentration of Hemoglobin per dL of RBCs

A

MCHC (Mean Corpuscular Hemoglobin Concentration)

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53
Q

MCHC >37%

A

May indicate problem with the specimen (HYPERLIPIDEMIA, COLD AGGLUTININS) or instrument

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54
Q

MCHC Formula

A

Hgb (g/dL) x 100 / Hct (%)

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55
Q

NORMOCYTIC NORMOCHROMIC

A

AHA
Acute blood loss
Hemolytic anemia
Aplastic anemia

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56
Q

MICROCYTIC HYPOCHROMIC

A

ATIS
Anemia of chronic inflammation
Thalassemia
IDA
Sideroblastic anemia

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57
Q

HEREDITARY SPHEROCYTOSIS:
indications

A

increased MCHC
increased OFT
(-) DAT

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58
Q

AUTOIMMUNE HEMOLYTIC ANEMIA: indications

A

increased MCHC
increased OFT
(+) DAT

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59
Q

Presence of NORMOCHROMIC & HYPOCHROMIC cells in the same film

A

DIMORPHIC ANEMIA

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60
Q

Causes of DIMORPHIC ANEMIA

A
  • Sideroblastic anemia
  • Weeks of IRON THERAPY for IDA
  • Hypochromic anemia AFTER TRANSFUSION with normal cells
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61
Q

Alterations or variations in SHAPE of erythrocytes

A

POIKILOCYTOSIS

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62
Q

POIKILOCYTOSIS are classified as to:

A

Poikilocytosis secondary to:
1. Developmental Macrocytosis
2. Membrane defects
3. Trauma
4. Abnormal hemoglobin content

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63
Q

Poikilocytosis secondary to Developmental macrocytosis

A

Oval macrocytes (MEGALOCYTES)

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64
Q

Oval macrocytes (MEGALOCYTES)

A

Oval or Egg-like in appearance

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65
Q

Poikilocytosis seen in Vitamin B12 and folate deficiency

A

Oval macrocytes (MEGALOCYTES)

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66
Q

Poikilocytosis secondary to MEMBRANE DEFECTS

A
  1. Acanthocyte
  2. Echinocyte
  3. Codocyte, Leptocyte
  4. Spherocyte
  5. Stomatocyte
  6. Elliptocyte, Ovalocyte
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67
Q

Irregularly spaced projections of varying length

A

Acanthocytes (spur, thorn cell)

68
Q

Increase in sphingomyelin over lecithin

A

Acanthocyte

69
Q

Acanthocytes are seen in:

A

McLeod Syndrome
Abetalipoproteinemia
Neuroacanthocytosis
Severe liver disease

70
Q

RBC with blunt or pointed, short projections that are usually evenly spaced over the surface of cell

A

Echinocyte/ Burr Cell (Crenated, sea urchin)

71
Q

_______ can occur as the result of the physical loss of intracorpuscular water (OSMOTIC IMBALANCE)

72
Q

Diseases associated with Echinocytes

A

Heparin therapy
Uremia
Liver disease
Pyruvate kinase

73
Q

Other term for echinocytes

A

Crenated, sea urchin, BURR CELL

74
Q

Equal length and distribution cell

A

Echinocyte/burr cell

75
Q

RENAL INSUFFICIENCY

A

Burr cell/Echinocytes

76
Q

Echinocytes as artifact

A
  1. Drying artifact = H2O artifact
  2. Stored blood (decreased ATP)
  3. Hypertonic solution (cells shrink and crenate)
77
Q

Mexican hat

78
Q

Target cell

79
Q

Excessive cholesterol and phospholipid in the membrane or a hemoglobin distribution imbalance

80
Q

Diseases associated with codocytes

A

Hemoglobinopathies
Thalassemia
Liver disease

81
Q

Thinner variant of codocyte

82
Q

no central pallor, decreased surafce to volume ratio; associated with defects of the red cell membrane proteins (SPECTRIN)

A

SPHEROCYTES

83
Q

diseases associated with spherocyte

A

HIS (Hereditary spherocytosis)
Immune Hemolytic Anemia
Extensive burns (along with schistocytes)

84
Q

bowl-shaped RBC

A

Stomatocyte

85
Q

mouth cell

A

stomatocyte

86
Q

RBC with slit like area of central pallor

A

Stomatocyte

87
Q

caused by osmotic changes due to CATION IMBALANCE

A

Stomatocytes

88
Q

Diseases associated to stomatocyte

A

Hereditary stomatocytosis
RH NULL SYNDROME
Acquired (liver disease, alcoholism)

89
Q

Defects in CYTOSKELETON. Decreased in membrane protein band 4.1

A

Elliptocytes

90
Q

Hereditary elliptocytosis
Anemia associated with malignancy
Hb C disease
Hemolytic anemias
IDA, Sickle cell trait, thalassemia
Pernicious anemia

A

Elliptocytosis

91
Q

Egg-shaped RBC, wider than elliptocyte

92
Q

Thinner variant of ovalocyte

A

Pencil/oat cell

93
Q

Megaloblastic anemia

94
Q

REDUCTION IN MEMBRANE CHOLESTEROL

95
Q

Elliptocytes are seen in what blood phenotype?

A

Leach phenotype (Gerbich null) Ge -2 -3 -4

96
Q

Cigar-shaped RBC

A

Elliptocytes

97
Q

POIKILOCYTES SECONDARY TO TRAUMA

A
  1. Schistocytes
  2. Dacrocytes
  3. Microspherocytes
  4. Semilunar bodies/Half-moon, Crescent cell
98
Q

Fragmented RBC due to the rupture in the peripheral circulation (rupturing of a blister cell)

A

Schistocytes

99
Q

Also called as HELMET CELLS

A

Schistocytes

100
Q

Pinched cell (triangular with 2 pallor areas)

A

Knizocytes

101
Q

Disease associated with Schistocytes

A

MICROANGIOPATHIC HEMOLYTIC ANEMIA
Traumatic cardiac hemolysis
Extensive burns

102
Q

seen in MMM: Myelofibrosis with Myeloid Metaplasia

A

Dacrocytes

103
Q

Squeezing and fragmentation during splenic passage. Resembles a teardrop or pear

A

Dacrocyte/Dacryocyte/Teardrop cell

104
Q

Defective cells exhibiting heat sensitivity

A

Microspherocytes/Pyropikilocyte

105
Q

Normal RBCs fragment at what temp?

A

49 degrees C

106
Q

RBCs fragment @ 45-46 degrees Celsius:

A

Hereditary pyropoikilicytosis
Hereditary microspherocytosis

107
Q

Poikilocyte seen in MALARIA

A

Semilunar bodies, halfmoon or crescent

108
Q

What is the poikilocyte secondary to abnormal hemoglobin content?

A

Drepanocyte (sickle cells)

109
Q

Holly-leaf shape

A

Drepanocyte (sickle cells)

110
Q

Results from the gelation of polymerized deoxygenated hemoglobin S

A

Drepanocyte (sickle cells)

111
Q

Folded cell: RBC with membrane folded over are seen in

A

Hb C disease & Hb SC disease

112
Q

Nuclear fragments of DNA

A

Howell-Jolly bodies

113
Q

Poikilocyte inclusion testing positive in Feulgen’s reaction

A

Howell-Jolly bodies

114
Q

Howell-Jolly bodies are seen in

A

MEGALOBLASTIC ANEMIA

115
Q

Deep blue to purple granules. Aggregation of ribosomes

A

Basophilic stippling

116
Q

Basophilic stippling is seen in

A

Lead and arsenic intoxication
Pyrimidine-5-nucleotidase deficiency

117
Q

Type of basophilic stippling seen when there is increased polychromatophilia, increased production of red cells

A

FINE STIPPLINE

118
Q

Type of basophilic stippling seen in LEAD POISONING

A

COARSE STIPPLING

119
Q

Reference range for LEAD

A

<3.5 ug/dL or <5 ug/dL

120
Q

lead: >0.5 mg/day

A

lead accumulation and toxicity

121
Q

lead: 0.5g absorbed

A

fatal dose

122
Q

normal lead in children

123
Q

normal lead in adults

124
Q

Supravital stain used in Reticulum

A

New Methylene Blue

125
Q

Supravital stain used in Hgb H

A

Brilliant Cresyl blue

126
Q

Supravital stain used in Heinz bodies

A

Crystal violet

127
Q

BEST vital dye

A

Neutral red

128
Q

6th GLU –> VAL

129
Q

6th GLU–> LYS

130
Q

Basophilic stippling may resemble

A

Pappenheimer bodies

131
Q

To differentiate Basophilic stippling from Pappenheimer bodies

A

Basophilic stippling - uniform and homogenous distribution

Pappenheimer bodies - distribution is in periphery

132
Q

Ring/Figure of 8 inclusion. Remnants of microtubules from the mitotic spindle

A

CABOT RINGS

133
Q

Cabot rings are seen in

A

DYSERYTHROPOIESIS, lead poisoning, pernicious anemia

134
Q

PITTED GOLF BALL

A

Heinz bodies

135
Q

Denatured hemoglbin

A

Heinz bodies

136
Q

Heinz bodies are seen in

A

G6PD deficiency
Unstable hemoglobins
FAVISM
Splenectomized pxs
Congenital hemolytic anemia
Child with ingested mothball

137
Q

Precipitate of Beta chains of hemoglobin

A

Hgb H bodies

138
Q

Alpha thalassemia with a deletion of 3/4 alpha chains

A

Hgb H disease

139
Q

glove or pistol-like in shape

A

Hemoglobin SC

140
Q

WASHINGTON MONUMENT

A

Hemoglobin SC

141
Q

Clam shell/gold bar shape

A

Hemboglobin C

142
Q

Nucleated RBC that contains nonheme iron particles

A

Ringed sideroblast (immature cell)

143
Q

Non-nucleated cell containing iron granules

A

Siderocyte

144
Q

Due to excessive IRON OVERLOAD; and defective heme synthesis

A

Sideroblastic Anemia

145
Q

Appears in:
Sideroblastic anemia
Hemoglobinopathies
Hyposplenism
Megaloblastic anemia

A

Pappenheimer bodies

146
Q

Inclusions composed of ferric iron on PRUSSIAN BLUE

A

Pappenheimer bodies

147
Q

Stain for hemosiderin

A

Perl’s prussian blue

148
Q

Component of Perl’s Prussian Blue

A

1% aqueous potassium ferrocyanide
2% aqueous hydrochloric acid

149
Q

What spp. of Plasmodium makes RBC size ENLARGED

A

P. vivax, P. ovale

150
Q

What spp. of Plasmodium makes RBC size NORMAL

A

P. malariae, P. falciparum

151
Q

P. vivax contains what type of RBC inclusions?

A

Schuffner’s dots

152
Q

P. ovale contains what type of RBC inclusions?

A

Schuffner’s dots & James dots

153
Q

P. malariae contains what type of RBC inclusions?

A

Ziemann stippling

154
Q

P. falciparum contains what type of RBC inclusions?

A

Maurer dots

155
Q

To quantify malaria parasites against RBCs

A

THIN SMEAR
% PARASITEMIA
= (parasitized rbc / total rbc) x 100

156
Q

To quantify malaria parasites against WBCs

A

THICK SMEAR
PARASITES/MICROLITER OF BLOOD
= (parasites/WBCs) x WBC count per microliter (or 8,000)

157
Q

NANTUCKET FEVER / most common cause of babesiosis

A

B. microti

158
Q

MALTESE CROSS

A

Babesiosis

159
Q

P. vivax and ovale attacks:

A

YOUNG RBCs (RETICS)

160
Q

P. falciparum attacks:

A

All stages of RBCs

161
Q

P. malariae attacks:

A

Mature RBCs

162
Q

Clumping of RBCs

A

AGGLUTINATION

163
Q

Occurs when an individual’s red cells agglutinate in his own plasma or serum that contains specific known agglutinins

A

AUTOAGGLUTINATION

164
Q

Agglutination occurs in:

A

Cold agglutinin disease (Cold Ab = Anti-I)
Primary Atypical Pneumonia

165
Q

GRADING OF AGGLUTINATION

A

1+ 25%
2+ 50%
3+ 75%
4+ 100%

166
Q

Represents erythrocytes arranged in rolls or stacks

A

Rouleaux formation

167
Q

Rouleaux formation occurs in:

A

(INCREASED ESR)
Multiple myeloma
Macroglobulinemia

168
Q

Due to the presence of concentrations of abnormal globulins or fibrinogen

A

Rouleaux formation

LEMAR ACTIVE RECALL (4 decks)

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