Hematopoiesis

Question 1

(i.e., normal size and shape) are biconcave discs usually about 6-8 m in diameter (about the same diameter as the nucleus of a small lymphocyte).

Answer 1

normocytic erythocytes

Question 2

(i.e., normal hemoglobin content) have a center somewhat paler than the peripheral rim of the cell

Answer 2

normochromic erythrocytes

Question 3

homogenous population of normochromic erythrocytes

Answer 3

normocytic normochromic

Question 4

demonstrate a central pale area that becomes larger and paler as the hemoglobin content diminishes.

Answer 4

hypochromic erythrocytes

Question 5

indicates the presence of both normochromic and hypochromic cells in the same blood film

Answer 5

anioschromia or dimorphic

Question 6

abnormally small erythrocytes (i.e., less than 6 m in diameter).

Answer 6

microcytes

Question 7

abnormally large erythrocytes (i.e., greater than 8 m in diameter)

Answer 7

macrocytes

Question 8

“generic” term used to indicate an abnormal variation in size of erythrocytes.

Answer 8

anisocytosis

Question 9

are oval-shaped erythrocytes and are abundant in hereditary ___

Answer 9

Elliptocytes (ovalocytes)

Question 10

Lesser amounts of elliptocytes seen in?

Answer 10

A lesser number are seen in thalassemia, aplastic anemia, leukemia, and macroovalocytes in megaloblastic anemia

Question 11

are irregularly contracted erythrocytes which stain densely and have contraction of hemoglobin from a part of the cell membrane, thereby giving the appearance that a “bite” has been take out of the cells.

Answer 11

keratocytes (“bitocytes”)

Question 12

When do we see keratocytes?

Answer 12

seen in G6PD deficiency and are thought to be cells from which Heinz bodies have been removed from the spleen.

Question 13

They are small pieces of cells cut from whole cells with a cell size less than one half of normal size. The segments can be a variety of shapes but helmet cells and triangle-shaped cells are particularly characteristic.

Answer 13

Schistocytes (fragmented red cell segments)

Question 14

What causes the creation of schistocytes (fragmented red cell segments)?

Answer 14

hemolytic process (e.g. disseminated intravascular coagulation, hemolytic uremic syndrome, etc.).

Question 15

are nearly spherical small dark hemoglobinized cells without a central pale area

Answer 15

spherocytes

Question 16

When do we see spherocytes?

Answer 16

prominent in hereditary spherocytosis, autoimmune hemolytic anemia, burns, thermal sensitivity

Question 17

Where do we see less spherocytes?

Answer 17

any anemia

Question 18

are abnormal RBC’s with a central, pale, cresent shaped area that resembles a mouth

Answer 18

stomatocytes

Question 19

When do we see stomatocytes?

Answer 19

Rh disorders

Question 20

erythrocytes that are thinner than normal which show a peripheral rim of hemoglobin with a dark, central hemoglobin-containing area. A pale unstained ring containing less hemoglobin separates the central and peripheral zones and gives the cell a target appearance. These cells have increased (redundant) surface membrane with increased lecithin and cholesterol content.

Answer 20

target cells (codocytes)

Question 21

look like teardrops. They are elongated cells that have one round end with the other end tapering off to a smaller point

Answer 21

teardrop-shaped cells (dacrocytes)

Question 22

What are teardrop-shaped cells associated with? macroteardrops?

Answer 22

with myelofibrosis. A few are typically associated with thalassemia and may be seen in other types of anemias.

Macroteardrops are associated with megaloblastic anemia.

Question 23

Erythrocytes with round or spiny spicules (projections) may be classified as?

Answer 23

crenated red cells, acanthocytes, spur cells, burr cells, or pyknocytes by some authors based upon the number and shape of the spicules

Question 24

resemble spherocytes with peripheral irregularly spaced spiny or thorny projections

Answer 24

acanthocytes

Question 25

When do we see acanthocytes?

Answer 25

severe liver disease, infantile pykno-cytosis (with underlying hemolytic process), abetalipoproteinemia, or anorexia nervosa.

Question 26

appear as irregularly shaped red cells with numerous small, thorny projections and preserved central pallor.

Answer 26

echinocytes

Question 27

How do we get echinocytes?

Answer 27

usually an artifactual phenomenon, they may be produced by lysins, sphering agents, or increases in pH

Question 28

When do we see echinocytes?

Answer 28

in liver and renal disease, hyperlipidemia, and red cell enzymopathies.

Question 29

mature red cells of approximately normal size with central pallor and one or more spiny projections

Answer 29

burr cells (keratocytes)

Question 30

When do we see burr cells?

Answer 30

uremia, bleeding peptic ulcer, heart valve replacement, vasculitis, DIC, and microangio-pathic hemolytic anemia

Question 31

red blood cells are symmetrical with heavy, coarse, scalloped edges (i.e., uniformly shrunken red cells with uniform irregular, wrinkled cell membranes).

Answer 31

crenated

Question 32

How do we get crenated RBCs? How differ from echinocytes?

Answer 32

artifact of storage and all red cells in the field are usually affected. By contrast, echinocytes are intermixed with normal red cells).

Question 33

How to differentiate artifacts resembling crenated cells (may be seen when a small amount of water has contaminated the Wright-Giemsa stain)?

Answer 33

The erythrocytes will appear to have a tiny pit or bubble indentation.

Question 34

“generic” term used to indicate an abnormal variation in erythrocyte shapes, which may include combinations of normal, oval, pear, teardrop, saddle, helmet, sickle, and irregular shapes.

Answer 34

Poikilocytosis

Question 35

formation describes an aggregation of erythrocytes that are aligned one upon the other resembling stacks of coins and is caused by elevated plasma fibrinogen or globulins. This phenomenon causes an increased erythrocyte sedimentation rate

Answer 35

rouleau

Question 36

Rouleau is characterstic of what?

Answer 36

paraproteinemia (monoclonal gammopathy)

Question 37

caused by agglutinins and resembles rouleau but is more irregular with round clumps rather than linear rouleau

Answer 37

agglutination of red cells

Question 38

are elongate hexagonal crystals, which may be intracellular or extracellular

Answer 38

Hemoglobin C crystals

Question 39

When do we see hemoglobin C crystals?

Answer 39

HbC syndromes

Question 40

indicate the presence of irregular basophilic granules (polyribosomes), which may be coarse or fine, within the mature or immature erythrocyte.

Answer 40

basophilic stippling

Question 41

When do we see basophilic stippling?

Answer 41

seen in normal smears

Question 42

intracellular inorganic iron-containing granules that may be observed on Wright’s stained peripheral blood smears

Answer 42

pappenheimer bodies

Question 43

When the pappenheimer bodies are demonstrated by stains for iron (e.g., Prussian Blue), the cells are called ___?

Answer 43

siderocytes

Question 44

When do we see pappenheimer bodies? particularly sideocytes?

Answer 44

iron-loading anemias (e.g., thalassemia)

Siderocytes may be found in large numbers when hemoglobin synthesis is impaired (as in siderochrestic anemias) and after splenectomy. They may also be seen in iron-loading anemias, hyposplenism, and in hemolytic anemias of various etiologies

Question 45

intracellular particles that are smooth, round remnants of nuclear chromatin (DNA). Usually, only one per cell is seen but, occasionally, there may be more than one.

Answer 45

howell-jolly bodies

Question 46

appear as intracellular red or reddish purple structures that are usually shaped like rings, loops, figure-of-eight with no internal structure

Answer 46

cabot rings

Question 47

precursors of the non-nucleated mature red cells. The orthochromatic erythroblast is the stage usually noted observed in peripheral blood in disease states, but less mature stages may also be seen

Answer 47

nucleated red blood cells (NRBC)

Question 48

What stain is needed to see reticulocytes and Heinz bodies?

Answer 48

supravital stain (e.g. crystal violet, new methylene blue stain)

Question 49

After staining, the cytoplasmic organelles of the cells (RNA) clump into an easily recognized blue-staining reticulum, which allows an accurate count of ____ to be made.

Answer 49

reticulocytes

Question 50

What does an increase in reticulocytes indicate? Characteristically seen when?

Answer 50

best indication that the bone marrow is functioning and responding to a demand for increased release of erythrocytes into circulation

hemolytic anemias

Question 51

appear as precipitates of denatured hemoglobin which characteristically adhere to the red cell membrane

Answer 51

Heinz bodies

Question 52

Heinz bodies are characteristically seen in?

Answer 52

G6-PD deficiency anemia