Heme

Question 1

acanthocyte (spur cell)

Answer 1

liver disease, abetalipoproteinemia (cholesterol dysregulation)

Question 2

basophilic stippling

Answer 2

ACD, alcohol abuse, lead poisoning, Thalassemia

“Basically ACiD alcohol is LeThal”

Question 3

Bite cell, Heinz bodies

Answer 3

G6PD deficiency

Question 4

macro-ovalocyte, hypersegmented PMNs

Answer 4

Megaloblastic anemia, marrow failure, B12/folate def, pernicious anemia

Question 5

ringed sideroblast

Answer 5

sideoblastic anemia (defect in protoporphyrin synthesis so Fe trappen in mito around nucleus)

Question 6

schistocyte

Answer 6

DIP, TTP/HUS, traumatic hemolysis (mechanical heart valve)

Question 7

Sickle cell (genetic mutation?)

Answer 7

6glu –> valine on Hgb B chain

sickles when deoxygenated

Question 8

defect in cytoskeleton (spectrin, ankyrin, band 31), inc RDW, osmotic fragility test

Answer 8

hereditary spherocytosis

Question 9

teardrop cell

Answer 9

bone marrow infiltration (myelofibrosis)

“RBC shed tea because forced out of home”

Question 10

Target cell

Answer 10

HbC disease, asplenia, liver disease, thalassemia

“HALT to target”

Question 11

Howell-Jolly bodies

Answer 11

basophilic nuclear remnants, asplenia, hyposplenia

Question 12

Causes of microcytic anemia

Answer 12

Fe deficiency (late), ACD, thalassemia, lead poisoning, sideroblastic anemia

Question 13

Causes of nonhemolytic normocytic anemia

Answer 13

ACD, aplastic anemia, CKD, Fe deficiency (early)

Question 14

Causes of INTRINSIC normocytic hemolytic anemia

Answer 14

RBC defect (spherocytosis), enzyme def, G6PD, pyruvate kinase, HbC defect, PNH, sickle cell

Question 15

Causes of EXTRINSIC normocytic hemolytic anemia

Answer 15

autoimmune, microangiopathic, macroangiopathic, infections

Question 16

Causes of megaloblastic macrocytic anemia

Answer 16

folate, B12 def; orotic aciduria

Question 17

Causes of non-megaloblastic macrocytic anemia

Answer 17

liver disease, alcoholism, reticulocytosis