Heme

Question 1

target cells

increased SA: vol
RBC folds on itself

Answer 1

HALT

• HbC disease (strucutral mutation)
• asplenia (can’t get rid of RBC)
• liver disease (cholesterol > phospholipid, so excess RBC cell membrane)
• thalassemia (smaller cell volume because less Hb)

Question 2

echinocytes (burr cell)

regular spikes

Answer 2

pyruvate kinase deficiency
end stage kidney disease
liver disease
uremia
hemolytic anemia
mechanical damage

Question 3

peripheral smear: basophilic stippling

aggregation of ribo precipitates (NOT Fe)

Answer 3

sideroblastic anemia

• Pb poisoning
• myelodysplastic syndromes

thalassemia

Question 4

elliptocytes

Answer 4

hereditary ellipocytosis

Question 5

spherocytes

Answer 5

hereditary spherocytosis

infection-induced hemolytic anemia

Question 6

Howell-Jolly bodies

nuclear remnants in RBC –> only 1 per cell

Answer 6

no spleen

Question 7

acanthocytes/spur cells

irregular spikes

Answer 7

abetalipoproteinemia

liver disease

Question 8

dacrocyte (teardrop)

Answer 8

BM infiltration (--> myelofibrosis)
thalassemia

*RBC sheds a tear b/c it’s squeezed out of it’s home in BM

Question 9

macro-ovalocytes

Answer 9

megaloblastic anemia

Question 10

schistocytes

Answer 10

microangiopathic hemolytic anemias

• DIC
• TTP/HUS
• HELLP syndrome
• mechanical hemolysis

Question 11

Pappenheimer bodies

Fe granules

Answer 11

sideroblastic anemia

Question 12

myelodysplastic syndromes

Answer 12

stem cell disorders involving ineffective hematopoiesis
-defective cell maturation of non-lymphoid lineages

-risk transforming to AML

Question 13

degmacyte (bite or basket cell)

-due to removal of Heinz bodies by splenic m-phages

Answer 13

G6PD def

Question 14

BM smear with Prussian blue: ringed sideroblasts

excess Fe in mito

Answer 14

sideroblastic anemia

• drugs
• chronic alcohol
• myelodysplastic syndrome

Question 15

Heinz bodies

(Fe + oxidized, precipitated Hb) –> can have multiple

Answer 15

G6PD def

Question 16

smudge cells

Answer 16

CLL

Question 17

aplastic anemia

Answer 17

pancytopenia with BM hypocellularity

• FATTY infiltratoin
• NO splenomegaly (NO extramedullary hematopoiesis because no hematopietic progenitor cells)

Question 18

-HbC disease (strucutral mutation)

Answer 18

target cell

Question 19

-asplenia (can’t get rid of RBC)

Answer 19

target cell

Question 20

-liver disease (cholesterol > phospholipid, so excess RBC cell membrane)

Answer 20

target cell

Question 21

-thalassemia (smaller cell volume because less Hb)

Answer 21

target cell

Question 22

pyruvate kinase deficiency

Answer 22

ecchinocyte (regular spike)

Question 23

end stage kidney disease

Answer 23

ecchinocyte (regular spike)

Question 24

liver disease

Answer 24

ecchinocyte (regular spike)

Question 25

uremia

Answer 25

ecchinocyte (regular spike)

Question 26

hemolytic anemia

Answer 26

ecchinocyte (regular spike)

Question 27

mechanical damage

Answer 27

ecchinocyte (regular spike)

Question 28

HELLP

Answer 28

schistocytes