L2 CBC and abnormal blood cell morphology

Question 1

Red cells are small with low hemoglobin concentration =

Answer 1

Microcytic hypochromic anemia

Question 2

Microcytic hypochromic anemia occurs in? (3)

Answer 2

1. Thalassemia
2. Iron deficiency (IDA)
3. Anaemia of chronic disease

Question 3

Red cells are large =

Answer 3

Macrocytic anemia

Question 4

Macrocytic anemia occurs in? (5)

Answer 4

1. Megaloblastic anemia due to VitB12 or folate deficiency
2. Myelodysplastic syndrome
3. Alcohol
4. Liver disease
5. Hypothyroidism

Question 5

Red cells are normal in size but low Hb =

Answer 5

Normocytic normochromic anemia

Question 6

Normocytic normochromic anemia occurs in? (2)

Answer 6

1. Acute blood loss

2. Anemia of chronic disease

Question 7

What is polycythaemia?

Answer 7

Increased in Hb, *in myeloproliferative neoplasm

Question 8

________ increased in thalassaemia trait with low Hb.

Answer 8

Increased in RBCs

Question 9

Increased in mean corpuscular haemoglobin concentration (MCHC) (=average Hb concentration in RBC) indicates?

Answer 9

Hereditary spherocytosis

Question 10

Increased in RDW (red cell distribution width) = ?

Answer 10

Variation in size of RBCs = iron deficiency anemia

Question 11

__________ is increased in reactive viral infection.

Answer 11

Lymphocytes

lymphocytes also increase in chronic lymphocytic leukemia

Question 12

Lymphopenia occurs when? (4)

Answer 12

1. Immunosuppressants
2. Viral infection
3. Bacterial infection
4. Sepsis

Question 13

________ is increased in reactive bacterial infection.

Answer 13

Neutrophils

also increased in inflammation, malignancy, steroid use

Question 14

Problem of neutropenia? (esp in oncology patients)

Answer 14

Increased risk of bacterial infection, especially when ANC <0.5
(Absolute neutrophil count = WBC x NEU%)

Question 15

Monocytosis occurs when? (2)

Answer 15

Chronic infections, granulomatous processes

Question 16

Monocytopenia occurs when?

Answer 16

Hairy cell leukemia

Question 17

Increased in eosinophils =?

Answer 17

1. Primary: myeloproliferative neoplasms

2. Secondary: parasitic infections, asthma, allergy, lymphoma

Question 18

Basophilia occurs when?

Answer 18

Chronic myeloid leukemia

Question 19

Thrombocytosis occurs when? (5)

Answer 19

1. Primary: essential thrombocythaemia

2. Secondary (reactive): Iron deficiency anaemia (IDA), infection, splenectomy, malignancy

Question 20

What do we have to check when there is thrombocytopenia?

Answer 20

Whether it is true or due to platelet aggregation (due to difficult blood taking/ EDTA reaction)

Question 21

Reaons for thrombocytopenia? (5)

Answer 21

1. Drug
2. Viral infection
3. ITP - immune thronbocytopenia purpura
4. TTP - thrombotic thrombocytopenia purpura
5. Rare hereditary thrombocytopenia

Question 22

Definition of hypochromasia in RBCs?

Answer 22

Central pallor > 1/3 enter cell space

Question 23

Definition of microcytosis in RBCs?

Answer 23

Size of RBC is smaller than nucleus of a small lymphocyte

Question 24

Polychromasia indicating?

Answer 24

Recticulocytosis, as in:

1. Hemolysis
2. Hemorrage > effecttive erythropoiesis

Question 25

Target cells (RBC) in? (4)

Answer 25

1. Thalassaemia 2. Hemoglobinopathies (HbC, HbE) 3. Liver disease 4. IDA

Question 26

Tear drop cells (RBC) in? (2)

Answer 26

1. Thalassaemia | 2. Myelofibrosis

Question 27

Spherocytes (RBC) in? (3)

Answer 27

1. HS 2. Autoimmune haemolytic anaemia 3. Alloimmune haemoloytic anaemia

Question 28

Schistocytes =? | Indicating? (3)

Answer 28

Fragmented RBCs 1. DIC *disseminated intravascular coagulation 2. HUS/TTP *hemolytic uremic syndrome/ thrombotic thrombocytopenic purpura 3. leaking prosthetic heart valves

Question 29

Bite cells (RBCs) in?

Answer 29

G6PD deficiency

Question 30

Elliptocytes (RBCs) in?

Answer 30

Hereditary elliptocytosis

Question 31

Cold haemagglutination disease and Atypical pneumonia: RBC distriction is ?

Answer 31

Agglutination

Question 32

Roulaeux RBc distriction in?

Answer 32

Hyperproteinaemia (e.g. multiple myeloma), plasma cell myeloma

Question 33

Basophilic stippling =? in?(2)

Answer 33

Abnormal aggregates of ribosomes 1. Lead poisoning 2. Thalassaemia

Question 34

What are Howell Jolly bodies ? | In? (3)

Answer 34

Remnant of nuclear chromatin 1. Post-splenectomy 2. Megaloblastic anemia 3. Abnormal erthropoiesis

Question 35

Hypersegmentation of neutrophils =?

Answer 35

Presence of > 6 lobes Megaloblastic anemia/ Uremia/ Chemotheraphy (cytotoxic treatment)

Question 36

Hyposegementation of neutrophils =?

Answer 36

1. Pelger-Huet anomaly | 2. Myelodysplastic syndrome

Question 37

>20% blast cells in PB =?

Answer 37

Acute Myeloid Leukemia

Question 38

Oval macroctye + hypersegmented neutrophils = ?

Answer 38

Megaloblastic anemia due to vitamin B12 deficiency

Question 39

Leukoerythroblastic blood picture (outpouring of immature forms)

Answer 39

- Myelofibrosis | - Bone marrow metastasis