module 4 CBC and INtro Anemia Flashcards
Normal RBC volume
80-100 fL
Acanthocyte
spur cell. irregular thorn like spikes. no central pallor. Cholesgerol preferentially trapped in outer leaflet.
codocytes
target cells. thin bell shaed increased surface area to volume.
Dacrocytes
teardrops. Round cell with a single elongated or pointed extremity; may be microcytic and/or hypochromic
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 166). Prentice Hall. Kindle Edition.
Drepanocyte
Round cell with a single elongated or pointed extremity; may be microcytic and/or hypochromic
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 166). Prentice Hall. Kindle Edition.
Echinochyte
sea urchin. Spiculated red cells with short equally spaced projections over the entire surface
elliptocyte
Spiculated red cells with short equally spaced projections over the entire surface
keratocyte
Helmet cells. Produced when a fibrin strand impales a RBC. Red cells with one or several notches with projections that look like horns on either end
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 166). Prentice Hall. Kindle Edition.
schistocyte
Fragments of red cells; variety of shapes including triangles, commas; microcytic
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 167). Prentice Hall. Kindle Edition.
spherocyte
—Spherocytic red cells with dense hemoglobin content (hyperchromatic); lack an area of central pallor
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 167). Prentice Hall. Kindle Edition.
stomatocyte
uniconcave red cells with the shape of a very thick cup; on stained blood smears cells have an oval or slitlike area of central pallor
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 167). Prentice Hall. Kindle Edition.
test for echinocyte artifact
use plastic slides as the glass releases chemicals which can cause echinocyte formation.
Normal RBC MCH
30 pg.
Only hyperchromic RBC
Spherocyte
Basophillic stipling
bluish black inclusions of ribosomes sometimes assoiaed with mitochondria. Artifact.
Cabot rings
Remnants of spindle fibers. Indicate dyserythropoesis.
hOWELL jOLLEY bODIES
Nuclear DNA suggest nucleaer maturation abnormalities. Individual chromosome fails to attach.
Heinz bodies
Denatured hemoglobin attached to band 3.
Sideroblasts
erythroblasts with stainabl iron granules
Siderocytes
non nucleated RBCS with stainable iron granules
Pappenheimer bodies
damages lysosomes and mitchondria
corrected reticulcute count
corrects for abnormally low or high hematocrit.
Patient hematocrit/ Normal hematocrit * % reticulocyte = Corrected reticulocyte count (%)
reticuocyte count HYPOPROLIFERATIVE ANEMIAS
62% or an absolute reticulocyte count 675 * 10 9 /L
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 184). Prentice Hall. Kindle Edition.
RETICULOCYTE COUNT HEMOLYTIC ANEMIA
corrected count 72% or an absolute count 7100 * 10 9 /L
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 184). Prentice Hall. Kindle Edition.
STRESS OR SHIFT RETICULOCYTES
RELEASED EARLIER THAN NORMAL WHEN MORE RBCS NEEDED. LARGE POLYCHROMATOPHILLIC CELLS. LONGER TO MATURE.
RPI
The RPI is a good indicator of the adequacy of the bone marrow response in anemia. Generally speaking, an RPI 72 indicates an appropriate bone marrow response, whereas an RPI 62 indicates an inadequate compensatory bone marrow response (hypoproliferation) or an ineffective bone marrow response.
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 185). Prentice Hall. Kindle Edition.
RPI CALCULATION
Patient’s hematocrit/ 0.45 L/L (normal hematocrit) * Reticulocyte count (%/ ) Reticulocyte maturation time (days)
IMMATURE RETICULOCYTE FRACTION
BASED ON RNA CONCENTRATION IN CELL. THROUGH FLOURESCENCE AND ABSORBANCE. IRF INCREASES BEFORE RETICULOCYTE COUNT.
ANISOCYTOSIS ASSOCIATED WITH:
Anemias associated with an increased RDW
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 186). Prentice Hall. Kindle Edition.
MICROCYTOSIS ASSOCIATED WITH:
Iron-deficiency anemia; thalassemia; sideroblastic anemia, long-standing anemia of chronic disease
MACROCYTOSIS ASOCIATED WITH
megaloblastic anemias; hemolytic anemia with reticulocytosis; recovery from acute hemorrhage; liver disease; asplenia; aplastic anemia; myelodysplasia; endocrinopathies; alcoholism
McKenzie, Shirlyn B.; Williams, Lynne. Clinical Laboratory Hematology (3rd Edition) (Pearson Clinical Laboratory Science Series) (Page 186). Prentice Hall. Kindle Edition.
INCREASED UNCONJUGATED BILLIRUBIN
HEMOLYSIS EITHER iv OR EV.
INCREASED IV HEMOLYSIS
11-9). Hemosiderin in urine (hemosiderinuria), decreased plasma haptoglobin and hemopexin (as a result of increased consumption), and increased methemalbumin
ERYTHROCYTE SURVIVAL STUDY
SMALL AMOUNT OF BLOOD REMOVED, RADIOLABELED. CHROMIUM IS TRAPPED. REINJECTED, AND DRAWN PERIODICALLY.
MASS =
PRODUCTION * SURVIVAL
COMPENSATION FOR HYPOXIA / ANEMIA
INCREASE IN 2-3 BPG DECREASED OXYGEN AFINITY DUE TO BOHR EFFECT
MCH
HB / RBC COUNT
MCHC
HB / HEMATOCRIT
