MODULE 6: BLOOD CELL ANOMALIES Flashcards

1
Q

A. VARIATION IN SIZE

A

ANISOCYTOSIS

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2
Q

ANISOCYTOSIS
Indicators of normal cell size:

A

i. Cell diameter
ii. Mean Corpuscular Volume (MCV)
iii. Red Cell Distribution Width

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3
Q

ANISOCYTOSIS
i. Cell diameter
ii. Mean Corpuscular Volume (MCV)
iii. Red Cell Distribution Width

A

6-8 µm
80-100 fL
11-14%

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4
Q

MICROCYTE
i. Cell diameter
ii. Mean Corpuscular Volume (MCV)

A

<6 um
<80 fL

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5
Q

MACROCYTE
i. Cell diameter
ii. Mean Corpuscular Volume (MCV)

A

> 8 um
100fL

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6
Q

B. VARIATION IN COLOR (HEMOGLOBIN CONTENT)

A

ANISOCHROMIA

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7
Q

ANISOCHROMIA
i. MCHC
ii. Central pallor

A

32-36 g/dL
1/3 of the red cell diameter

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8
Q

HYPOCHROMIA
i. MCHC 32-36 g/dL
ii. Central pallor 1/3 of the red cell diameter

A

<32-36 g/dL
>1/3

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9
Q

HYPERCHROMIA
i. MCHC 32-36 g/dL
ii. Central pallor 1/3 of the red cell diameter

A

> 32-36 g/dL
Absent

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10
Q

more than one color RNA remnants
blue-gray discoloration of a red cell absorbs the alkaline stain

A

POLYCHROMIA

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11
Q

absorbs the alkaline stain

A

RNA remnants

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12
Q

failure of hemoglobin synthesis

A

MICROCYTE

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13
Q

Anemia of Chronic Disease
Thalassemia
Iron Deficiency Anemia
Sideroblastic Anemia

A

MICROCYTE

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14
Q

impaired DNA synthesis
stress erythropoiesis
excess surface membrane

A

MACROCYTE

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15
Q

Megaloblastic anemia
Liver disease

A

MACROCYTE

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16
Q

Thalassemia
Iron Deficiency Anemia

A

HYPOCHROMIA

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17
Q

Spherocytosis
Macrocytosis

A

HYPERCHROMIA

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18
Q

increased erythropoietic activity
Hemolytic anemia
Physiologic need

A

POLYCHROMIA

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19
Q

C. VARIATION IN CELL SHAPE

A

POIKILOCYTOSIS

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20
Q

C. VARIATION IN CELL SHAPE POIKILOCYTOSIS
Indication of a normal shape:

A

biconcave disc-shape

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21
Q
  1. Poikilocytes secondary to membrane abnormalities
A

a. Acanthocytes
b. Echinocytes
c. Target cells or Codocytes
d. Elliptocytes
e. Ovalocytes
f. Spherocytes
g. Stomatocytes

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22
Q
  1. Poikilocytes secondary to trauma
A

a. Schistocytes/Schizocytes
b. Dacrocytes
c. Microspherocytes
d. Semi-lunar bodies

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23
Q
  1. Poikilocytes secondary to abnormal hemoglobin content
A

a. Drepanocyte

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24
Q

D. RED CELL INCLUSIONS

A
  1. Howell-Jolly Bodies
  2. Basophilic Stippling
  3. Cabot Rings
  4. Heinz Bodies
  5. Hb H Inclusions
  6. Hb CC Crystals
  7. Hb SC Crystals
  8. Pappenheimer Bodies
  9. Parasites
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25
Q

E. MISCELLANEOUS

A
  1. Autoagglutination
  2. Rouleaux Formation
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26
Q

A. RBC Distribution and Size

A
  1. Agglutination
  2. Rouleaux Formation
  3. More than 50% microcytosis seen in an oil immersion field (in reference to MCV)
  4. More than 50% macrocytosis in an oil immersion field (in reference to MCV)
  5. Less than 50% microcytes or macrocytes in an oil immersion field (in reference to RDW)
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27
Q

B. RBC QUALITATIVE ABNORMALITIES

A
  1. Hypochromia
  2. Polychromia
  3. Large Number of Poikilocytes
  4. Small Number of poikilocytes
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28
Q

C. DIAGNOSTIC ABNORMALITIES and INCLUSIONS

A
  1. Basophilic Stippling
  2. Howell-Jolly and Pappenheimer Bodies
  3. Nucleated RBCs
  4. Malarial Parasites
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29
Q

agglutination disappears after warming the sample

A

“cold agglutination present”

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30
Q

agglutination persists after warming

A

“RBC agglutination present”

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31
Q
  1. Rouleaux Formation
    Slight
    Moderate
    Marked
A

intermittent stacks of 4-8 RBCs
Frequent stacks of 4-8 RBCs
Many stacks of RBCs

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32
Q
  1. More than 50% microcytosis seen in an oil immersion field (in reference to MCV)
    Slight
    Moderate
    Marked
A

76 fL to 79 fL
66 fL to 75 fL
<66 fL

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33
Q
  1. More than 50% macrocytosis in an oil immersion field (in reference to MCV)
    Slight
    Moderate
    Marked
A

101 fL to 108 fL
109 fL to 120 fL
>120 fL

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34
Q
  1. Less than 50% microcytes or macrocytes in an oil immersion field (in reference to RDW)
    Slight
    Moderate
    Marked
A

16 to 18
18 to 22
>22

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35
Q
  1. Hypochromia
    Slight
    Moderate
    Marked
A

25-26 pg
>30 %
6-15 %

21-24 pg
>30 %
16-30%

<21 pg
25-30%
>30#

36
Q
  1. Polychromia
    Slight
    Moderate
    Marked
A

2-5%
6-15%
>15%

37
Q
  1. Large Number of Poikilocytes
    Few
    Moderate
    Many
A

<5%
6-25%
>25%

38
Q
  1. Small Number of poikilocytes
    Slight
    Moderate
    Marked
A

6-10%
11-15%
>15%

39
Q
  1. Basophilic Stippling
    Slight
    Moderate
    Marked
A

1-5%
6-10%
>10%

40
Q
  1. Howell-Jolly and Pappenheimer Bodies
    Few
    Moderate
    Many
A

1-2%
3-5%
>5%

41
Q
  1. Nucleated RBCs
    a. (?) or 1000 RBCs
    b. If (?) or 1000 RBCs, perform WBC correction
A

Report number/100 WBCs
>10 nRBCs/100 WBCs

42
Q

Report presence, identifying the genus, species and stage.

A
  1. Malarial Parasites
43
Q

are also known as sour cells or thorn cells

A

Acanthocytes

44
Q

These are spheroid in shape with 3-12 irregular spikes/spicules caused by abnormal ratios of membrane lecithin and sphingomyelin or increased ratio of cholesterol to lecithin.

A

Acanthocytes

45
Q

Acanthocytes are seen in

A

end-stage liver disease , alcoholic cirrhosis with hemolytic anemia, severe hemolytic anemia with cirrhosis and metastatic liver disease, hepatitis of the new born, malabsorption states, postsplenectomy states, pyruvate kinase deficiency and abetalipoproteinemia

46
Q

burr cells, crenated cells or sea urchin cells are red cells with regular 10-30 scalloped short projections

A

Echinocytes

47
Q

These occur due to depletion of ATP and exposure to hypertonic salt solution.

A

Echinocytes

48
Q

Sometimes, they also appear as artifacts in air drying. Clinically, burr cells are

A

Echinocytes

49
Q

associated with uremia, chronic renal disease, cirrhosis and hepatitis.

A

Echinocytes

50
Q

also termed as target cells or Mexican hat cells appear as bell or tall hat shaped cells on scanning electron microscope

A

Target cells or Codocytes

51
Q

The cells show a peripheral rim of hemoglobin surrounded by a clear area and central hemoglobinized area

A

Target cells or Codocytes

52
Q

resembling a bull’s eye appearance

A

Target cells or Codocytes

53
Q

Formation of codocytes is due to excess surface membrane to volume ratio or increased cholesterol and phospholipids.

A

Target cells or Codocytes

54
Q

Hemoglobinopathies SS, CC, DD, EE and disorders such as thalassemias, obstructive liver disease, post-splenectomy states and iron deficiency anemias cause the formation of codocytes.

A

Target cells or Codocytes

55
Q

rod or cigar shaped cells, that are narrower than ovalocytes.

A

Elliptocytes

56
Q

Defects in the polymerization of hemoglobin that cause defects in the cytoskeleton or decreased membrane protein band 4.1 lead to a condition known as Hereditary Elliptocytosis.

A

Elliptocytes

57
Q

are egg-like or oval-shaped cells that are wider than elliptocytes.

A

Ovalocytes

58
Q

The change in shape is due to a bipolar arrangement of hemoglobin or reduction of membrane cholesterol.

A

Ovalocytes

59
Q

Disorders exhibiting ovalocytes include megaloblastic anemia, myelodysplasia or Sickle Cell Anemia.

A

Ovalocytes

60
Q

are smaller red cells with concentrated hemoglobin and no visible central pallor

A
61
Q

cause the lowest surface area to volume ratio cause the formation of spherocytes

A

Defective membrane (spectrin deficiency)

62
Q

seen in cases of Hereditary Spherocytosis, isoimmune and autoimmune hemolytic anemia and in severe burns

A

Defective membrane (spectrin deficiency)

63
Q

can also show spherocytes due to storage lesions

A

Banked blood stored for a long time

64
Q

are otherwise known as mouth cells or hydrocytes

A

Stomatocytes

65
Q

have mouth or slit-like pallor and are bowl-shaped

A

Stomatocytes

66
Q

seen in Hereditary stomatocytosis, alcoholism, cirrhosis, obstructive liver disease and in Rh null individuals

A

Stomatocytes

67
Q

cloven

A

schistos

68
Q

split

A

schizo

69
Q

fragmented red cells varying in size and shape

A

Schistocytes/Schizocytes

70
Q

There are two (2) variants of schistocytes

A

keratocytes/helmet cells
knizocytes

71
Q

have hornlike projections

A

keratocytes/helmet cells

72
Q

triangular in shape with two (2) pallor areas

A

knizocytes

73
Q

caused by presence of fibrin in the blood vessels; altered vessel walls; or prosthetic heart valves

A

Extreme fragmentation of red cells

74
Q

indicative of disseminated intravascular coagulation (DIC); thrombocytopenic purpura, burns and microangiopathic hemolytic anemia

A

schistocytes

75
Q

tear-drop cells

A

Dacrocytes

76
Q

pearshaped cells with elongated point or tail

A

Dacrocytes

77
Q

morphological change happens during squeezing or fragmentation of the red cells during splenic passage

A

Dacrocytes

78
Q

Associated conditions in the appearance of tear drop cells are myeloid metaplasia and hypersplenism.

A
79
Q

red blood cells with smaller diameter that ruptures at a much lower temperature (450C) than a normal red cell (fragments at 490C)

A

Microspherocytes or pyropoikilocytes

80
Q

half-moon/crescent cells

A

Semi-lunar bodies

81
Q

large, pale pink staining ghosts of the red cells

A

Semi-lunar bodies

82
Q

form when the red cell membrane is disrupted causing the release of its content

A

Semi-lunar bodies

83
Q

sickle cells

A

Drepanocyte

84
Q

menisocytes

A

Drepanocyte

85
Q

cresentshaped cells that lack the central pallor

A

Drepanocyte

86
Q

defect lies in the abnormal polymerization of deoxygenated hemoglobin due to the presence of an abnormal hemoglobin compound

A

Drepanocyte

87
Q

seen in Sickle Cell Anemia and Hemoglobin SC disease

A

Drepanocyte