Peripheral Blood Morphology

Question 1

the area of the slide that you would exam on a peripheral smear

Answer 1

from the monolayer to the feathered edge

Question 2

RBC should be the size of a _______ nucleus

Answer 2

lymphocyte

Question 3

the ares of the central pallor in a RBC should be ___ of the total RBC diameter

Answer 3

1/3

Question 4

anisocytosis

Answer 4

refers to the red cells which vary widely in size

Question 5

RDW

Answer 5

red cell distribution width; measures the range of red cell sizes ; measures anisocytosis

Question 6

microcytosis

Answer 6

refers to RBC that are small

Question 7

MCV

Answer 7

mean cell volume; measures the individuals volume of red blood cells; measures microcytosis and macrocytosis

Question 8

differential diagnosis for microcytosis (6)

Answer 8

1. Iron deficiency 2. Anemia of chronic disease 3. Thalassemia 4. Hemoglobin C disease 5. Lead Poisoning 6. Sideroblastic anemia

Question 9

macrocytosis

Answer 9

RBC are too large; use MCV

Question 10

differential diagnosis of macrocytosis (8)

Answer 10

1. B12/FOLATE DEFICIENCY 2. Liver disease 3. Thyroid disease 4. MDS myelodysplastic syndrome 5. Anti-retrovirals 6. Aplastic anemia 7. Chemotherapy 8. Elevated reticulocyte count

Question 11

hypochromasia

Answer 11

RBC with too little hemoglobin

Question 12

hypochromasia RBC have a central pallor that is less/more than 1/3 the total red cell diameter

Answer 12

more

Question 13

hypochromasia is measured by

Answer 13

MCH mean cell hemoglobin

Question 14

polychromasia

Answer 14

RBC that have more of a blueish tinge; probably reticulocytes

Question 15

poikilocytosis

Answer 15

RBC that vary in shape

Question 16

target cells

Answer 16

look like bulls-eyes

Question 17

differential diagnosis of target cell (4)

Answer 17

1. liver disease (most common) 2. thalassemias 3. hemoglobin C 4. After a splenectomy

Question 18

spherocytes

Answer 18

have loss of central pallor

Question 19

Spherocytes can be seen in

Answer 19

1. autoimmune hemolysis 2. hereditary spherocytosis

Question 20

schistocytes

Answer 20

red cell fragments with sharp edges

Question 21

schistocytes are hallmark of

Answer 21

microangiopathic hemolytic anemia (MAHA)

Question 22

sickle cell

Answer 22

seen in sickle cell anemia

Question 23

echinocytes

Answer 23

• aka burr cell - small, regular projections - seen in renal disease

Question 24

acanthocytes

Answer 24

• aka spur cells - large, irregular projections - seen in liver disease

Question 25

teardrop cells

Answer 25

myelophthisic processes, which are diseases of marrow infiltration

Question 26

teardrop cells can be seen in (5)

Answer 26

1. splenomegaly 2. Leukemia and lymphoma 3. Granulomatous disease 4. tumor metastatic to marrow 5. myelofibrosis

Question 27

Howell Jolly Bodies

Answer 27

peripheral, round, small purple inclusions within red cells that represent nuclear remnants

Question 28

when are Howell Jolly Bodies most likely seen

Answer 28

after splenectomy

Question 29

rouleaux

Answer 29

linear arrangements of RBC

Question 30

rouleaux cells are typically seen in disorders with

Answer 30

1. increased levels of immunoglobulin (Multiple Myeloma or Waldenstroms macroglobulinemia) 2. severe hypo-albuminemia

Question 31

agglutination occurs when red cells are coated with

Answer 31

IgM

Question 32

iron deficiency anemia (3)

Answer 32

1. hypochromic 2. microcytic 3. increased number of platelets

Question 33

megaloblastic anemia

Answer 33

• red cells are macrocytic - hyper-segmented neutrophils

Question 34

autoimmune hemolytic anemia (AIHA)

Answer 34

• polychromasia - microspherocytes

Question 35

Answer 35

iron deficiency anemia

Question 36

Answer 36

a. target cell
b. howell-jolly body
c. nucleated rbc
d. schostpcyte
e. basophilic stippling

Question 37

Answer 37

megaloblastic anemia

Question 38

Answer 38

autoimmune hemolytic anemia (AIHA)

black arrows- polychromasia

green arrows- microspherocytes

Question 39

Answer 39

microangiopathic hemolytic anemia

Question 40

Answer 40

sickle cell anemia