Peripheral Blood Smear

Question 1

Where on a Wright stained PBS should cells be evaluated?

Answer 1

Area just inside the feather edge

Question 2

What are the stages of neutrophilic maturation?

Answer 2

Myeloblast-> Promyelocyte-> Myelocyte-> Metamyelocyte-> Band-> Segmented Neutrophil

Question 3

In what conditions are segmented neutrophils increased?

Answer 3

Infections, stress, leukemoid reactions

Question 4

What does the presence of band neutrophils in a PBS indicate?

Answer 4

Increased in myeloproliferative disorders, “left shift” in infections and stress, leukemoid reactions

Question 5

What is a ‘left shift’?

Answer 5

An increase in one or more immature white cell forms seen found in peripheral blood

Question 6

True or False: The combined presence of Dohle bodies and toxic granulations is indicative of leukemias

Answer 6

False– won’t see this in leukemias

Question 7

In what conditions are hypersegmented neutrophils seen?

Answer 7

Megaloblastic anemia- B12 or Folate deficiency

Question 8

In what conditions are hyposegmented neutrophils (Pseudo Pelger Huet cells) seen?

Answer 8

Myelodysplastic syndromes

Question 9

What conditions are associated with basophila?

Answer 9

Myeloprolifetative disorders and hypersensitivity reactions

Question 10

What conditions are associated with monocytosis

Answer 10

Chronic infections, malignancy, IBD, and collagen vascular disease

Question 11

What is an increased number of reactive lymphocytes indicative of?

Answer 11

Viral infections

Question 12

What is the most dire finding on a peripheral blood smear?

Answer 12

The absence of platelets

Question 13

What are the stages of RBC maturation?

Answer 13

Proerythroblast-> Erythroblast-> Polychromatophilic normoblast-> Orthochromatophilic normoblast-> Polchromatophilic erythrocyte-> erythrocyte

Question 14

Which is the first stage of RBC development that is found in the peripheral blood under normal conditions?

Answer 14

Polychromatophilic erythrocytes

Question 15

What RBC adjectives describe the hemoglobin content?

Answer 15

Normochromic, hypochromic, and, hyperchromic

Question 16

Nucleated red blood cells are normal findings in the peripheral blood of what population of patients?

Answer 16

Newborns

Question 17

What is polychromasia?

Answer 17

Increased polychromatic RBCs on PBS

Question 18

What can the presence of target cells in a PBS indicate?

Answer 18

Excessive membrane- liver disease; less cell interior content- hemoglobinopathies, thalassemias, anemia

Question 19

What are schistocytes?

Answer 19

Fragmented cells with ariable shapes

Question 20

What formation is associated with bite cells?

Answer 20

Heinz bodies

Question 21

What are tear drop cells indicative of?

Answer 21

Bone marrow fibrosis

Question 22

What is the appearance of spherocytes?

Answer 22

Sphere shaped cells that lack central pallor

Question 23

What are acanthocytes? What are the most common two causes?

Answer 23

RBCs with irregular projections; Abetalipoproteinemia and Adv. liver disease

Question 24

What is the appearance of echinocytes?

Answer 24

RBCs with evenly distributed short, blunt or pointed spircules along the surface

Question 25

What are Howell Jolly bodies composed of? What conditions cause their appearance?

Answer 25

DNA; severe hemolytic anemias or megaloblastic anemias

Question 26

What are Pappenheimer bodies composed of?

Answer 26

Iron/ protein in lysosomes or mitochondria

Question 27

What are Heinz bodies made of?

Answer 27

Precipitated Hgb

Question 28

What is a rouleaux?

Answer 28

A linear arrangement of 4 or more RBCs