Peripheral Blood Smears

Question 1

Anisocytosis

Answer 1

unequal sized RBCs

cellar are are otherwise uniform

Question 2

Microcytosis

Answer 2

Iron deficiency anemia
Thalassemia
Anemia of chronic disease
Sideroblastic anemias
Chronic lead exposure

Question 3

Macrocytosis

Answer 3

Folate/B12 deficiency
Liver disease
Primary bone marrow failure; myelodysplasia
Reticulocytosis (polychromasia)

Question 4

Hypersegmented neutrophils

Answer 4

normally should have 4-6 lobes
these have 9-9 lobes and are larger
seen in megaloblastic anemia

Question 5

Poikilocytosis

Answer 5

indicates the shape of thecells

Question 6

macroocalocytes

Answer 6

large oval cells

B12/foltae megaloblastic anemia

Question 7

Eliiptocytes

Answer 7

heriditary,

ellipsoid

Question 8

Fragmetned erythrocytoses

Answer 8

chopped up RBCs (aka schistocytosis)
TTP, DIC, HUS
**prosthetic heart valves
hemolytic anemisa

Question 9

acanthocyte

Answer 9

(Burr cell)
RBC w/ irregular shaped cells
liver disorders

Question 10

Codocyte

Answer 10

aka target cells

red cells w/ central color spot in area of pallor (SCA, HbC, thalassemias)

Question 11

dacrocyte

Answer 11

teardrop
myeloproliferative disorders
pernicious anemia
thalassemias

Question 12

Stomatocyte

Answer 12

folded RBC mimicking a mouth and lips (slit-like appearance)
seen in hemolytic anemias
constitutive or acquired

Question 13

Hypochromia

Answer 13

increased pallor int he center of RBC, lack of Hb
Thalassemia
Iron deficiency anemia
Sideroblastic anemia

Question 14

Normochromic

Answer 14

normal Hb and stain w/ normal RBC intensity on peripheral smears
central pallor is 1/3 of cell

Question 15

Hyperchromic

Answer 15

DOES NOT EXIST

can only cram 270mil Hb into 1 RBC

Question 16

Rouleaux

Answer 16

stack of coins

seen in MM d/t elevated plasma globulins or globulins

Question 17

Clumping

Answer 17

d/t cold agglutinins

Question 18

basophilic stippling

Answer 18

round dark blue granules in retics on smears stained

classic lead poisoning

Question 19

Reticulocytes

Answer 19

): immature red cell progenitors not normally present in blood
The nucleus is pyknotic
undergoing hemolytic crises.(normal in new-borns)

Question 20

Howell Jolly Bodies

Answer 20

Spherical blue-black red cell inclusions seen on Wright-stained smears.
nuclear fragments,
hemolytic anemias and in post-splenectomy patients (below).

Question 21

Signet ring

Answer 21

indicates infection by plasmodium vivax

Question 22

Neutrophilia

Answer 22

elevated in bacterial infections, stress, corticosteroids

immature forms often present w/ elevated count

Question 23

Lymphcytosis

Answer 23

elevated in viral infections

“atypical lymphocytes”= EBV mono

Question 24

fragile lymphocytes

Answer 24

smudge or basket cells

common in CLL

Question 25

Basophilia

Answer 25

elevated in CML

Question 26

Left shift

Answer 26

indicates more immature forms of PMNs

d/t increased production (infection, myeloid cancers)

Question 27

Dohle body

Answer 27

toxic granulations w/in PMN made of cytoplasmic vacuoles
indicates infections

often w/ L shift

Question 28

Reduced lobulation of PMN

Answer 28

often associated w/ myelodysplastic syndromes

Question 29

Giant Plt

Answer 29

Suggest marrow response secondary to increased platelet destruction or consumption

Congenital disorders
Immune destruction
Disseminated intravascular coagulation (DIC)
Hemolytic uremic syndrome (HUS)
Thrombotic thrombocytopenic purpura (TTP)

Question 30

normoblasts

Answer 30

immature red cell progenitors not normally present in blood.
pyknotic nuclei
patients undergoing hemolytic crises.