Peripheral Blood Smears

Question 1

the part of the peripheral smear that we are interested in looking at

Answer 1

• the feathered edge

Question 2

RBC size in normal peripheral blood

Answer 2

• the size of a lymphocyte nucleus

Question 3

area of pallor of RBC in normal peripheral blood

Answer 3

• 1/3 of total RBC diameter

Question 4

other cell present in normal peripheral blood

Answer 4

• white cells and platelets should be present

Question 5

name for red cells which vary widely in SIZE

Answer 5

anisocytosis

Question 6

The RDW measures

Answer 6

• the range of red cell sizes

- distribution of width of red blood cells

Question 7

name for red cells that are small

Answer 7

• microcytosis

Question 8

MCV

Answer 8

• direct measurement of RBC volume

- used for measurement in micro and macrocytosis

Question 9

differential diagnosis of microcytosis includes

Answer 9

• anemia of chronic disease (normally normocytic)
• thalassemias
• lead poisoning
• iron deficiency
• sideroblastic anemia
• hemoglobin C disease and trait

SALTIH

Question 10

name for large red blood cells

Answer 10

• macrocytosis

Question 11

differential diagnosis of macrocytosis includes

Answer 11

• B12/folate deficiency
• liver disease
• thyroid disease
• chemotherapy (hydra in particular)
• anti-retrovirals
• aplastic anemia
• MDS (myelodysplastic anemia)
• Elevated reticulocyte count

BLT CAAME - macro

Question 12

name for red cells that have too little hemoglobin

Answer 12

• hypochromasia

Question 13

area of central pallor in hypochromasia

Answer 13

• more than 1/3 the total RBC diameter

Question 14

how to measure hypochromasia

Answer 14

• MCH - mean corpuscular hemoglobin

Question 15

name for red blood cells that have more of a bluish tinge

Answer 15

• polychromasia

Question 16

in general, the blue cells are

Answer 16

• larger

- probably reticulocytes

Question 17

name for red cells that vary widely in SHAPE

Answer 17

• poikilocytosis

Question 18

name for cells that look like bulls-eyes

Answer 18

• target cells

Question 19

differential diagnosis of target cells

Answer 19

• liver disease
• thalassemia
• hemoglobin C
• after splenectomy

T SHL

Question 20

name for cells that have a loss of central pallor

Answer 20

• spherocytes

Question 21

spherocytes seen in which conditions

Answer 21

• hereditary spherocytosis

- autoimmune hemolysis

Question 22

if spherocytes are due to autoimmune hemolysis

Answer 22

• the cells are smaller

Question 23

name for red cell fragments with sharp edges

Answer 23

• schistocytes

Question 24

schistocytes hallmark of

Answer 24

• microangiopathic hemolytic anemia

- MAHA

Question 25

cells seen in sickle cell anemia

Answer 25

- sickle cells

Question 26

name of cells with small regulator projections

Answer 26

- Echinocytes | - Burr cells

Question 27

Echinocytes seen in

Answer 27

- renal disease

Question 28

cells with larger, irregular projections

Answer 28

- Acanthocytes | - spur cells

Question 29

acanthocytes seen in

Answer 29

- liver disease

Question 30

teardrop cells seen in

Answer 30

- myelophthisic processes - myelofibrosis - tumor metastatic to marrow - granulomatous diseases - leukemias and lymphomas - (massive) splenomegaly (sometimes) SLT GMM

Question 31

myelophthisic processes are diseases of

Answer 31

- marrow infiltration MARROW IS SO FULL IT'S CRYING OUT TEARS

Question 32

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

Answer 32

- Howell-Jolly bodies

Question 33

Howell-Jolly bodies seen

Answer 33

- after splenectomy | - splenic hypofunction

Question 34

After splenectomy we can also see

Answer 34

- target cells - acanthocytes - schistocytes - nucleated red cells

Question 35

name for linear arrangements of red cells

Answer 35

- rouleaux

Question 36

rouleaux seen in which disorders

Answer 36

- those with increased levels of immunoglobulin - Multiple Myeloma - Waldenstrom's macroglobulinemia

Question 37

red cell agglutination occurs when

Answer 37

- red cells are coated with IgM | - not orderly and linear

Question 38

things seen in beta-thalassemia major

Answer 38

- target cells - Howell-jolly bodies - nucleated red cells - schistocytes - basophilic stippling - teardrops

Question 39

cells in megaloblastic anemia

Answer 39

- red cells are macrocytic | - hypersegmented neutrophils can also be seen

Question 40

cells in autoimmune hemolytic anemia

Answer 40

- polychromasia | - microspherocytes

Question 41

cell in iron deficiency anemia

Answer 41

- hypochromic - microcytic - look more like cigars - increased number of platelets