POIKILOCYTOSIS prt. 1

Question 1

Poikilocytes secondary to DEVELOPMENT ABNORMALITIES

Answer 1

Oval Macrocytes (Microovalocytes)

Question 2

-Large oval shaped cells with marked increased MCV.

Answer 2

Macroovalocytes

Question 3

-Occur due to nuclear maturation defect in the early marrow cells caused by Vit B12 or folate deficiency;

strongly suggest MEGALOBLASTIC ANEMIA

Answer 3

Macroovalocytes

Question 4

Poikilocytes secondary to MEMBRANE ABNORMALITIES

Answer 4

Elliptocytes (Ovalocytes)
Spherocytes
Codocytes
Echinocytes
Burr cells
Acanthocytes
Stomatocytes

Question 5

These cells result from hereditary or acquired conditions and range from egg-shaped or slightly oval to sausage, rod, or pencil forms

Answer 5

Elliptocytes (Ovalocytes)

Question 6

With electron microscopy, Hb appears to be concentrated at the two ends of the cell, leaving a normal central area of pallor.

Answer 6

Elliptocytes or ovalocytes

Question 7

may be acquired in iron deficiency anemia, megalo-blastic anemia, and myelophthisic anemia, in which as many as_____ of the cells may be oval.

Answer 7

Elliptocytes or ovalocytes

10%

Question 8

Megaloblastic anemia is characterized by oval macrocytes, which may be____ um or more in diameter and lack central pallor.

These are also observed in thalassemia and sickle cell anemia.

Answer 8

9

Elliptocytes

Question 9

The principal defect is considered to be in the cytoskeleton, with a decrease in the skeletal membrane protein band 4.1.

An increased heat sensitivity of spectrin in some families with hereditary______ has been reported.

Answer 9

elliptocytosis

Question 10

The life span of______ may be somewhat shortened in a few individuals; however, they usually function normally.

The osmotic fragility is normal.

Answer 10

elliptocytes

Question 11

Spherocytes may be caused by a hereditary or an acquired condition. Several molecular defects in membrane proteins have been identified in hereditary spherocytosis;_______ deficiency has been found in many patients

Answer 11

spectrin

Question 12

are not easily deformed and therefore may lose their membrane by fragmentation during passage through the circulation.

These cells become smaller and denser with increased Hb content and become less deformable with age.

Answer 12

Spherocytes

Question 13

When the cell is deprived of membrane as it ages, it assumes the spherical shape.

______have a shortened survival time because they are sequestered in the spleen and hemolyzed.

Answer 13

Spherocytes

Question 14

The hallmark of ___________ is a spherocyte that is fairly uniform in size and density with a decreased membrane surface:volume ratio.

Answer 14

hereditary spherocytosis

Question 15

show increased fragility when placed in increasing dilutions of hypotonic saline in the osmotic fragility test

Answer 15

Spherocytes

Question 16

After splenectomy in patients with_________, hemolysis decreases but they still persist, indicating that the abnormality involves the red cell membrane itself rather than splenic damage to the cells.

Answer 16

hereditary spherocytosis

Question 17

Frequent causes of_______ are immu-nohemolytic anemia secondary to autoimmune or isoim-mune antibodies, Heinz body hemolytic anemia, microan-giopathic hemolytic anemia, and hemolysis secondary to water dilution.”

Answer 17

acquired spherocytosis

Question 18

Banked blood stored for long periods of time develops_______.

Answer 18

spherocytes

Question 19

have a central area of Hb surrounded by a relatively colorless ring and a peripheral ring of Hb

Answer 19

Codocytes or target cells

Question 20

By scanning electron microscopy the cell has a bell or tall hat shape and appears to be thin walled and concave.

Answer 20

Codocytes or target cells

Question 21

A codocyte (Greek kodon, “____”) is also called a _____cell. This shape is always acquired.

Answer 21

bell

Mexican hat

Question 22

appear when the membrane surface is increased after loading of the membrane with cholesterol and phospholipids.

In other words, the cell is similar to a bag too large for its contents.

Its greater osmotic resistance (or decrease in osmotic fragility) is explained by the increase in surface to volume ratio.

Answer 22

Codocytes

Question 23

appear when the membrane surface is increased after loading of the membrane with cholesterol and phospholipids.

In other words, the cell is similar to a bag too large for its contents.

Its greater osmotic resistance (or decrease in osmotic fragility) is explained by the increase in surface to volume ratio.

Answer 23

Codocytes

Question 24

Finding target cells in only one portion of the film suggests an_____ of film preparation.

Fixing blood films in_____ before staining may help avoid this problem.

Answer 24

artifact

methanol

Question 25

are characteristic of thalassemia; hemoglobinopathies SS, CC, DD, EE, and S-thalassemia; obstructive liver disease; postsplenectomy state; and iron deficiency anemia

Answer 25

Codocytes

Question 26

Echinocytes (from the Greek echinos, “_________”) have evenly distributed, uniform-size blunt spicules or bumps on their surfaces

Answer 26

sea urchin

Question 27

______ or ______ red cells may be seen on films made from anticoagulated blood that is several hours old but such cells are artifacts not normally present in vivo.

Answer 27

Echinocytes or crenated

Question 28

crenation is caused by release of basic substances from glass slides that change the pH and transform the cells into_______.

In stored blood, the cells may be numerous because of depletion of ATP and biochemical abnormalities in plasma.

The cells formed in vitro can be reversed to normal shape, whereas those formed in vivo cannot.

Answer 28

echinocytes

Question 29

Transformation of discocytes to_____ can be observed on a glass slide using a moist saline preparation of red cells in the presence of an elevated (basic) pH

Answer 29

echinocytes

Question 30

red cells acquire a membrane abnormality with irregularly sized and unevenly spaced spicules. Such red cells are called_______

Answer 30

burr cells

Question 31

The number of______ often increases as blood urea nitrogen (BUN) increases.

This membrane alteration is probably related to plasma chemical abnormalities.

Answer 31

burr cells

Question 32

The differences between crenated cells (echinocytes) and burr cells may be minimal and not always recogniz-able.

________with uniform blunt spicules represent an artifact that is evident in practically every cell in the thin portion of the film and SHOULD NOT BE REPORTED

In contrast,______ may be distinguished by their irregularly sized spicules and variable number in different microscopic fields and should be reported.

A burr cell has also been called an______ by several hematologists because of its membrane irregularities.

Answer 32

Crenated cells

burr cells

echinocyte

Question 33

Acanthocytes (from the Greek word acantho,______ or ______)

Answer 33

“thorn” or “spike”

Question 34

_______are small, densely stained red cells that are no longer disc shaped and have a few irregularly spaced pointed spicules or thornlike projections of various lengths and widths over their surfaces

Answer 34

Acanthocytes

Question 35

The spicules may appear clublike.

Answer 35

Acanthocytes

Question 36

may be acquired or inherited and are smaller than normal red cells because they are becoming spheroidal.

Generally they have fewer, more irregular, and more blunted points than burr cells.

Answer 36

Acanthocytes

Question 37

Unlike burr cells,______ cannot be induced to regain a normal shape.

These cells may be caused by changes in the ratio of plasma lipids (lecithins and sphingomyelins).

Answer 37

acanthocytes

Question 38

_______ have been observed in alcoholic cirrhosis with hemolytic anemia, malabsorption states, postsplenectomy states, hepatitis of newborns, pyruvate kinase deficiency, and disorders of lipid metabolism

Answer 38

Acanthocytes

Question 39

Increased numbers of acanthocytes have been reported in a rare congenital syndrome called_________, which is characterized by mild hemolytic anemia, retinal degeneration, and steatorrhea.

Answer 39

abetalipoproteinemia

Question 40

______ on a fixed and stained film have an elongated or slitlike area of central pallor instead of the usual circular form.

Answer 40

Stomatocytyes

Question 41

______ on a fixed and stained film have an elongated or slitlike area of central pallor instead of the usual circular form.

Answer 41

Stomatocytyes

Question 42

are so named for their mouth-shaped central pallor.

These cells appear bowl shaped in a moist preparation and by stereoscan microscope.

Answer 42

Stomatocytes

Question 43

are so named for their mouth-shaped central pallor.

These cells appear bowl shaped in a moist preparation and by stereoscan microscope.

Answer 43

Stomatocytes

Question 44

Blood films from normal individuals may demonstrate a few_______, but these cells are usually observed in patients with alcoholism, cirrhosis, obstructive liver disease,” and Rh null disease.

These cells also may occur as artifacts of blood film preparation.

Answer 44

stomatocytes

Question 45

One of the suggested consequences involves a membrane defect that results in high cellular sodium and low potassium content

The heterogeneous clinical picture
results from an abnormal sodium to potassium transport ratio and a greatly increased rate of active cation trans-port.

Because of the shape of the red cell and the somewhat impaired deformability, ________ may be retained in the spleen.

Answer 45

stomatocytes