POIKILOCYTOSIS, RBC INLCUSIONS

Question 1

Have evenly spaced round projections; central pallor area present; caused by changes in osmotic pressure’ seen in liver disease, uremia, heparin therapy, pyruvate kinase deficiency or as an artifact

Answer 1

Burr cells

Question 2

have unevenly spaced pointed projections; lack central pallor area; caused by excessive cholesterol in the membrane; associated with alcoholic liver disease, post-splenectomy and abetalipoproteinemia

Answer 2

Acanthocytes

Question 3

Show central areas of hemoglobin surrounded by a colorless ring and a peripheral ring of hemoglobin; cells have an increased surface-to-volume ratio; seen in liver disease, hemoglobinopathies, thalassemia, iron deficiency anemia

Answer 3

Target cells/ Codocytes/ Mexican Hat cells

Question 4

Disk-shaped cells with a smaller volume than normal erythrocytes; cells have a decreased surface-to-volume ratio; lack a central pallor; associated with defects of the red cell membrane proteins; MCHC may be >37%; increased osmotic pressure (OFT)

Answer 4

Spherocytes

Question 5

Frequently seen in severe injury (burns); Extreme poikilocytosis with fragmentation, microspherocytosis, and elliptocytosis; thermal sensitivity, fragments at 41-45C

Answer 5

pyropoikilocytes/ microspherocytes

Question 6

Pear-shaped cells with one blunt projection; seen in megaloblastic anemia, thalassemias, and intramedullary hematopoiesis (myelofibrosis, myelophthisic anemia)

Answer 6

Teardrop cells/ Dacryocytes

Question 7

Shapes vary but show thin, elongated, pointed ends and will appear crescent-shaped; usually lack a central pallor

Answer 7

Sickle cells/ Depranocytes

Question 8

Most common cause of death in patients with sickle cell anemia

Answer 8

Infectious Crisis

Question 9

Interior portion of cell is hollow, resembling a horn or a helmet; seen in microangiopathic hemolytic anemias (MAHA)

Answer 9

helmet cells/ horn cells/ Keratocytes

Question 10

Damaged RBCs; fragments of various sizes and shapes are present, often with pointed projections; seen in MAHA, thermal injury, renal transplant rejection, and G6PD deficiency

Answer 10

Schistocytes/RBC fragments

Question 11

Characterized by an elongated or slit-like area of central pallor; seen in liver disease, hereditary stomatocytosis or as artifact; caused by osmotic changes due to cation imbalance (Na/K); Rh deficiency syndrome, familial pseudohyperkalemia, cryohydrocytosis

Answer 11

Stomatocytes/ Mouth Cells

Question 12

Cigar to egg-shaped erythrocytes; Also seen in patients with the Leach phenotype - RBCs lack Gerbich Ag and Glycoprotein C

Answer 12

Elliptocytes/ Ovalocytes

Question 13

Usually ORTHOCHROMIC NORMOBLASTS/ metarubricyte but can appear in aby erythropoietic stage of maturation; indicated bone marrow stimulation or increased erythropoiesis

Answer 13

Nucleated RBCs

Question 14

Normal value of nucleated RBCs in newborns

Answer 14

0-10/OIO

Question 15

Small round DNA fragments; Usually one per cell, but can be multiple; stain dark purple to black with Wright’s stain

Answer 15

Howell-Jolly Bodies

Question 16

Conditions where Howell-jolly Bodies can be seen

Answer 16

1. Sickle cell anemia
2. beta thalassemia major
3. Hemolytic anemias
4. Megaloblastic anemia
5. alcoholism
6. post-splenectomy

Question 17

Multiple, tiny, fine and coarse inclusions (ribosomal RNA remnants) evenly dispersed throughout the cell; “blueberry bagel” appearance; stains dark blue with Wright’s stain

Answer 17

basophilic stippling

Question 18

Conditions where basophilic stippling can be seen

Answer 18

1. thalassemia
2. megaloblastic anemias
3. sideroblastic anemia
4. lead poisoning
5. alcoholism

Question 19

Small, irregular, dark staining iron granules when stained with Wright’s stain; usually clump together at periphery of the cells. s

Answer 19

Pappenheimer bodies

Question 20

Iron granules stained with Prussian blue are called Siderotic granules. iron granules stained with Wright’s stain is called pappenheimer bodies

A. both statements are correct
B. both statements are wrong
C. 1st statement is correct, 2nd is wrong
D. 2nd Statement is correct, 1st is wrong

Answer 20

A. Both statements are correct

Prussian blue - Siderotic granules
Wright’s stain - Pappenheimer bodies

Question 21

Thin red-violet, single to multiple ring-like structures that may appear in loop of figure 8 shapes

Answer 21

Cabot rings

Question 22

Conditions where cabot rings can be seen

Answer 22

1. Megaloblastic anemia
2. myelodysplastic syndromes
3. lead poisoning

Question 23

Condensed, intracellular, rod-shaped crystals

Answer 23

Hemoglobin C crystals

Question 24

‘Washington monument’ can be seen in what condition

Answer 24

Hb SC disease

Question 34

Degraded hemoglobin. RBC inclusion that can only be seen using supravital stains and not with wright’s stain

Answer 34

Heinz bodies (Hb H inclusion)

Question 34

Mention malarial parasites

Answer 34

P. vivax
P. falciparum
P. malariae
P. ovale

Question 34

Conditions where Heinz bodies can be seen

Answer 34

1. G6PD deficiency
2. Beta-thalassemia major
3. Hb H disease
4. Unstable hemoglobinopathies
5. Drug-induced anemias

Question 35

Stacking or “coining” pattern of RBCs due to abnormal or increased plasma protein

Answer 35

Rouleaux

Question 36

Characterized by clumping of erythrocytes with no pattern; occurs when erythrocytes are coated with IgM antibodies and complement

Answer 36

Agglutination

Question 37

The effect of cold agglutinins to RBCs ______ and Hb _____

Answer 37

RBCs decreased
Hb no effect

Question 38

RBC indices result when agglutination is suspected

RBC ______
Hct _____
MCV ______
MCHCH ______

Answer 38

RBC - decreased
Hct - decreased
MCV - Increased
MCHC - Increased