RBC ABNORMALITIES Flashcards
T/F: it provides an experienced observer with valuable information about morphology
TRUE
T/F: rbc abnormality importance suggests a particular disease, aids in diagnosis
what are of RBCs should be slightly separated from one another or barely touching without overlapping; should represent 1/3 of the entire film
thin area
what are of RBCs may overlap or lie on top of one another, making them unsuitable
thicker portions
what is the ideal distribution of rbc
thin portion adjacent to the feather end of the film
not separated with each other; appear in short/long stacks resembling coins
rouleaux
cells are in clusters or masses when exposed to antibodies
agglutination
normal or in disease state (atypical pneumonia or hemolytic anemia)
autoagglutination
clumping at below 25 celsius; increased mcv in automated machine- (artifactual) since clumps are counted as one
cold agglutinin disease
T/F: central pallor of rbc should be more than 1/3 of the cell
FALSE dapat not more than 1/3
clear central pallor (1/3)
normochromic
- increasing central pallor, decreasing hgb concentration
- caused by impaired hb synthesis
- associated most often with microcytosis; (e.g. IDA, thalassemia,sideroblastic anemia)
hypochromic
- lack of central pallor associated with macrocytosis
- mchc is elevated in true hyperchromia
- hemolytic anemia including hemolysis caused by burns
hyperchromic
premature released cells occurs as a result of stimulated erythropoiesis
shift cells
rbc size that is correlated with MCV:
- if diameter exceeds 8.5-9um and MCV exceeds 100fL
- low vitamin b12, alcoholism with or without liver disease, cancer chemotheraphy, chronic HA with reticulocytosis, myeloma etc.
- diffusely basophilic occurs as a result of stimulated erythropoiesis
normocytic
macrocytic
rbc size that is correlated with MCV:
- small rbc, occurs when mcv is below 80fL
- characteristic of IDA
microcytic
lack central pallor and appear to have increased Hb seen in hemolytic anemia
spherocytes
thinner than normal and have a colorless center; increased surface area that is out of the proportion to the volume
leptocytes
- describes red blood cells that are of different sizes.
- shows variation in population size or diameter in the blood
anisocytosis
T/F: red cell distribution width is an estimate of erythrocyte variation in sizes, calculated in most automated analyzers, and is used as index of red cell population homorogeneity
FALSE - dapat heterogeneity
- large oval shaped cells with marked increased mcv
- occur due to nuclear maturation defect in the early marrow cells caused by vit b12 or folate deficiency; strongly suggest MEGALOBLASTIC ANEMIA
- > 125fL ; size: > 7 Hg
oval macrocytes
- elliptical egg-shaped/oval to sausage shaped
- seen in hereditary elliptocytosis, IDA, MMM
elliptocytes
- round, small redcells, lacks central pallor, showing an intense staining affinity
- h or a, seen in HS, acquired HA, burned patient
spherocyte
- central area of Hb surrounded by a relatively colorless ring, appear like a bell or tall hat shaped, or mexican hat shell
- membrane surface is increased after loading of the membrane with cholesterol and phospholipids
codocytes
having many uniform tiny spicules on their surfaces; represent artifact on films; should not be reported
echinocytes
- having irregularly sized and unevenly spaced spicules, that differs from echinocytes, and should be reported when seen
- related to increase in bun
burr cells
- small, densely stained rbcs having few irregular, large pointed spicules or thorn like projections
- caused by changes in ratio of plasma lipids
- abetalipoproteinemia, alcoholic cirrhosis with HA
acanthocytes
- having an elongated or slit like area of central pallor (mouth shaped)
- H or A membrane defect in the Na+: K+ transport ratio and a greatly increased rate of active cation trn
- alcoholism, cirrhosis, obstructive liver disease, Rh null disease
stomatocytes
T/F: poikilocytes are primary to trauma
FALSE - secondary
- aka helmet cells
- undergoes cleavage and fragmentation
- process is associated with either small blood vessel disease or fibrin in small blood vessel and results in intravascular fragmentation
- MAHA, severe burns, renal graft rejection, glumerulonephritis, vasculitis
schistocytes
- a schistocyte with one or more horn like projections; a rare phenomenon; should be reported as schistocyte
- a result of rbc being caught on a fibrin strand w/c could cut it to two. when this escapes, it may have a vacoule like area (blister cell) - associated with g6pd
keratocyte
- teardrop or pear shaped cells
- rbc containing heinz bodies that squeeze through the spleenic sinuses, hence, will have its original shaped stretched
- seen in MMM, heinz body anemia, myelophthisic anemia
dacrocytes
- usually seen in severe burns as small, round cells, as a result of thermal damage to the membrane
- rare hereditary HA associated with heat sensitivity at 45 celsius
microspherocytes
- large fragments of red cell membrane with their contents being extruded, and stain pale pink forming a half moon or crescent shape cell
- frequently seen in malaria
drepanocytes
intracellular hexagonal crystals with blunt ends and strains darkly; forms within the red cell membrane when hb c crystallizes
hemoglobin cc crystals
small round fragments of a metarubricyte and stain reddish blue in wright’s; result from kharyorrhexis or from incomplete extrusion of nucleus during mitosis, give positive feulgen reaction
howell-jolly bodies
- dark-hued crystals of condensed hb that distorts rbc membrane
- one or more fingerlike blunt pointed projections, that protrude from the cell membrane in different directions
hemoglobin sc crystals
two forms of basophilic stippling
fine stippling
granular stippling
irregularly shaped basophilic granules; represents aggregates of ribosomes
basophilic stippling
stippling due to increased red cell population, seen with increased polychromatophilia
fine stippling
stippling due to abnormal instability of RNA in the young cells, seen in lead poisoning, thalassemia, megaloblastic anemia, and severe anemia
granular stippling
small irregular dark staining granules located in the periphery; positive with prussian blue
pappenheimer bodies
heinz bodies is best stained with
supravital stain
- round refractile bodies of denatured hemoglobin precipitates, not visible in wrights stain; pitted golf apperance if multiple
- seen in hereditary g6pd deficiency
heinz bodies
- small greenish-blue inclusion bodies
- precipitated hb h
- a-thalassemia
hemoglobin H inclusions
an oxidant used in heinz bodies for a long period induces heinz body formation
acetylphenylhydrazine
plasmodium spp transmitted to man by anopheles mosquito
malaria
schuffner’s stippling, four maturation stages infects the rbc-enlarged
p. vivax
protozoan inclusion that is the same but rbc is not enlarged
p. malariae
small delicate ring froms, gametocytes are banana shaped
p. falciparum
rbc is oval, schuffners stippling is present
p. ovale
- rare transmission to humans by tick bites
- resemble ring stages of malarial parasites
- tiny rings 1-5um
- tetrad formation
- rbc not enlarged
babesia microti
