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Clinical Microscopy > RBC Abnormalities > Flashcards

RBC Abnormalities Flashcards

0
Q

RBC production

A

Erythropoiesis

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1
Q

Functions of blood

A

1 Transports nutrients, waste products, hormones, and oxygen
2 Regulates fluid, electrolytes, and acid-base balance
3 Protects

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2
Q

RBC production is controlled by ______

A

Erythropoietin

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3
Q

Destruction of RBCs

A

Hemolysis

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4
Q

Where are RBCs destroyed?

A

Spleen

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5
Q

Where are RBCs synthesized?

A

Kidney

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6
Q

Causes of anemia

A

Decreased erythrocyte production

Erythrocyte loss

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7
Q

Normal RBC diameter

A

7-8 um

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8
Q

Normal RBC thickness

A

2-5 um

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9
Q

Normal RBC volume

A

90 fl

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10
Q

Normal RBC surface area

A

160 um

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11
Q

Morphologic alterations in erythrocytes

A 
Distribution
Hemoglobin concentration
Size
Shape
Inclusions
Morphology
Parasites
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12
Q

Normal distribution of RBCs

A

Even distribution in the thin portion (1/3)

No overlapping

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13
Q

Abnormal distribution

A

Rouleaux

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14
Q

When does abnormal distribution of RBCs happen?

A

Increased serum proteins (fibrinogen and globulins)

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15
Q

Abnormal distribution of RBCs is seen in:

A 
Hyperproteinemia
Multiple myeloma
Increased fibrinogen
Infection
Necrosis
Pregnancy
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16
Q

Own RBCs agglutinate in own serum or plasma

A

Autoagglutination

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17
Q

Autoagglutination is seen in:

A 
Hemolytic anemia
Atypical pneumonia
Mycoplasma infection
Staphylococcal infection
Trypanosomiasis
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18
Q

Clumping at temperatures below 25 C

A

Cold agglutinin

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19
Q

Alterations in erythrocyte color or hemoglobin content

A 
Normochromic
Hypochromic
Hyperchromasia
Polychromasia
Anisochromia
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20
Q

Variation in hemoglobin content

A

Anisochromia

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21
Q

Contain normal amount of hemoglobin

A

Normochromic cells

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22
Q

Very pale and show an increased area of central pallor (making up more than 1/3 of the cell)

A

Hypochromic cells

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23
Q

Seen as decreased MCV or microcytosis

A

Hypochromic cells

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24
Q

Hypochromic RBCs are characteristic of:

A

Iron deficiency anemias

Infections such as rheumatoid arthritis, chronic infection, and inflammation (defective macrophage release of iron)

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25
Q

Hyperchromasia is seen in

A

Macrocytes

Spherocytes

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26
Q

Homogeneous color of RBC (at least 2/3)

A

Hyperchromasia

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27
Q

Hyperchromasia is true if ________

A

MCHC is elevated

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28
Q

Blue RNA and red hemoglobin

A

Polychromasia

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29
Q

Increased reticulocyte count

A

Polychromasia

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30
Q

Polychromasia is seen in:

A

Hemolytic anemias

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31
Q

Alterations in erythrocyte size

A

Anisocytosis
Macrocytosis
Microcytosis

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32
Q

Increased variation in the size of RBCs

A

Anisocytosis

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33
Q

Mean cell diameter and MCV of macrocytes

A

> 9 um and > 100 fl

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34
Q

Macrocytosis is seen in:

A 
Megaloblastic anemias of B12 or folic acid deficiency
Alcoholism without liver disease
Cancer chemotherapy
Chronic hemolytic anemia
Myeloma
Leukemia
Lymphoma
Metastatic carcinoma
Hypothyroidism
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35
Q

Erythrocyte maturing factor

A

Vitamin B12

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36
Q

Drugs causing megaloblastic anemia

A 
Methotrexate (cancer)
AZT (Ziodovudine)
Phenytoin (Folate deficiency)
Liver disease drugs
Ethanol
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37
Q

Diameter and MCV of microcytes

A

< 6.5 um and < 78 fl

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38
Q

A characteristic of iron deficiency anemia, thalassemia, lead poisoning, sideroblastic anemia, idiopathic pulmonary hemosiderosis, anemias of chronic diseases

A

Microcytosis

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39
Q

RBC is thinner and has a colorless center

A

Leptocyte

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40
Q

Alterations in erythrocyte shape

A 
Discocyte
Poikilocytosis
Elliptocyte and Ovalocyte
Sickle Cell (Drepanocyte)
Target Cell (Codocyte)
Spherocyte
Stomatocyte
Schistocyte (Fragmented Cell, Helmet Cell)
Tear Drop (Dacrocyte)
Burr Cell, Crenated (Echinocyte)
Acanthocyte (Spike Cell, Acanthoid Cell)
Keratocyte (Horn Cell)
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41
Q

Red cell with a normal shape

A

Discocyte

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42
Q

General term indicating an increased variation in the shape of RBCs

A

Poikilocytosis

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43
Q

Causes of poikilocytosis

A 
Structural and biochemical changes in cell membrane
Metabolic state
Hemoglobin molecule abnormalities
Abnormal microenvironment
Red cell age
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44
Q

Poikilocytes due to Vitamin B12 or Folate Deficiency

A

Oval macrocytes

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45
Q

Oval or egg-shaped seen in megaloblastic anemias

A

Elliptocyte and ovalocyte

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46
Q

Other term for sickle cell

A

Drepanocyte

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47
Q

Sickle cell disease

A

Hb SS

48
Q

Genetic condition in which abnormal hemoglobin (Hb S) is present in a homozygous state on RBCs

A

Sickle Cell

49
Q

Diagnostic of chronic hereditary hemolytic anemia

A

Poikilocytes

50
Q

Characteristics of abnormal hemoglobin

A

Drepanocytes (sickle cells)
Hb CC crystals
HbSc crystals

51
Q

Produces a specific mutant form of beta-globin

A

Sickle cell disease

52
Q

Causes a mild chronic hemolytic anemia

A

Hb C

53
Q

Sickling of RBCs

A

Hb S
Low concentration of RBCs
Low oxygen level

54
Q

Other terms for codocyte

A

Target cell
Mexican hat
Bull’s eye

55
Q

Shows a peripheral ring of hemoglobin, an area of pallor or clearing, and a central area of hemoglobin

A

Codocyte

56
Q

Membrane surface is increased because of cholesterol and phospholipid loading

A

Codocyte

57
Q

Codocytes are always ______

A

acquired

58
Q

Codocytes are seen in:

A 
Thalassemia
Hemoglobinopathies
Obstructive liver disease
Postsplenectomy
Iron deficiency
59
Q

Lost a portion of the cell membrane

A

Spherocytes

60
Q

Diameter of spherocytes

A

< 6 um

61
Q

Spherocytes are seen in:

A

Autoimmune hemolytic anemias
Hemolysis
Microangiopathic hemolytic anemias

62
Q

Show a slitlike or mouthlike area of central pallor

A

Stomatocyte

63
Q

Stomatocytes may be

A

Hereditary or acquired

64
Q

Seen in normal PBS and occur as artifacts

A

Stomatocytes

65
Q

Artifact if found only in one portion of the PBS

A

Codocytes

66
Q

Stomatocytes are seen in:

A

Alcoholism
Cirrhosis
Obstructive liver disease

67
Q

Result of high cellular sodium and low potassium content

A

Stomatocytes

68
Q

Other terms for schistocytes

A

Fragmented cells

Helmet cells

69
Q

Causes of fragmentation of RBCs

A

RBC passes through fibrin strands
Damaged heart valves
RBC develops a blister

70
Q

Schistocytes are seen in:

A 
Severe burns
Renal graft rejection
Glomerulonephritis
Disseminated Intravascular Coagulation
Vasculitis
March disease
Thrombotic thrombocytopenic purpura
71
Q

Other term for tear drop cell

A

Dacrocyte

72
Q

Pear-shaped with an elongated point or tail at one end

A

Dacrocytes

73
Q

Formed when RBCs have inclusions (Heinz body)

A

Dacrocyte

74
Q

Dacrocytes are seen in:

A

Myelofibrosis with myeloid metaplasia
Pernicious anemia
Tuberculosis
Tumor in the marrow

75
Q

Other term for acanthocyte

A

Spike cell

76
Q

Spiny projections are irregularly distributed around the cell membrane

A

Acanthocyte

77
Q

T or F. Acanthocytes are artifacts.

A

F

78
Q

Acanthocytrw in cirrhosis and metastatic liver disease

A

Spur cells

79
Q

Caused by changes in the ratio of plasma lipids (lecithins and sphingomyelins)

A

Acanthocytes

80
Q

Seen in renal insufficiency

A

Burr cells

81
Q

Look like echinocytes

A

Burr cells

82
Q

Other term for echinocytes

A

Crenated cells

83
Q

RBCs with scalloped, spicular, or spiny projections regularly distributed around the cell membrane.

A

Echinocytes

84
Q

Regarded as an artifact and not normally seen in vivo

A

Echinocyte

85
Q

Other term for keratocyte

A

Horn cell

86
Q

Shaped like a half-moon or spindle

A

Keratocyte

87
Q

Results when RBC is caught in a fibrin strand

A

Keratocyte

88
Q

Alterations in erythrocyte structure and inclusions

A 
Basophilic stippling
Siderocyte and Pappenheimer Body
Howell-Jowell Body
Cabot's Rings
Parasitized Red Cell
89
Q

Presence of dark blue granules evenly distributed

A

Basophilic stippling

90
Q

Basophilic stippling is seen in:

A

Toxic injury to bone marrow

Severe megaloblastic anemia

91
Q

Results in alteration in the biosynthesis of hemoglobin

A

Basophilic stippling

92
Q

Cells contain small, dense, blue-purple granules of free iron, uncombined with hemoglobin

A

Siderocytes

93
Q

Stain for siderocytes

A

Prussian blue

94
Q

Siderocytes that are Wright-stained

A

Pappenheimer bodies

95
Q

Seen after removal of spleen

A

Pappenheimer bodies

96
Q

Round, densely staining purple granules

A

Howell-Jolly Bodies

97
Q

Positive fulgean reaction

A

DNA

98
Q

Where are howell-jolly bodies derived from?

A

Incomplete extrusion of the nucleus

Chromosomes separated from the spindle

99
Q

Inclusions of nuclear chromatin remnants

A

Howell-Jolly Bodies

100
Q

Howell-Jolly Bodies are seen in:

A

Sickle cell anemia
Hemolytic anemia
Megaloblastic anemia

101
Q

Threadlike red-violet strands occur in ring, twisted, or figure-8 shapes in reticulocytes

A

Cabot’s Rings

102
Q

May represent part of the mitotic spindle, remnants of microtubules or fragments of nuclear membrane

A

Cabot’s Rings

103
Q

Cabot’s Rings are seen in:

A

Megaloblastic anemia
Severe anemia
Lead poisoning

104
Q

Poikilocytes secondary to developmental macrocytosis

A

Oval macrocytes

105
Q

Poikilocytes secondary to membrane abnormalities

A 
Spherocytes
Elliptocytes and ovalocytes
Echinocytes
Burr cells
Acanthocytes
Stomatocytes
Codocytes
106
Q

Poikilocytes secondary to trauma

A 
Schistovytes
Keratocytes
Dacrocytes
Microspherocytes
Semilunar bodies
107
Q

Poikilocytes secondary to abnormal hemoglobin content

A

Sickle cell

108
Q

Inclusions in the RBC

A 
Howell-Jolly bodies
Basophilic stippling
Pappenheimer bodies
Polychromatophilic red cells
Cabot's rings
109
Q

Occur in severe burns as small round cells

A

Microspherocytes

110
Q

Other term for semilunar bodies

A

Degmacytes

111
Q

Large, pale pink staining ghost of the RBC

A

Semilunar body

112
Q

Young RBCs that are diffusely basophilic

A

Polychromatophilic red cells

113
Q

Larger than normal, contain ribosomes, mitochondria, and other organelles

A

Polychromatophilic red cells

114
Q

Polychromatophilic red cells with methylene blue

A

Reticulocytes

115
Q

Inclusions seen in malaria

A

Schuffner’s stippling or granules

116
Q

Produced by particles of fat or detergent on the glass itself

A

Artifacts

117
Q

Heinz bodies are seen in:

A

Poisoning with aromatic nitro- compounds, amino compounds
Hemolytic anemia
Sulfonamide intake

118
Q

Consist of denatured globin derived from destruction of the hemoglobin molecule

A

Heinz bodies

Clinical Microscopy (3 decks)

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