RBC Abnormalities Flashcards
Components of whole blood and percentages
plasma (54%)
buffy coat (1%)
red blood cells/erythrocytes (45%)
plasma is a colorless fluid which is composed of?
Water (91-92%) Protein (7-8%) Electrolytes Nutrients Blood gases Hormones
the layer contaminated with bacteria if blood is not properly processed
buffy coat (white cells + platelets)
the plasma without the firbinogen; usual specimen submitted for blood exam for serological tests
serum
volume of RBCs/unit plasma
hematocrit
- males: 40-50
females: 35-40%
characteristics and shape of normal rbc
circular biconcave with smooth edge and central pale area that gradually fades into reddish cytoplasm
diameter of normal rbc
7-8 micrometers
thickness of normal rbc
2-5 micrometers
volume of normal rbc
90 fl.
surface area of normal rbc
160 micrometers
simplest test to check for structure and form of RBCs since they are diagnostic
peripheral blood smear
What does PBS examine?
Distribution of RBCs Concentration of hemoglobin Size of RBCs Shape of RBCs Inclusion of the RBCs
Describe normal distribution of rbc in PBS
there is an even distribution in thin portion (part examined): 1/3 of film
RBC in the area should be barely touching each other and no overlapping is seen
abnormal distribution of RBC in PBS would include
Rouleaux formation (should be separated in thin portion; short and long stacks; not seen in normal) Autoagglutination (when own rbcs agglutinate in own serum or plasma; seen in normal persons)
Rouleaux formation is seen in
THIMP
§ Hyperproteinemia § Infection § Multiple myeloma § Tissue necrosis § Increased fibrinogen § Pregnancy
Autoagglutination is seen in:
SHAT
§ Hemolytic anemia
§ Staphylococcal infections
§ Atypical pneumonia
§ Trypanosomiasis
It is an autoimmune disease characterized by presence of high concentrations of circulating antibodies, usually IgM, directed against red blood cells. There is clumping at low temperatures below 25C
Cold agglutinin
[hemoglobin content]
contains normal amoutn of hb which carries oxygen and gives blood its red color
normochromic
[hemoglobin content]
RBC lacks central pallor due to excessive amount of hb
hyperchromia
*seen in:
spherocytes (thick membrane), sickle cell anemia, hb concentrated in crystal in the abnormal hb, elevated mchc (true state)
[hemoglobin content]
RBC appears pale because of the lower amount of hb due to impaired hb synthesis
hypochromia
*seen in IDA (most common cause), rheumatoid arthritis, chronic infxn, inflammation (defective macrophage release of iron)
variation in hb content
anisochromia
T or F: average size of rbc is correlated with MCHC
False, with MCV
diameter and MCV of macrocytic RBC
8.5-9 micrometers and MCV = 100 fl.
macrocytic normochromic (megaloblastic) type of anemia
Pernicious anemia
Pernicious anemia is associated with?
achloryhdria and absence of gastric intrinsic factors necessary for the binding and absorption of vit.b12
an erythrocyte maturing factor which is secondary to megaloblastic anemia and secondary to pernicious anemia
vit b12
other findings in pernicious anemia
atrophic glossitis (large tongue) gastrointestinal and nervous disorders
RBC precursors of megaloblastic anemia appearance
Nuclear-cytoplasmic asynchrony (abnormally large and have nuclei that appear much less mature than would be expected from the development of cytoplasm)
drugs which can lead to megaloblastic anemia (MAPLE)
methotrexate AZT-Zidovudine (anti-HIV drug) Phenytoin (Fenytoin-folate deficiency: anti-seizure drug) liver disease ethanol
where macrocytosis is seen
LAMBMCHC
§ Lymphoma § Leukemia § Alcoholism w/o liver disease § Myeloma § B12 deficiency § Metastatic carcinoma § Chronic hemolytic anemia § Hypothyroidism § Cancer chemotherapy
MCV of microcytic RBC
below 80 fl.
T or F: microcytic rbcs always have less hemoglobin
false, normal or less hb
where is microcytic rbcs usually seen?
- After chronic iron deficiency
- During decreased globin synthesis in β Thalassemia, along with the target cell
- In leptocytes
variation in RBC size (combination of macrocytosis and microcytosis)
Anisocytosis
RBCs that are thinner than normal with colorless centers and increased surface area not proportional to volume;
leptocytes
*Found in thalassemia, obstruction of bile ducts, cirrhosis and steatorrhea
variation in shape of rbc
poikilocytosis
probable causes of poikilocytosis
® Structural and biochemical changes in the cell membrane ® A metabolic state in the cell ® Hemoglobin molecule abnormalities ® Abnormal microenvironment ® RBC age
a hereditary disorder of β-globin chain synthesis (in Hb) that leads to ineffective
erythropoiesis and a microcytic anemia. Some of the RBCs resemble jigsaw
puzzle pieces.
β-thalassemia