rbc anomalies Flashcards
what are the 3 classification of rbc based on variation of hemoglobin content
normochromic cell
hypochromic cell
spherocytes “hyperchromic cell”
In hypochromic cell, what is the size of the central pallor
larger than usual - larger than the 1/3 of the cell
describe how much or how concentrated the amount of hemoglobin in hypochromic cell
the hgb is less than normal
In hyperchromic or spherocytes cell, what is the size of the central pallor
smaller than the normal size of 1/3 and the hemoglbin content is higher than normal
hypochromic is associated to a condition wherein the red cell is smaller than normal, smaller than 7 um
microcytosis
refers to erythrocytes with normal
amount of hemoglobin
and possess a central pallor which is about 1/3 of its diameter
normochromic
explain what will happen to the mch and mchc of an rbc if it’s hypochromic
both indices will decrease
classifications of rbc if it’s about the variation in staining property
POLYCHROMASIA
HYPOCHROMASIA
HYPERCHROMASIA
This condition wherein the red cell are stained with
various shades of blue with tinges of pink.
Polychromatophilia
explain the action of Polychromatophilia
This is due combination of the affinity of hb to acid
stain and the affinity of RNA to the basic dye.
polychromasia will indicates ___
reticulocytosis
what is the reference value of reticulocytes
0.5 - 1.5%
Polychromasia grading
state the grade
slight
1+
2+
3+
4+
In a slight grade of polychromasia
what is the PERCENTAGE OF RBCs that are polychromatophilic
1%
In a 1+ grade of polychromasia
what is the PERCENTAGE OF RBCs that are polychromatophilic
3%
In a 2+ grade of polychromasia
what is the PERCENTAGE OF RBCs that are polychromatophilic
5%
In a 3+ grade of polychromasia
what is the PERCENTAGE OF RBCs that are polychromatophilic
10%
In a 4+ grade of polychromasia
what is the PERCENTAGE OF RBCs that are polychromatophilic
higher than 11%
variation in staining properties
Condition where in the
red cells appear pale.
hypochromasia
why hypochromasia exist?
because of thinness of the red blood cell and low concentration of hemoglobin
conditions wherein hypochromasia can be observed
IDA or iron deficiency anemia
sideroblastic anemia
thalassemia
common type of anemia and the easiest one to treat
IDA - iron deficiency anemia
a type of anemia wherein there is a “blockage in the iron” in the protoporphyrin pathway
sideroblastic anemia
type of anemia wherin there’s a deficiency in either the alpha or beta chain
thalasemia
reading for hypochromasia. Where do we based it?
the size of the central pallor
reading for hypochromasia. Where do we based it?
number of population that is polychromatophilic
gradings for hypochromasia
1+
2+
3+
4+
gradings for hypochromasia and the description
1+
Area of central pallor is½ofcell
diameter
2+ in hypochromasia
area of the central pallor is 2/3 of the cell diameter
3+ hpochromasia
area of the cental pallor is 3/4 of the cell diameter
4+ hypochromasia
think rim of hemoglobin
variation in staining properties
Conditioned where in the
red cell are deeply
stained to abnormal
thickness of cells.
HYPERCHROMASIA
what are the conditions we can observe hyprchromasia
- Macrocytosis
- Spherocytosis
- Megaloblastic anemia
do old samples became spherocytes?
yes
condition where in the red
cells vary in size both macrocytes and
microcytes coexist on the same smear.
anisocytosis
normocyte size
7-8 um diameter
classification of red blood cells under the variation in size
microcyte
macrocyte
megalocyte
in normocyte - normal size
wht are the associated diseases
acute post hemorrhagic anemia
hemolytic anemia
aplastic anemia
what happens in hemolytic anemia
premature distraction of the rbc in which di kaya makareach ng 120 days
what happens in aplastic anemia
problem withthebone marrow, they produce vert little cells in bone marrow
what is the hallmark of aplastic anemia
presence of pancytopenia
the decrease of all the formed elements of our blood
pancytopenia
decrease of all the formed elements in the blood
In pancytopenia - low rbc
low wbc
low platelets will cause
low rbc - anemia
lowewbc - infection
low platelet bleeding
In macrocyte - the mean corpuscular volume is greater than
100 femtoliter
larger than normal greater than
8 um in size round in shape mcv > 100FL
macrocyte
conditions where we can observed macrocyte
Non-Megaloblastic anemia
myelodysplastic syndrome
macrocyte
megalocyte
differentiate the megalobastic
macro - non megalo
mgalo - megalo
what’s the difference with non megalo and megalo
in non megalo,there’s no characteristics like hypersigegmented neutrophils
hallmark of the megaloblastic anemia is the
presence of hypersegmented neutrophil
the mcv of non megaloblastic is always
not greater than 100 FT
an indices that represents the size or volume of the red blood cell
mean corpuscular volume
defect in macrocyte
Abnormal nuclear maturation
but
normal cytoplasmic maturation
other diseases we can observe macrocyte
- Chronic liver disease
- BM failure
- Reticulocytosis - continuous production of blood due to bleeding
cell which is less than 7 um in size
MCVless than 80 ft
microcyte
defect in microcyte
normal
nuclear maturation
but
Abnormal cytoplasmic maturation
Microcytosis is found
- Iron deficiency Anemia
- Thalassemia
- Hemolytic anemia
- Hb E disease
large oval-shaped red cell which is 9-12
um
megalocyte
defect in megalocyte
Abnormal nuclear maturation
but
normal
cytoplasmic maturation
Megalocytosis is found in :
- Megaloblastic anemias like pernicious anemia
- Anemia
- Vit. B12 deficiency anemia or vit B12 def.
- Diphyllobothrium latum infection
what is Diphyllobothrium latum
it competes with the vitamins with the host
red cells exhibit variation in shape.
poikilocytosis
classifications in rbc variation in size
discocyte
acanthocytes (spur cells)
biscuit cell (folded rbc)
burr cell
blister cell (bite cell)
echinocytes or crenated cell burr cell
codocytes
teardrop cell (dacryocytes)
elliptocytes
spherocytes
sickel cells (drepanocytes)
schistocytes
stomatocyte
what are the causes of the variation in shape of the rbc
carbohydrates
lipids
proteis
conditions associated with discocyte
Acute post hemorrhagic anemia
aplastic anemia
reasons why biconcave shaped
to become flexible to pass through narrow vessels
to carry hemoglobin efficiently
acanthocytes is also called
spur cell
small dense
RBC with few irregularly
spaced projections of varying
length
Acanthocyte(spur cell)
defect in Acanthocyte (spur cell)
abnormal membrane
defect caused by an
increase sphingomyelin and
dec in cholesterol and
phospholipid.
acanthocyte can is caused by increased in ___ and decrease in
increase in sphingomyelin and
dectrease in cholesterol and phospholipid.
associated disease in Acanthocyte(spur cell)
Neuroacanthocytosis (abetalipoproteinemia,
McLeod syndrome)
Severe liver disease (spur cell anemia)
biscuit cell is also called as
folded rbc
defect found in biscuit cell
cell membrane folded
cell decscription in biscuit cell
Cell assumes a “
Pocket bookroll”
appearance or biscuit
shape
associated disease for biscuit cell
HbSC diease
HbCC disease
diseases seen in hemoglobinopathies
burr cell is also called as
echinocyte
defect in burr cell
abnormal lipid content in the membrane
cell description of burr cell
cell with irregularly
spaced blunt processes,
resembles crenated RBC
associated disease in burr cell
uremia
MAHA - microangiopathic hemolytic anemia
liver disease
DIC - Disseminated intravascular coagulation
TTP - Thrombotic thrombocytopenic purpura
PK - Pyruvate kinare
is crenated rbc pathologic?
yes and no
yes if the sample is near to drying
Blister cell is also called as
bite cell
defect of blister or bite cell
G6P def. resulting
to accumulation of Heinz
bodies
cell description of blister or bite cell
cell w/ eccentric
vacuoles due to the
plucked out Heinz body
associated disease for blister cell or bite cell
G6PD def.
HUS - hemolytic uremic syndrome
MAHA microangiopathic hemolytic anemia
echinocytes is also called as
crenated cells
sea urchin cells
echinocytes or crenated cells
deficiency in ATP due to prolonged
storage of
anticoagulated blood is associated to which variatio in shapre
Pathologically ; due to
abnormal lipid content
of the membrane
ECHINOCYTES OR CRENATED CELLS
ECHINOCYTES OR CRENATED CELLS disease associated
Usually artifactual.
Seen in uremia, bleeding
ulcers, gastric
carcinoma, hepatitis,
Cirrhosis
CODOCYTES is also called as
Target cell/ Mexican Hat
/cells with bull’s eye
appearance
defect in codocytes
Def. in cholesterol,
phospholipid in the membrane
Def in Lecithin cholesterol acyl
transferase ( LCAT)
description of codocytes
Cell w/ central area of Hb
surrounded by colorless area and a peripheral ring
associated diseases for codocytes
Thalassemia. Liver ds ,
Hemolytic anemia, and hemoglobinopathies HbSS
teardrop cell is also called as
dacryocyte
defect in teardrop cell
abnormal
maturation squeezing
and fragmentation
during splenic passage
cell description for teardrop cell
Cells appear in the
shape of a teardrop or
pear with a single short
or long protrusion
conditions associated with teardrop cell
hemolytic anemia
megaloblastic anemia
mmm myelofibrosis with myeloid metaplasia
myelophthistic anemia
ELLIPTOCYTES is also known as
ovalocytes
defect in elliptocytes ovalocytes
Abn membrane due
to defective spectrin,
def in band protein 4.1
cell description for elliptocyes
oval or elliptical
Hb appearsto be
concentrated at the two
ends of the cell leaving a
normal central area of pallor
elliptocytes
Can be found inhealthy
person in elliptocytes
yes provided that it’s not numerous
why rbc for elliptocytes has shortened life span
not stable
oxygen content is low
elliptocyte can be seen in associated diseases such as
- Megaloblastic anemia
- Hypochromic anemia
22 - Hereditary ovalocytosis
cell desription of spherocyte
small round dense cell
which lacks the central
pallor area usually
microcytic and sphere
shaped.
defect in spectrin
Primary : Spectrin
Def
Secondary : defective
interaction of spectrin with
other skeletal proteins.
associated disease for spherocyte
HS,
Chronic lymphocytic leukemia.
Immune homlytic anemia
due to ABO incompatibility
Small, round, dense RBC
with no central pallor
SPHEROCYTE
Cells becomesmallerand
denser r with increase Hb
content and become less
deformable with age.
- Shortened survival time
because they can be
sequestred in the spleen
and destroyed
spherocyte
SICKLE CELLS is also called as
drepanocytes
Cresent shape cell due to
abnormal aggregation of ___
which gives a tendency for the
cell to assume a sickle shape
HbS
__cells are thin and
elongated with pointed ends
and are well filled with Hb.
Sickle
They may be curved or
straight or have S, V or L
shaped
SICKLE CELLS ( DREPANOCYTES)
dieases associted with sickle cell
sickle anemia and sickle cell trait
Cell fragmentation
due to trauma caused by
physical and mechanical
agents.
SCHISTOCYTES
SCHISTOCYTES is also called as
Schizocyte
schistocytes cell description
irregularly, contracted
cell; fragmented cell
SCHISTOCYTES is one of the hallmark associated with
MAHA
ieases associated wth schistocytes
MAHA,TTP,DIC HUS, UREMIA
STOMATOCYTE is also called as
mouth cells
Characterized by an
elongated or slit-like area of
central pallor
stomatocyte
Causedby osmtic changes
due tocation imbalance (
Na,K)
stomatocyte
Stomatocytosis is found in
Alcoholic cirrhosis
Hereditary stomatocytosis
hepatobiliary disease
Rh null syndrome
VARIATION DUE TOTHE
PRESENCE OFINCLUSION
BODIES
diffuse basophhilia
basophilic stippling
howell jolly body
heinz body
pappenheimer bodies
cabot ring
Hgb H inclusions (golf ball size)
