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Hema 1 > RBC Anomalies (Part 6) > Flashcards

RBC Anomalies (Part 6) Flashcards

1
Q

increased number of red cells with VARIATION in SIZE

A

ANISOCYTOSIS

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2
Q

Diameter of normal RBCs (normocytes)?

A

7-8 µm

(usually seen when MCV is 80-100 fL)

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3
Q

Four ways to detect anisocytosis:

A
  1. Using the NUCLEUS of a small lymphocyte in a peripheralblood smear (PBS)
  2. Using the MCV value
  3. Using the RDW value
  4. Using the RBC histogram
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4
Q

Larger than normal RBCs (diameter > 8.0 µm)

A

Macrocytes

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5
Q

Associated with impaired DNA SYNTHESIS

BIGGER than the nucleus of lymphocyte

A

Macrocytes

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6
Q

Macrocytes are seen when value of MCV is?

A

> 100 fL

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7
Q

Smaller than normal RBCs (diameter < 7.0 µm)

A

Microcytes

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8
Q

Associated with DEFECTIVE HEMOGLOBIN FORMATION

SMALLER than the nucleus of lymphocyte

A

Microcytes

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9
Q

Microcytes are seen when the MCV value is?

A

< 80 fL

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10
Q

Normal erythrocyte = ?

A

= NUCLEUS of SMALL LYMPHOCYTE

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11
Q

The average volume of individual RBCs?

A

MCV

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12
Q

Formula of MCV?

A

Hct / RBC count x 10

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13
Q

Reference range of MCV?

A

80-100 fL

(Should be consistent with the PBS)

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14
Q

↓MCV = ?

Normal MCV = ?

↑MCV = ?

A

↓MCV = MICROcyte

Normal MCV = NORMOcyte

↑MCV = MACROcyte

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15
Q

Regardless of the SIZE, the RDW is always __________ in Micro/Macrocytic.

A

INCREASED

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16
Q

A calculated index (from the RBC histogram) given by hematology analyzers to help identify ANISOCYTOSIS and provide information about its DEGREE (or how severe it is)?

A

Red Cell Distribution Width (RDW)

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17
Q

Most recent hematology analyzers have provided two methods to calculate the RDW:

A
  1. RDW-CV (coefficient of variation)
  2. RDW-SD (standard devitation)
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18
Q

Based on BOTH the width of the RBC distribution curve and the mean RBC size?

A

RDW-CV

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19
Q

Based on the actual measurement of the width of the RBC distribution curve in fL (femtoliters)?

A

RDW-SD

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20
Q

⭐️ RDW-CV reference range for ADULTS:

A

11.5% to 14.5%

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21
Q

⭐️ RDW-SD reference range in ADULTS?

A

39 - 46 fL

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22
Q

EARLIEST method provided by the hematology analyzers to measure red cell variations?

A

RDW-CV

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23
Q

DEPENDENT on the WIDTH of the DISTRIBUTION CURVE and the MCV that is MORE COMMON in the Philippines

A

RDW-CV

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24
Q

WIDTH of the curve is measured at the point that is 20% ABOVE the baseline

NOT influenced by the MCV

A

RDW-SD

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25
Q

BETTER and MORE RELIABLE measure of erythrocyte variability, specifically in
HIGHLY ABNORMAL conditions?

A

RDW-SD

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26
Q

RDW Reference range for newborns?

A

14.2% to 19.9%

RDW is MARKEDLY INCREASED in newborns but gradually, the value will decrease until it reaches adult levels by 6 MONTHS of age.

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27
Q

If the RBC histogram is ________ than normal, the RDW would be _____________.

A

WIDER

ABNORMAL

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28
Q

Examples of conditons with their MCV and RDW values:

A

See INDEX 2

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29
Q

A visual display of CELL SIZE (X-axis) and CELL FREQUENCY or the number of cells
(Y-axis)

A

Blood cell histogram

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30
Q

provided by many high-volume instruments to provide size distribution of the different cell populations

A

RBC histogram

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31
Q

Automated hematology analyzers produce histograms for?

A

RBCs, WBCs, and platelets

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32
Q

TWO parameters calculated from RBC histogram?

A

MCV & RDW

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33
Q

Instruments being used count those cells with volume sizes as RBCs?

A

Between 36 fL to 360 fL in size

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34
Q

RBC histogram can measure cells as small as?

A

24 fL

(However, cells that are counted in the 24 to 36 fL range are NOT included in the RBC count)

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35
Q

LEUKOCYTES are present in the diluted fluid containing RBCs, but their numbers are statistically ____________ in the count.

A

INsignificant

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36
Q

If the leukocyte count is significantly _________, the RBC histogram will be affected.

A

ELEVATED

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37
Q

RBC Histogram:

Shift to the RIGHT = ?

A

MACROcytic

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38
Q

RBC Histogram:

Shift to the LEFT = ?

A

MICROcytic

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39
Q

RBC histogram curve is BIMODAL = ?

A

There are TWO POPULATIONS of RBCs in the sample.

40
Q

Illustrations [Figures] showing RBC histogram examples:

A

See * INDEX 3 *

41
Q

Cases that may cause a BIMODAL distribution curve?

A
  1. Blood transfusion (when NORMOcytic DONOR erythrocytes are transfused to a RECIPIENT with MICROcytic red cells)
  2. Cold agglutinin disease
  3. Hemolytic anemia with SCHISTOCYTES present (+)
42
Q

A WIDER or FLATTENED curve on a histogram indicates?

A

MORE VARIATION in the SIZE of the cells

(The cell population is NOT homogeneous.)

43
Q

General term for a VARIATION in the NORMAL COLORATION?

A

“ANISOCHROMIA”

by Turgeon

44
Q

NORMAL RBC have central pallor of?

A

approximately 1/3 the diameter

45
Q

may also mean the occurrence of HYPOCHROMIC cells and NORMOCHROMIC cells in the same blood smear

A

Anisochromia

46
Q

may be found in SIDEROBLASTIC ANEMIAS, also in a HYPOCHROMIC ANEMIA after transfusion with normal cells and some weeks after IRON THERAPY for iron deficiency anemia

A

Anisochromia

47
Q

Central pallor of Hypochromic cells?

A

> 1/3 of diameter

48
Q

Hypochromic cells are usually ______________.

A

MICROCYTIC

“Pag maliit, maputla”

49
Q

⭐️ GRADING OF HYPOCHROMIA:

1+ Area of central pallor = ?

2+ Area of central pallor = ?

3+ Area of central pallor = ?

4+ = ?

A

1+ Area of central pallor = 1/2 of diameter

2+ Area of central pallor = 2/3 of diameter

3+ Area of central pallor = 3/4 of diameter

4+ = Thin Rim of Hemoglobin ⭐️

50
Q

RBC with a THIN RIM of HEMOGLOBIN and a large, CLEAR CENTER?

51
Q

Another name for Anulocyte?

A

GHOST CELL

or

PESSARY CELL

52
Q

Anulocyte is observed in what type of anemia?

A

IRON Deficiency Anemia
(severe cases)

53
Q

HYPERchromic cells are usually ____________.

A

SPHEROCYTES

54
Q

RBCs that lack central pallor even though they lie in a desirable area for evaluation?

A

HYPERchromic cells

55
Q

These RBCs are actually caused by a shape change?

A

HYPERchromic cells

56
Q

This occurs whem MCHC is HIGH?

A

True HYPERchromia

57
Q

3 key clinical manifestations of Hereditary Spherocytosis?

A
  1. Splenomegaly
  2. Anemia
  3. Jaundice
58
Q

Hereditary Spherocytosis:

DAT = ?

MCV = ?

MCH = ?

MCHC = ?

A

DAT (direct antiglobulin test) = NEGATIVE ❗️

MCV = Normal to Low

MCH = Normal

MCHC = SLIGHTLY INCREASED (35-38 g/dL)

59
Q

⭐️ REMEMBER:

The immune disorders that HAVE spherocytes also are usually characterized by a _____________.

A

POSITIVE (+) result on DAT

60
Q

Other tests for H. Spherocytosis?

A
  1. Autohemolysis test
  2. OFT (osmotic fragility test)
  3. EMA Binding Test (Eosin-5’-maleimide)
61
Q

HS results:

Autohemolysis test = ?

OFT = ?

EMA Binding Test = ?

A

Autohemolysis test = GREATLY INCREASED (but can be corrected with either glucose or ATP)

OFT = INCREASED osmotic fragility
(NOT diagnostic of HS; old confirmatory test)

EMA Binding Test = ↓ fluorescence (flow cytometry)

62
Q

CONFIRMATORY TEST for HS?

A

EMA Binding Test

63
Q

larger than normal red cells with bluish tinge (Wright’s stain)?

A

Polychromatophilic erythrocytes

64
Q

Large numbers of Polychromatophilic erythrocytes are associated with?

A
  1. DECREASED BC survival
  2. hemorrhage
  3. erythroid hyperplastic marrow
65
Q

The BLUISH TINGE on polychromatophilic erythrocytes is caused by the presence of?

A

Residual RNA

66
Q

⭐️ GRADING OF POLYCHROMASIA

Slight = ?

1+ = ?

2+ = ?

3+ = ?

4+ = ?

A

Slight = 1%

1+ = 3%

2+ = 5%

3+ = 10%

4+ = >11%

67
Q

(↑) increased number of red cells with variation in SHAPE?

A

POIKILOCYTOSIS

68
Q

Almost SPHERICAL in shape

LACKS the central pallor

A

SPHEROCYTE

69
Q

Associated conditions to SPHEROCYTE?

A

✓ Hereditary spherocvtosis
✓ Autoimmune hemolytic anemia
✓ Burns
✓ ABO HDN
✓ following transfusion of stored blood

70
Q

🍁 Natural RBC death can result also to

A

SPHEROCYTIC red cells

71
Q

⭐️ REMEMBER:

Spherocytes may be WRONGLY reported if one examines the ____________ of the blood film because the red blood cells in the said area LACK CENTRAL PALLOR.

A

feathered edge

72
Q

ELONGATED RBCs with a “slit-like” central pallor (may be considered as an artifact)

A

STOMATOCYTE

“Puto”

73
Q

⭐️ Other name of STOMATOCYTE?

A

MOUTH CELL

“Puto”

74
Q

STOMATOCYTES are considered to be significant if?

A

ALL FIELDS should have MULTIPLE MOUTH CELLS and only an artifact if there are few seen / field

75
Q

⭐️ Associated conditions to STOMATOCYTES?

A

✓ Rh Deficiency Syndrome (⭐️BB)
✓ Alcoholism
✓ Electrolyte imbalance
✓ Severe liver diseases
✓ Overhydrated hereditary stomatocytosis
✓ Dehydrated hereditary stomatocytosis (Hereditary Xerocytosis)

76
Q

MOST COMMON form of stomatocytosis?

A

Dehydrated hereditary stomatocytosis (Hereditary Xerocytosis)

77
Q

Hereditary Xerocytosis is characterized by the presence of?

A

XEROCYTES

(appears to have PUDDLED at one end; half-light, half-dark)

78
Q

RBCs with IRregularly spiculated surface?

A

ACANTHOCYTE

“Rambutan”

79
Q

Other name for ACANTHOCYTE?

A

THORN CELL

or

SPUR CELL

80
Q

⭐️ Associated conditions to ACANTHOCYTE?

A

✓ Abetalipoproteinemia ⭐️

✓ McLeod Syndrome

✓ Pyruvate kinase deficiency

✓ Hepatic hemangioma

✓ Neonatal hepatitis

✓ After heparin administration

✓ Post-splenectomy

✓ Cirrhosis of the liver with
associated hemolytic anemia

81
Q

Other name for Abetalipoproteinemia?

A

Bassen-Kornzweig Syndrome

and

Hereditary Acanthocytosis

82
Q

Abetalipoproteinemia is characterized by?

A

DEFECTIVE apo B synthesis

83
Q

In Abetalipoproteinemia, these lipoproteins are NOT found in PLASMA?

A

VLDL , LDL , and Chylomicrons

84
Q

RBCs with regularly spiculated surface (even in size)?

A

BURR CELL

“Fita”

85
Q

Other name for BURR CELL?

A

Echinocytes

“Fita”

86
Q

Associated conditions to ECHINOCYTES?

A

✓ Uremia

✓ Pyruvate kinase deficiency

87
Q

In Echinocytes, Uremia is characterized by?

A

✓ MARKED (↑) in plasma urea and other nitrogenous waste products

✓ Generalized edema

✓ Acidemia

✓ electrolyte imbalance (K+ elevation)

✓ NORMOcytic, NORMOchromic Anemia

✓ Uremic Frost (dry skin)

✓ Foul breath

✓ “URINE-like” sweat

88
Q

Oval-shaped RBCs?

89
Q

Associated condition/s to OVALOCYTE?

A

Hereditary Ovalocytosis

90
Q

Other name for Hereditary Ovalocytosis?

A

Southeast Asian ovalocytosis

91
Q

Elliptical (CIGAR-shaped) RBC?

A

ELLIPTOCYTE

92
Q

Associated conditions to ELLIPTOCYTE?

A

✓ Hereditary Elliptocytosis

✓ Thalassemia

93
Q

Other name for Thalassemia?

A

Hereditary Leptocytosis

94
Q

PEAR-shaped or TEARDROP shaped RBCs?

A

DACRYOCYTE

95
Q

Other name for DACRYOCYTE?

A

Teardrop cells

96
Q

Associated conditions to DACRYOCYTE?

A

✓ Primary Myelofibrosis (PMF)

✓ Megaloblastic Anemia

✓ thalassemia

✓ myelophthislc anemia

✓ after Heinz body formation induced by drug ingestion

✓ tuberculosis

✓ tumor metastasized to the bone marrow

✓ some hemolytic anemias

Hema 1 (2 decks)

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