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Hematology > RBC MORPH > Flashcards

RBC MORPH Flashcards

1
Q

SUMMARY OF STEPS REQUIRED TO PERFORM THE COMPLETE PERIPHERAL SMEAR

A

CHECK SLIDE IDENTIFICATION

PERFORM PATIENT SPECIMEN
ORIENTATION

PERFORM LOW POWER (x10) SCAN OF THE BLOOD FILM

PERFORM OIL EXAMINATION (100x) OF THE BLOOD FILM

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2
Q

PERFORM LOW POWER (x10) SCAN OF THE BLOOD FILM

A

Check feather edge for fibrin threads
Examine film edges for excessive leukocytes
Very acceptable number of leukocytes
Verify stain quality
Examine RBC distribution patterns and shapes

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3
Q

PERFORM OIL EXAMINATION (100x) OF THE BLOOD FILM

A

Prepare blood film with oil

Estimate platelet count

Estimate leukocyte count

Perform leukocyte differential

Classify 100 leukocytes

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4
Q

Classify 100 leukocytes

A

Report results as percentages of all leukocyte counted
Keep separate counts of nucleated red blood cells
Note and report abnormal leukocyte morphology
Grade abnormal erythrocyte morphology
Identify miscellaneous abnormal cells

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5
Q

CHECK THE SLIDE IDENTIFICATION

A

Check blood smear identification to ensure that the film and the AUTOMATED COUNT REPORT match

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6
Q

-
-
Compare the actual findings on the blood film
Any extreme discrepancy should be investigated and resolved before the report is generated.

A

Number of leukocytes
Number of platelets
The erythrocyte indices

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7
Q

CHECK FEATHERY EDGE FOR ____

A

FIBRIN THREADS

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8
Q

PERFORM LOW POWER (x10) SCAN OF THE BLOOD FILM

Fibrin threads to entrap ____ and are accompanied by ___

Neither a differential count or a platelet estimate should be attempted on these blood films

A

leukocytes

platelet clumps

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9
Q

A PROPERLY MADE PUSH WEDGE PERIPHERAL BLOOD FILM SHOWING THE BATTLEMENT PATTERN FOR LEUKOCYTE DIFFERENTIAL PROCEDURE

A

FEATHERY EDGE
LATERAL EDGE
EXAMINATION AREA
ORIGIN

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10
Q

The edges of even the best prepared films have accumulations of _ and _

Edges should contain __ more leukocytes than the number present in the body of the film

A

granulocytes and monocytes

<2-3x

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11
Q

VERIFY ACCEPTABLE NUMBER OF LEUKOCYTES

In a total leukocyte count of not less than ____, the acceptable working area should contain at least __ leukocytes

A

4.0 x 109/L

300

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12
Q

VERIFY STAIN QUALITY

The stain should clearly distinguish between ___ ___ ___ ___ and __-___ ___

A

dark purple nuclear material and red-orange erythrocytes

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13
Q

EXAMINE RBC DISTRIBUTION, PATTERNS, AND SHAPES

A

RBCs normally repel one another
RBCs should be distributed evenly (or just slightly overlapping)
Cells should not be distorted

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14
Q

Indicates presence of abnormal serum globulins MULTIPLE MYELOMA

A

ROULEAUX FORMATION

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15
Q

Presence of certain antibodies to RBC surface antigens

A

AGGLUTINATION

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16
Q

Normal red cells should be:

A

Circular with smooth edges
Uniform in shapes and size and hemoglobin concentration
Normal diameter = 7-8mm
Diameter of the central pale area should not be > 1/3 of the cell diameter
No inclusions

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17
Q

HYPERCHROMIC

NORMOCHROMIC

HYPOCHROMIC

A

MCHC = >37 g/dL
Seen in Spherocytosis

MCHC = 31-37 g/dL

MCHC = <31 g/dL
Seen in IDA, thalassemias, etc

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18
Q

Term used to describe the variation in Hb content when both hypochromic and normochromic cells are present

A

ANISOCHROMASIA

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19
Q

RED CELL SIZE
MACROCYTIC
NORMOCYTIC
MICROCYTIC

A

100fL

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20
Q

MEAN CORPUSCULAR VOLUME (MCV)

Expressed in SI units as __
1 fL = —
NV: —-

A

Indicates the average volume of a single erythrocyte in a given blood sample

FEMTOLITERS

10-15/L

80-100fL

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21
Q

MCV =

A

RBC (1012/L)

22
Q

ERYTHROCYTE INDICES

Discussed in relation to __ AND ___
Increased in ____, ____, ____, and ______
A ___ population yields a normal MCV
Increased _____ may increase MCV

A

Discussed in relation to anemia and hematologic disorders
Increased in megaloblastic anemias, chronic hemolytic anemias, liver disease, and hypothyroidism
A DIMORPHIC population yields a normal MCV
Increased reticulocytes may increase MCV

23
Q

MEAN CORPUSCULAR HEMOGLOBIN (MCH)
Expressed in SI as ___ (1pg = ___)
NV: ___
Should correlate well with __ and ___

A

Indicates the average WEIGHT of Hb per erythrocyte
PICOGRAMS
(1pg = 10-12g)

26-34pg

MCV and MCHC

24
Q

MCH =

A

RBC (1012/L)

25
Q

MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION (MCHC)

Expressed in SI units as __ (formerly in %)
NV : __

MCHC formula

A

Indicates the average concentration of Hb in the erythrocytes of any specimen

g/L
31-37 g/L

HCT%

26
Q

MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION (MCHC)
“___” is NOT used as an actual description of RBC morphology

RBC cannot accommodate Hgb — therefore, a result of — should be —-

A

Hyperchromia
>37g/dL\
recalculated

27
Q

Variation in red cell population size or diameter
Should be estimated semi-quantitatively: _, _, _.

___ vs ___
Correlated with the RED CELL DISTRIBUTION WIDTH (RDW)

A

ANISOCYTOSIS
SLIGHT, MODERATE, MARKED

MICROCYTES VS MACROCYTES

28
Q

Normal RBCs show little or no shape variation

Recognition of various shapes or poikilocytes on the film is very helpful in the differentiation of ___

A

POIKILOCYTOSIS

anemia

29
Q 
Poikilocyte shape can be explained by:
-
-
-
-
-
-
A

Structural and biochemical changes in the membrane
Metabolic state of the cell
Hemoglobin molecule abnormalities
Abnormal microenvironment
Changes in the red cell’s ability to deform
Red cell age

30
Q

OVAL MACROCYTES

A

Megaloblastic erythropoiesis

31
Q

SPHEROCYTES

A

Hereditary spherocytosis

SPECTRIN

32
Q

ELLIPTOCYTES

A

Hereditary elliptocytosis

ANKYRIN/BAND 4.1

33
Q

ECHINOCYTES (CRENATED CELLS)

BURR CELLS

A

Uremia and Renal Insufficiency

34
Q

ACANTHOCYTES (SPUR CELLS)

A

Abetalipoproteinemia,
alcoholic cirrhosis,
post- splenectomy cases,
hepatitis, etc

35
Q

STOMATOCYTE

A 
Alcoholism, 
cirrhosis, 
obstructive liver disease, 
Rh null disease, 
Hereditary stomatocytosis
36
Q

TARGET CELLS (LEPTOCYTES/MEXICAN HAT CELLS)

A 
Thalassemias,  
Hemoglobinopathies SS, 
CC, 
DD, 
EE, 
Obstructive liver disease, 
postsplenectomy, and 
IDA
37
Q

SCHISTOCYTES/KERATOCYTES

A 
Microangiopathic hemolytic anemia, 
severe burns, 
renal graft rejection, 
glomerulonephritis, 
vasculitis, 
TTP, and 
DIC
38
Q

DACROCYTES (TEARDROP CELLS)

A

Myelofibrosis,
myelophthisic anemia,
b-thalassemia and
pernicious anemia

39
Q

PYROPOIKILOCYTES

A

Burns,
Hereditary
Pyropoikilocytosis

40
Q

DREPANOCYTES (SICKLE CELLS)

A

Sickle cell Disease and Sickle cell Trait

41
Q

HEMOGLOBIN CC CRYSTALS

A

crystal daw

42
Q

INCLUSIONS

A 
POLYCHROMATOPHILIC RED CELLS
HEINZ BODIES
CABOT RINGS
HEMOGLOBIN H INCLUSIONS
MALARIA
BABESIA
43
Q

37C X 30 minutes in BCB

Multiple small dots in ALL cells

A

HEMOGLOBIN H INCLUSIONS

44
Q 
Blue ring with red dot
Mitotic spindle (?)
A

CABOT RINGS

45
Q

37C X 4H in acetylphenylhydrazine + crystal violet

N: 70% of cells

A

HEINZ BODIES

46
Q

Diffuse basophilia

A

POLYCHROMATOPHILIC RED CELLS

47
Q

Few irregular dots in periphery

(+) Iron Stain

A

PAPPENHEIMER BODIES

48
Q

Dark, irregular dots

A

BASOPHILIC STIPPLING

49
Q

Round, singlular, reddish-blue bodies

A

HOWELL-JOLLY BODIES

50
Q

SEMIQUANTITATIVE REPORTS ON ABNORMALITIES IN ERYTHROCYTE MORPHOLOGY SHOULD BE FORMATTED TO PROMOTE BOTH _______ and _________

A

EFFECTIVE COMMUNICATION WITH THE PHYSICIAN AND LABORATORY REPRODUCIBILITY

51
Q

SEMIQUANTITATIVE WAY OF REPORTING (DEGREE OF POIKILOCYTOSIS, ANISOCYTOSIS AND COLOR CONTENT)

A

SLIGHT (15%)

52
Q

SEMIQUANTITATIVE WAY OF REPORTING (FOR PARTICULAR SIZE VARIATION OR VARIATION IN SHAPE)

A

OCCASIONAL (10%)

Hematology (5 decks)

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