RBC Morphology

Question 1

Target Cells

Answer 1

Too much lipid not enough membrane

thalassemia, splenectomy, liver disease, IDA, hemoglobinopathies, decreases osmotic fragility

Question 2

Spherocytes

Answer 2

increased hemoglobin content, increased thickness of cell and decrease in diameter
DDX: autoimmune hemolytic anemia, hereditary spherocytosis

Question 3

Schistocytes

Answer 3

trauma to membrane, blood vessel gets damaged and fibrin close lines the RBC
DDX: artifical heart valve, hemolytic uremic syndrome, disseminated intravascular coagulation, thrombotic thrombocytopenia purpura

Question 4

Echinocytes

Answer 4

spicules on cell surface, the enzyme that builds the lipid bilayer is messed up
DDX: uremia

Question 5

Acanthocytes

Answer 5

spheroid with thorny projections, Changes to lipids or cytoskeleton
DDX: splenectomy, alcoholic, cirrhosis, hemolytic anemias

Question 6

Dacrocytes

Answer 6

teardrop shaped cells, bone marrow problem

DDX: megaloblastic anemia, renal failure, sever IDA, thalassemia major

Question 7

Elliptocytes/Ovalocytes

Answer 7

Membrane protein defect, pencil or oval

DDX: myelodysplastic syndrome, thalassemic syndromes, macrocytic anemia, IDA, hereditary elliptocytes, idiopathic

Question 8

Sickle cell

Answer 8

sickle shape with deoxygenation, gene mutation

DDX: sickle cell anemia/ hemolytic anemia

Question 9

Howell jolly bodies

Answer 9

DNA from nucleus

DDX: hyposplenism, asplenism, severe hemolytic anemia

Question 10

Heinz bodies

Answer 10

hemoglobin, oxidative damage

DDX: G6PD deficiency, oxidant drugs, unstable hemoglobin, alpha thalassemia, congenital hemolytic anemia

Question 11

Basophilic stippling

Answer 11

ribosomes, blocking of enzyme to degrade it

DDX: lead poisoning, thalassemia, sickle cell anemia, MDS, myelofibrosis