RBC Morphology Flashcards
Anisocytosis
Abnormal variation in RBC size
Poikliocytosis
Abnormal variation in RBC shape
Normocytic parameters
7-8 um, MCV 80-100 fl
Microcytic parameters & causes
<7 um, MCV <80 fl
Hemoglobin production problem
Microcytic diseases
iron deficiency, hemoglobinpathies, thalassemias, sideroblastic anemias (lead poisoning), anemia of inflammation (chronic disease)
Macrocytic parameters & causes
> 8 um, MCV >100 fl
DNA synthhesis defect
Megaloblastic changes (asynchronism)
Macrocytic diseases
Megaloblastic anemias, megaloblastoid (chemo), increased reticulocyte count
Hypochromic cause
RBCs lack normal amount of hemoglobin
Hypochromic diseases
Irong deficiency, thalassemia
Polychromasia causes
Young RBC that has just spit out its nucleus, pale lavendar due to remnant RNA
Polychromasia diseases
Increased levels normal due to compensating for blood loss, hemolysis
Decreased/insufficient increase indicative of bone marrow not responding properly
Oval/Elliptocyte Diseases
Lateral spectrin-ankyrin juction defect
Myelodysplastic syndroms
Target cell cause
Increase in lipid membranes result in increased surface area or reduced hemoglobin
Target cell diseases
HgB abnormality
Liver disease, anemias, IDA
Sickle Cells (Drepanocytes) cause
Presence of abnormal Hgb S in reduced oxygen tension cells will sickle
Sickle cell diseases
HgB SC disease
HgB S - thalassemia
Sickle cell anemia
Crystal cells (HgB C)
Condensation of abnormal HgB C into “washington monument” shaped crystal, one or both ends pointed
Crystal cells (HgB SC)
Bird shaped crystal
Needs to be confirmed with electrophoresis
Envelope cause
Associated with Hgb C
Burr Cells (Echinocytes) cause
change in tonicity of intravascular fluid
Burr cells (echinocytes) diseases
Uremia, liver disease, burns, microangiopathic hemolytic anemia (MAHA)
Acanthocyte causes
abnormal lipid membranes
Acanthocyte diseases
abetalipoproteinemia, liver disease
Schistocytes diseases
Dic, ttp, hem, HUS, MAHA, Aprol
Tear Drop (Dacryocytes) cause/disease
Inclusions being removed, myelofibrosis
Spherocyte cause
Defect/lack of cell membrane (they can’t deform, so they lose membrane over time and can’t keep biconcave shape)
Spherocytes diseases
Defect in vertical spectrin ankyrin interactions
Stomatocyte diseases
Liver disease
Rh deficiency syndrome
-Rh null (absent)
-Rh-mod (reduced)
Stomatocyte causes
Failure of Na/K pumps, increased cellular H2O and cells swell
Agglutination causes
RBC antibody (cold agglutinin, immune hemolytic anemia)
Rouleaux cause
increase in plasma proteins/antibodies, coat RBCs, masking zeta potential/sialic acid
fix with saline replacement
Rouleaux diseases
Multiple myeloma, Waldenstom’s, macroglobulinemia
Howell-Jolly Bodies description
Bit of nucleus left behind, small dense blue dot at RBC periphery
Howell-Jolly Body diseases
Occasional is normal. High amounts indicate busy bone marrow (hemolysis, megaloblastic nemias, thalassemias)
Splenectomy!
Basophilic stippling description
Remnant RNA
Basophilic stippling diseases
Coarse = lead poisoning
Blood loss, hemolysis, thalassemia
Pappenheimer bodies description
Iron granules (too much, or ineffective use)
Use Prussion Blue stain to confirm
Pappenheimer diseases
Sideroblastic anemias, hemochromatosis, hemoglobinopathies, thalassemias
Cabot ring description
Very fine, single or double loop
Nuclear membrane remnant, indicative of busy bone marrow
Heinz Bodies
Requires supravital stain
Precipitated, denatured hemoglobin due to oxidative injury (G6PD deficiency, looking at you Hexose monophosphate pathway)
Hemoglobin H inclusions
Requires supravital stain
Precipitated Beta-Hgb chains
