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Haematology Y3 > RBC Morphology > Flashcards

RBC Morphology Flashcards

1
Q

What is the normal morphology of red blood cells?

A
  • 7.5 micrometres (roughly the size of a lymphocyte nucleus).
  • Central pallor (central pale area) takes up approximately 1/3rd of the cell.
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2
Q

What is anisoscytosis?

A

Red blood cells that are of different sizes. Normal red blood cells are generally the same size.

Having red blood cells of unequal sizes may be a sign of anemia

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3
Q

What is poikilocytosis?

A

An increase in abnormal red blood cells of any shape that makes up 10% or more of the total population

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4
Q

What is microcytosis?

A

Red blood cells smaller than 7-7.2 micrometres.

Indicates microcytic anaemia.

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5
Q

What are the causes of microcytic anaemia (TAILS)?

A

Thalassaemia

Anaemia of chronic disease

Iron deficiency

Lead poisoning

Sideroblastic anaemia

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6
Q

How is microcytosis identified on a blood film?

A

Comparing the RBC diameter to the nucleus of the lymphocyte. If the RBC is smaller, this indicated microcytosis.

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7
Q

What is macrocytosis?

A

Red blood cells larger than 7-7.2 micrometres.

Indicates macrocytic anaemia.

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8
Q

What are the causes of non-megaloblastic macrocytic anaemia (HAND LAMP)?

A

Hypothyroidism

Aplastic anaemia

Neonate

Drugs e.g. azathropine

Liver disease

Alcohol

Myelodysplasia

Pregnancy

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9
Q

What are elliptocytes?

A

Thin, elongated RBC’s

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10
Q

What are the causes of elliptocytes?

A

Iron deficiency

Myelodysplastic syndrome

Hereditary elliptocytosis

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11
Q

What are schistocytes?

A

RBC fragments. These are fragmented red cells resulting from sheer stress (mechanical damage).

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12
Q

What are the causes of schistocytes?

A

Microangiopathic haemolytic anaemia

Mechanical e.g. metallic cardiac valve haemolysis

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13
Q

What are spherocytes?

A

Cells that lack central pallor and are spherical in shape (lost their membrane without losing their cytosol).

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14
Q

What are the causes of spherocytes?

A

Hereditary spherocytosis

Warm and cold AIHA

Immediate and delayed haemolytic transfusion reaction

ABO haemolytic disease of the newborn

Drug-induced haemolytic anaemia i.e. ceftriaxone.

Burns

Cold agglutination disease

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15
Q

What are stomatocytes?

A

RBC’s with a slit like area of central pallor. Occurs as a result of a decreased surface area to volume ratio in RBC’s.

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16
Q

Causes of stomatocytes?

A

Hereditary stomatocytosis

Liver disease

17
Q

What are “target” cells?

A

RBC’s that have areas of increase staining due to redundant RBC membrane in relation to the cytoplasm.

18
Q

Causes of “target” cells (Mnemonic: LOTSS)?

A

Liver disease

Obstructive jaundice

Thalassaemia

Splenectomy

Sideroblastic anaemia

19
Q

Characteristic feature of “target” RBC’s?

A

Contains a characteristic “bullseye” appearance

20
Q

What are “tear drop” cells?

A

RBC’s that are round at one side and tapered at the other.

Arises from conditions that affect the bone marrow architecture and resulting in RBC’s exiting the bone marrow

21
Q

Causes of “tear drop” cells?

A

Bone marrow fibrosis

Bone marrow infiltration

22
Q

What are Howell-Jolly bodies?

A

Normal RBC nuclear DNA remnants which are normally removed by the spleen.

23
Q

Causes of Howell-Jolly bodies?

A

Splenectomy

Hyposplenism (impaired spleen function)

Neonates with functionally immature spleens

24
Q

How does a Howell-Jolly body appear on blood film?

A

Dark purple spot within the RBC.

25
Q

What are Pappenheimer bodies?

A

Small aggregates of ferritin.

Such debris is normally removed by the spleen.

26
Q

Causes of Pappenheimer bodies?

A

Post-splenectomy

Lead poisoning

Sideroblastic anaemia

27
Q

How do Pappenheimer bodies appear on blood film?

A

Usually presents as smaller faint dots inside the RBC’s.

28
Q

What are the indications for splenectomy?

A

ITP

AIHA

Thalassaemia intermedia (old indication)

Congenital RBC membrane defects
- Hereditary spherocytosis
- Hereditary elliptocytosis

Lymphoproliferative disorders
- Splenic marginal zone lymphoma
- Hairy cell leukaemia (old indication)

Myelofibrosis (old indication)

Trauma

Haematology Y3 (39 decks)

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