RBC Morphology

Question 1

Answer 1

Basophilic stippling

Composed of RNA and ribosome aggregates

Lead poisoning, thalassemia, abnormal heme synthesis

Question 2

Answer 2

Bite cells

Result of splenic pitting of Heinz bodies

Associated with microangiopathic hemolytic anemia (TTP, DIC), severe burns, renal graft rejection

Question 3

Answer 3

Blister cells

Result of splenic pitting of Heinz bodies

Associated with microangiopathic hemolytic anemia (TTP, DIC), severe burns, renal graft rejection

Question 4

Answer 4

Echinocytes/burr cells

Uremia, pyruvate kinase deficiency, microangiopathic hemolytic anema, neonates, artifact

Question 5

Answer 5

Heinz bodies (new methylene blue stain)

Precipitated hemoglobin

Unstable hemoglobin, some hemoglobinopathies, some erythrocyte enzyme deficiencies (ex. G6PD)

Question 6

Answer 6

Howell-Jolly bodies

Composed if DNA

Splenectomy, hyposplenism, megaloblastic anemia, hemolytic anemia

Question 7

Answer 7

Hypochromia

IDA, thalassemias, siderblastic anemias, lead poisoning, anemia of chronic inflammation (some)

Question 8

Answer 8

Macrocytes

Liver disease, vitamin B deficiency, folate deficiency, neonates, reticulocytosis

Question 9

Answer 9

Microcytes

IDA, thalassemia minor, chronic inflammation (some cases), lead poisoning, hemoglobinopathies (some), sideroblastic anemia

Question 10

Answer 10

Ovalocytes

Hereditary elliptocytosis or ovalocytosis, thalassemia major, IDA, megaloblastic anemias (macro-ovalocytes), myelophthisic anemias

Question 11

Answer 11

Pappenheimer bodies (Wright stain)

Composed of iron

Splenectomy, hemolytic anemia, siderblastic anemia, megaloblastic anemia, hemoglobinopathies

Question 12

Answer 12

Polychromasia

Retained RNA
Acute and chronic hemorrhage, hemolysis, effective treatment for anemia, neonates

Question 13

Answer 13

Schistocytes

Associated with microangiopathic hemolytic anemia (TTP, DIC), severe burns, renal graft rejection

Question 14

Answer 14

Sickle cells/drepanocytes

Homozygous hemoglobin S disease

Question 15

Answer 15

Spherocytes

Hereditary spherocytosis, some hemolytic anemias, transfused cells, severe burns

Question 16

Answer 16

Stomatocytes

Hereditary stomatocytosis, alcoholism, liver disease, Rh null phenotype, artifact

Question 17

Answer 17

Target cells/codocytes

Hemoglobinopathies, thalassemia, iron deficiency anemia, splenectomy, obstructive liver disease

Question 18

Answer 18

Tear drop cells/dacryocytes

Primary myelofibrosis, thalassemia, myelophthisic anemia, other causes of extramedullary hematopoiesis

Question 19

Answer 19

Acanthocytes/spur cells

Severe liver disease, splenectomy, malabsorption, hypothyroidism, vitamin E deficiency, abetalipoproteinemia

Question 20

Answer 20

Rouleaux

Acute and chronic inflammatory disorders, plasma cell myeloma, lymphoplasmacytic lymphoma

Question 21

Answer 21

Cabot ring

Remnants of mitotic spindle

Myelodysplastic syndrome, megaloblastic anemia