RBC variations

Question 1

Acanthocyte (Spur Cell)

Answer 1

H Acanthocytosis

Severe liver disease

Splenectomy

Malabsorption

Hypothyroidism

Vitamin E. deficiency

Question 2

Burr Cell (Echinocyte, Crenated Cell)

Answer 2

burr-like eryth, W/short evenly spaced projections.

Seen in: Uremia, PK deficiency, Microangiopathic Hemolytic Anemia, Neonates (especially pre-mature), Artifacts.

Question 3

Spherocyte

Answer 3

Round, W/ no central pallor.

Seen in: H. Spherocytosis, some hemolytic anemias, transfused cells, and sever burns.

Question 4

Target cells

Answer 4

Associated W/:

Hemoglobinopathies

Thalassemia

IDA

Splenectomy

Obstructive liver disease

Question 5

Sickle Cells

Answer 5

Homozygous Hgb S Disease

Question 6

Hb C Crystals

Answer 6

Hexagonal, usually 1 per cell.

Homozygous Hgb C disease.

Question 7

Hb SC Crystals

Answer 7

1-2 fingerlike projections

Look like a mitten.

Hb SC disease

Question 8

Stomatocytes

Answer 8

Eryth W/ slit-like area of central power.

H Stomatocytosis

Alcohol

Liver Disease

Rh null phenotype

Artifact

Question 9

Elliptocytes/Ovalocytes

Answer 9

Elliptos: Cigar-shaped

Ovalos: egg-shaped

Seen in: HE, HO, Thalassemias major, IDA, Megaloblastic anemias (Macro ovalocytes), Myelophthisic anemias.

Question 10

Teardrop Cell

Answer 10

Eryth in shape of pear.

Myelofibrosis W/ myeloid metaplasia, Thalassemias, Myelophthisic anemias,

Other causes extramedullary Hematopoiesis.

Question 11

Schistocytes

Answer 11

Fragmented eryth W/ many sizes and shapes.

Seen in:
Microangiopathic Hemolytic Anemia
(Disseminated Intravascular Coag DIC)

Severe burns

Hemolytic uremic syndrome

Thrombotic Thrombocytopenic purpura (TTP)

Renal graft rejection

Question 12

Rouleaux

Answer 12

Erythrocytes arranged in rows like stacks of coins.

Increased concentrations of globulins and/or paraproteins.

Question 13

Autoagglutination

Answer 13

Clumping of Eryths.

Ag/Ab reactions

Question 14

Normocyte

Answer 14

MCV 80-100 fL

MCHC 32-36%

Question 15

Microcytic

Answer 15

MCV < 80 fL

IDA

SA

Thalassemia Minor

Chronic disease (occasionally)

Lead Poisoning

Hemoglobinopathies (Some)

Question 16

Macrocytes

Answer 16

MCV > 100 fL

Liver Disease

Vitamin B-12 deficiency

Folate deficiency

Neonates

Question 17

Dimorphic RBC pop.

Answer 17

RDW > 14.5

Transfusion

Myelodysplastic Syndromes

Folate or Iron deficiencies

Question 18

Hypochromia

Answer 18

MCHC < 32 g/dL

Increased central pallor.

IDA

Thalassemias

SA

Lead poisoning

Chronic Inflammatory

Question 19

Polychromasia

Answer 19

Blue/Salmon, Residual RNA

Acute/Chronic hemorrhage

Hemolysis

Effective treatment for anemia

Neonates