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HEMATOLOGY 1 > Red Blood Cell anomalies (1) > Flashcards

Red Blood Cell anomalies (1) Flashcards

1
Q

Increased number of red cells with variation in size

A

Anisocytosis

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2
Q

Size of normal RBCs (normocytes)

A

6-8 um in diameter

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3
Q

Normal MCV value

A

80-100 fL

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4
Q

Larger than normal RBCs (>8.0 um), MCV > 100 fL, impaired DNA synthesis

A

Macrocytes

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5
Q

Smaller than normal RBCs (diameter < 6.0 um), seen when MCV is < 80 fL, defective hemoglobin formation

A

Microcytes

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6
Q

Four ways to detect anisocytosis

A

1) Using the nucleus of a small lymphocyte in a peripheral blood smear (PBS), 2) Using the MCV value, 3) Using the RBC histogram, 4) Using the RDW value

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7
Q

Average volume of individual RBCs

A

MCV

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8
Q

Visual display of cell size (X-axis) and cell frequency (Y-axis), provided by high-volume instruments

A

RBC histogram

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9
Q

Two parameters calculated from RBC histogram

A

MCV and RDW

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10
Q

RBC histogram range for RBCs

A

36 fL to 360 fL

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11
Q

MCV formula

A

MCV = HCT * 10 / RBC count

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12
Q

Decreased MCV

A

Microcytic < 80 fL, RDW > 14.5%

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13
Q

Normocytic MCV

A

80-100 fL, RDW 11.5 - 14.5%

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14
Q

Macrocytic MCV

A

> 100 fL, RDW > 14.5%

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15
Q

RDW in macrocytic and microcytic

A

Increased regardless of size

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16
Q

RBC histogram measurement range

A

Can measure cells as small as 24 fL

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17
Q

Effect of elevated leukocyte count on RBC histogram

A

Affects the RBC histogram

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18
Q

Shift to the right in RBC histogram

A

Indicates macrocytic RBCs

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19
Q

Shift to the left in RBC histogram

A

Indicates microcytic RBCs

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20
Q

Bimodal RBC histogram curve

A

Indicates two populations of RBCs, such as in blood transfusion, cold agglutinin disease, or hemolytic anemia with schistocytes

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21
Q

Wider or flattened RBC histogram curve

A

Indicates more variation in cell size, the population is not homogeneous

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22
Q

Methods to calculate RDW

A

RDW-CV (coefficient of variation), RDW-SD (standard deviation)

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23
Q

RDW-CV based on

A

Width of the RBC distribution curve and mean RBC size

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24
Q

RDW-SD based on

A

Measurement of the width of the RBC distribution curve at 20% above the baseline

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25
Q

RDW-CV reference range

A

11.5 - 14.5%

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26
Q

RDW-SD reference range

A

39 - 46 fL

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27
Q

RDW-CV measurement method

A

Depends on the width of the distribution curve and MCV

28
Q

RDW-SD advantage

A

Not influenced by MCV, better measure of erythrocyte variability, especially in abnormal conditions

29
Q

Methods to evaluate RBC size

A

PBS, MCV, RBC Histogram

30
Q

Methods to detect anisocytosis

A

RDW, PBS, MCV, RBC Histogram

31
Q

Reference range for RDW in newborns

A

14.2 to 19.9%

32
Q

RDW in newborns

A

Markedly increased, decreases to adult levels by 6 months of age

33
Q

Abnormal RDW indication

A

Wider-than-normal RBC histogram

34
Q

Normal, little or no anisocytosis, Decreased MCV (microcytic)

A

Anemia of chronic inflammation (ACI)

35
Q

Normal, little or no anisocytosis, Normal MCV (normocytic)

A

G6PD deficiency

36
Q

Increased MCV (macrocytic), Normal, little or no anisocytosis

A

Liver disease

37
Q

Increased anisocytosis, Decreased MCV

A

Iron deficiency anemia (IDA)

38
Q

Increased anisocytosis, Normal MCV

A

Sickle cell anemia

39
Q

Increased anisocytosis, Increased MCV

A

Megaloblastic anemia

40
Q

Variation in normal coloration of RBCs, may involve hypochromic and normochromic cells in the same smear

A

Anisochromia

41
Q

Normal RBC coloration

A

Central pallor is approximately 1/3 the diameter

42
Q

Conditions associated with Anisochromia

A

Sideroblastic anemias, hypochromic anemia after transfusion or iron therapy

43
Q

Hypochromic cells appearance

A

Central pallor >1/3 of diameter, usually microcytic

44
Q

Grading of hypochromia 1+

A

Area of central pallor = 1/2 diameter

45
Q

Grading of hypochromia 2+

A

Area of central pallor = 2/3 diameter

46
Q

Grading of hypochromia 3+

A

Area of central pallor = 3/4 of diameter

47
Q

Grading of hypochromia 4+

A

Thin rim of hemoglobin

48
Q

A.k.a. Pessary cell, Ghost cell; RBC with a thin rim of hemoglobin and a large, clear center; observed in iron deficiency anemia

A

Anulocyte

49
Q

Hyperchromic cells appearance

A

RBCs that lack central pallor, caused by shape change (e.g., spherocytes); true hyperchromia occurs when MCHC is high

50
Q

Only disease where MCHC is high above reference range

A

Hereditary Spherocytosis

51
Q

Key clinical manifestations of symptomatic HS

A

Splenomegaly, Anemia, Jaundice

52
Q

DAT (direct antiglobulin test) in HS

A

Negative

53
Q

MCV in HS

A

Normal to low

54
Q

MCH in HS

A

Normal

55
Q

MCHC in HS

A

Slightly increased

56
Q

Immune disorders with spherocytes

A

Usually characterized by a positive DAT result

57
Q

Autohemolysis test in HS

A

Greatly increased (can be corrected with glucose or ATP)

58
Q

OFT (Osmotic Fragility Test) in HS

A

Increased osmotic fragility, not diagnostic of HS

59
Q

EMA binding test in HS

A

Decreased fluorescence (flow cytometry)

60
Q

Polychromatophilic erythrocytes

A

Larger than normal red cells with bluish tinge caused by residual RNA (Wright’s stain)

61
Q

Polychromasias are associated with

A

Decreased RBC survival, hemorrhage, erythroid hyperplastic marrow

62
Q

Grading of Polychromasia - Slight

A

1% of Polychromatophilic RBCs

63
Q

Grading of Polychromasia - 1+

A

3% of Polychromatophilic RBCs

64
Q

Grading of Polychromasia - 2+

A

5% of Polychromatophilic RBCs

65
Q

Grading of Polychromasia - 3+

A

10% of Polychromatophilic RBCs

66
Q

Grading of Polychromasia - 4+

A

> 11% of Polychromatophilic RBCs

HEMATOLOGY 1 (27 decks)

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