Red Blood Cells Part 2 Flashcards
1
Q
describe polychromasia
A
- bluish anucleate RBCs on Romanowsy stain (polychromatiphils); or have highlighted cellular reticulum with NMB stain; indicate bone marrow regeneration
- MCHC may be decreased with marked polychromasia as immature cells have not finished synthesizing hemoglobin yet
2
Q
describe hypochromasia
A
- pale cells with an increased area of central pallor; correlates with low MCH or MCHC
- don’t confuse with punched out RBCs: water artifact with crisp outlines; pallor looks increased but RBC color is robust!
3
Q
what is poikilocytosis?
A
general term for all abnormally shaped RBCs; classify overall poik (mild, mod, etc.) and then identify and quantify any shapes with specific names
4
Q
describe schistocytes
A
- RBC fragments, associated with RBC trauma
- even a FEW are IMPORTANT
- could be due to lots of thrombi or abnormal blood vessels and therefore a big problem
5
Q
describe echinocytes
A
- cells with evenly spaced, short projections
- differentiate from crenation, a similar looking artifact from slow drying or excess EDTA
- echinocytes are expected in pigs but could also be due to dehydration, electrolyte depletion, and some drugs, as well as snake envenomation
6
Q
describe acanthocytes
A
- spiculated cells with single to multiple, UNEVENLY spaced, blunted projections
- often seen with schistocytes due to the same conditions
7
Q
contrast echniocytes to acanthocytes
A
Echinocytes: Evenly spaced projections
Acanthocytes: irregulAr, often rounded projections
8
Q
describe spherocytes
A
- cells that have lost their biconcave disc shape and become sphered
- appear as smaller, darker RBCs with lack of central pallor
- volume stays the same so MCV and Hgb are not altered
- when seen, immune mediated hemolytic anemia is TOP differential!!! when mod to high numbers are present in the monolayer
9
Q
describe ghost cells
A
- cells that have been lysed in the bloodstream, not in a tube
- pale red cell-shaped structures (empty membranes)
- ONLY seen with intravascular hemolysis (a hella serious condition)
10
Q
describe target cells
A
- also called codocytes; bell shaped cells with an extra membrane that folds up, giving the appearance of a target
- most common in regenerative anemia but also iron deficiency
11
Q
describe the 2 RBC distribution changes and how to differentiate
A
- rouleaux formation: RBC stacking; some is okay in dogs and pigs, this is expected in horses, and is due to hyperglobulinemia and high fibrinogen
- agglutination: grape-like clusters of RBCs due to antibody-mediated cell bridging, often in IMHA; can result in falsely increased MCV
do saline dispersion test if unclear; if the clusters break apart, was just rouleaux formation
12
Q
describe Heinz bodies
A
- denatured, precipitated hemoglobin (result of oxidation) attached to the internal surface of the cell membrane
- on Romanowksy stain: small pale protruding bumps
- on NMB stain: dark, basophilic round structures
- heinz bodies can shorten RBC survival and if severe can cause hemolytic anemia
- cats are more susceptible to HB formation
13
Q
describe Howell-Jolly bodies
A
- single, homogenous, dark blue dot near periphery of cell that is a remnant of nuclear material (usually removed by spleen)
- increased numbers can indicate regenerative anemia, splenic dysfunction, or a splenectomy
- NOT A PARASITE
14
Q
describe nRBCs
A
- usually metarubricytes
- rare is okay but try to correct WBC count if more than 5/100WBCs
- recall appropriate rubricytosis and inappropriate rubricytosis from RBCs Part 1
15
Q
describe basophilic stippling
A
- residual aggregates of RNA appear as small basophilic dots
- indicative of regenerative anemia; more prominent than polychromasia in ruminants; only seen with MARKED regeneration in dogs and cats
