Red Cell Morphology

Question 1

Name four components of the RBC membrane.

Answer 1

Peripheral proteins
Integral proteins
Structural proteins (Actin, spectrin, ankyrin)
Ion Channels (anion channel)

Question 2

In transfusion we are primarily interested in protein outside the cell (why?)

Answer 2

Many antigens on the surface of the cell determine blood type as transf. rxns

Question 3

In hematology we are primarily interested in what is inside the cell (why?)

Answer 3

l

Question 4

Three types of stains in hematology?

Answer 4

Wright’s stain

Supravital stains:
Methyl violet (thalassemia)
New methylene blue (retics, Heinz bodies)
Brilliant cresyl blue (Hgb H)

Giemsa Stain

Question 5

Wright Stain: Composition and Mech of action?

Answer 5

Composition
Eosin (red)
Methylene blue
Wright’s-Giemsa
Also includes methylene blue azure
Mechanism of action
Methanol fixes the cells to the slide
After buffer is added, cells are stained
Methylene blue is basic and stains acidic things (RNA)
Eosin is acidic and stains basic things

Question 6

Wright stain procedure?

Answer 6

Procedure – manual method
Slides are prepared and dried as quickly as possible
Flood the slide surface with stain
Wait 1-3 minutes
Flood the surface of the slide with buffer
A metallic sheen should appear on the slide if the stain is mixed correctly
Wait 3 mins (or more)
Rinse the stain with neutral pH water and dry in a vertical position

Question 7

Manual Staining Methods?

When do we use?

Answer 7

Used when many WBCs are present

In this case, lengthening the staining time will help with better visualization of cells

OR, pass the bone marrow slides through the automatic stainer twice

Question 8

What things are we looking for/at in a smear review at 10X?

Answer 8

“high and dry” to assess

Overall stain quality

Color

Distribution of cells (WBCs at feathered edge and thicker parts of the smear)

Fibrin strands (+ = reject sample why?)-cell get caught in fibrin

Rouleaux- Mult. Myeloma

Red cell distribution

Large abnormal cells (blasts, reactive lymphs, parasites)

Question 9

Smear Review at 40X

Answer 9

40X
Select the area of the slide to review
WBC estimate
(WBCs per hpf) X 2000 = white count

Question 10

Smear Review 100X

Answer 10

100X (or 50X) under oil

• —-Count and classify WBCs
• —-Evaluate RBC morph (do not forget this step!!!)
• —-Evaluate Plt morph and count
• —-Inclusions in RBCs and WBCs

All review is performed in an area of the slide where RBCs are touching but not overlapping

Question 11

Normal size, normal colo/ hgb content RBCs are called?

Answer 11

Normocytic Normochromic biconcave discs

Question 12

Polychromasia

Answer 12

Red Cells With Different Colors

***ie: Gunther’s disease

Question 13

Term for RBCs without enough Hgb/color?

Answer 13

hypochromic