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Hematology I Fall > Section 7: RBC Morphology > Flashcards

Section 7: RBC Morphology Flashcards

1
Q

What is anisocytosis?

A

Variation in RBC size

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2
Q

What can be used as comparison for RBC side when screening for anisocytosis?

A

Nucleus of a small lymph

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3
Q

What is normal RBC size in microns?

A

7 microns

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4
Q

What does microcytosis indicate? Seen in which diseases?

A

Indicates hemoglobin production problem, so often see hypochromasia too

Diseases: Iron deficiencies, thalassemias (hemoglobin deficiencies), anemia of inflammation, hemoglobinopathy, sideroblastic anemias (lead poisoning)

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5
Q

What does macrocytosis indicate? Seen in which abnormal conditions?

A

Indicates DNA synthesis defect. Asynchronism (slow nucleus maturation but normal cytoplasmic growth)

Diseases: Megaloblastic anemias, high reticulocyte count, tumors, fish tapeworm, hemodialysis, normal in newborns

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6
Q

What is hypochromasia? What traits do you look for?

A

RBCs lack normal hemoglobin amount

Look for: More central pallor (more than 1/3 of cell) and often microcytic

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7
Q

What trait(s) do you look for in polychromasia?

A

Diffuse pale blue/gray/or lavender due to remnant RNA. Often Macrocytic and lack central pallor. Macrocytosis

*These are young RBCs (reticulocytes)

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8
Q

What does increase or decrease in polychromasia (aka young RBCs) indicate?

A

Increase: body’s normal attempt to compensate for RBC loss such as in blood loss or hemolysis

Decrease: Bone marrow not responding properly to generate enough young RBCs

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9
Q

Define poikilocytosis. What are some specific types of poikilocytosis?

A

It’s variation in RBC shape. Ovalocytes and elliptocytes are types.

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10
Q

What are target cells? What trait(s) are you looking for?

A

They are cells with increased membrane lipids, thus increasing surface area OR decreasing Hgb

Look for bullseye appearance

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11
Q

What are sickle cells? What trait(s) are you looking for?

A

They’re cells that have abnormal Hgb S such that decreased oxygen environments will cause enough tension to deform RBCs to a sickle or crescent shape.

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12
Q

What are crystal cells? What trait(s) are you looking for you?

A

Cells with abnormal Hgb C condensed into a crystal shape. Look for super dark crystal shape either by itself or attached to RBC

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13
Q

What are envelope cells? Are they diagnostic? What trait(s) are you looking for?

A

These cells have Hgb pushed to one side with clear “flap” area. NOT DIAGNOSTIC bc can be artifact. See red color on just one side of cell and pallor on the other side.

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14
Q

What are Burr cells (echinocytes)? What trait(s) are you looking for?

A

They’re cells that underwent change in tonicity of intravascular fluid. Look for small blunt and evenly spaced projections. Don’t mistake for crenated cells, which have more spiky projections

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15
Q

What are acanthocytes? What trait(s) are you looking for?

A

They’re cells with abnormal membrane lipids. Look for long, irregular, spiny/spiky uneven projections

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16
Q

What are schistocytes? What types of schistocytes are there?

A

They’re fragmented RBCs.

Types: Bite cells, blister cells, helmet/horn cells, or triangle fragments

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17
Q

What trait(s) do you look for in blister cells?

A

See giant clear pocket within RBC

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18
Q

What’s another name for a teardrop cell? Causes? What trait(s) are you looking for?

A

Dacryocyte caused by macrophage biting it and myelofibrosis (squeezing through microvasculature or fibrous tissue and not bouncing back)

Look for tear or pear-shaped cells

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19
Q

What are spherocytes? What trait(s) are you looking for?

A

They’re cells with a defect in or loss of cell membrane. Vertical spectrin-ankyrin interaction defect

Look for microcytic, dark, very round cells that lack central pallor

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20
Q

What are stomatocytes? What trait(s) are you looking for?

A

They’re cells that may exist due to hereditary defect in sodium/potassium pump.
Look for coin slot or mouth shaped pallor

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21
Q

What causes agglutination? Trait to look for?

A

RBC antibody causes it. Look for RBC clumps

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22
Q

What are Rouleaux cells? What trait(s) are you looking for? How do you fix the problem?

A

They’re cells with increased plasma proteins or immunoglobulins, which mask the overall negative charge that sialic acid gives and thus causes the appearance of stacked coins.

Fix by saline replacement

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23
Q

What are Howell-Jolly bodies? What trait(s) are you looking for?

A

They’re cells caused by a busy bone marrow so see leftover nuclear components in RBCs

Look for small, dense, round nuclear remnant in cell (usually found in periphery but not every time)

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24
Q

What is basophilic stippling? What trait(s) are you looking for? Which stain do you use for reticulocyte (young RBC) counts?

A

Reticulocytes with remnant precipitated RNA showing up as a bunch of dots. Thick dots indicate lead poisoning.

Look for lots of fine to course blue dots evenly dispersed throughout cytoplasm. Use supra vital stain to do reticulocyte count

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25
Q

What is increased basophilic stippling associated with?

A

Body’s attempt to compensate for loss of blood/hemolysis. Shows up in lead poisoning or thalassemia

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26
Q

What are Pappenheimer bodies? What trait(s) are you looking for? Which stain do you use to confirm their presence?

A

They’re granules of iron that can’t get into Hbg due to ineffective utilization or excess

Look for small, irregular, blue granules clustered near cell periphery. They look like stain ppt so be careful!

Confirm with Prussian blue stain

27
Q

What are Cabot rings? What trait(s) are you looking for?

A

DNA that got spit out (nuclear membrane remnant)

Look for very fine single or double thread loops in shape of ring or figure 8. Have nuclear dot(s) that resemble malarial ring-forms

28
Q

What are Heinz bodies? What trait(s) are you looking for? Which stain do you use to identify them?

A

They’re precipitated denatured Hbg inclusions due to oxidative injury. Must use Supravital stain because CANNOT see on Wright’s stain

Look for big dot(s) in RBC (not a lot though)

29
Q

What are Hemoglobin H crystals? What trait(s) are you looking for? Which stain do you use?

A

RBCs with precipitated chains of beta-hemoglobin. Use Supravital stain to see them.

Look for many purple-blue inclusions stippling the whole cell. Gives golf-ball appearance

30
Q

Not a question but here’s a review of mean ranges for anisocytosis

A

:)

31
Q

Not a question but here’s a review of mean ranges for poikilocytosis

A

:D

32
Q

Not a question but here’s a review of mean ranges for inclusions

A

:P

33
Q

Practice! What is happening here?

A

Microcytosis

34
Q

Practice! What is happening here?

A

Macrocytosis

35
Q

What is happening here?

A

Nothing. These are normochromic RBCs

36
Q

What is happening here?

A

Hypochromasia

37
Q

What is happening here?

A

Polychromasia

38
Q

What is happening here?

A

Poikilocytosis: Ovalocytes and elliptocytes

39
Q

What RBC abnormality do you see here?

A

Target cells (aka codocytes)

40
Q

What RBC abnormality do you see here?

A

Sickle cells

Michelle G thinks they look like Mexican guajillo peppers you can use for yummy Birria Tacos

41
Q

What RBC abnormality do you see here?

A

Crystal cells (Hgb C)

42
Q

What RBC abnormality do you see here?

A

Hgb SC crystals

43
Q

What RBC abnormality do you see here?

A

Envelope cells

44
Q

What RBC abnormality do you see here?

A

Burr cells

45
Q

What RBC abnormality do you see here?

A

Acanthocytes

46
Q

What RBC abnormality do you see here?

A

Schistocytes: bite cells

47
Q

What RBC abnormality do you see here?

A

Schistocytes: blister cells

48
Q

What RBC abnormality do you see here?

A

Schistocytes: triangle fragments

49
Q

What RBC abnormality do you see here?

A

Schistocytes: horn cells

50
Q

What RBC abnormality do you see here?

A

Tear drop cells

51
Q

What RBC abnormality do you see here?

A

Spherocytes

52
Q

What RBC abnormality do you see here?

A

Stomatocytes

53
Q

What RBC abnormality do you see here?

A

Agglutination

54
Q

What RBC abnormality do you see here?

A

Rouleaux

55
Q

What RBC abnormality do you see here?

A

Howell-Jolly bodies (inclusions)

56
Q

What RBC abnormality do you see here?

A

Basophilic stippling (can see on Wright’s stain)

57
Q

What RBC abnormality do you see here?

A

Pappenheimer bodies

58
Q

What RBC abnormality do you see here?

A

Cabot ring

59
Q

What RBC abnormality do you see here?

A

Cabot ring

60
Q

What RBC abnormality do you see here?

A

Heinz bodies

61
Q

What RBC abnormality do you see here?

A

Hemoglobin H inclusions

62
Q

Distinguish the identities of A and B

A

A = platelet on top of RBC
B = malaria ring-form

63
Q

What causes ovalocytes and elliptocytes?

A

Abnormal or loss of horizontal spectrin-ankyrin interactions

Hematology I Fall (14 decks)

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