Section 7: RBC Morphology

Question 1

smaller rbcs = Hbg production issue

Answer 1

Question 2

BIG RBCs = few mitotic division

Answer 2

Question 3

Perfect sized w/ nice central pallor = evolution baby

Answer 3

Question 4

Empty looking RBCs = Lacking normal amounts of Hbg

Answer 4

Question 5

Lavender colored larger RBCs = Left shift => young blood

Answer 5

Question 6

Egg like/ cylindrical w/ rounded ends = horizontal Spec-Ank protein defect

Question 7

different shaped cells = Multiple reasons - Spec-Ank protein defect, macrophage bites

Question 8

Target like cells = Increase in membrane lipid

Question 9

Guajillo chilies cells w/ point ends = Abnormal Hgb S

Question 10

Crystal cells (Hgb CC) — Tic-tac red ufo & typical ufo with bubble like light on the bottom = Abnormal Hgb CC

Crystals (Hgb SC) — Birdie shaped cells or end piece of banana

Question 11

Hgb pushed to one side w/ clear “flap” area & see dense red color on one side of cell and light pallor on the other side = NOT diagnostic

Answer 11

En

Question 12

Evenly disbursed round goose bumps around the RBC = Change in tonicity of intravascular fluid

Answer 12

burr

Question 13

RBC w/ long, irregular, spiny/spiky uneven projections =

Answer 13

Acanthocytes

Question 14

Four different RBC fragments. RBC w/ a bite take out, blister like bubble w/in RBC, helmet shaped RBC, and a triangular shaped RBC.

Answer 14

Schistocytes: bite cells, blister cells, Helmet/ horn cells triangle fragments.

Question 15

Tear drop shaped RBC = extra-medullary-hematopoiesis. Exact mechanism unknown.

Answer 15

Tear drop

Question 16

Dark - no pallor, small & round RBC = loss of cell membrane

Answer 16

Spherocytes

Question 17

Coin slot or mouth shaped pallor RBCs = NA+/P+ pump defect

Answer 17

Stomatocytes

Question 18

Clusters/clumps of RBCs = Cold Ab IgM or just clotted

Answer 18

Agglutination

Question 19

Coin-like stacking of the RBCs = Increased plasma proteins act like a positive charge allowing the negative charged RBCs to stack on each other

Answer 19

Rouleaux

Question 20

What RBC abnormality do you see here?

Answer 20

Howell-Jolly bodies (inclusions)

Question 21

Lots of fine to course blue dots evenly dispersed throughout cytoplasm = remanent RNA / wall licking => lead poisoning

Answer 21

Basophilic stippling (can see on Wright’s stain)

Question 22

RBCs w/ small, irregular, blue granules clustered at cell periphery. They look like stain ppt so be careful! = They’re granules of iron that can’t get into Hbg due to bad utilization or excess

Confirm with Prussian blue stain

Answer 22

Pappenheimer bodies

Question 23

RBC w/ thin ring like formation = remnant cell membrane

Answer 23

Cabot ring

Question 24

ONLY visible on SVS. Big dot(s) in RBC (not a lot though) = Precipitated & denatured Hgb due to O2 injury

Answer 24

Heinz bodies

Question 25

Many kind of parasites
1. Spirochetes - look for spirals outside of RBC = infected ticks

2. Malaria - look for 1-2 faint ring formations w/ RBC = infected mosquitos
3. Babesia - 2-3 hole-like appearances w/ RBC = infected ticks
4. Typanosomes = 3 sub types
   -Wucheria Bancrofti (WB) = contaminated food
   -Typanosoma Cruzi (TC) = contaminated food
   -Loa Loa (LL) = contaminated food

Question 26

Different sized RBC = multiple factors like Hgb production issues & few mitotic division

Answer 26