Final Exam > Chap 16 > Flashcards

Chap 16 Flashcards

RBC Morphology (102 cards)

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1
Q

RBC morphology is examined via?

A

Wright stained blood smear.

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2
Q

What are the 5 morphological features of RBCs examined?

A

Size
Color
Shape
Inclusions
Distribution

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3
Q

What 2 morphological features correlate W/ red cell indices?

A

Size and Color

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4
Q

A normal mature RBC is?

A

Normochromic-normal color 1/3 of RBC empty

Normocytic- Normal Size 7-8um (MCV=80-100fL)

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5
Q

Discocyte

A

normal RBC survival of 120 days, depending upon maintaining the RBC shape.

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6
Q

What is the main Hgb type in normal RBCs?

A

Hgb A

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7
Q

(T or F) Normal RBC morphology is not quantitated?

A

True

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8
Q

Normocytic RBCs MCV?

A

82.0-98.0 fL

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9
Q

Normocytic RBCs RDW?

A

< or = 14.0%

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10
Q

A uniform RBC size would indicate the the RBC population is?

A

Homogeneous

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11
Q

Anisocytosis

A

Heterogenous RBC population

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12
Q

Anisocytosis has a high?

A

RDW >14.0%

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13
Q

Dimorphic RBC Population means?

A

The RBC population is heterogeneous or is made of 2 different cell populations.

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14
Q

A dimorphic RBC population would cause what RBC indice to be falsely normal?

A

MCV

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15
Q

Anisocytosis is classified as being w/?

A

Microcytic or Macrocytic

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16
Q

Normal Color of RBCs is called?

A

Normochromic

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17
Q

Normochromic MCHC is?

A

32-36%

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18
Q

Hypochromic

A

less Hgb coloring the cell, MCHC <32.0%

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19
Q

Poikilocytosis

A

Abnormal RBC shape, Rigid RBCs.

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20
Q

Spherocyte

A

No longer biconcave discs, slightly smaller, Hyperchromic, Little to no are of central pallor due to being overfilled w/ Hgb.

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21
Q

Spherocyte MCHC is?

A

> 36%

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22
Q

Spherocyte MCV is?

A

Within normal range

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23
Q

Hereditary Spherocytosis

A

Red cell membrane defect due to deficiency of Spectrin, Ankyrin, or Band 3 protein.

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24
Q

What happens to the membrane of an RBC, in a PT W/ Hereditary Spherocytosis?

A

The skeletal lipid bilayer is uncoupled, resulting in membrane loss.

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25
Autoimmune Hemolytic Anemia
end result of the coating of RBCs W/ IgG and/or Complement proteins.
26
Acanthocytes (Spur Cells)
Between 3-12 thorny projections of uneven length along cell membrane.
27
What is the specific mechanism for the formation of acanthocytes?
Unknown
28
What is increased in acanthocytes?
Cholesterol to Phospholipid ratio.
29
What are the possible pathologies of a PT W/ Acanthocytes?
Alcohol Intoxication Pyruvate Kinase (PK) deficiency Congenital Abetalipoproteinemia Vitamin E Deficiency Post-Splenectomy
30
Echinocytes (Burr Cell, Crenated Cells)
Sea-urchin cells that can develop as a result of allowing blood to stand for prolonged time.
31
When a freshly made blood film has the presence of Burr Cells what could it indicate?
Renal Disease Dehydration as a result of severe gastroenteritis. In larger #s, are a artifact of sample contamination.
32
"True" Burr Cells (Echinocytes) occur in small numbers in what pathologies?
Uremia Heart Disease Stomach Cancer Bleeding Peptic Ulcers PTs W/ untreated Hypothyroidism Liver Disease Renal Disease Burn PTs
33
When can Burr Cells appear in any situation?
Changes in tonicity of the intravascular fluid (Dehydration).
34
What separates spherocytes and acanthocytes from Burr cells, in appearance only?
Spherocytes and Acanthocytes have no pallor.
35
Codocytes (Target Cells)
Bell-shaped, thin-walled cells W/ increased surface area compared to volume.
36
Pathologies associated W/ Target Cells?
Liver Disease Thalassemias Hyposplenism Some abnormal Hgb (Hgb S)
37
Drepanocyte (Sickle Cells)
Deoxygenated RBC that becomes a crescent or sickle-shaped.
38
Which pathology are Sickle cells seen in?
Abnormal Hb S SCD Sickle Cell Trait
39
What causes Hb S?
Replacement of glutamic acid W/ valine @ the 6th position on the Hgb B-chain.
40
What deforms the RBC?
Precipitation of polymerized Hb S.
41
Characteristic of SCD is?
Double-Heterozygote disorder
42
C Crystals?
RBCs contain Hb C
43
SC Crystals?
RBCs contain Hb S and Hb C
44
Sickle Cells?
RBCs contain Hb S.
45
What cell is always present W/ sickle cells?
Target Cells
46
What is the shape of SC Crystals?
Bizarre
47
Elliptocytes (Cigars, Ovalocytes)
Oval or cylindrical shaped, biconcave disc.
48
Both oval and cylindrical shaped elliptocytes, have quantitative and qualitative abnormality of which 2 major membrane proteins?
Skeletal proteins Spectrin and Protein 4.1.
49
Incidence of Elliptocytes seen in a normal PB smear?
5%
50
Percentage of Elliptocytes seen in Hereditary Elliptocytosis?
Between 30-100%
51
What type of anemia are Elliptocytes a feature of?
Iron Deficiency Anemia (IDA)
52
Dacryocytes (Teardrops)
Single, elongated extremity.
53
Characteristic feature of which disorders?
Leukoerythroblastic Disorders (I.E. Myelofibrosis or Metastatic Carcinoma) Thalassemias Megaloblastic Anemia
54
Stomatocytes (The mouth, Stomas)
Bowl-shaped RBCs W/ a slit-like area of pallor.
55
Stomas are associated W/?
Alcoholism Hereditary Stomatocytosis S.E. Asian Ovalocytosis
56
What is the cause of Hereditary Stomatocytosis?
A membrane deficiency of protein 7.2b or stomatin, resulting in sodium influx into cell and potassium exiting the cell.
57
The MCV of a PT W/ Hereditary Stomatocytosis is?
High, about 130 fL
58
(T or F) Stomas can occur as an artifact?
True
59
Schistocytes (Schistos)
Fragmentation due to a loss of a piece of the cell membrane, may or may not contain Hgb.
60
Schistocytes include?
Burr Cells Helmet Cells Schistos
61
How many pathways can lead to fragmentation for Schistocytes?
2 pathways
62
1 Pathway of schistocytes fragmentation?
Alteration of normal fluid in circulation (Vasculitis, Malignant Hypertension, Heart Valve replacement).
63
What is the intrinsic pathway of fragmentation in Schistocytes?
Defects of RBCs that make it less deformable (Spherocytes and Antibody-covered RBCs).
64
Dangocytes (Bite Cells)
Formed when Heinz Bodies (HBs) are removed from cell.
65
Bite cells are characteristic of what?
Oxidant Hemolysis
66
What pathologies are bite cells seen it?
G6PD Deficiency Oxidative Drug use (Dapsone, Salazopyrin, Anti-malarial Drugs)
67
Keratocytes ( Blister Cell, Helmet Cell)
Appear W/ horns or helmet W/ chin straps.
68
What pathologies are associated W/ Helmet Cells?
Trauma, especially cellular damage from contact with fibrin strands.
69
(T or F): RBC inclusion reduce RBC deformity?
True
70
Basophilic Stippling
Fine, medium, or coarse blue granules W/ uniform distribution w/n the RBC.
71
Basophilic Stippling represents ribosomal RNA which is precipitated during?
Staining
72
Conditions/diseases Basophilic Stippling is found in?
Thalassemias Hemoglobinopathies Sideroblastic Anemia (SA) Heavy Metal Poisoning (Lead) Myelodysplastic Syndrome
73
Howell-Jolly Bodies (HJBs)
Spherical blue-black inclusions of RBCs seen on a Wright-stained smear.
74
What are HJBs made of?
Nuclear fragments of condensed DNA (1-2um), that are normally removed by the spleen.
75
What conditions/diseases do we find HJBs in?
Severe Hemolytic Anemias PTs W/ dysfunctional spleens PTs who've had a Splenectomy Megaloblastic Anemia Thalassemia Myelodysplastic Syndrome Hyposplenism
76
Pappenheimer Bodies (PHBs)
Iron-containing granules in RBCs (Siderotic Granule).
77
Why are PHBs seen in RBCs?
The iron aggregated W/ the mitochondria and ribosomes.
78
What is the appearance of PHBs?
Faint violet or magenta specks, often in small clusters.
79
What conditions/diseases are associated W/ PHBs?
Sideroblastic Anemia Thalassemias Hemoglobinopathies Megaloblastic Anemia Hyposplenism Post-Splenectomy
80
Siderocytes
A mature erythrocyte containing siderotic granules.
81
Siderotic Granules
Iron-containing granules
82
To verify RBC inclusions containing Iron, what stain should be used?
Iron stain, such as Prussian Blue.
83
Heinz Bodies (HBs)
small, round inclusions of denatured Hgb.
84
HBs are associated W/ what conditions/diseases?
Congenital Hemolytic Anemias, resulting in Hb precipitates (G6PD Deficiency). Unstable Hgbs Oxidant drugs/chemicals
85
Cabot Rings
Thin, Red-violet stained strands.
86
Cabot Rings shape?
Rings, Figure 8, Shapes of the letter B.
87
Cabot ring incidence?
Rare
88
What is the possible cause of Cabot rings?
Microtubules remaining from a mitotic spindle.
89
Cabot rings are associated W/ what conditions?
Megaloblastic Anemia Lead poisoning Disorders of Erythropoiesis Splenectomy Myelodysplastic Syndromes
90
Diffuse Basophilia (Polychromasia)
RNA inclusion of bluish tinge throughout the plasm of an erythrocyte.
91
What cell is polychromasia commonly seen in?
Retics under supravital stain
92
Diseases/Conditions associated W/ polychromasia?
Hemolytic Anemia Treatment of Iron, Vitamin B-12, or Folate deficiency.
93
Which type of Hb is seen W/ golf ball looking, dispersed, dark blue granules?
Hb H
94
(T or F): Hb H is visible on Wright's Stain?
False
95
What is the composition of the Hb H inclusion?
Precipitated B- globin chains of Hgb.
96
Polychromasia under Wright's Stain and Supravital Stain?
Bluish tinge T/O plasm under Wright's. Dark blue granules & filaments in the plasm under Supravital.
97
Basophilic stippling W/ Wright's and Supravital?
SVS & Wright's- Dark blue-purple W/ punctate grans T/O plasm.
98
HJBs under wright's and SVS?
The same, dark blue-purple, dense, round granules, usually 1 per cell, but can have multiples.
99
HBs W/ SVS and Wright's?
SVS- Round, dark blue-purple granule, attached to inner RBC membrane. Wright's- Not visible
100
PHBs on Wright's and SVS?
The same, irregular clusters, small, light to dark blue granules, near the periphery of cell.
101
Cabot Rings on SVS and Wright's?
SVS- Rings or figure 8s Wright's- Blue rings or figure 8s
102
Hb H W/ Wright's and SVS?
SVS- Fine evenly dispersed dark blue granules, "Golf Ball appearance. Wright's- Not visible
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