W1 MORPHOOGY PT 4

Question 1

Name two types of nutritional anaemia

Answer 1

-Iron deficiency
-Megaloblastic anaemia

Question 2

What is the cause of megaloblastic anaemia?

Answer 2

Folate and Vitamin B12 deficiency in RBCs

Question 3

What are the consequences of Iron deficiency?

Answer 3

• Haemoglobin will not be synthesized (Iron is responsible for the synthesis of haem, haem is required for the synthesis of haemoglobin)

Question 4

What are the features of RBCs lacking iron?

Answer 4

• They have a central pallor. There is no haemoglobin in those cells.
  The anaemia is also called Hypochromic microcytic anaemia

Question 5

Features of Iron deficiency in a marrow aspirate under a microscope

Answer 5

-Presence of target cells: these are the cells with too much membrane for the haemoglobin present
-Pencil cells

Question 6

How to get a target cell?

Answer 6

-Increase the membrane of a RBC, and decrease the haemoglobin

Question 7

What is right shift?

Answer 7

Right shift is achieved when the cells in the marrow are all matured and there is no presence of precusor or cells at developmental stages

Question 8

What are the features or characteristics of megaloblastic anaemia in a marrow aspirate?

Answer 8

• Increased Howel Jolly body: RBCs containing small remnants of DNA retained by a RBC
• Tear drop cells: From mechanical torsion/twisting during maturation in the marrow
• Big cells: Cytoplasm of megaloblastic cells continues growing in preparation of cell division, but the cells never divide because their nucleus are hampered due to hypersegmentation from right shift.
• Nucleocytoplasmic disocciation
• Abnormal megakaryocyte: they have hypersegmented nucleus due to right shift
• Lot of haemapoiesis be taking place in the marrow (hypercellular): This hemapoiesis is called ineffective hemapoiesis because cells are continuosly made but none leave the nucleus, they die there.
• Oval macrocytes: RBCs much larger than normal RBCs

Question 8

What is left shift?

Answer 8

Left shift is achieved when cells in the marrow are mostly precusor cells, they are all immature and are at diff developmental stages.

Question 9

Leukoerythroblastic reaction

Answer 9

A Leukoerythroblastic reaction is present when BOTH granulocytic precursors and nucleated red blood cells are present within peripheral blood.

Question 10

Leukemic hiatus

Answer 10

Characterized by the presence of blast cells and mature cells (neutrophils) without an orderly morphologic progression between in the peripheral blood..