-
a general increase in RBC's
pancytosis
-
a general decrease in RBC's
pancytopenia
-
storage form of iron in tissue
Ferritin
-
Disorders in production of myelod stem cells
myelodysplastic syndromes
-
what are the four aspects of RBC evaluation
- Size
- Color
- Shape
- Inclusion bodies
-
The color of an RBC depends on what?
the amount of Hgb
-
any variation in size due to deficiency in the raw material; associated with increased RDW.
anisocytosis
-
Normal RDW range.
11.5-14.5%
-
an RBC that is, <6 microns, MCV is <80fL, and seen in Iron deficiency, Thalassemia, Lead Poisoning, and sideroblastic anemia.
Microcyte
-
An RBC that is >8 microns, MCV is 99fL, and seen in liver disease, megaloblastic process, hypothyroidism, Chemotherapy and newborns.
macrocytes
-
RBC's have decreased Hgb, increased central pallor, and MCHC is <32%.
hypochromasia
-
RBC's decreased surface-to-volume ration, decreased to absent central pallor, increaed Hgb, MCHC is >36%, usually spherical, not biconcave.
hyperchromasia
-
This refers to the entire red cell morphology in the scanned area of a peripheral smeal.
poikilocytosis
-
Grading scale for RBC morphology
Normal:
Slight:
1+:
2+:
3+:
4+:
- Normal: 5%
- Slight: 5-10%
- 1+: 10-25%
- 2+: 25-50%
- 3+: 50-75%
- 4+: >75%
-
An RBC that has an irreversible defect or loss of the cell membrane resulting in no central pallor.
Spherocytes
-
This abnormality is seen in hereditary spherocytosis, immune hemolytic anemia, and post transfusion.
Spherocytes
-
These are also called crenated, or burr cells and may be artifact in origin.
echinocytes.
-
True forms of this abnormality occur in small numbers and have unevenly spaced spicules.
echinocytes
-
These abnormalities are associated with uremia, heart disease, dehydration, and untreated hypothyroidism.
echinocytes
-
These are RBC's with 3-12 blunt, irregularly spaced spicules that result from LCAT enzyme deficiency.
acanthocytes
-
These cells have contain excess cholesterol and are associated with abetalipoproteinemia, pyruvate kinase deficiency, zieve's syndrome, and vitamin E deficiency.
acanthocytes.
-
These abnormalities also called dacrocytes are pair shaped and associated with thalassemia and iron deficiency.
Tear Drop
-
These are RBC's that have been caught in fibrin strands in circulation and fuses together to create a vacuole that resembles a blister.
keratocyte
-
These cells are formed when the spleen bites off large RBC inclusion like Heinz bodies. They are associated with G6PD and pulmonary emboli. also called bite cells.
helmet cells
-
these cells, also called codocytes, may be artificially induced on a slide or caused by excess membrane cholesterol.
Target cells
-
This abnormality is associated with liver disease, thalassemia, Hgb C, and iron deficiency anemia.
Target cells
-
These cells have been transformed by hemoglobin polymerization into a ridged and inflexible crescent shape. also called a drepanocyte.
sickle cell
-
These are extreme fragmentations of RBC's that have been split, cut or cloven due to trauma to the cell membrane.
Schistocytes
-
This abnormality is associated with DIC, hemolytic anemia, heart valve surgery, and severe burns.
schistocytes
-
The name for these abnormalities is used interchangeably but one is more egg shaped while the other is more pencil shaped.
-
These abnormalities are belived to be a result of mechanical weakness or fragility of the membrane skeleton.
ovalocyte/elliptocyte
-
This abnormality is associated with thalassemia and the megaloblastic process
ovalocyte
-
This abnormality is associated with hereditary elliptocytosis and iron deficiency anemia
elliptocyte
-
These cells have an oval or rectangular central pallor as the result of membrane defect or artifactual origin; they are associated with acute alcoholism and hereditary stomatocytosis.
stomatocyte
-
in a stomatocyte cause by membrane defect how will the central pallor appear?
slit like area of pallor appear shaded.
-
if artifactual in origin how will the central pallor appear in a stomatocyte?
slit like area of pallor
-
RBC's arranged in stacks like coins due to abnormal protein coating on the cell's surface.
rouleaux formation
-
This is associated with multiple myeloma, waldentrom's macroglobulinemia, and chronic inflammatory disorders.
rouleaux formation
-
This is when RBC's are clumped and results from Ab-Ag interaction associated with cold agglutinins and paroxysmal cold hemoglobinuria.
RBC agglutination
-
This is a round purple staining body seen single or doubly in peripherary of cell membrane that is normally pitted by the spleen.
howell-jolly bodies
-
This inclusion is associated with splenectomy, megaloblastic anemia, thalassemia, hemolytic anemia, and sickle cell anemia
howell jolly bodies
-
These are small irregular, magenta colored inclusions seen in periphery of cell usually in clusters.
pappenheimer bodies.
-
these inclusions are referred to as siderotic granules if stained with prussian blue which is the confrimation test.
pappenheimer bodies
-
These inclusions consist of nonheme iron, resulting from excess of available iron throught the body.
pappenheimer bodies
-
These inclusions are associated with sideroblastic anemia, sickle cell anemia, thalassemia and splenectomy.
pappenheimer bodies
-
This is a coarse or diffuse blue staining body that consists of percipitated ribosomes that occurs when smear is drying.
basophilic stippling
-
this inclusion is associated with thalassemia, lead poisoning, alcoholism, and megaloblastic anemia.
basophilic stippling
-
This is a purple thread-like loop that is remnants of microtubules found in stippled cells.
cabots ring
-
This inclusion is associated with megaloblastic anemia, post splenectomy,and homozygous thalassemia.
Cabot's ring
-
This inclusion is aggregates of precipitated hemoglobin only seen in crystal violet stain or cresyl blue.
heinz bodies
-
This inclusion is associated with G6PD deficiency under oxidative stress and alpha thalassemia.
heinz bodies
-
this is the most common protozoal infection, contracted thru mosquito bites.
malaria
-
This is caused by four species fo plasmodium that invade RBC's.
malaria
-
This parasite may be mistaken for platelets.
malaria
-
This parasite is caused by infection thru tick bites, organism is called babesia microti.
babesiosis
-
Condition in which there is reduced oxygen delivery to the tissues
anemia
-
what are three things anemia may result from?
- destruction of RBC's
- Excessive blodd loss
- decreased production of red cells
-
what is classification of anemias based on?
RBC morphology
-
what are the three types microcytic hypochromic anemias?
- Iron deficiency anemia
- anemia of chronic diseases
sideroblastic anemia
-
This is a microcytic hypochromic anemia that develops in 3 stages, it is acquired and prgessive.
iron deficiency anemia
-
what are the three stages that lead to iron deficiency anemia?
- iron depletion (w/o anemia)
- iron deficient erythropoiesis (w/ mild anemia)
- Iron deficiency anemia develops (w/severe anemia)
-
this anemia occurs in:
decreased iron intake
inadequate absorption
increased iron utilization
loss of iron
iron deficiency anemia
-
Which type of anemia will result in weakness and dyspnea, increased TIBC, and decreased Hgb and retics.
iron deficiency anemia
-
This is a microcytic, hypochromic anemia that in sex linked and congenital.
sideroblastic anemia
-
what is the cause of primary sideroblastic anemia?
idiopathic
-
what is the cause of secondary sideroblastic anemia?
toxins or drugs
-
This microcytic hypochromic anemia will cause dismorphic RBC's, decreased TIBC, and increased serum iron and ferritin.
hereditary sideroblastic anemia
-
This microcytic hypochromic anemia will cause dismorphic RBC's basophilic stippling and ringed sideroblasts.
acquired sideroblastic anemia
-
This anemia is associated with infections, and autoimmune disorders.
anemia of chronic disorders.
-
This anemia is caused by a failure of kidneys to produce erythropoetin, or a renal disease that leads to chemical imbalance or uremia
anemia of chronic renal problems.
-
This anemia may cause burr cells due to uremia and hemolysis due to mechanical trauma or adverse metabolic environment.
anemia of chronic renal problems
-
This anemia is associated with diseases of the thyroid, pituitary, adrenals, and gonads which produce hormones for erythropoiesis.
anemia of endocrine diseases.
-
Macrocytic normochromic anemia is also know as what?
megaloblastic anemia
-
This anemia has defective nuclear maturation caused by impared DNA synthesis due to Vit B12 and folic acid deficency
- macrocytic normochromic anemia
- (megaloblastic)
-
This Anemia is seen in strict vegetarians, fish tapeworm, and pernicious anemia patients.
- macrocytic normochromic anemia
- (megaloblastic)
-
The lab findings in this anemia are slight ovalocytosis and tear drops, abnormal schilling test, increased MCV, and hypersegmented neutrophils in more than 98% of cases.
- macrocytic normochromic anemia
- (megaloblastic)
-
This anemia is a failure of bone marrow to produce blood cells.
aplastic anemia
-
the congenital form of aplastic anemia is known as what?
fanconi's anemia
-
The Lab findings of this anemia include pancytopenia, normocytic normochromic RBC's, polychromasia, and decreased retic count, Hgb, and Hct.
Aplastic anemia
-
This is a group of anemia characterized by increased destruction of RBC's.
hemolytic anemias
-
This is the most common hereditary hemolytic anemia in northern europe.
spherocytosis
-
This hemolytic anemia is due to defective spectrin, it causes jaundic durring hemolytic episodes and is diagnosed in early childhood.
spherocytosis
-
In this hemolytic anemi RBC's are spherical instead of biconcave which makes them hyperpermeable to sodium.
spherocytosis
-
Lab finding of this hemolytic anemia include spherocytes, an MCHC >36% in 50% of cases, and osmotic fragility is increased.
spherocytosis
-
This anemia is caused by a defective cytoskeleton, 90% have no clinical, 10% have symptoms similar to spherocytosis.
elliptocytosis
-
The Lab findings of this anemia are elliptocytes and increased reticulocytes.
elliptocytosis
-
This hemolytic anemia is characterized by a sodium potassium imbalance that causes RBC's to swell.
Stomatocytosis
-
The lab finding of this hemolytic anemia are stomatocytes, MCV increased, and MCHC decreased.
stomatocytosis
-
This is the most common RBC enzyme disorder that is generally seen in black populations.
G6PD deficiency
-
This hemolytic anemia is harmless unless exposed to oxidative stress such as antimalarial drugs and fava beans.
G6PD
-
The lab finding of this Hemolytic anemia include heinz bodies, basophilic stippling, and hemoglobinuria.
G6PD
-
In this hemolytic anemia deficiency in PK causes reduced ATP and RBC's become fragile.
pyruvate kinase (PK) deficiency
-
This anemia results from infection and causes a loss of self recognition of individual's own RBC's, auto-antibody's are produced against own RBC's,
autoimmune hemolytic anemia
-
What are the three types of auto immune hemolytic anemia?
- Warm agglutinin auto-immune hemolytic anemia (WAIHA)
- Cold Agglutinin auto-immune hemolytic anemia (CAIHA)
- Paroxysmal cold hemoglobinuria (PCH)
-
This very rare hemolytic anemia involves antibodies with optimal serological activity at 37oC has Lab findings of schistocytes and Retculocytes.
WAIHA
-
This Hemolytic anemia involves antibodies with optimal serological activity at 4oC, (also seen at 25-31oC, and has lab findings of rouleaux formation and RBC agglutination.
CAIHA
-
This is the least common of the AIHA and is seen almost exclusively in children.
PCH
-
This animia involves anti-P which attaches to RBC's at low temperatures and as body temp increases it causes RBC hemolysis that results in severe and rapid anemia
PCH
-
what is the test for PCH?
donath-landstier test
-
This Hemolytic anemia is caused a blood type incompatiblity betwen the mother and fetus.
Hemolytic Disease of Newborns (HDN)
-
In HDN administration of this drug prior to a fetal-maternal hemorrhage can prevent the other from producing anti-D.
rhogam
-
What is it called when rhogam is administered prior to a fetal-maternal hemmorhage?
maternal sensitization
-
Rhogam is usually given when durring pregnancy to D-negative mother
- at 28 weeks
- again within 72hrs of birth.
-
This fairly rare hemolytic anemia has an insidious onset, the RBC membrane is abnormal, and is confired by the HAM's test.
Proximal Nocturnal Hemolysis (PNH)
-
This Hemolytic anemia's Lab findings are hematuria (worst in the morning), leukopenia, thrombocytopenia, and slight macrocytosis.
Proximal Nocturnal Hemolysis (PNH)
-
This anemia is caused by drugs that lead to immune complex formation, autoimmunity, or membrane modification.
drug induced IHA
-
This anemia has lab findings of extravascular hemolysis, spherocytosis and a positive DAT test.
Drug induced IHA
-
This is a diverse group of conditions that shorten RBC survial such as infections, mechanical damage or chemical and physical agents. Lab findings are dependent on causative factor.
Acquired Non-IHA
-
This anemia is caused by a sudden loss of blood in a short period of time.
acute blood loss anemia
-
In acute blood loss anemia reticulocytes will increase ____ days after blood loss and peak at ______ days.
-
this anemia is caused by a loss of small quantities of blood over a long period of time.
chronic blood loss anemia
-
This is synthesized in mitochondria and contains iron.
hemoglobin
-
This is synthesized in ribosomes and is twisted along the heme group, each has an exact number and sequence of amino acid.
globin
-
what are the four types of globin?
-
This hemoglobin consists of two alpha chains, and two beta chains and is 95-97% of all hemoglobin.
Hgb A
-
This hemoglobin consists of two alpha chains and two delta chains and is 2-3% of all Hgb.
Hgb A2
-
This Hemoglobin consists of 2 alpha chains and two gamma chains and is 1-2% of all hemoglobin.
Hgb F
-
Anemias characterized by a structural defect in the hemoglobin.
hemoglobinopathies
-
what type of Hgb chain defects are usually clinically significant?
alpha or beta
-
what type of Hgb chain defects are usually not clinically significant?
gamma and delta
-
these are hgb structural defects due to amino acid substitutions.
qualitative structural defects
-
These are hgb structural defects due to impared production of the globin chain.
quantitative structural defects
-
what are the types of qualitative structural defects.
-
What are the types of quantitative structural defects?
- Beta Thalassemia (major and minor)
- Alpha Thalassemia
-
This is due to substitution of amino acid valine for glutamic acid on the 6th position of beta chain, also known as sickle cell.
Hgb S
-
This condtion leads to chronic hemolytic anemia, decreased O2 causes RBC's to sickle and become rigid, sickle cells plug small vessels in joints and abdomen.
Sickle Cell Anemia
-
in this conditon sickle cells, target cells, howell-jolly bodies, and NRBC's are seen along with a positive sickle cell. electrophoresis shows no Hgb A, 80% or more Hgb S, and 1-20% Hgb F.
Sickle Cell anemia
-
In this condition no sickle cells will be in the smear unless in crisis, sickle cell test is positive and electrophoresis shows 60% Hgb A and 40% Hgb S.
Sickle cell Trait
-
This is the substitution of lysine for glutamic acid on the 6th position of beta chain mostly in black populations.
Hgb C
-
in this conditon 50-90% target cells are seen, increased retics are noted as well as Hgb C crystals, electrophoresis shows no Hgb A, 95% Hgb C plus A2, and <7% Hgb F.
Hgb C disease
-
In this condtion there are no clinical symptoms and electrophoresis shows 60% Hgb A and 40% Hgb C plus A2.
Hgb C trait
-
This condition mostly seen in blacks has symptoms like sickle cell and is caused by two abnormal beta chains, Hgb S and Hgb C.
Hgb SC
-
This condition will have Target cells, Hgb C crystals, Folded RBC's, and sickle cells. electrophoresis will show 50% Hgb S and 50% Hgb C.
Hgb SC
-
This is the substitution of lysine for glutamic acid at the 26th position of beta chain, mostly seen in south east asia.
Hgb E
-
This condition has mild anemia and moderate target cells, electrophoresis shows 95-97% Hgb E plus A2 and 3-5% Hgb F.
Hgb E
-
Electrophoresis of this condition will show 70% Hgb A and 30% Hgb E plus A2
Hgb E trait
-
This is the decreased production of one globin chain that causes decreased production of normal hemoglobin.
Thalassemia
-
In this condition the beta chain is decreased or absent, and excess A2 causes apoptosis of red cell precursors which leads to ineffective erythropoiesis.
Beta Thalassemia
-
This is a homozygous state that occurs in people of Mediterranean decent and causes severe anemia.
Thalassemia major
-
Symptoms of this conditon are splenomegaly, retarded growth and mongoloid facial features.
Thalassemia major
-
Lab findings of this condition include basophillic stippling, many target cells, howell jolly bodies, pappenheimer bodies, NRBC's and increased Retic count.
Thalassemia Major
-
In this condition Alpha chains are reduced or absent and there is an excess of Fetal and beta chains.
Alpha thalassemia
-
In this condition Beta chains form stable nonfunctional tetramers.
Alpha Thalassemia
-
what are some stable nonfunctional tetramers seen in alpha thalassemia?
- Hgb H: 4 beta chains
- Hgb Bart's: 4 Gamma Chains
-
Absence of all alpha chains is ___________.
incompatible with life
-
which type of thalassemia occurs in the uterus
Alpha
-
Who is ID of alpha thalassemia minor important to? why?
- Women of childbearing years or pregnant of mediterranean decent.
- at risk for hydrop fetalis
- prevent unnecessary treatment of Iron deficency anemia
-
This is a chronic life shortening myeloproliferative disorder involving all bone marrow elements, characterized by an increase in RBC mass and Hgb concentration.
polycythemia vera
-
what are the types of polycythemia?
- polycythemia vera
- secondary polycythemia
-
this is a chronic disease with insidious onset, symptoms are headaches, epistaxis, myocardial infarction, thrombosis, splenomegaly, hepatomegaly, and erythromelalgia.
polycythemia vera
-
Lab findings of this condition are an elevated RBC count, Hgb, and Hct. thrombocytosis, leukocytosis, decreased erythopoesis, and increased red cell mass.
polycythemia vera
-
in polycythemia vera this must be seperated from a true increase in red cell mass.
hemoconcentration
-
This condition is caused by hypoxic situations such as COPD, cyanosis and CHF, and an excess production of erythropoietin causes an increase in RBC's.
Secondary polycythemia
-
This condition is also known as hypoxic erythrocytosis.
secondary polycythemia
-
this condition has an increased red cell mass, increased erythropoietin, and a normal plt/WBC count.
secondary polycythemia
-
In this condtion an increased Hct is secondary to a decrease in plasma volume.
relative polycythemia
-
This condition is seen in acute and subacute dehydration and also middle aged men with a history of smoking, hypertension, and obesity.
relative polycythemia
-
This test measures the ability of the RBC's to take up fluid without lysing, it is used to diagnose hemolytic anemias specifically spherocytosis.
osmotic fragility test
-
in this test whole blood is added to saline dilutions which lyses RBC's Hgb is measured.
osmotic fragility test
-
what is an effective measure of erythrocyte susceptibility to hypotonic damage?
the presence or absence of hemolysis
-
In normal RBC's
inital hemolysis occurs at:
complete hemolysis occurs at:
- inital hemolysis: 0.45% NaCl
- Complete hemolysis: 0.30% NaCl
-
In spherocytes
initial hemolysis occurs at:
Complete heolysis occurs at:
- initial hemolysis: 0.65% NaCl
- Complete hemolysis: 0.45% NaCl
-
In this test lysing agent and sodium dithionate is added to RBC to release Hgb and reduce Hgb S which forms turbid crystals.
Sickle cell test
-
This test is used to determine the different types of Hgb present in blood.
Hgb Electrophoresis
-
What is the specimen of choice for Hgb electrophoresis?
EDTA whole blood
-
using cellulose acetate at pH 8.4 Hgb migration pattern is:
-
Using citrate agar pH 6.0-6.2 migration pattern is:
|
|