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What is the normal size of a RBC?
- -6-8 microns
- -about the size of small lymphocyte
- -MCV is 80-99fl
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What is the size of a microcyte?
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Microcyte are seen in what?
- -Sideroblastic anemia
- -Lead poisoning
- -Iron defiency
- -Thalassemia
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What are the size of macrocytes?
-
Macrocytes are seen in what?
- -Liver disease, post-splenectomy
- -Megaloblastic process, hypothyroidism
- -chemotherapy & newborns
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Poikilocytosis refers to what?
-the entire red cell morphology in the scanned area if a peripheral smear
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What are the grades for Poikilocytosis(variation in shape)?
Grade 1+ to 4+
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this cell is small, hyperchromic , has no central pallor, reduced surface-to-volume ratio, its irreversible, due to abnormality of the cell membrane(defect or loss of cell membrane)
spherocytes
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This is also called crenated or burr cells?
Echinocytes
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Echinocytes are __-__ even evenly spicules distributed?
10-30
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Echinocytes may be artifact in origin due to what?
specimen contamination (bad drying)
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Echinocytes are associated w/ what?
- -uremia(waste in blood from kidney)
- -dehydration
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What is the size of Acanthocyte?
- -RBC's w/ 3-12 irregularly spaced spicules
- -spicules vary in length and are blunt rather pointed
-
What is another name for tear drop?
dacrocyte
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this cell RBC is pulled into one spicule (pear shaped), inclusion body left RBC, spleen take a bite or RBC?
Tear drop
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A tear drop is associated w/what?
- -Iron defiency
- -Thalassemia syndrome
-
What is another name for helmet cells?
bite cells or Keratocyte
-
this cell has distinctive projections surrounding an empty space in the RBC w/ 2 distinctive projection surround an empty space.
helmet cells
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In helmet cells fragmentation occurs by what?
pitting mechanism of spleen(removes inclusion)
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Helmet cells are formed when what?
spleen bites off large RBC inclusion like Heinz bodies
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Helmet cells are associated w/ what?
- -G6PD deficiency
- -Pulmonary emboli
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Another name for Target cell are what?
codocyte
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this may be artificially induced on smear and appears bell shaped(using electron microscope), hypochromic( decreased hemoglobin)
Target cell
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Another name for drepanocyte is what?
sickle cell
-
this cell is sickle or crescent shape w/ pointed projections at one or both ends of the cell
sickle cell or hemoglobin S
-
this cell is oval or rectangular central pallor
stomatocyte
-
this cell may result of membrane defect(slit appears shaded) and may be artifactual in origin (slit like area of pallor)
stomatocyte
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Stomatocyte is associated w/ what?
- -hereditary stomatocytosis
- -acute alcoholism
-
this cell is round, purple staining bodies seen in Wright's stain
-Howell-jolly bodies
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Howell-Jolly bodies are remnants of ____?
DNA
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Howell-jolly bodies seen in ____ or ____ in peripherary of cell membrane?
single, doubly
-
this cell is small irregular, magenta colored inclusions seen in periphery of cell
Pappenheimer bodies
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Pappenheimer bodies are usually seen in what?
- -clusters
- -seen in wright's stain
- -referred to as siderotic granules if stained w/ Prussian blue (confirmatory test)
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Pappenheimer bodies consist of what?
nonheme iron, resulting frome excess of available iron thoughout the body
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describe the basophilic stippling
- -coarse or diffuse blue staining bodies
- *seen wright's stain
- -consist of precipitated ribosomes
- -occurs when smear is drying
- *does not occur in vivo
-
the cabot's ring looks like what?
- purple thread like loops
- *seen in wright's stain
-
this cell is remnants of microtubule from mitotic spindle( found in stippled cells and appear in a figure 8 pattern), and abnomal erythopoisis
Cabot's ring
-
this cell aggregates of denatured precipitated hemoglobin, not seen wright's stain(use crystal violet stain or brilliant cresyl blue)
Heinz bodies
-
What is the Etiology of iron deficiency anemia?
acquired and progressive
-
this anemia is deffiency in pregnancy, chronic blood loss, infancy, women in child bearing yrs
Iron deficiency anemia
-
What are the 3 stages of iron deficiency anemia?
- -iron depletion w/ anemia
- -iron deficiency erythropoiesis w/ mild anemia
- -iron deficiency anemia develops w/ severe anemia
-
Iron deficiency anemia occurs in what?
- -inadequate absorption
- -decreased iron intake
- *meat poor diet
- *malabsorption
- -increased iron utilization
- *pregnancy
- *growth spurts
- -loss of iron
-
The morphological of iron deficiency anemia is what?
- -hypochromic/microcytic
- -mild to moderate anisopoiklocytosis (target cells)
-
Sideroblastic anemia are acquired by what?
- -primary(idiopathic)
- -secondary ...drug or toxin induced -anti TB drugs-alcolism-lead poisonig-antimicrobial-anti parkinsons drug
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What are the laboratory features for a sideroblastic anemia?
- dimorphic RBCs
- -microcytic, hypochromic
- -normocytic, normochromic
- anisopoikilocytosis (ringed sideroblasts)
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What are the etiology for Anemia of chronic disorders?
- -multifactorial in origin
- -associated w/ infections, autoimmune disorders
- -anemia present 1-3 months following onset of chronic disease state
-
Anemia of chronic disorders laboratory features are what ?
- -normocytic RBCs (normal MCV), may be hypochromic or normalchromic
- -anisopoikilocytosis- mild to absent
- -polychromasia -mild to absent
- decrease in RBC life expentancy
- -decrease in erythropoisis
- -impaired of iron metabolism
- -suppression of erythopoisis by cytokines
- -starts as normal/normal
- increases in RDW, serum iron
-
What is the Etiology of anemia of chronic renal problems?
- -failure of kidneys to produce erythropoetin
- -renal diesease leads to chemical imbalance or uremia
-
Macrocytic normochromic are due to what?
- -Vit B12 and folic acid deficiency
- dietary
- -result in large RBC 2 granulocytes
- B12 not absorbed
-
What are the laboratory features for macrocytic/normochromic?
- large hypersegmented neutrophils
- -5 or more lobes
- -seen in more than 98% of the cases
-
What is the etiology of aplastic anemia?
- failure of bone marrow to produce blood cells
- -cellular depletion of BM
- -fatty replacement of BM
-
Aplastic anemia laboratory findings are what?
- Pancytopenia(decrease RBC, WBC, Platelets)
- normocytic, normochromic RBCs
- polychromasia
-
list the types of hemolytic anemias?
- inherited
- :due to intrinsic defect in RBC membrane
- -hereditary spherocytosis
- -hereditary elliptocytosis
- -hereditary stomatocytosis
-
What is the most common RBC enzyme disorder?
G6PD Defiency
-
What is the Etiology of G6PD?
- absence of G6PD is harmless unless exposed oxidative stress
- -antimalarial drug
- -fava beans
-
This anemia involves antibodies w/ optimal serological activity at 37 degree C and is rare
WAIHA(warm agglutinin auto-immune hemolytic anemia)
-
PCH(paroxysmal cold hemoglobinuria) involves what?
- -biphasic autoantibody Anti-P
- -anti-P attaches to RBC at low temperature
-
what is called when the mother sensitized during pregnancy or delivery called fetal-maternal hemorrhage?
HDN (hemolytic disease of Neworn)
-
in Poximal Nocturnal hematuria the membrane is what?
- abnormal
- -susceptible to hemolytic action of component
- fairly rare
-
What the types of Hemoglobin and ranges?
- Hgb A:95-97%
- Hbg A2: 2-3%
- Hgb F: 1-2%
-
this the anemias characterized by a structural defect in the hemoglobin?
hemoglobinopathies
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What happens in homozygous condition of Hgb S?
- -leads to chronic hemolytic anemia
- -ischemic tissue injury due to vaso-occlusion
- -decreased oxygen causes RBC to sickle and become very rigid
- -sickled cells plugs small vessels in joints and abdomen
-
What are the laboratory feature of sickle cell anemia?
- -moderate anisocytosis and poikilocytosis
- -decreased ESR
- -sickle cell test:positive
- -Hgb electrophoresis shows:
- no hgb A
- 80% or more Hgb S
- 1-20% Hgb F
-
what is the etiology of Hbg C?
substitution of lysine for glutamic acid on 6th position of beta chain
-
Hgb C may be seen in what?
Hgb C crystals
-
this decreases erythropoisis?
polycythemia vera
-
erythrocytes are increased in number?
secondary polycythemia
-
this is hypoxic situation like cynosis, COPD, CHF, High altitudes
secondary polycythemia
-
this is an increase red cell mass and due to decrease in plasma
secondary polycythemia
-
Relative polycythemia is seen in where?
- acute & subacute dehydration
- -middle aged men w/ history of smoking, hypertension, obesity
-
this test is use to diagnose heolytic anemia, specifically hereditary sperocytosis
Osmotic fragility test
-
% of cells that differe in size or shape for normal RBCs
- normal..5%
- slight...5-10%
- 1+......10-25%
- 2+......25-50%
- 3+......50-75%
- 4+.......>75%
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