RBC Abnormalities Review

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corbin19
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14203
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RBC Abnormalities Review
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2010-04-12 23:15:08
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MLT 10005
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Review for 2.4
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  1. What is the normal size of an RBC?
    • 6-8 microns
    • about the size of a small lymphocyte
  2. What is the normal value for MCV?
    80-99fL
  3. an RBC that is less <6 microns, MCV is <80fL
    microcyte
  4. what are four conditions microcytes seen in?
    • Iron deficiency
    • Thalassemia
    • Lead poisoning
    • sideroblastic anemia
  5. an RBC that is >8 microns, MCV is >99fL.
    macrocyte
  6. what are six diseases that macrocytes are seen in?
    • liver disease
    • post splenectomy
    • megaloblastic process
    • hypothyroidism
    • chemotheraphy
    • newborns
  7. This refers to the entire red cell morphology in the scanned area of a peripheral smear.
    poikilocytosis
  8. how is poikilocytosis graded?
    1+ to 4+
  9. these are small, hyperchromic cells with no central pallor, increased Hgb and a MCHC>36%.
    sphereocytes.
  10. These cells are caused by a defect or loss of cell membrane.
    spherocytes
  11. these cells have evenly spaced spicules that may be artifact in origin from faulty drying.
    echinocytes
  12. These cells are alo called crenated or burr cells
    echinocytes
  13. If not artifactula in origin these cells are associated with uremia, heart disease, dehydration and untreated hypothyroidism.
    Echinocytes
  14. these are cells with 3-12 irregularly spaced blunt spicules that vary in length.
    acanthocytes
  15. what is another name for a tear drop cell?
    dacrocyte
  16. These are pear-shaped cells that have been pulled into one spicule.
    Tear drop
  17. What are tear drop cells associated with?
    • thalassemia
    • iron deficiency
  18. these cells are associated with G6PD and have two distinctive projections surrounding an empty space in the RBC.
    • Helmet cell
    • keratocytes
  19. Fragmentation of this cell occurs by pitting mechanism of spleen
    helmet cells
  20. These cells are also called bite cells
    helmet cells
  21. These are hypochromic cells that may be artificially induced on smear, they appear as a target or bullseye.
    Target cells
  22. these cells are also called codocytes
    target cells
  23. when does targeting occur in target cells?
    while drying
  24. These are sickle or crescent shaped cells cells that are pointed at one or both ends.
    sickle cells
  25. These cells are also called drepanocytes
    sickle cells
  26. what causes sickle cells to become ridged and inflexible
    hemoglobin polymerization
  27. these cells have an oval or rectangular central pallor, and are mostly artifactual in origin.
    stomatocyte
  28. If the result of a stomatocyte is membrane defect how will the central pallor appear?
    shaded slit like
  29. what two condtions are stomatocytes associated with?
    • acute alcoholism
    • hereditary stomatocytosis
  30. these are round purple staining bodies that are remnants of RNA, they are usually seen single.
    howell-jolly bodies
  31. multiples of these bodies indicate megaloblastic anemia.
    howell-jolly bodies
  32. These are small irregular, magenta colored clusters seen in periphery of cell.
    pappenheimer bodies
  33. these inclusions are aggregates of iron.
    pappenheimer bodies
  34. these cells are referred to as siderotic granules if staind with what stain?
    prussian blue
  35. These are coarse or diffuse blue staining bodies that consist of precipitated ribosomes.
    basophilic stippling
  36. when does basophilic stippling occur.
    while smear is drying
  37. These are purple thread like loops that are remnants of microtubules from the mitotic spindle.
    Cabots ring
  38. This inclusion body indicates abnormal erythropoiesis
    cabots ring
  39. These inclusions are aggregates of denatured precipitated hemoglobin
    heinz bodies
  40. what stains are used to see heinz bodies?
    • crystal violet
    • cresyl blue
  41. Iron deficiency anemia is acquired and prgressive, what are its three stages?
    • iron depletion
    • iron deficient erythropoiesis
    • iron deficiency anemia
  42. This anemia occurs in pregnant women or women of childbearing years, also in blood loss.
    iron deficiency anemia
  43. hypochromic/microcytic cells, anisopoiklocytosis and target cells are all noted in what anemia?
    iron deficiency anemia
  44. This hereditary anemia causes dimorphic RBC's, anisopoikilocytosis, and ringed sideroblasts.
    sideroblastic anemia
  45. what are the two populations of dimorphic RBC's seen in sideroblastic anemia?
    • microcytic/hypochromic
    • normocytic/normochromic
  46. this anemia may be drug induced from anti TB meds, antimicrobials, and antiparkinsonian drugs, or induced by alcoholism or lead poisoning
    sideroblastic anemia
  47. This anemia starts as normo/normo then slowly gets worse.
    anemias of chronic disorders
  48. This anemia may result from decreased RBC life, impared iron metablolism, decreased Epo, or suppression of Epo.
    anemia of chronic disorders
  49. this anemia is caused by the failure of kidneys to produce erythropoietin
    anemia of chronic renal problems
  50. This anemia is caused by vit B12 and folic acid deficency which leads to impared DNA synthesis, in turn creating large RBC's and granulocytes.
    macrocytic normochromic
  51. This anemia is also called mgealoblastic anemia
    macrocytic normochromic
  52. this anemia can be caused by a loss of parietal cell intrinsic factors which are needed for vit B12 absorption, aslo pernicious anemia.
    macrocytic normochromic
  53. This anemia causes large hypersegmented nutrophils in more than 98% of cases
    macrocytic normochromic
  54. This anemia is caused by a failure of bone marrow to produce blood cells
    aplastic anemia
  55. what two factors are of aplastic anemia can cause a failure of bone marrow?
    • cellular depletion of BM
    • fatty replacement of BM
  56. this anemia causes pancytopenia, normocytic, normochromic RBC's and polychromasia.
    aplastic anemia
  57. what are three hereditary causes of of hemolytic anemias due to intrinsic defects of RBC membrane.
    • hereditary spherocytosis
    • hereditary elliptocytosis
    • hereditary stomatocytosis
  58. this is the most common RBC enzyme disorder
    G6PD
  59. G6PD is harmless unless exposed to what?
    oxidative stress
  60. what are two things that can cause oxidative stress in G6PD patients?
    • antimalarial drugs
    • Fava beans
  61. This is a very rare condition that involves antibodies with optimal serological activity at 37oC.
    Warm agglutinin auto-immune hemolytic anemia (WAIHA)
  62. What does PCH stand for
    paroxysmal cold hemoglobinuria
  63. in this conditon anti-P attaches to RBC's at low temperatures.
    PCH
  64. in HDN if mother is sensitized durring pregnancy or deliver this can happen.
    fetal maternal hemorrhage
  65. In this insidious anemia the RBC membrane is abnormal and susceptible to hemolytic action of complement.
    PNH
  66. what is the confirmatory test for PNH?
    HAM's
  67. normal hemoglobin content
    Hgb A:
    Hgb A2:
    Hgb F:
    • Hgb A: 95-97%
    • Hgb A2: 2-3%
    • Hgb F: 1-2%
  68. these are anemias characterized by a structural defect in the hemoglobin.
    hemoglobinopathies
  69. This is a homozygous conditon that leads to chronic hemolytic anemia and ischemic tissue injury due to vaso-occlusion.
    Hgb-S
  70. This is characterized by decreased ESR, and HGB electrophoresis shows no Hgb A, 80% or more Hgb S, and 1-20% Hgb F.
    Hgb S
  71. This is the substitution of lysine for glutamic acid on 6th position of beta chain.
    Hgb C
  72. in this chronic hemolytic anemia 50-90% target cells are seen, as well as increased reticulocytes and Hgb C crystals.
    Hgb C
  73. what effect does hypoxic situations have on erythropoietin?
    it increases it
  74. what are four situations secondary polycythemia is seen in.
    • cyanosis
    • COPD
    • CHF
    • High altitudes
  75. This condition casues an increased Hct, Increase Hgb, increased red cell mass, and increased epo, but platelet/WBC count is normal.
    secondary polycythemia
  76. this condition is caused by a decrease in plasma volume but not an actual increase in red cell mass.
    relative polycythemia
  77. this condition is seen in acute and subacute dehydration in middle aged men with a history of smoking, hypertension, and obesity
    relative polycythemia
  78. This test measures the ability of the RBC's to take up fluid without lysing.
    osmotic fragility test
  79. what is the test used to diagnose hemolytic anemias, specifically hereditary spherocytosis?
    osmotic fragility test

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