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babybless88
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14221
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Test questions
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2010-04-13 01:24:36
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Red Blood Cell Abnormalities
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Reb blood cells
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  1. What is the normal size of a RBC?
    • -6-8 microns
    • -about the size of small lymphocyte
    • -MCV is 80-99fl
  2. What is the size of a microcyte?
    • *<6 microns
    • *MCV is <80fl
  3. Microcyte are seen in what?
    • -Sideroblastic anemia
    • -Lead poisoning
    • -Iron defiency
    • -Thalassemia
  4. What are the size of macrocytes?
    • >8 microns
    • MCV is 99fl
  5. Macrocytes are seen in what?
    • -Liver disease, post-splenectomy
    • -Megaloblastic process, hypothyroidism
    • -chemotherapy & newborns
  6. Poikilocytosis refers to what?
    -the entire red cell morphology in the scanned area if a peripheral smear
  7. What are the grades for Poikilocytosis(variation in shape)?
    Grade 1+ to 4+
  8. 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
  9. This is also called crenated or burr cells?
    Echinocytes
  10. Echinocytes are __-__ even evenly spicules distributed?
    10-30
  11. Echinocytes may be artifact in origin due to what?
    specimen contamination (bad drying)
  12. Echinocytes are associated w/ what?
    • -uremia(waste in blood from kidney)
    • -dehydration
  13. What is the size of Acanthocyte?
    • -RBC's w/ 3-12 irregularly spaced spicules
    • -spicules vary in length and are blunt rather pointed
  14. What is another name for tear drop?
    dacrocyte
  15. this cell RBC is pulled into one spicule (pear shaped), inclusion body left RBC, spleen take a bite or RBC?
    Tear drop
  16. A tear drop is associated w/what?
    • -Iron defiency
    • -Thalassemia syndrome
  17. What is another name for helmet cells?
    bite cells or Keratocyte
  18. this cell has distinctive projections surrounding an empty space in the RBC w/ 2 distinctive projection surround an empty space.
    helmet cells
  19. In helmet cells fragmentation occurs by what?
    pitting mechanism of spleen(removes inclusion)
  20. Helmet cells are formed when what?
    spleen bites off large RBC inclusion like Heinz bodies
  21. Helmet cells are associated w/ what?
    • -G6PD deficiency
    • -Pulmonary emboli
  22. Another name for Target cell are what?
    codocyte
  23. this may be artificially induced on smear and appears bell shaped(using electron microscope), hypochromic( decreased hemoglobin)
    Target cell
  24. Another name for drepanocyte is what?
    sickle cell
  25. this cell is sickle or crescent shape w/ pointed projections at one or both ends of the cell
    sickle cell or hemoglobin S
  26. this cell is oval or rectangular central pallor
    stomatocyte
  27. this cell may result of membrane defect(slit appears shaded) and may be artifactual in origin (slit like area of pallor)
    stomatocyte
  28. Stomatocyte is associated w/ what?
    • -hereditary stomatocytosis
    • -acute alcoholism
  29. this cell is round, purple staining bodies seen in Wright's stain
    -Howell-jolly bodies
  30. Howell-Jolly bodies are remnants of ____?
    DNA
  31. Howell-jolly bodies seen in ____ or ____ in peripherary of cell membrane?
    single, doubly
  32. this cell is small irregular, magenta colored inclusions seen in periphery of cell
    Pappenheimer bodies
  33. 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)
  34. Pappenheimer bodies consist of what?
    nonheme iron, resulting frome excess of available iron thoughout the body
  35. 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
  36. the cabot's ring looks like what?
    • purple thread like loops
    • *seen in wright's stain
  37. 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
  38. this cell aggregates of denatured precipitated hemoglobin, not seen wright's stain(use crystal violet stain or brilliant cresyl blue)
    Heinz bodies
  39. What is the Etiology of iron deficiency anemia?
    acquired and progressive
  40. this anemia is deffiency in pregnancy, chronic blood loss, infancy, women in child bearing yrs
    Iron deficiency anemia
  41. 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
  42. Iron deficiency anemia occurs in what?
    • -inadequate absorption
    • -decreased iron intake
    • *meat poor diet
    • *malabsorption
    • -increased iron utilization
    • *pregnancy
    • *growth spurts
    • -loss of iron
  43. The morphological of iron deficiency anemia is what?
    • -hypochromic/microcytic
    • -mild to moderate anisopoiklocytosis (target cells)
  44. Sideroblastic anemia are acquired by what?
    • -primary(idiopathic)
    • -secondary ...drug or toxin induced -anti TB drugs-alcolism-lead poisonig-antimicrobial-anti parkinsons drug
  45. What are the laboratory features for a sideroblastic anemia?
    • dimorphic RBCs
    • -microcytic, hypochromic
    • -normocytic, normochromic
    • anisopoikilocytosis (ringed sideroblasts)
  46. 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
  47. 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
  48. What is the Etiology of anemia of chronic renal problems?
    • -failure of kidneys to produce erythropoetin
    • -renal diesease leads to chemical imbalance or uremia
  49. Macrocytic normochromic are due to what?
    • -Vit B12 and folic acid deficiency
    • dietary
    • -result in large RBC 2 granulocytes
    • B12 not absorbed
  50. What are the laboratory features for macrocytic/normochromic?
    • large hypersegmented neutrophils
    • -5 or more lobes
    • -seen in more than 98% of the cases
  51. What is the etiology of aplastic anemia?
    • failure of bone marrow to produce blood cells
    • -cellular depletion of BM
    • -fatty replacement of BM
  52. Aplastic anemia laboratory findings are what?
    • Pancytopenia(decrease RBC, WBC, Platelets)
    • normocytic, normochromic RBCs
    • polychromasia
  53. list the types of hemolytic anemias?
    • inherited
    • :due to intrinsic defect in RBC membrane
    • -hereditary spherocytosis
    • -hereditary elliptocytosis
    • -hereditary stomatocytosis
  54. What is the most common RBC enzyme disorder?
    G6PD Defiency
  55. What is the Etiology of G6PD?
    • absence of G6PD is harmless unless exposed oxidative stress
    • -antimalarial drug
    • -fava beans
  56. This anemia involves antibodies w/ optimal serological activity at 37 degree C and is rare
    WAIHA(warm agglutinin auto-immune hemolytic anemia)
  57. PCH(paroxysmal cold hemoglobinuria) involves what?
    • -biphasic autoantibody Anti-P
    • -anti-P attaches to RBC at low temperature
  58. what is called when the mother sensitized during pregnancy or delivery called fetal-maternal hemorrhage?
    HDN (hemolytic disease of Neworn)
  59. in Poximal Nocturnal hematuria the membrane is what?
    • abnormal
    • -susceptible to hemolytic action of component
    • fairly rare
  60. What the types of Hemoglobin and ranges?
    • Hgb A:95-97%
    • Hbg A2: 2-3%
    • Hgb F: 1-2%
  61. this the anemias characterized by a structural defect in the hemoglobin?
    hemoglobinopathies
  62. 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
  63. 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
  64. what is the etiology of Hbg C?
    substitution of lysine for glutamic acid on 6th position of beta chain
  65. Hgb C may be seen in what?
    Hgb C crystals
  66. this decreases erythropoisis?
    polycythemia vera
  67. erythrocytes are increased in number?
    secondary polycythemia
  68. this is hypoxic situation like cynosis, COPD, CHF, High altitudes
    secondary polycythemia
  69. this is an increase red cell mass and due to decrease in plasma
    secondary polycythemia
  70. Relative polycythemia is seen in where?
    • acute & subacute dehydration
    • -middle aged men w/ history of smoking, hypertension, obesity
  71. this test is use to diagnose heolytic anemia, specifically hereditary sperocytosis
    Osmotic fragility test
  72. % 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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