BSMLS Week 3: Red Blood Cell Morphology

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Questions and Answers

What are elliptocytes commonly referred to as?

Ovalocytes (correct)

Target cells

Sickle cells

Ovoid cells

What size do mature red blood cells typically measure?

6-8 micrometers (correct)

4-6 micrometers

8-10 micrometers

10-12 micrometers

Which of the following conditions is associated with codocytes?

Sickle cell anemia

Liver disease (correct)

Iron deficiency anemia

Polycythemia vera

What term refers to an increased variation in red blood cell size?

Anisocytosis (C) Signup and view all the answers

Which statement is true about the shape of mature red blood cells?

They are round and biconcave discs. (C) Signup and view all the answers

In what condition might you expect to see megaloblastic anemia?

Vitamin B12 deficiency (C) Signup and view all the answers

What is the average thickness of a mature red blood cell?

1.5-2.5 micrometers (A) Signup and view all the answers

What appearance do codocytes have?

Centrally stained with a thin outer rim (C) Signup and view all the answers

What is a key characteristic of a spherocyte?

Lacks central pallor (A) Signup and view all the answers

Which condition is associated with spherocyte formation?

Hereditary spherocytosis (D) Signup and view all the answers

What is a distinctive feature of a dacryocyte?

Pear-shaped with one blunt projection (D) Signup and view all the answers

In which conditions are dacryocytes commonly seen?

Primary myelofibrosis (A) Signup and view all the answers

What is the primary cause of stomatocytes?

Osmotic changes due to cation imbalance (D) Signup and view all the answers

Which of the following inclusions is characterized by aggregated RNA?

Basophilic stippling (D) Signup and view all the answers

What stain is used to visualize basophilic stippling?

Wright stain (D) Signup and view all the answers

Which condition is NOT typically associated with stomatocytes?

Lead poisoning (D) Signup and view all the answers

What do echinocytes resemble due to their regular spicules?

Sea urchin cells (A) Signup and view all the answers

Which condition is associated with microcytic red blood cells?

Iron deficiency anemia (A) Signup and view all the answers

What structural change characterizes a drepanocyte?

Elongated and crescent shape (B) Signup and view all the answers

Macrocytic red blood cells are larger than normal due to defects in what process?

Nuclear maturation or stimulated erythropoiesis (A) Signup and view all the answers

What causes schistocytes to form?

Fragmentation of red cells (B) Signup and view all the answers

Which of the following conditions does NOT typically present with microcytic anemia?

Aplastic anemia (B) Signup and view all the answers

What condition is hyperchromasia NOT associated with?

Neutropenia (A) Signup and view all the answers

What is a common cause of the elongated appearance seen in drepanocytes?

Amino acid substitution (D) Signup and view all the answers

In what condition are megaloblastic anemias primarily classified?

Defect in nuclear maturation or stimulated erythropoiesis (A) Signup and view all the answers

Which of the following best describes Pappenheimer bodies?

Dark-staining particles of Iron visualized by iron stain (A) Signup and view all the answers

Nucleated red blood cells indicate which physiological condition?

Increased erythropoiesis (B) Signup and view all the answers

Which of the following conditions are associated with megaloblastic anemia?

Alcoholism (C) Signup and view all the answers

Which statement is true regarding the cells involved in hemoglobinopathies?

They can include Pappenheimer bodies. (D) Signup and view all the answers

What is the significance of finding macrocytosis along with hyperchromasia?

Is associated with megaloblastic anemia or splenectomy (A) Signup and view all the answers

Which condition does NOT typically lead to increased erythropoiesis?

Chronic kidney disease (C) Signup and view all the answers

Which of the following is a characteristic of spherocytosis?

Deformed shape resembling spheres (B) Signup and view all the answers

Which type of malaria is associated with Plasmodium falciparum?

Malignant Tertian malaria (A) Signup and view all the answers

What feature is characteristic of Plasmodium ovale?

Schuffner’s dot (A) Signup and view all the answers

In grading of hypochromia, what does a grade of 2+ indicate?

Central pallor is 2/3 of the cell diameter (A) Signup and view all the answers

What condition is associated with hyperplasia of red blood cells?

Polycythemia (B) Signup and view all the answers

What percentage of red cells must be polychromatophilic to receive a grade of 3+?

10% (C) Signup and view all the answers

What is the significance of Maurer’s dots?

They are associated with Plasmodium falciparum (D) Signup and view all the answers

Which species of Plasmodium is considered benign?

Plasmodium ovale (A) Signup and view all the answers

What indicates a condition of 4+ in grading hypochromia?

Thin rim of hemoglobin (B) Signup and view all the answers

Study Notes

Red Blood Cell (RBC) Variations

Variations in RBC include size, shape, hemoglobin content, presence of inclusion bodies, and distribution in blood smears.
Elliptocyte (Ovalocyte): Cigar to egg-shaped, caused by defects in red cell membrane proteins. Associated conditions: Hereditary Elliptocytosis, Megaloblastic anemia, Thalassemia.

Normal Red Blood Cell Characteristics

Erythrocytes measure 6-8 micrometers in diameter (average 7.5 μm).
Thickness ranges from 1.5-2.5 micrometers (average 2 μm).
Shape is round and biconcave, known as discocyte, with salmon pink coloration and central pallor.

Types of Abnormal RBC Morphology

Codocyte (Target Cell): Bull's-eye appearance, associated with liver disease, hemoglobinopathies, Thalassemia.
Anisocytosis: Increased variation in RBC size.
Microcytic RBC: Smaller than normal, linked to iron deficiency anemia and thalassemia.
Macrocytic RBC: Larger than normal, often due to defects in nuclear maturation, seen in Megaloblastic anemia.
Echinocyte (Crenated Cell): Regular spicules; changes in osmotic pressure, associated with liver disease.
Drepanocyte (Sickle Cell): Crescent-shaped; results from hemoglobin S polymerization, associated with hemoglobinopathies.

Specific RBC Shapes

Spherocyte: Lacks central pallor; caused by spectrin deficiency, associated with hereditary spherocytosis and G6PD deficiency.
Dacryocyte (Teardrop Cell): Pear-shaped, seen in primary myelofibrosis and thalassemia.
Stomatocyte (Mouth Cell): Slit-like central pallor, caused by osmotic changes and associated with Rh null, alcoholism.
Hyperchromasia: Deeply stained RBCs with abnormal thickness, observed in macrocytosis and megaloblastic anemia.

Erythrocyte Inclusion Bodies

Basophilic Stippling: Aggregated RNA within red cells, visualized by Wright and supravital stains, associated with lead poisoning and severe anemia.
Cabot Rings: Found in hemolytic and megaloblastic anemia.
Pappenheimer Bodies: Dark-staining iron particles, aggregates of mitochondria and ribosomes, associated with hemoglobinopathies.

Nucleated RBCs

Indicate bone marrow stimulation or increased erythropoiesis; associated with hemolytic anemias and myeloproliferative disorders.

Alterations in RBC Distribution

Rouleaux Formation: Stacking of RBCs.
Agglutination: Clumping of RBCs.

Parasitic Inclusions in Erythrocytes

Plasmodium falciparum: Malignant tertian malaria, normal size with Maurer’s dots.
Plasmodium ovale: Benign tertian malaria, normal to slightly enlarged, with Schuffer’s dots.
Plasmodium vivax: Benign tertian malaria, enlarged RBCs with Schuffner’s dots.
Plasmodium malariae: Quartan malaria, normal size with Ziemann’s dots.

Grading of Hypochromia

1+: Area of central pallor is ½ diameter of the cell.
2+: Central pallor is 2/3 of cell diameter.
3+: Central pallor is ¾ of cell diameter.
4+: Thin rim of hemoglobin.

Grading of Polychromasia

1+: 3% of red cells are polychromatophilic.
2+: 5%.
3+: 10%.
4+: >11%.

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Description

This quiz focuses on the morphology of red blood cells, specifically variations from the normal, such as elliptocytes or ovalocytes. Understanding these variations is crucial for students in the Bachelor of Science in Medical Laboratory Science course. Dive into the details and test your knowledge on this important topic.