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Questions and Answers
What condition is most likely indicated by a markedly increased MCV (more than 125 fL)?
What condition is most likely indicated by a markedly increased MCV (more than 125 fL)?
- Sideroblastic anemia
- Megaloblastic erythropoiesis (correct)
- Thalassemia
- Iron deficiency anemia
Which types of anemia are associated with the appearance of small leptocytes?
Which types of anemia are associated with the appearance of small leptocytes?
- Thalassemia and hemoglobinopathies (correct)
- Iron deficiency anemia and sideroblastic anemia
- Megaloblastic anemia and cirrhosis
- Aplastic anemia and chronic disease
How is anisocytosis defined in relation to red blood cells?
How is anisocytosis defined in relation to red blood cells?
- Variation in the white blood cell count
- Variation in hemoglobin levels among red blood cells
- Variation in size or diameter of red blood cells (correct)
- Variation in color of the red blood cells
What is a characteristic feature of macrocytes observed in megaloblastic anemia?
What is a characteristic feature of macrocytes observed in megaloblastic anemia?
Which of the following accurately describes the assessment of anisocytosis?
Which of the following accurately describes the assessment of anisocytosis?
What is the average diameter range of a normal red blood cell?
What is the average diameter range of a normal red blood cell?
What is the average volume of a normal red blood cell in femtoliters?
What is the average volume of a normal red blood cell in femtoliters?
Which structural characteristic differentiates red blood cells from small lymphocytes?
Which structural characteristic differentiates red blood cells from small lymphocytes?
What is a probable consequence if the factors maintaining the disc shape of erythrocytes are altered?
What is a probable consequence if the factors maintaining the disc shape of erythrocytes are altered?
How might excess plasma cholesterol affect red blood cells?
How might excess plasma cholesterol affect red blood cells?
What does macrocytosis refer to?
What does macrocytosis refer to?
What measurement is usually included in automated complete blood counts?
What measurement is usually included in automated complete blood counts?
In which condition is macrocytosis often debated?
In which condition is macrocytosis often debated?
What is the primary visual characteristic of acanthocytes?
What is the primary visual characteristic of acanthocytes?
What is the shape of stomatocytes when viewed in moist preparations?
What is the shape of stomatocytes when viewed in moist preparations?
Which of the following conditions is commonly associated with the presence of stomatocytes?
Which of the following conditions is commonly associated with the presence of stomatocytes?
What feature distinguishes acanthocytes from burr cells?
What feature distinguishes acanthocytes from burr cells?
What is a characteristic of hereditary stomatocytosis?
What is a characteristic of hereditary stomatocytosis?
What cellular defect is suggested to contribute to hereditary stomatocytosis?
What cellular defect is suggested to contribute to hereditary stomatocytosis?
Which of the following statements about acanthocytes is accurate?
Which of the following statements about acanthocytes is accurate?
In which scenario might you typically find a few stomatocytes in a blood film?
In which scenario might you typically find a few stomatocytes in a blood film?
What is the primary reason keratocytes do not remain in circulation for long?
What is the primary reason keratocytes do not remain in circulation for long?
Which cell shape is characteristic of dacryocytes?
Which cell shape is characteristic of dacryocytes?
What can cause intravascular hemolysis alongside shortened red cell survival?
What can cause intravascular hemolysis alongside shortened red cell survival?
What is a schistocyte?
What is a schistocyte?
Why do red cells with rigid inclusions like Heinz bodies develop a teardrop shape?
Why do red cells with rigid inclusions like Heinz bodies develop a teardrop shape?
In which condition are teardrop cells typically observed?
In which condition are teardrop cells typically observed?
What is the hallmark of hemolytic anemia secondary to red cell fragmentation?
What is the hallmark of hemolytic anemia secondary to red cell fragmentation?
Which of the following is NOT a form associated with severe trauma in erythrocytes?
Which of the following is NOT a form associated with severe trauma in erythrocytes?
Which condition is associated with the presence of dacryocytes in blood films?
Which condition is associated with the presence of dacryocytes in blood films?
What type of cells are depicted as having bizarre shapes in blood films of patients with thrombotic thrombocytopenic purpura?
What type of cells are depicted as having bizarre shapes in blood films of patients with thrombotic thrombocytopenic purpura?
Which of the following conditions is NOT associated with the presence of schistocytes?
Which of the following conditions is NOT associated with the presence of schistocytes?
In which type of blood disorder would you likely find keratocytes?
In which type of blood disorder would you likely find keratocytes?
What does the term 'codocytes' refer to in hematological evaluations?
What does the term 'codocytes' refer to in hematological evaluations?
Which term describes the irregularly spaced processes seen on schistocytes?
Which term describes the irregularly spaced processes seen on schistocytes?
What are blister cells indicative of in a blood film?
What are blister cells indicative of in a blood film?
Which of the following disorders is characterized by the presence of hemolytic cells with horn-like projections?
Which of the following disorders is characterized by the presence of hemolytic cells with horn-like projections?
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Study Notes
Red Blood Cell Size
- Normal red blood cell diameter is 7 to 8 μm.
- The average thickness is 2.5 μm.
- The average volume is 90 fL.
- The average surface area is 160 μm².
Mean Corpuscular Volume (MCV)
- MCV is a measure of red blood cell size.
- It is included in automated complete blood counts.
- Higher than normal MCV indicates macrocytosis.
- Lower than normal MCV indicates microcytosis.
Variation in Size (Anisocytosis)
- Anisocytosis is a variation in red blood cell size.
- It is estimated semi-quantitatively as slight, moderate, or marked.
Macrocytosis
- It can be caused by liver disease, excess plasma cholesterol, vitamin B12 or folate deficiency.
- In vitamin B12 or folate deficiency, macrocytes are mostly oval.
- With macrocytosis, red blood cell size increases, causing a filled appearance with less central pallor.
Microcytosis
- It may be seen in thalassemia, hemoglobinopathies such as Hb C, sideroblastic anemia, obstruction of bile ducts, and sometimes in cirrhosis and steatorrhea.
Poikilocytosis
- Poikilocytosis is a variation in red blood cell shape.
Acanthocytes
- Acanthocytes are small, densely stained red cells with pointed spicules.
- They are smaller than normal red blood cells and have a spheroidal shape.
- They may be acquired or inherited.
Stomatocytes
- Stomatocytes have an elongated or slitlike area of central pallor.
- They may be hereditary or acquired.
- They are observed in patients with alcoholism, cirrhosis, obstructive liver disease, Rh null disease.
Schistocytes
- Schistocytes are red cell fragments resulting from physical trauma in the cardiovascular system.
- They are a hallmark of hemolytic anemia secondary to red cell fragmentation.
Keratocytes
- Keratocytes are damaged red cells formed when a red cell attempts to pass between fibrin strands.
- They are fragile, do not remain in circulation for long, and are a rare phenomenon.
Dacryocytes
- Dacryocytes have a tear-drop or pear shape due to their inability to pass through the splenic sinuses.
- They are observed in myelofibrosis with myeloid metaplasia, myelophthisic anemia, pernicious anemia, β-thalassemia, drug-induced Heinz body formation, tuberculosis, and tumor metastasized to the marrow.
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