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Questions and Answers
What morphology is associated with red blood cells that are larger than the nucleus of a small lymphocyte?
What morphology is associated with red blood cells that are larger than the nucleus of a small lymphocyte?
Which type of red blood cell is characterized by its spherical shape and lack of central pallor?
Which type of red blood cell is characterized by its spherical shape and lack of central pallor?
Poikilocytosis refers to what aspect of red blood cells?
Poikilocytosis refers to what aspect of red blood cells?
What condition is associated with teardrop-shaped red blood cells?
What condition is associated with teardrop-shaped red blood cells?
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Which type of red blood cell is identified by having short, regularly spaced projections?
Which type of red blood cell is identified by having short, regularly spaced projections?
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What is a distinguishing characteristic of monocytes regarding their nucleus?
What is a distinguishing characteristic of monocytes regarding their nucleus?
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What is the typical size range of platelets?
What is the typical size range of platelets?
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What feature is common in the cytoplasm of monocytes?
What feature is common in the cytoplasm of monocytes?
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What can be inferred about giant platelets?
What can be inferred about giant platelets?
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What is a key difference between normal and abnormal platelets?
What is a key difference between normal and abnormal platelets?
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What morphological characteristic is most commonly associated with reactive lymphocytes?
What morphological characteristic is most commonly associated with reactive lymphocytes?
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Which type of lymphocyte is associated with viral infections and has a morphology characterized by abundant cytoplasm with prominent granules?
Which type of lymphocyte is associated with viral infections and has a morphology characterized by abundant cytoplasm with prominent granules?
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Which lymphocyte morphology is indicative of pertussis (whooping cough) in children?
Which lymphocyte morphology is indicative of pertussis (whooping cough) in children?
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What is the primary site of monocyte maturation?
What is the primary site of monocyte maturation?
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What is the main function of plasma cells in the immune response?
What is the main function of plasma cells in the immune response?
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Reactive lymphocytes are most commonly associated with which type of infections?
Reactive lymphocytes are most commonly associated with which type of infections?
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Which feature is NOT typical of plasma cells?
Which feature is NOT typical of plasma cells?
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What occurs when lymphocytes are activated by contact with antigens?
What occurs when lymphocytes are activated by contact with antigens?
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What is the size range of mature eosinophils?
What is the size range of mature eosinophils?
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What characterizes the cytoplasm of mature neutrophils?
What characterizes the cytoplasm of mature neutrophils?
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Which features are common to both basophils and eosinophils?
Which features are common to both basophils and eosinophils?
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What is a known effect of bacterial infections on neutrophils?
What is a known effect of bacterial infections on neutrophils?
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What are the aggregations of ribosomes that result in darkly staining inclusions known as?
What are the aggregations of ribosomes that result in darkly staining inclusions known as?
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Which characteristic is NOT true for basophils?
Which characteristic is NOT true for basophils?
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What causes variations in the appearance of granulocytes?
What causes variations in the appearance of granulocytes?
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Which of the following inclusion bodies are composed of denatured hemoglobin?
Which of the following inclusion bodies are composed of denatured hemoglobin?
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What type of inclusions are presented as dark purple, dense, round structures often associated with patients who have had their spleens removed?
What type of inclusions are presented as dark purple, dense, round structures often associated with patients who have had their spleens removed?
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What can be observed in the morphology of malaria parasites?
What can be observed in the morphology of malaria parasites?
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What is NOT a characteristic of a mature neutrophil's nucleus?
What is NOT a characteristic of a mature neutrophil's nucleus?
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Which inclusions are considered small, dark blue, irregularly shaped granules that may cluster together?
Which inclusions are considered small, dark blue, irregularly shaped granules that may cluster together?
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Which erythrocyte inclusion is characterized by uniformly distributed dark blue granules?
Which erythrocyte inclusion is characterized by uniformly distributed dark blue granules?
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In which condition may Heinz bodies typically be visualized?
In which condition may Heinz bodies typically be visualized?
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Which inclusion may indicate a history of splenectomy when observed in erythrocytes?
Which inclusion may indicate a history of splenectomy when observed in erythrocytes?
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What type of stains are Heinz bodies usually visualized with?
What type of stains are Heinz bodies usually visualized with?
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What is the characteristic morphology of schistocytes?
What is the characteristic morphology of schistocytes?
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In which condition are acanthocytes primarily seen?
In which condition are acanthocytes primarily seen?
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What is the morphology of elliptocytes?
What is the morphology of elliptocytes?
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Sickle cells are characterized by which of the following shapes?
Sickle cells are characterized by which of the following shapes?
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Target cells are known to exhibit which unique morphological feature?
Target cells are known to exhibit which unique morphological feature?
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Which condition is associated with the presence of schistocytes?
Which condition is associated with the presence of schistocytes?
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What type of inclusions are observed in erythrocytes when stained?
What type of inclusions are observed in erythrocytes when stained?
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Which of the following describes acanthocytes?
Which of the following describes acanthocytes?
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Study Notes
Red Blood Cell Variations
- Erythrocytes contain hemoglobin, staining pink on Wright's smears.
- The degree of central pallor in erythrocytes suggests their hemoglobin content.
- Automated instrument indices are the best method for determining erythrocyte hemoglobin content.
Normochromic
- Morphology: Erythrocytes have a central pallor not exceeding one-third of the cell's diameter.
- Comment: Normochromic red blood cells are typical in healthy patients.
Hypochromic Red Blood Cells
- Morphology: Erythrocytes have a central pallor greater than one-third of the cell's diameter.
- Comment: These cells are often seen in iron deficiency anemia.
Variation in Size (Anisocytosis)
- Anisocytosis describes variations in red blood cell size.
- This variation is seen in iron deficiency anemia, megaloblastic anemia, and burn patients.
- Terms for variation in size include normocytic, microcytic, and macrocytic.
Normocytic Red Blood Cells
- Morphology: Erythrocytes are approximately the same size as a small lymphocyte's nucleus.
- Comment: Normocytic red blood cells are present in healthy individuals.
Microcytic Red Blood Cells
- Morphology: Erythrocytes are smaller than the nucleus of a small lymphocyte.
- Comment: These cells can be seen in iron deficiency anemia and thalassemia.
Macrocytic Red Blood Cells
- Morphology: Erythrocytes are larger than the nucleus of a small lymphocyte.
- Comment: These cells are commonly associated with vitamin B12 or folate deficiency anemia.
Variation in Shape (Poikilocytosis)
- Poikilocytosis describes variations in red blood cell shape.
- It can be observed in sickle cell anemia, severe iron deficiency anemia, and burn patients.
- Inherited blood disorders like HS, HE, HPP, and Southeast Asian ovalocytosis can also present with poikilocytosis.
Spherocytes
- Morphology: Spherical, intensely stained red blood cells without central pallor.
- Comment: Spherocytes are common in hereditary spherocytosis and immune hemolytic anemias.
Tear Drop Cells (Dacrocytes)
- Morphology: Tear-drop shaped red blood cells.
- Comment: These are often observed due to marrow replacement by fibrosis or malignancy.
Burr Cells (Echinocytes)
- Morphology: Red blood cells with regularly spaced, short projections.
- Comment: Burr cells are associated with uremia, typically seen in chronic renal disease.
Stomatocytes
- Morphology: Red blood cells with a rod-shaped central pallor.
- Comment: These cells are observed in liver disease and acute alcoholism.
Schistocytes (Keratocytes)
- Morphology: Irregularly shaped red blood cell fragments, often with pointed ends.
- Comment: Seen in disseminated intravascular coagulation and thrombotic thrombocytopenic purpura.
Acanthocytes (Spur Cells)
- Morphology: Red blood cells with multiple, irregularly spaced, blunt projections of varying sizes.
- Comment: Observed in abetalipoproteinemia and severe liver disease.
Elliptocytes
- Morphology: Oval or elliptical red blood cells.
- Comment: Typically found in hereditary elliptocytosis and various anemias.
Sickle Cells (Drepanocytes)
- Morphology: Long, narrow, curved red blood cells with a point on at least one end.
- Comment: Characteristic of sickle cell anemia.
Target Cells (Codocytes)
- Morphology: Alternating rings of pallor and dense staining resembling a target.
- Comment: Seen in thalassemia and liver disease.
Red Blood Cell Inclusions
- Inclusions in red blood cells stain red to dark purple on Wright-stained smears.
- These inclusions can be nuclear remnants, iron particles, RNA, or intracellular parasites, varying in appearance based on their composition.
Basophilic Stippling
- Morphology: Uniformly distributed dark blue granules.
- Comment: Basophilic stippling is the result of darkly stained ribosome aggregates. Seen in thalassemia, lead poisoning, and sideroblastic anemia.
Howell-Jolly Bodies
- Morphology: Dark purple, dense, round inclusions with distinct borders.
- Comment: Howell-Jolly bodies are nuclear remnants and are often seen in patients who have had their spleens removed.
Pappenheimer Bodies
- Morphology: Small, dark blue, irregularly shaped granules, often clustered.
- Comment: Composed of iron. Observed in several conditions, including sideroblastic anemia and following splenectomy.
Heinz Bodies
- Morphology: Round bodies within red blood cells (observed using supravital stains).
- Comment: These are composed of denatured hemoglobin. Frequently seen in patients with G6PD deficiency or unstable hemoglobin disorders.
Malaria Parasites
- Morphology: Malaria ring forms are seen intracellularly.
- Comment: Malaria is a parasitic disease caused by different Plasmodium species.
Neutrophil (Mature)
- Size: 10-15 microns in diameter.
- Nucleus: 3-5 lobes connected by thin filaments, coarse chromatin, no nucleoli.
- Cytoplasm: Pale pink, fine pink/purple granules.
Eosinophil (Mature)
- Size: 10-15 microns in diameter
- Nucleus: 2-3 lobes, very coarse chromatin, no nucleoli
- Cytoplasm: Abundant, red-orange granules
Basophil
- Size: 10-15 microns in diameter.
- Nucleus: 2-3 lobes, very coarse chromatin, no nucleoli
- Cytoplasm: Dark blue-black granules, often overlying the nucleus, some granule stain loss is common.
Granulocytes Variations
- Variations in granulocyte appearance can stem from maturation defects, inflammation, or infections.
- Maturation defects are often due to genetic or metabolic disorders.
- Bacterial infections can induce toxic changes in neutrophils.
Hyposegmentation
- Morphology: Granulocytes with one or two poorly segmented nuclear lobes.
- Comment: Hyposegmented neutrophils are seen in conditions such as Pelger-Huët anomaly and myelodysplastic syndrome.
Hypersegmentation
- Morphology: Neutrophils with six or more nuclear segments.
- Comment: Hypersegmented neutrophils are frequently observed in vitamin B12 or folate deficiency anemia.
Auer Rods
- Morphology: Pink, rod-shaped inclusions in myeloblast cytoplasm.
- Comment: Auer rods may be present in myeloblasts from patients with acute myeloid leukemia.
Toxic Granulation
- Morphology: Neutrophils with increased dark granules in the cytoplasm.
- Comment: Toxic granulation is associated with severe bacterial infections.
Toxic Vacuolation
- Morphology: Round, clear spaces within granulocyte cytoplasm
- Comment: Toxic vacuolation in neutrophils is commonly found in patients with severe bacterial infections.
Döhle Bodies
- Morphology: Pale blue, irregularly shaped inclusions in neutrophil cytoplasm.
- Comment: Consists of ribosomes and/or rough endoplasmic reticulum. Observed in severe bacterial infections.
Lymphocytes Variations
- The majority of lymphocytes reside in extravascular sites (e.g., lymph nodes, gastrointestinal tract, spleen).
- Antigen stimulation prompts morphological changes in lymphocytes.
- Specific morphological changes correlate with the lymphocyte function
Reactive Lymphocyte
- Morphology: Lymphocytes with abundant cytoplasm that may be indented by surrounding red blood cells.
- Comment: Reactive lymphocytes, also known as atypical lymphocytes, are associated with viral infections.
Large Granular Lymphocyte
- Morphology: Lymphocytes having abundant cytoplasm with prominent granules.
- Comment: Large granular lymphocytes can indicate viral infection or neutropenia.
Cleaved Lymphocytes
- Morphology: Lymphocytes exhibiting large nuclear clefts.
- Comment: Cleaved lymphocytes are linked to pertussis (whooping cough) in children.
Plasma Cells
- Morphology: Blue cytoplasm, eccentric nucleus with prominent perinuclear clearing.
- Comment: Plasma cells are rarely found in peripheral blood except in cases of severe inflammation or end-stage multiple myeloma.
Monocytes
- Bone marrow is the primary site for monocyte maturation.
- Majority of monocytes reside in tissues as macrophages.
- Monocytes migrate to tissues through the peripheral blood.
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Key Features:
- Size: 12–24 microns in diameter.
- Nucleus: Folded or indented, sieve-like chromatin, no nucleoli.
- Cytoplasm: Abundant, gray-blue, vacuoles commonly present, few granules possible.
Platelets (Mature)
- Shape: Round or oval.
- Size: 1.5–4 microns in diameter.
- Nucleus: Absent.
- Cytoplasm: Pale blue, purple granules.
Platelet Variations
- Platelets vary slightly in shape, size, and staining characteristics.
- Normal and abnormal platelets often show substantial morphological differences.
- Morphologically abnormal platelets usually correlate with disease states.
Large Platelets
- Morphology: Platelets larger than a typical red blood cell.
- Comment: Associated with conditions prompting increased platelet production.
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Description
This quiz delves into the characteristics and variations of red blood cells, including normochromic and hypochromic types, as well as anisocytosis. It focuses on the morphology and hemoglobin content indicators important for diagnosing conditions like anemia. Test your understanding of erythrocytes and their significance in hematology.
