Quiz sobre Stomatocytes e Acanthocytes
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Questions and Answers

Quo es le condition medical caracterisate per cellulas sanguinee appellent stomatocytes?

  • Ictere
  • Anemia ferrosa
  • Leucemia cronica
  • Stomatcytosis (correct)

    • Quale de iste condiciones es associate con un alto consumo de alcool acute?

  • Anemia megaloblastica
  • Thrombocytopenia
  • Stomatcytosis (correct)
  • Leucemia

    • Quale phenotype es caracterisate per un deficiency total de antigenos Rh?

  • Rh null (correct)
  • Rh positivo
  • Rh transiente
  • Rh negativo

    • Quale de iste condiciones es un tipo de cancer hematologic?

    <p>Leucemia acute</p> Signup and view all the answers

    Quale de estas affermazione super stomatcytosis es falsa?

    <p>Le presenza de stomatocytes es diagnostic per le leucemia.</p> Signup and view all the answers

    Qual es le forma de Auer rods?

    <p>Simile a cigar</p> Signup and view all the answers

    In qual tipo de cellulas sono trovate Auer rods?

    <p>Blast cells</p> Signup and view all the answers

    In qual condition medical Auer rods pote esser detectate?

    <p>Leucemia Myeloblastic Acute</p> Signup and view all the answers

    Qual color le Auer rods typicamente ha post un colorante?

    <p>Reddish purple</p> Signup and view all the answers

    Qual cells non contine Auer rods?

    <p>Lymphoblasts</p> Signup and view all the answers

    Quo es le forma de un acanthocyte?

    <p>Normal o reducite con spicules uneven</p> Signup and view all the answers

    In qual conditiones se trovan acanthocytes?

    <p>Abetalipoproteinemia congenitale e deficiencia de LCAT</p> Signup and view all the answers

    Qual es le ratio de MCHC in acanthocytes?

    <p>In le range normale</p> Signup and view all the answers

    Quo es un caracteristic importante de acanthocytes?

    <p>Contenente excessive de colesterol</p> Signup and view all the answers

    Que es le aspecte physic de le spicules de un acanthocyte?

    <p>Blunt e uneven</p> Signup and view all the answers

    In qual conditiones se encuentra celulas a forma de goccia (teardrop cells)?

    <p>Mieloma multiple</p> Signup and view all the answers

    Qual es un exemplo de condition que non se relaciona con celulas a forma de goccia?

    <p>Leucemia linfatica</p> Signup and view all the answers

    Que tipo de celulas es descrite como 'teardrop cells'?

    <p>Celulas deformate</p> Signup and view all the answers

    Qual es un condition associate con IDA?

    <p>Anemia ferropenica</p> Signup and view all the answers

    In qual type de sangre se trovano teardrop cells?

    <p>Sangre periferica</p> Signup and view all the answers

    Quae assertiones es correcte sur le granules azurophiles?

    <p>Le granules azurophiles resemble a granulation toxico in neutrophiles.</p> Signup and view all the answers

    Qual es le function de neutrophiles in le presente contexto?

    <p>Ili functiona normalemente.</p> Signup and view all the answers

    Qui pote esser un misconception commun riguardante le granules azurophiles?

    <p>Ili pote apparer in omnes leukocytes.</p> Signup and view all the answers

    Le qualitas de granules azurophiles es importante pro comprender:

    <p>Le function normales de neutrophiles.</p> Signup and view all the answers

    Quae de le suivante non es ver sobre le granules azurophiles?

    <p>Ili indica un dysfunction in neutrophiles.</p> Signup and view all the answers

    Quale cellula es indicate per le sagitta in le imagine 5-23?

    <p>Cellula bite</p> Signup and view all the answers

    Quo se refere al 'Howell–Jolly body' mostrato in le imagine 5-28?

    <p>Un residuo nucleare in cellula sanguinea</p> Signup and view all the answers

    Le quale figura menciona un 'bite cell'?

    <p>Figura 5-23</p> Signup and view all the answers

    Quo indica un 'Howell–Jolly body' in un examina sanguine?

    <p>Splenectomia recente</p> Signup and view all the answers

    Quale de istos es un artefacto observabile in le sanguine?

    <p>Cellula bite</p> Signup and view all the answers

    Study Notes

    Evaluation of Red Cell Morphology & Introduction to Platelets & White Cell Morphology

    • This chapter covers the evaluation of red blood cell (RBC), platelet, and white blood cell (WBC) morphology.
    • Objectives: The objectives include discussions about hematology stains, identifying normal RBC morphology, defining anisocytosis and poikilocytosis, and correlating RBC indices with morphology.
    • Peripheral Blood Smear: A peripheral blood smear is used to detect abnormalities in blood cells. The purpose is to detect or confirm abnormalities and provide information for a differential diagnosis.
    • Hematology Stains: Wright's stain, a nonvital polychrome stain, is commonly used Peripheral blood smears. It contains methylene blue (basic dye), eosin (acidic dye), and methanol fixative. Staining only begins when a phosphate buffer (with a pH between 6.4 and 6.8) is added.
    • Nonvital Monochrome Stain: Perl's test (Prussian blue stain) is an example, used to visualize iron granules in red blood cells (RBCs).
    • Supravital Monochrome Stain: Used to stain specific parts of living cells, without fixation. New methylene blue and neutral red are used to stain specific cellular components.
    • Examination of Blood Smear: Various stages are used in the examination of a blood smear. This includes a low power scan (10x), high power scan (40x), and oil immersion examination (100x). Each stage has unique objectives.

    Hematology Stain Types

    • Nonvital (dead cell) polychrome stain (Romanowsky):
    • Most common stain used for routine peripheral blood smears.
    • Nonvital monochrome stain:
    • Stains specific cellular components. Prussian blue (Perl's Test) is an example.
    • Supravital (living cell) monochrome stain:
    • Used to stain cellular components without fixing.

    Examination of Blood Smear Stages

    • Low Power Scan (10x): Determine staining quality, blood cell distribution, and locate areas with clumps or abnormal cells. Identify the optimal area for examination and enumeration.
    • High Power Scan (40x): Determine WBC estimate, counting WBCs in 10 fields—averaged to per mm³.
    • Oil Immersion Examination (100x): Perform 100 WBC differential count. Evaluate RBCs, including anisocytosis, poikilocytosis, hypochromia, polychromasia, and inclusions. Perform platelet estimates.

    Assessment Question

    • A 19-year-old male patient presented with joint pain, fever, fatigue, and cough. Laboratory results included: WBC 21.0 x 10⁹/L, RBC 3.23 x 10¹²/L, Hb 9.6 g/dL, and PLT 252 x 10⁹/L. A differential count indicated: 17 band neutrophils; 75 segmented neutrophils; 5 lymphocytes; 2 monocytes; 1 eosinophil; and 26 NRBCs.

    Normal Red Blood Cells (RBCs)

    • RBC dimensions: 6-8 µm x 1.5-2 µm.
    • Volume: 80-100 fL.
    • Central pallor: 2-3µm.
    • Size variation in normal patients: ~5%.
    • Appearance on Wright-stained film: reddish-orange, biconcave disc shape.

    Assessment of Red Cell Abnormality

    • When checking for abnormal RBC morphology, consider whether the abnormality is seen in every field. Assess size (anisocytosis) and shape (poikilocytosis).
    • Consider the red blood cell indices and RDW.
    • Take into account the percentage of abnormal cells in 10 fields of vision.

    Variations in Red Cell Distribution & Agglutination

    • Normal distribution: cells are dispersed.
    • Agglutination: In the patient's plasma with cold agglutinins occurs, as well as in cold hemoglobinuria, etc., RBCs appear in stacks. Saline does not disperse.

    Variations in RBC Size, Anisocytosis and Macrocytes

    • Size: ≥9 µm.
    • MCV: >100 fL
    • Mechanism of macrocytosis: Impaired DNA synthesis, accelerated erythropoiesis, and increased membrane cholesterol & lecithin.
    • Evaluation points: shape (round vs. oval), pallor, and presence of inclusions.

    Variations in RBC Size, Microcytes and Ovalocytosis

    • Size: <7µm; MCV=<80fL
    • Mechanism: Impaired Hb synthesis (ineffective iron utilization, decreased or defctive globin synthesis).
    • Characteristics: Shape (round or oval), pallor, presence of inclusions.

    Variations in RBC Shape, Polychromasia, Poikilocytosis

    • Evaluation of red blood cell shape and inclusions, and how these help determine the presence of abnormal conditions.

    Variations in RBC Shape, Sickle Cells (Drepanocytes)

    • Rigid, inflexible cells formed by Hb polymerization.
    • Varying shapes, most are reversible.
    • Irreversible cells are 10% with a pointed projection.
    • Not seen in heterozygote subjects.
    • Are seen in HbS disease or HbC, Harlem disease, or thalassemias.

    Variations in RBC Shape, Fragmented Cells (Schistocytes, Helmet Cells, Keratocytes)

    • Mechanism: Alterations in normal fluid circulation (vasculitis, prosthetic heart valves), intrinsic defects of RBCs (spherocytes, antibody-mediated RBC destruction).
    • Types include schistocytes, helmet cells, and keratocytes.

    Variations in RBC Shape, Acanthocytes (Thorn Cells, Spur Cells)

    • Normal or reduced size, 3-12 spiky projections.
    • Increase in cholesterol and decreased phospholipid ratio.
    • Found in certain conditions, including congenital abetalipoproteinemia and LCAT deficiency.

    Variations in RBC Shape, Tear Drop Cells (Dacrocytes)

    • Pear-shaped cells.
    • Mechanism of formation is unclear. Associated with certain illnesses, like multiple myeloma, idiopathic myelofibrosis, myeloid metaplasia, IDA, and thalassemia.

    RBC Inclusions, Howell-Jolly Bodies

    • Irregular dark purple or black cytoplasmic inclusions.
    • Represent nuclear remnants.
    • Seen in megaloblastic anemia, thalassemia, hemolytic anemias, splenectomy, and hyposplenia.

    RBC Inclusions, Basophilic Stippling

    • Multiple tiny, fine, or coarse inclusions in the rRNA and ribosome remnants.
    • Seen in conditions like poisoning, burns, chemotherapy, and certain anemias such as thalassemia, megaloblastic anemia, and sideroblastic anemia.

    RBC Inclusions, Siderotic Granules (Pappenheimer Bodies)

    • Small, irregular clusters along the peripheral part of RBCs.
    • Composed of non-heme iron.
    • Seen in conditions like sideroblastic anemia, hemochromatosis, hemosiderosis, sickle cell anemia, and following splenectomy.

    RBC Inclusions, Heinz Bodies (Unstable Hbs)

    • Denatured hemoglobin.
    • Appear as small, round, reddish-purple inclusions.
    • Seen in G6PD deficiency, thalassemia, and unstable hemoglobin disorders.

    RBC Inclusions, Cabot Rings

    • Round to ring-shaped inclusions.
    • Represent remnants of the mitotic spindle.
    • Seen in megaloblastic anemia and thalassemia or it can be seen following splenectomy

    RBC Inclusions, Hb H bodies

    • Denatured hemoglobin in a-thalassemia major.
    • Have golf ball appearance with supravital stain (not visible with Giemsa-Wright stain).

    RBC Inclusions, Hb SC

    • Hemoglobin SC crystals; fingerlike projection.
    • Occur when Hemoglobin SC is present.

    RBC Inclusions, Hemoglobin C Crystals

    • Condensed, rod-shaped intracellular crystals, present in hemoglobin C or SC disease.

    Platelet Morphology

    • Size: 2-4µm.
    • Shape: Discoid.
    • MPV (mean platelet volume): 6.8-10.2 fL
    • Platelet granules: Fine blue granules scattered throughout the cytoplasm.
    • Morphological changes after splenectomy.

    Examination of Platelet Morphology II

    • Increased platelet count in myeloproliferative disorders (MPD).
    • Platelets of various sizes (anisocytosis).
    • Platelets with or showing loss of granules (agranular or hypogranular).

    Examination of Platelet Morphology III & IV

    • Characteristic morphologies: Bernard-Soulier syndrome (giant platelets), grey platelet syndrome (agranular platelets).
    • Platelet clumps: EDTA as a possible cause.

    Examination of Platelets & White Blood Cell (WBC) Morphology.

    • Normal and abnormal platelet counts

    Leucocytes: Normal and Abnormal Morphology

    • Morphology of normal cells.
    • Eosinophils: 12-16 µm; bilobed nucleus; bright red-orange granules.
    • Basophils: 10-15 µm; bilobed nucleus; dark purple granules.
    • Monocytes: 12-20 µm; horseshoe or kidney-bean shaped nucleus; gray/blue cytoplasm.
    • Lymphocytes: 6-9 µm round nucleus; scant cytoplasm; light purple/bluish granules.

    Toxic Granulation

    • Dark blue-black cytoplasmic granules in neutrophils.
    • Associated with acute infections, drug poisoning, burns, vasculitis, or toxemia of pregnancy.

    Dohle Bodies

    • Small light blue cytoplasmic inclusions.
    • Associated with infections, poisoning, burns, or chemotherapy.

    Hypersegmented Neutrophils

    • Neutrophils with 5 or more lobes.
    • Seen in megaloblastic anemia, inherited anomalies, chronic infections.

    Pelger-Huet Anomaly

    • Inherited condition, neutrophils nuclei do not segment properly, with two lobes.

    Chediak-Higashi Syndrome

    • Inherited, rare, fatal disorder in children.
    • Neutrophils and other leukocytes contain large, reddish-purple granules.
    • Associated with anemia, neutropenia, and thrombocytopenia.

    Alder-Reilly Anomaly

    • Heavy, densely stained azurophilic granules in neutrophils.

    May-Hegglin Anomaly

    • Inherited disorder characterized by Dohle body-like inclusions in neutrophils and giant platelets. Associated with thrombocytopenia.

    Auer Rods

    • Rod-like cytoplasmic inclusions; reddish-purple.
    • Seen in acute myeloblastic leukemia (AML).

    Vacuolated Neutrophils

    • Clear unstained areas in cytoplasm, often associated with active phagocytosis, infections, burns, etc.

    Smudge or Basket Cells

    • Disintegrating WBCs; condensed, structureless nuclear chromatin.

    Hypogranular or Agranular Neutrophils

    • Fewer/no granules in neutrophils.
    • Seen in some myelodysplastic syndromes (MDS) and myeloid leukemias.

    LE Cells

    • Neutrophil engulfing a nucleus of another neutrophil.
    • Seen in systemic lupus erythematosus (SLE).

    Barr Bodies (Drum Stick)

    • Small, round chromatin projection attached to a neutrophil nucleus.
    • Represents the inactive X-chromosome in females.

    Erythrophagocytosis

    • Neutrophils and/or monocytes have engulfed red blood cells (RBCs).
    • A positive direct antiglobulin test (DAT) often accompanies the condition.
    • Common in cases with polyagglutinable blood components

    Effect of Storage on Blood Cell Morphology

    • Storage can cause granular changes in some leukocytes and effect RBC shape and appearance.

    Conclusion

    • Information regarding abnormal hemoglobin and variations in red blood cell and platelet morphology.
    • Relevant data is gathered for different cells of the blood and their related diseases.

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    Chapter 5 Evaluation of Cell Morphology Handout - PDF

    Description

    Este quiz explora condiciones medicales relacionadas a células sanguinee, incluyendo stomatocytes e acanthocytes. Respond le perguntas que examina le characteristics e le conditiones associato con iste tipos de cellulas. Amplia tu cognoscentia in hematologia e le implicasiones clinicos de iste phenomena.

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