Hema I Lesson 3 PDF

Hema I L-III [RBC Morphology] 2. Elliptocytes - Cigar~Egg shaped Caused by RBC membrane Cell Morphology classifications deficiency; Spectrin Size (Anisocytosis) Hereditary...

Hema I L-III [RBC Morphology] 2. Elliptocytes - Cigar~Egg shaped Caused by RBC membrane Cell Morphology classifications deficiency; Spectrin Size (Anisocytosis) Hereditary Elliptocytosis, Shape (Poikilocytosis) Thalassemia Major, Hgb Variation (Anisochromia) Megaloblastic Anemia Inclusion Bodies Distribution Alteration 3. Codocytes - “Leptocytes, Target cell, Bull’s eye appearance, Mexican Hat A. Size - Anisocytosis cell, Greek helmet cells” To determine, PBS, RBC indices, RDW Centrally large + thin outer MCV - 80~100 Normal Value stain 100, macrocytic EXCESS Surface: Volume 1. Microcytic - decreased Hgb Ratio synthesis leading to mitochondrial Liver diseases, abnormality Hemoglobinopathies, Low in Iron Thalassemia ATIS - Anemia of Chronic Disease 4. Echinocytes - SPICULES (Regular) Thalassemia “Crenated” cells, Sea Iron Deficiency Anemia Urchin cell, Burr cell Sideroblastic Anemia > Artificially caused in PBS when drying 2. Macrocytic - defect in nuclear Caused by changes within maturation of RBC the osmotic pressure within = Megalobastic Anemia the cell = Vit B12, Folate deficiencies Liver disease, Uremia (high Urea; waste), Pyruvate 3. Normocytic - Normal size, kinase deficiency “Discocytes” 7.2 avg diameter, 2 avg 5. Drepanocytes - “Sickle cell” thickness - Elongated ends Biconcave, round, ⅓ central - Polymerization of Hgb S pallor, Salmon Pink color - > Caused by cell membrane alteration B. Shape - Poikilocytosis - Decreased oxygen level, 1. Spherocytes - No central pallor Blood ph: Acidic Caused by RBC membrane deficiency; Spectrin 6. Schistocyte - Fragmented RBCs DECREASED Surface: Disseminated Intravascular Volume Ratio Coagulation Hereditary Spherocytosis, Microangiopathic Hemolytic G6PD Deficiency Anemia  Uremia D. Inclusion Bodies 7. Dacryocyte - “Teardrop cell” - Pear-shaped 1. Basophilic stippling - fine/ coarse Primary Myelofibrosis granules in RBC Thalassemia -> RNA remnants Megaloblastic anemia -> Increased heme synthesis “Blueberry bagel” appearance 8. Stomatocytes - “Mouth Cells” Lead poisoning, Severe > Slit-like central pallor anemia Na+, K+ imbalance Overhydrated: increased Na [ Wright & Supravital stain ] inside the cell Dehydrated: decreased K in 2. Cabot rings - “ 8 / loop-shaped” the cell > from mitotic spindle remnants Rh-null (negative), > red/reddish purple Alcoholism, Severe liver Pernicious anemia, Lead diseases poisoning, Abnormal erythropoiesis, Histone 9. Acanthocyte - SPICULES (Uneven) biosynthesis “Thorny cell, Spur cell” - Lacks central pallor [ Wright & Supravital stain ] - INCREASED cholesterol - McLeod Syndrome 3. Heinz Bodies - denatured & - Abetalipoproteinemia precipitated Hgb - Post splenectomy > Pitted golf ball appearance G6PD deficiency, C. Hgb Variation (Color) Anisochromia Hemoglobinopathy, > To determine: MCH, MCHC Beta-thalassemia major > ⅓ central pallor = smaller: increased Hgb, larger: decreased Hgb [ Supravital stain ] Hyperchromia, Normochromia, Hypochromia 4. Howell-Jolly Bodies - DNA remnants > Accelerated/abnormal 1. Hypochromic - dominant pale, bigger erythropoiesis than 1/3cp - microcytic Hemolytic anemia, Fe Deficiency Megaloblastic anemia, Thalassemia Splenectomy Sideroblastic [ Wright & Supravital stain ] 2. Hyperchromic - Deeply stained, Abnormal thickness 5. Pappenheimer bodies - Siderotic Macrocytosis granules Spherocytosis > Aggregates of mitochondria, Megaloblastic ribosomes, & iron  [ Prussian blue / Wright Stain ] 6. Crystal > Hb C Hb H -> Polymerization from Hb A 7. Parasitic inclusions >Plasmodium falciparum - Malignant Tertian (normal RBC) Maurer’s dots >Plasmodium ovale - Benign Tertian (enlarged young RBC) Schuffner’s dots (Jame’s dots) >Plasmodium vivax - Benign Tertian (enlarged RBC) Schuffner’s dots >Plasmodium malariae - Quartan malaria (normal RBC) Zeimann’s dots >Plasmodium knowlesi - Stinton & Mulligan’s dots >Babesia microti - (normal RBC) Maltase cross “tetrad-form” > Nucleated RBC - Orthochromatic/metarubricyte (RETICS) Accelerated erythropoiesis, Myeloproliferative disorder E. Alteration in RBC Distribution 1. Rouleaux formation - stack of coins >High protein content 2. Agglutination - Clumps/ no pattern / irregular