Those RBC look weird
Randomness
Case in point
You look pale
Test me
100
Result of excess membrane cholesterol and phospholipids with decreased cellular hemoglobin.
Found in abnormal Hgb syntheses, thalassemia, sickle cell anemia, and liver disease
What is a Target cell (Codocyte)
100
4 Metabolic pathways used by RBC's
What are Embden-Meyerhof, Pentose-monophosphate shunt, methemoglobin reductse, luebering rapopport pathways?
100
An 81-year-old man had a previous history of heart arrhythmia but was otherwise in good health. He reported feeling fatigued lately and unable to complete his daily walk. Following review of the initial results, the patient was treated. Results repeated after 6 weeks of treatment showed no change. A bone marrow aspiration showed hypercellularity and dyserythropoiesis with a mild increase in stored iron. There was also an abundance of ringed sideroblasts at all stages of erythrocyte maturation.
What is sideroblastic anemia?
100
MCV = 55 fL
What is Iron deficiency anemia?
Microcytic, hypochromic cells, target cells
100
Used to diagnose pernicious anemia (PA)
What is the schillings test?
200
Result of polymerization of Hgb
What is a Drepanocyte (sickle cell)
200
Hemolytic anemia caused by a deficiency of an enzyme necessary in the pentose-monophosphate shunt.
What is G6PD (glucose-6-phosphate dehydrogenase) deficiency anemia?
200
•A patient with a traumatic motor vehicle injury was brought to the emergency room, after having “lost a lot of blood” at the scene. His initial blood work showed a hemoglobin of 140 g/L and a hematocrit of 0.470 L/L. His bleeding was controlled in surgery and he was stabilized with intravenous fluids.
•Eight hours later, all blood work was repeated, at which time his hemoglobin was 92 g/L and his hematocrit was 0.270 L/L.
What is acute post hemorrhagic anemia?
200
Normo, Normo, Pancytopenia
Increases serum Fe and EPO
Decreased TIBC
Retic may be 0
What is Aplastic anemia?
200
test performed to aid in the diagnosis of different types of hemolytic anemia and is the most sensitive test for the presence of spherocytes.
What is the osmotic fragility test?
300
Caused by a membrane defect and high intracellular sodium, may be seen as artifact
What is a Stomatocyte
300
RBC's showing marked thermal sensitivity caused by mutant/deficient alpha or beta spectrin weakening the cell skeleton.
Seen in infancy and treated with a splenectomy
What is hereditary pryopoikilocytosis?
300
•A 63-year-old male, with a 20 year history of diabetes, reported a recent weight loss of 27 pounds. His tongue was red and fissured. On neurologic examination he had decreased vibratory sensation and his thyroid was enlarged. His CBC results were:
•WBC 5.0 x 109/L Chemistry results were:
•RBC 2.9 x 1012/L Serum B12 50 pg/ml (200 – 900)
•Hgb 101 g/L Serum folate 10 ng/ml (2 – 16)
•Hct 0.31 L/L
•PLT 173 x 109/L Schilling test without intrinsic factor 1% excretion
•RDW 14.3% Schilling test with intrinsic factor 8%
IF blocking antibody test Positive
What is Pernicious anemia (B12 deficiency)?
300
Polychromasia, shistocytes of various kinds
Decreased Hgb, Hp (haptoglobin)
Increased Bilirubin, LD, Creatinine
What are microangiopathic hemolytic anemias (MAHA)?
What is Hemolytic uremic syndrome (HUS)?
300
Ham's test and sugar water test are two tests used to diagnose this
What is paroxysmal nocturnal hemoglobinuria (PHN)?
400
Spherical bodies of denatured or precipitated Hgb that are attached to and distort the membrane.
Very is size and may be single or multiple
Found in G6PD deficiency.
What are Heinze bodies?
400
group of disorders characterized by an elevated hematocrit
What are polycythemias?
400
•A 38-year-old woman came into the family practice clinic because of weakness and shortness of breath of two months duration. It was noted during the patient interview, that she had a 15-year history of seizures, which were controlled by Dilantin. Results of the physical exam revealed pallor but no enlargement of the lymph nodes or spleen.
•Initial laboratory data:
•WBC 5.2 x 109/L Serum iron 156 ug/dL (55 – 160)
•RBC 1.52 x 1012/L TIBC 324 ug/dL (230 – 400)
•Hgb 62 g/L Serum folate 0.4 ng/ml (2 – 16)
•Hct 0.18 L/L Serum B12 465 pg/ml (200 – 900)
•PLT 132 x 109/L LDH 532 IU/L (100 –225)
What is Folic acid deficiency megaloblastic anemia (drug related)?
400
Macrocytic, normochromic, Ovalocytes, dacrocytes, shistocytes. May see HJ bodies, Pap bodies, and basophilic stippling,
Pancytopenia
What is Megaloblastic anemia (pernicious anemia and folate deficiency)?
400
A test to detect intravascular hemolysis.
uses spectroscopy to determine significant levels of methemalbumin in the blood.
What is the Schumm's test?
500
Remnant of mitotic spindle, very rarely seen.
Found in megaloblastic anemia, thalassemia, myelodysplastic syndrome.
Important not to confuse with Malaria
What are Cabot rings?
500
Over production of the formed elements
What is panmyelosis?
500
•A 70-year-old female visited the Opthamologist complaining of itchy eyes. She was prescribed an antihistamine, but the condition worsened. Her family doctor then noticed her complexion was purple and referred her to an Internist. Blood work revealed the following:
•WBC: 18.0 X 109/L
•RBC: 9.04 X 1012/L
•PLT: 506 X 109/L
•Hgb: 208 g/L
•Hct: 0.640 L/L
•RDW: Normal
•Indices: Normal
•Therapeutic phlebotomy was ordered, with 4 units of blood being removed over the next 10 days. Her hgb and hct were both slightly reduced, while her platelet count rose to 615 x 109/L. Therapeutic phlebotomy was continued for 2 more months, and then radioactive phosphorus was given. Four months later, her hgb and hct were within the reference range.
What is polycythemia rubra vera?
500
Round macrocytes, normochromic, increased polychromasia, codocytes, echino and acanthocytes
Increased bilirubin
What is non-megaloblastic anemia (liver disease)?
500
A qualitative test for PK (Pyruvate kinase) deficiency and G6PD deficiency, but gives opposite results
What is fluorescent spot test?