RBC indices
The laboratory report on a patient is as follows:
MCV : 55 fl
MCHC: 25%
MCH : 17 pg
How would you classify the RBC seen on peripheral smear ?
Microcytic , Hypochromic
All of the following are characteristics of
megaloblastic anemia except:
A. Pancytopenia
B. Elevated reticulocyte count
C. Hypersegmented neutrophils
D. Macrocytic erythrocyte indices
B
patients have a decreased reticulocyte count because although body is making more RBCs they are being destroyed before circulation ( ineffective erythropoiesis)
Key WBC seen in Macrocytic anemia ?
Hypersegmented neutrophil
what term describes the bluish tinge of the immature erythrocytes (reticulocytes) circulating in the peripheral blood?
Polychromasia
Which Leukemia is most associated with DIC
What is the MCHC if the HCT is 20% , the RBC is 2.4 X 10^6/uL , AND Hgb is 5 g/dl ?
25g/dl
5x100 / 20
The first lab test to change in iron deficiency anemia
Serum Ferritin decreases
All of the following are characteristic findings in a
patient with iron deficiency anemia except:
A. Microcytic, hypochromic red cell morphology
B. Decreased serum iron and ferritin levels
C. Decreased total iron-binding capacity (TIBC)
D. Increased RBC protoporphyrin
C
TIBC increases ( therefore Transferrin increases ) bodies way of compensating trying to "pick up" more iron.
What RBC morphology is associated with Myelofiboris?
Tear drop cells / Dacrocytes
Basophils are often increased in what Leukemia ?
CML
Which RBC indices is abnormal in Hereditary spherocytosis ? Is it abnormally high or low ?
MCHC - High
In hereditary spherocytosis, the MCHC (the average concentration of hemoglobin in a red blood cell) is elevated, often exceeding 35.5 g/dL. This is due to the increased concentration of hemoglobin in the spherical red blood cells.
Which of the hemoglobin electrophoresis patterns in image #2 is consistent with B-Thalassemia major ?
C
a type of macrocytic anemia with impaired absorption of vitamin B12 due to decreased intrinsic factor
Pernicious anemia
What RBC morphology is associated with Rh null phenotype ?
Stomatocytes
Which disease is most associated with the Philadelphia Chromosome.. What translocation takes place in the Philadelphia chromosome?
CML
Translocation of chromosomes 22 and 9 resulting in
A fusion gene, This fusion gene produces an abnormal protein called BCR-ABL1
Mean cell volume (MCV) is calculated using what formula?
(Hct ÷ RBC) × 10
Results from deletions in one or more of the 4 alpha genes (HBA) on Ch 16
alpha thalassemia - results in unstable hgb depending on the # of gene deletions..
1 gene- silent carrier
2 genes - alpha thalassemia minor
3 genes - hgb H disease
4 genes - 100% Barts Hgb
Barts hgb= 4 gamma chains
H hgb = 4 beta chains
PNH ( Paroxysmal Nocturnal Hemoglobinuria) can cause a N/N anemia due to hemolysis of red blood cells when the patient is sleeping resulting in chronic intravascular hemolysis followed by hemoglobinuria after sleeping. We can use flow cytometry to diagnosis this by looking for?
Absence of CD55 and CD59
What RBC inclusion consists of nuclear remnants containing DNA found in
Howell Jolly Bodies
Name the cell seen in image #1 and what Leukemia it typically seen in
Smudge cell - CLL
The malignant cells in CLL are more fragile than normal lymphocytes and in smear preparation produce "Smudge cells "
General term to describe increased RBCs, Hgb and Hct (>53%)
Polycythemia
Group of rare inherited or acquired disorders of defective synthesis of Hgb due to disruption of the enzymes regulating Hgb synthesis
Sideroblastic anemia
results in increased sideroblasts in bone marrow
decreased osmotic fragility test would be
associated with which of the following conditions?
A. Sickle cell anemia
B. Hereditary spherocytosis
C. Hemolytic disease of the newborn
D. Acquired hemolytic anemia
Sickle cell anemia
make sure you know this.. decreases in sickle cell or when target cells present
increased in spherocytosis
The red blood cell inclusions often seen in G6PD deficiency as well as unstable hemoglobinopathies , which is denatured or precipitated Hgb?
What type of stain can you see these with ?
Heinz Bodies
A supravital stain, such as brilliant green, crystal violet, or new methylene blue
What is the cell seen in picture #3 and what does it indicate?
Reed Sternberg cell- Hodgkins Lymphoma