First Aid - Red Blood Cell Disorders

Front 1

Name each RBC morphology

Back 1

Left: Reticulocylte (blue hue from mitochondria)

Right: Spherocyte

Front 2

What is this and what can cause it?

Back 2

Howell-Jolly body

Basophilic nuclear reminants/framents in RBCs, which are normally removed by spleen.

Asplenic or hyposplenic patients can have these (e.g. splenectomy for sperocytosis)

Front 3

Coombs test and pneumonic

Back 3

DBICM = Don't buy inexpensive combs for Mom

Front 4

Inflammation and repair chart from Robbins

Back 4

Front 5

Function of TXA2

Back 5

Causes

vasoconstriction,

promotes platelet

aggregation

Front 6

Define anisocytosis, erythrocytosis, poikilocytosis, polycythemia

Back 6

Front 7

How do you calculate the reticulocyte index?

Back 7

Hint 7

Front 8

Platelets, including receptors

Back 8

Front 9

Leukocytes, including normal leukocyte percentages

Back 9

Front 10

What compound activates macrophages and what is its CD marker?

Back 10

Front 11

Eosinophil and causes of eosinophilia

Back 11

Front 12

Basophil and causes of basophilia

Back 12

Front 13

Mast cell

Back 13

Front 14

Dendritic cell is called what in skin?

Back 14

Langerhans cell

Front 15

Explain how to prevent hemolytic disease of the newborn (erythrolastosis fetalis)

Back 15

Front 16

Coagulation cascade components (procoagulation and antiticoagulation)

Back 16

Front 17

Platelet plug formation and thrombogenesis

Back 17

Hint 17

Front 18

Back 18

Hint 18

G6PD = Hb precipitate

Front 19

Back 19

Hint 19

Teardrop cell = dacrocyte

Target cell = Intravascular hemolysis; dehydrated RBC causes it to bleb

Front 20

Back 20

Hint 20

To see Heinz bodies, need Heinz prep

Asplenia: e.g. treatment for spherocytosis

Front 21

Anemia chart and signs and symptoms of anemia

Back 21

Hint 21

S/s: weakness, fatigue, dyspnea, pale conjunctiva and skin, headache, faintness, angina

<13.5 for men

<12.5 for women

MCV = size of RBC

Front 22

Iron deficiency anemia

Back 22

Hint 22

1/3 of World Population!

Iron absorbed in duodenum

Fe2+ absorbed more easily than Fe3+ (aside converts to Fe2+)

Increased FEP (free erythrocyte protoporphorin) associated with IDA (i.e. not found to anything)

Other causes: breast feeding; PUD; colon polyps; hookworm; colon carcinoma; celiac disease; gastrectomy

Findings include hypochromia and increased RDW

Front 23

Alpha-thalassemia

Back 23

Hint 23

decreased globin

Front 24

Beta-thalassemia

Back 24

Hint 24

decreased globin

Front 25

Lead poisoning

Back 25

Hint 25

microcytic, hypochromic anemia

Front 26

Sideroblasic anemia

Back 26

Hint 26

Decreased protoporphorin

Alcohol damages mitochondria

isoniazid causes B6 deficiency

Image: Iron trapped in mitochondria of erythroid precursors in bone marrow. Prussian-blue stain (stains Fe).

Labs:

increased ferritin

decreased TIBC

increased serum iron

increased percent saturation

Front 27

Pathophysiology of microcytic anemia (Goljan)

Back 27

Front 28

General cause of microcytic anemia

Back 28

Extra division due to decreased hemoglobin

Front 29

General cause of macrocytic anemia

Back 29

Cells fail to divide due to decreased DNA

Front 30

Macrocytic anemias

Back 30

Hint 30

1) All cells big, including RBCs and neutrophils (hyperhsegmented); enlargement of gut epithelial cells

Front 31

General:

normocytic, normochromic anemia

intravascular hemolysis

extravascular hemolysis

Back 31

Hint 31

Front 32

Nonhemolytic, normocytic anemia:

anemia of chronic disease

aplastic anemia

chronic kidney disease

Back 32

Hint 32

Front 33

Hereditary spherocytosis

Back 33

Front 34

G6PD deficiency

Back 34

Hint 34

Front 35

Pyruvate kinase deficiency

Back 35

Hint 35

Front 36

HbC defect

Paroxysmal nocturnal hemoglobinuria

Back 36

Hint 36

Front 37

Sickle cell anemia

Back 37

Hint 37

Front 38

Extrinsic hemolytic normocytic anemias

Back 38

Hint 38

1) Warm, Tx: steroids, IVIG, splenectomy

Warm causes spheroctosis b/c membrane consumed by macrophages

Direct

Baby

Indirect

Coombs

Mom

Don't

Buy

Inexpensive

Combs for

Mom

Front 39

Lab values in anemia

and

Causes of leukopenia

Back 39

Hint 39

Haptoglobin: transports "freed" hemoglobin

Hemosiderin: Iron storage complex

Transferrin made in liver

Front 40

Heme synthesis,

porphyrias, and lead

poisoning

Back 40

Front 41

Coagulation disorders: hemophilia A/B and Vitamin K deficiency

Back 41

Hint 41

Also: liver failure: decreased production of cog factors, dec. Vit K activation, follow with PT

Also: large-volume transfusions (dilution)

Front 42

Platelet disorders

Bernard-Soulier

Glanzmann thrombasthenia

Immune thrombocytopenia

Thrombotic thrombocytopenia purpura

HUS

Back 42

Hint 42

Front 43

Mixed platelet and coagulation disorders:

von Willebrand disease

DIC

Back 43

Hint 43

Front 44

Hereditary thrombosis syndromes leading to hypercoagulability:

Factor V Leiden

Prothrombin gene mutation

Antithrombin deficiency

Protein C or S deficiency

Back 44

Hint 44

Front 45

Blood transfusion therapy

Packed RBCs

Platelets

Fresh frozen plasma

Cryo

Back 45

Front 46

Back 46

Polychromasia

Front 47

Back 47

basophilic stippling

Front 48

Back 48

Peripheral blood in megaloblastic anemia showing a hypersegmented neutrophil (solid arrow) with nine lobes. Neutrophils normally have less than five nuclear segments. Hypersegmented neutrophils are excellent markers of folate and vitamin B12 deficiency. The enlarged, egg-shaped red blood cells (macro-ovalocytes; interrupted arrow) characteristic of macrocytic anemias are associated with problems in DNA maturation.

Front 49

Back 49

Bone marrow biopsy in aplastic anemia. The biopsy shows a marrow largely replaced by adipose cells. Scattered lymphocytes are present in between adipose cells.

Front 50

Back 50

Peripheral blood with sickle cells and Howell-Jolly bodies. The three dense boat-shaped sickle cells and the two cells containing a single dark, round inclusion (arrows) represent nuclear remnants. Howell-Jolly bodies in sickle cell disease indicate splenic dysfunction.

Front 51

Back 51

Peripheral blood smear in pyruvate kinase deficiency. The arrow shows one of many red blood cells with thorny projections (echinocytes) extending from the red blood cell membrane.

Front 52

Back 52

The hypergranular form of APL features faggot cells. This term is applied to these blast cells because of the presence of numerous Auer rods in the cytoplasm. The accumulation of these Auer rods gives the appearance of a bundle of sticks, from which the cells derive their name.

Front 53

Back 53

Normal morphology of eosinophil (A), basophil (B), lymphocyte (C), and monocyte (D). The cytoplasm of an eosinophil (A) is packed with reddish-orange granules that do not cover the nucleus. The cytoplasm of a basophil (B) is packed with large purplish black granules that cover the usually bilobed nucleus. The cytoplasm of a small lymphocyte (C) is scant and surrounds a nucleus that is usually round (sometimes indented) and contains condensed nuclear chromatin. The cytoplasm of a monocyte (D) is grayish blue and contains many fine azurophilic granules and one or more clear vacuoles. The nucleus is large, eccentrically located, and either round, kidney- or horseshoe-shaped (monocyte in the picture), or lobulated.

Front 54

Back 54

Peripheral blood in hairy cell leukemia. Clusters of neoplastic cells show dense chromatin and cytoplasmic projections.

Front 55

Back 55

12-13: Ringed sideroblasts in a bone marrow aspirate.

Dark blue iron granules around the nucleus of developing

normoblasts (arrows) represent iron trapped within

mitochondria and indicate a defect in mitochondrial

heme synthesis (sideroblastic anemia).