Rbc Morphology/inclusions

Front 1

What is the basic structure of the RES?

Back 1

reticuloendothelial system:
-FIXED macroph/reticulum cells of primary and 2ndary lymphoid tissue
-FREE macroph/histiocytes in spleen/lymph nodes, serous cavities, etc.
-endothelial cells that line liver, 1/2 LT
-circulating monocytes of blood

Front 2

How is the Lymphatic System comprised?

Back 2

-Lmph capillaries, ducts, nodes

-lymph drains into inguin/cerv/axill nodes

-nodes trap junk, T/Bcells do their thing.

Front 3

What is special about the spleen?

Back 3

The organ w/ both RES and lymph elements.

Front 4

What is the Spleen's function?

Back 4

removes foreign particles and aged/deformed RBCs from circulation.

Front 5

How does the spleen do its job?

Back 5

when cells pass through, they have to be deformable to go through tiny spaces.

if they're not, they get trapped and removed.

If cells have inclusions spleen PITS them.
Immunological functions occur too

Front 6

What are the 2 components of the RBC membrane structure?

what is each made up of?

Back 6

a dynamic structure of
-Lipid bilayer: phospholipids, glycoproteins, proteins, cholesterol

-Skeleton: spectrin, actin, protein 4.1 and 2.1

Front 7

What is the function of the RBC membrane?

Back 7

-keep the Hemoglobin in
-critical component of CO2 transport
-its buffering ability facilitates cation passage.

Front 8

4 things that affect erythrocyte morphology:

Back 8

-genetics
-availability of building materials
-environment
-age

Front 9

What are 2 ways to have Spherocytes?

Back 9

-Decreased Surface area to Vol ratio

-Increased Volume to Surface ratio

Front 10

What does a decreased SA:Vol ratio mean?

Back 10

there is not enough membrane to make a nice dimple in the middle, so it's SPHEROCYTIC.

Front 11

4 Causes of Spherocytes w/ decr. SA:

Back 11

1. Normal splenic processing causes symmetrical membrane loss.
2. Sensitized membrane partly phatocytosed in immunologic reactions.
3. Burns
4. Impact w/ fibrin, diseased vessel wall causes loss of fragments.

Front 12

What is the problem in a spherocyte due to volume:SA ratio increase?

Back 12

there's too much inside the cell - membrane is normal, but can't hold it in, so it's a SPHEROCYTE instead of nice and dimpled.

Front 13

3 causes of Spherocytosis via too full:

Back 13

1. Hereditary Spherocytosis
2. Membrane protein abnormality - Spectrin
3. Loss of cell deformability

Front 14

what is a codocyte? two ways it can be?

Back 14

a Target Cell
-due to increased SA:V ratio, i.e., there's more membrane than innards


-due to decreased V:SA ratio, i.e., there's not enough innards

Front 15

Why would codocytes be sean? - 4 reasons

Back 15

too much membrane:
-Decreased LCAT causes too much cholesterol in membrane
-After splenectomy, the normal plucking of lipids doesn't happen anymore.
Not enough innards:
-Hemoglobinopathies
-Iron deficiency anemia

Front 16

What are hemoglobinopathies?

Back 16

problems making Hb.
Sickle cell disease, hemoglobin C disease.

Front 17

what is LCAT?

Back 17

lecithin cholesterol acyltransferase - an enzyme in liver that esterifies cholesterol.

when decreased, too much cholesterol is in RBC membranes and Codocytes are seen.

Front 18

What are Acanthocytes?
Can it be treated?
What 4 things is it seen?

Back 18

spiny cells
irreversible
seen in:
-Abetalipoproteinemia
-Post-splenectomy
-Hepatocellular liver disease
-Pyruvate kinase deficiency

Front 19

What are Echinocytes?
Are they treatable?
What 3 things are they seen in?

Back 19

Burr cells - more rounded projections.
Yes, reversible.
Seen in:
1. Uremia
2. Stomach cancer
3. Bleeding peptic ulcers

Front 20

What are Stomatocytes?
What 5 things induce them?
When are they seen? (3 things)

Back 20

Smiling cells - uniconcave slits.
Inducers:
-Chlorpromazine, antihistamine, Vitamin A or E, cationic detergents, low pH

Seen in:
-Hereditary Stomatocytosis
-Alcoholic cirrhosis
-Obstructive liver disease

Front 21

What RBC morphology might be seen in an Rh null patient?

Back 21

stomatocytes

Front 22

What are elliptocytes, what 2 things might they be seen in?

Back 22

ovalocytes - potato cells
-Hereditary ovalocytosis
-Megaloblastic anemias

Front 23

What are Schizocytes, what causes them?

3 things they're seen in:

Back 23

Fragmented cells from cardiovascular trauma, OR microspherocytes from burns
Seen in:
1. DIC - dissemntd intravascular clotting
2. Thrombotic THrombocytopenia Purpura
3. Malignant Hypertension

Front 24

what are Dacrocytes?
what are 2 causes?

Back 24

teardrop cells
-Myelofibrosis - catching on fibrin as the cell pulls away
-Pitting in the spleen - removal of inclusions. Megaloblastic anemia, thallasemia.

Front 25

what are drepanocytes?

Back 25

sickled cells

Front 26

what causes drepanocytes?
-abnormality
-conditions
is it treatable?

Back 26

abnormal Hb S - rodlike polymers, so they get stuck in capillaries.

decreased O2 or pH causes sickling.

they're reversible, but repeated sickling causes dmg to membrane.

Front 27

What are 4 artifcats that can be mistaken as abnormal morphology?

Back 27

1. too thin of area = spherocytes
2. too thin cuz you're at the edge = pointy, elongated, crowded cells.
3. Donut cells due to drying problem
4. Agglutinated cells stack, look like Rouleaux - true condition is abnormal protein levels so cells fail to repel each other.

Front 28

what are 6 RBC inclusions

what do they all stain with?

Back 28

Basophilic stippling
Howell-jolly bodies
Cabot's ring
Pappenheimer bodies
Infectious agents

-All stain with Wright's stain

Front 29

What causes basophilic stippling?
What 5 diseases is it seen in?

Back 29

Abnormal or accelerated heme synthesis.

-Lead poisoning
-Hemoglobinopathy
-Thalassemia
-Sideroblastic anemia
-Megaloblastic anemia

Front 30

What causes Howell Jolly bodies?
2 diseases they're seen in:

Back 30

Incomplete expulsion of Nucleus or necrotic chromatin.

Megaloblastic anemia
Post-splenectomy

Front 31

What is a Cabot's Ring?
What causes it?
3 diseases it's seen in:

Back 31

a ring or fig 8 that stains red-violet.

It's a microtubule! caused by abnormal mitosis.

Megaloblastic anemia
Homozygous thalassemia
Post-splenectomy

Front 32

What are Pappenheimer Bodies composed of?

Caused by?

Seen in what?

Back 32

Micelles of Iron in Swollen Mitochondrias

caused by faulty putting Iron into heme.

-Pre-leukemia
-Hemoglobinopathy
-Hemolytic anemia
-Sideroblastic anemia

Front 33

3 infectious agents that may be seen w/ wright's stain:

Back 33

-Malarial parasites
-Babesiosis
-Bartonella bacilliformis

Front 34

4 RBC inclusions that require SPECIAL stains:

Back 34

-Retics
-Siderocytes
-Heinz bodies
-Hemoglobin H bodies

Front 35

What stain is used for Retics?
Alternate?

Back 35

New Methylene Blue or
Brillian Cresyl Blue

Front 36

What is a siderocyte aka?
What stains it?

What's it composed of?

Back 36

Pappenheimer bodies
-Perl's Prussian Blue

composed of ferritin

Front 37

What are Heinz bodies?
What stains them?
When are they seen?

Back 37

Aggregates of Hb that precipitate when Heme dissociates from globin or enzyme deficiency causes Hb oxidation.

Cresyl Violet, Methyl Violet.

Seen in G6PD, Unstable Hb.

Front 38

What is a Hb H body?
What stains it?
When is it seen?

Back 38

Stippling through the RBC
Stained with Brilliant cresyl blue

Too many B globin chains because of alpha thallasemia