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17 Cards in this Set
- Front
- Back
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Biconcave RBC
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NORMAL!!
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Spherocytes
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Hereditary Spherocytosis; Autoimmune Hemolytic Anemia
Differentiate between two: if all spherocytes, then it is HS. Also, pigment stones and early cholecystectomies are signs of HS. Fever is common for AIHA |
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Elliptocytes
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Hereditary Elliptocytosis
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Macro-ovalocyte
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Megaloblastic Anemia (B12 or Folate Deficiency). B12 has neuro symptoms. Also look for HYPERSEGMENTED NEUTROPHILS.
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Helmet cells/Schistocyte
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DIC, TTP/HUS, Trauma.
Schistocytes are a sign of intravascular hemolysis due to mechanical trauma. DIC - look for D-dimers or other signs of clots as well as signs of bleeding (purpura, etc.) TTP - ADAMTS13 problem leads to thrombocytopenia because vWF not cleaved correctly and platelets are picked up and cause microangiopathic thromboses. HUS - think E. coli O157:H7 in right clinical context. |
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Sickle Cell
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Sickle cell DISEASE (not trait). HbS high in blood. Low oxygen tension causes sickling; Autosomal Recessive disease valine for glutamic acid in aa6 in B globin chain. confers partial malarial resistance. Ass'd with autosplenectomy by age 20 or so. Painful or vaso-occlusive crisis is ass'd with Sickle cell. Tx: hydroxyurea
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Bite Cell/Blister Cell
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G6PD. X-linked disease (boys); ass'd with oxidative stress, partially protective against malaria. Causes hemoglobinemia/hemoglobinuria. Key words: Mediterranean (greek or italian) and Fava Beans. (sulfonamides - heavy loads can cause episodes as well)
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Teardrop cells
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Myelofibrosis. Anemia, neutropenia, but not normally thrombocytopenia.
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Acanthocyte (spur cell)
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Spiny appearance in Liver Disease and Abetalipoproteinemia.
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Target Cell
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HbC disease, Aspleia, Liver Disease, Thalassemia: Mnemonic: HALT = Target cell
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Burr Cell
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TTP/HUS
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Basophilic Stippling
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Iron Deficiency, Lead poisoning, Thalassemias, Anemia of Chronic Disease; Mnemonic: TAIL
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Differential diagnosis: Microcytic Anemia
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Iron Deficiency Anemia; Thalassemia; Anemia of Chronic Disease.
Use Iron studies to help differentiate (p. 332) |
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Differential Diagnosis: Normocytic Anemia
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Disorders of Hemoglobin Synthesis: Acute Hemorrhage or Hemolysis
Hemolysis: Intracorpuscular: Membrane, Enzyme Deficiency, Hemoglobinopathies Membrane: HS, PNH Enzyme Deficiency: G6PD & PK Hemoglobinopathies: Sickle Cell Extracorpuscular: Immune or Non-Immune Immune: Autoimmune Hemolytic Anemia (AIHA) or Cold Agglutinin Dz Non-Immune: Trauma, microangiopathy, Toxins, Drugs |
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Differential Diagnosis: Macrocytic Anemia
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Due to Abnormalities in DNA synthesis.
Megaloblastic Anemia --> B12 or Folate (folate more common). Diff. by MMA (B12 high, not in folate) and neuro symptoms (B12). Drugs (sulfa, phenytoin, AZT); or simple reticulocytosis |
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Heinz Bodies
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Denatured hemoglobin in G6PD and alpha Thalassemia due to oxidation of iron to Fe3+ forms.
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Howell-Jolly Bodies
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Basophilic nuclear remnants found in RBCs. Seen in patients with asplenia, autosplenectomy, or surgical splenectomy.
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