Clinical Laboratory Science:
Hematology
Anemia - ANSWER 1. Iron Deficiency Anemia
2. Thalassemia
3. Vitamin B12/Folate deficiency (Pernicious Anemia)
4. Lead Poisoning
5. Sideroblastic Anemia
Anemia:
Iron Deficiency Anemia - ANSWER * Microcytic
* Hypochromic red blood cells with anisocytosis & platelet increase
Anemia:
Lead Poisoning - ANSWER * Coarse basophilic stippling
* Lead ingestion
Anemia:
Sideroblastic Anemia - ANSWER * Dimorphic population of red blood cells
* Anisocytosis
* Poikilocytosis
* Abnormalities in the heme synthetic pathways
* Genetically abnormal
* Vitamin B6 deficiency
Anemia:
Thalassemia - ANSWER * Poikilocytosis
* Target cells
* Nucleated red blood cells
* Decreased globin production
* Common in Mediterranean, Southeast-Asian, and African descent
Anemia:
Vitamin B12/Folate Deficiency (Pernicious Anemia) - ANSWER * Oval macrocytes
* Anisocytosis
* Poikilocytosis
* Hypersegmented neutrophils
,Clinical Laboratory Science:
Hematology
* Decreased platelets
* Patients with poor nutrition or undergoing chemotherapy
Anisocytosis - ANSWER 1. Normocyte
2. Microcyte
3. Macrocyte
Anisocytosis:
Macrocyte - ANSWER * Larger than the nucleus of a small lymphhocyte
* Vitamin B12 deficiency
* Folate deficiency
Anisocytosis:
Microcyte - ANSWER * Smaller than the nucleus of a small lymphocyte
* Iron Deficiency Anemia
* Thalassemia
Anisocytosis:
Normocyte - ANSWER * Approximately the same size as the nucleus of a small lymphocyte
* Seen in healthy patients
Artifacts - ANSWER 1. Stain precipitate
2. Water artifact
3. Crenated red cells
4. Smudge cells (Basket cells)
5. Platelet satellitism
6. Platelet aggregates
7. Platelet superimposition
8. Degenerated nucleus
Artifacts:
Crenated red cells - ANSWER * red blood cells with regularly spaced projections on their
surface
* formed from EDTA-anticoagulated blood over time
Artifacts:
, Clinical Laboratory Science:
Hematology
Degenerated nucleus - ANSWER * dark purple nucleus with round lobes, homogenous
chromatin, w/o nuclear filaments
* mostly found in neutrophils from aged specimens
Artifacts:
Platelet aggregates - ANSWER * clumped platelets
* improper collection or poorly anticoagulated blood
Artifacts:
Platelet satellitism - ANSWER * 4 or more platelets touching the membrane of a neutrophil
* formed from EDTA-anticoagulated blood
Artifacts:
Platelet superimposition - ANSWER * platelet overlying a red blood cell often surrounded
with a halo
* mistaken for red blood cell inclusion
Artifacts:
Smudge cells (Basket cells) - ANSWER * ruptured WBC smeared during slide preparation
* disruption of fragile cells commonly seen in Chronic Lymphocytic Leukemias
Artifacts:
Stain precipitate - ANSWER * dark blue granules or filaments in between or on top of blood
cells
* re-dissolve by re-staining for 10 seconds with Wright's stain & rinsing with distilled water
Artifacts:
Water artifact - ANSWER * refractile areas within red blood cells
* slow drying in a humid environment
* water contamination of Wright's stain
Erythrocyte Maturation Sequence - ANSWER 1. Pronormoblast (Rubriblast)
2. Basophilic Normoblast
3. Polychromatophilic Normoblast
4. Orthochromic Normoblast
5. Polychromatophilic Red Cells
6. Erythrocyte
Hematology
Anemia - ANSWER 1. Iron Deficiency Anemia
2. Thalassemia
3. Vitamin B12/Folate deficiency (Pernicious Anemia)
4. Lead Poisoning
5. Sideroblastic Anemia
Anemia:
Iron Deficiency Anemia - ANSWER * Microcytic
* Hypochromic red blood cells with anisocytosis & platelet increase
Anemia:
Lead Poisoning - ANSWER * Coarse basophilic stippling
* Lead ingestion
Anemia:
Sideroblastic Anemia - ANSWER * Dimorphic population of red blood cells
* Anisocytosis
* Poikilocytosis
* Abnormalities in the heme synthetic pathways
* Genetically abnormal
* Vitamin B6 deficiency
Anemia:
Thalassemia - ANSWER * Poikilocytosis
* Target cells
* Nucleated red blood cells
* Decreased globin production
* Common in Mediterranean, Southeast-Asian, and African descent
Anemia:
Vitamin B12/Folate Deficiency (Pernicious Anemia) - ANSWER * Oval macrocytes
* Anisocytosis
* Poikilocytosis
* Hypersegmented neutrophils
,Clinical Laboratory Science:
Hematology
* Decreased platelets
* Patients with poor nutrition or undergoing chemotherapy
Anisocytosis - ANSWER 1. Normocyte
2. Microcyte
3. Macrocyte
Anisocytosis:
Macrocyte - ANSWER * Larger than the nucleus of a small lymphhocyte
* Vitamin B12 deficiency
* Folate deficiency
Anisocytosis:
Microcyte - ANSWER * Smaller than the nucleus of a small lymphocyte
* Iron Deficiency Anemia
* Thalassemia
Anisocytosis:
Normocyte - ANSWER * Approximately the same size as the nucleus of a small lymphocyte
* Seen in healthy patients
Artifacts - ANSWER 1. Stain precipitate
2. Water artifact
3. Crenated red cells
4. Smudge cells (Basket cells)
5. Platelet satellitism
6. Platelet aggregates
7. Platelet superimposition
8. Degenerated nucleus
Artifacts:
Crenated red cells - ANSWER * red blood cells with regularly spaced projections on their
surface
* formed from EDTA-anticoagulated blood over time
Artifacts:
, Clinical Laboratory Science:
Hematology
Degenerated nucleus - ANSWER * dark purple nucleus with round lobes, homogenous
chromatin, w/o nuclear filaments
* mostly found in neutrophils from aged specimens
Artifacts:
Platelet aggregates - ANSWER * clumped platelets
* improper collection or poorly anticoagulated blood
Artifacts:
Platelet satellitism - ANSWER * 4 or more platelets touching the membrane of a neutrophil
* formed from EDTA-anticoagulated blood
Artifacts:
Platelet superimposition - ANSWER * platelet overlying a red blood cell often surrounded
with a halo
* mistaken for red blood cell inclusion
Artifacts:
Smudge cells (Basket cells) - ANSWER * ruptured WBC smeared during slide preparation
* disruption of fragile cells commonly seen in Chronic Lymphocytic Leukemias
Artifacts:
Stain precipitate - ANSWER * dark blue granules or filaments in between or on top of blood
cells
* re-dissolve by re-staining for 10 seconds with Wright's stain & rinsing with distilled water
Artifacts:
Water artifact - ANSWER * refractile areas within red blood cells
* slow drying in a humid environment
* water contamination of Wright's stain
Erythrocyte Maturation Sequence - ANSWER 1. Pronormoblast (Rubriblast)
2. Basophilic Normoblast
3. Polychromatophilic Normoblast
4. Orthochromic Normoblast
5. Polychromatophilic Red Cells
6. Erythrocyte
