Blood Cell Identification Quiz

Matured in the thymus, under the direction of thymocins

Lymphocyte

Produced from megakaryocytes in the red bone marrow

Basophils

First responders

Neutrophils

Considered macrophages when in the tissue

Monocyte

Hct formula

(RBC x MVC) / 10

MCH (Mean Cell Hemoglobin) Formula

(Hgb x 10) / RBC

MCHC (Mean Cell Hemoglobin Concentration) Formula

(Hgb x 10) / RBC

MCV (Mean Cell Volume) Formula

(Hct x 10) / RBC

Microcytic MCV

< 80

Normocytic MCV

80 - 100

Macrocytic MCV

>100

Hypochromic MCHC

<32

3 part counts…

lymphocytes, monocytes, granulocytes

5 part counts..

neutrophils, lymphocytes, monocytes, eosinophils, basophils

Absolute Lymphocyte Count Formula

(WBC x % of lymphocytes) / 100

• WBC = 5 × 10⁹ / L; lymphocytes = 30%

  • 5.0 × 0.30 = 1.5 × 10⁹ / L

Retic % Formula

(# retics / 1000 RBCs) x 100

Corrected Retic % Formula

Retic % x (Patient Hct / 45%)

• Retic 3.5; Hct = 26

  • 3.5 x (26/45) = 2.0%

RPI Formula

Retic count in % x (Hct / 45%) / Maturation Time

• Retic = 7.8; Hct = 30%; Maturation Time for 30% is 2 days

• RPI = 7.8 x (30/45) / 2 → 2.6

  • Adequate bone marrow reponse: RPI > 3

1 day maturation time

40-45

1.5 day maturation time

35-39

2 day maturation time

25-34

2.5 day maturation time

15-24

3 day maturation time

<15

Abosolute Retic Count

(Retic % x RBC count) / 100

Actives site of bone marrow

vertebrase, sternum, pelvis, ribs, skill, proximal femur/humerus

Asplenia

absence or non-functioning spleen → increased infection risk, presence of abnormal RBCs (Howell-Jolly bodies)

Primary Lymphoid organs

Bone marrow (B cell), Thymus (T cells)

Secondary lymphoid organs

Lymph nodes, spleen, MALT

Wright stain

general morphology, differential count

Prussian blue stain

iron

Normal M:E ratio

Myeloid to erythroid ratio

2:1 to 4:1

Erythropoiesis steps

Pronormoblast, Basophilic normoblast, Polychromatic normoblast, Orthocrhomic normoblast, Reticulocyte, Mature RBC (erythrocyte)

• Please Bring Purple Oranges Right Eway

Myelopoiesis steps

Myeloblast, Promyelocyte, Myelocyte, Metamyelocyte, Band, Segmented neutrophil

• My Poor Mother Made Bad Soup

Where is EPI produced?

Kidneys

Function: stimulates erythroid progenitor cell proliferation.differentiation in bone marrow in reponse to hypoxia

Lipids precent

40% - maintains fluiditiy/flexibility

• phospholipids, cholesterol

Proteins precent

50 % - structual integrity and transport-

• Spectrin, ankyrin, band 3, glycophorins

Carbohydrates precent

10% - blood group antigens, surface charge

• glycoprotiens

Embden-Meyerhof (glycolysis)

ATP production

Hexose monophophate shunt (H6PD)

procudes NADPH, reduces glutathione (GSH) to prevent oxidative damage

Rapaport-Luebering Shunt

produces 2,3-BPG, regluates oxygen release

Methemoglobin reducatase pathway

Kepps iron in Fe2+ state

Burr cells (Echinocytes)

Even projections

Stomatocytes

slit-like central pallor

Target Cells (Condocytes)

bullseye

Acanthocytes

Irregular projections

Spherocytes

No central pallor (suppose to have dark membrane and pale inside)

Elliptocytes

Oval

Schistocytes

fragments

Sickle Cell

crescent

Teardrop Cells

Teardrop

Anisocytosis

Size variation

Poikilocytosis

Shape variation

Hypochromic Cells

pale centers of >3um

Hypochromic grading

• 1+ area of central pallor is ½ of the cell diameter

• 2+ area of pallor is 2/3 of cell diameter

• 3+ area of pallor is ¾ of cell diamter

  • 4+ Thin thin of hemoglobin (most cell is pale)

Microcytes

Small RBCs (<6)

Macrocytes

Large RBCs (> 8,5)

Pappenheimer Bodies

Iron granules

Howell-Jolly Bodies

DNA remants

Basophilic stippling

RNA remnants

Heinz Bodies

Denatured Hgb (only viisble with supravital stain)

Polychromatic Cells

Blusish tint

First reaction and last reaction of heme synthesis

First: Succinyl-Coa + Glycine → ALA

Last: Insertion of Fe2+ into protoporphyrin IX → heme

Grower 1

2 zeta, 2 epsilon

embryo

Grower 2

2 alpha, 2 epsilon

embryo

Portland

2 zeta, 2 gamma

Embryo

HbF

2 alpha, 2 gamma

Fetal

HbA

2 alpha, 2 beta

Adult (96-98%)

HbA2

2 alpha, 2 delta

Adult (2-3%)

HbA normal

96-98%

HbA2 normal

2-3%

HbF normal

<1%

P50

Partial pressure of O2 where Hb is 50% saturated

Normal: 26-27 mmHg

Increased P50 leads to

↓ affinity (right shift)

Right shift

(↓ affinity): ↑ CO₂, ↓ pH, ↑ 2,3-BPG, ↑ temp

Left shift

(↑ affinity): ↓ CO₂, ↑ pH, ↓ 2,3-BPG, ↓ temp

Carboxyhemoglobin

CO bound to Hb → cherry red color

Methemoglobin

Fe3+ → cannot bind to O2

Sulfhemoglobin

irreversible sulfur binding → cyanosis

Normal hemoglobin for Male

13.5 - 17.5 g/dL

Normal Hemoglobin females

12 - 16 g/dL

Fragmentation

• intravascular

• Mechanical trauma

  • ↑ LDH, ↓ haptoglobin, hemoglobinemia, schistocytes

Macrophage-mediated

• Extravascular

• Splenic/liver macrophages

  • Sphereocytes, inc bilirubin, splenomegaly

Condocytes

Target cells

Drepanocytes

Sickle cell

Dacryocytes

Tear drop cells