HEMA P3 PRACTICALS

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A. Spherocytes

B.

  • Hereditary Spherocytosis

  • Immune Hemolytic Anemia

  • Extensive Burns

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1

A. Spherocytes

B.

  • Hereditary Spherocytosis

  • Immune Hemolytic Anemia

  • Extensive Burns

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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2

A. Burr Cell

B.

  • Uremia

  • Pyruvate Kinase Deficiency

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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3

A. Elliptocytes / Ovalocytes

B.

  • Hereditary Elliptocytosis / Ovalocytosis

  • Iron deficiency anemia

  • Thalassemia Major

  • Myelophthisic anemias

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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4

A. Stomatocytes

B.

  • Hereditary Stomatocytosis

  • Rh Deficiency Syndrome

  • Acquired Stomatocytosis (liver disease, alcoholism)

  • Artifacts

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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5

A. Sickle Cells

B.

  • Sickle Cell Anemia

  • Sickle cell-b-thalassemia

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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6

A. Hb C Crystals

B. Hb C disease

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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7

A. Hb SC crystals

B. Hb SC disease

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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8

A. Target Cells (Codocytes)

B.

  • Liver disease

  • Hemoglobinopathies

  • Thalassemia

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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9

A. Schistocytes (Schizocytes)

B.

  • Microangiopathic hemolytic anemia

  • Macroangiopathic hemolytic anemia

  • Extensive burns

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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10

A. Helmet cells (Keratocytes)

B. Same as schistocyte

  • Microangiopathic hemolytic anemia

  • Macroangiopathic hemolytic anemia

  • Extensive burns

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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11

A, Acanthocytes (Spur cells)

B.

  • Severe liver disease (Spur cell anemia)

  • Neuroacanthocytosis (Abetalipoproteinemia, McLeod syndrome)

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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12

A. Teardrop Cells (Dacryocytes)

B.

  • Primary Myelofibrosis

  • Myelophthisic Anemia

  • Thalassemia

  • Megaloblastic Anemia

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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13

A. Diffuse basophilia

B.

  • Hemolytic Anemia

  • After treatment for iron, vitamin B12, or folate deficiency

C. RNA

A. Identify the cell
B. Identify the disease / condition
C. Composition of Inclusion

<p>A. Identify the cell<br>B. Identify the disease / condition<br>C. Composition of Inclusion</p>
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14

A. Basophilic stipplings

B.

  • Lead Poisoning

  • Thalassemias

  • Hemoglobinopathies

  • Megaloblastic anemia

  • Myelodysplastic syndromes

C. Precipitated RNA

A. Identify the cell
B. Identify the disease / condition
C. Composition of Inclusion

<p>A. Identify the cell<br>B. Identify the disease / condition<br>C. Composition of Inclusion</p>
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15

A. Howell-Jolly Bodies

B.

  • Hyposplenism

  • Postsplenectomy

  • Megaloblastic anemia

  • Hemolytic anemia

  • Thalassemia

  • Myelodysplastic syndromes

C. DNA (Nuclear fragments)

A. Identify the cell
B. Identify the disease / condition
C. Composition of Inclusion

<p>A. Identify the cell<br>B. Identify the disease / condition<br>C. Composition of Inclusion</p>
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16

A. Heinz Bodies

B.

  • Glucose-6-phosphate dehydrogenase deficiency

  • Unstable hemoglobins

  • Oxidant drugs / chemicals

C. Denatured hemoglobin

A. Identify the cell
B. Identify the disease / condition
C. Composition of Inclusion

<p>A. Identify the cell<br>B. Identify the disease / condition<br>C. Composition of Inclusion</p>
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17

A. Pappenheimer bodies

B.

  • Sideroblastic anemia

  • Hemoglobinopathies

  • Thalassemias

  • Megaloblastic anemia

  • Myelodysplastic syndromes

  • Hyposplenism

  • Postsplenectomy

C. Iron

A. Identify the cell
B. Identify the disease / condition
C. Composition of Inclusion

<p>A. Identify the cell<br>B. Identify the disease / condition<br>C. Composition of Inclusion</p>
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18

A. Cabot rings

B.

  • Megaloblastic anemia

  • Myelodysplastic syndromes

C. Remnant of mitotic spindle

A. Identify the cell
B. Identify the disease / condition
C. Composition of Inclusion

<p>A. Identify the cell<br>B. Identify the disease / condition<br>C. Composition of Inclusion</p>
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19

A. Hb H

B. Hb H disease

C. Precipitated β-globin chains of hemoglobin

A. Identify the cell
B. Identify the disease / condition
C. Composition of Inclusion

<p>A. Identify the cell<br>B. Identify the disease / condition<br>C. Composition of Inclusion</p>
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20

A. Ringed Sideroblasts

B. Sideroblastic anemia

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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21

A. Hypersegmented neutrophils and oval macrocytes

B. Megaloblastic anemia

A. Identify the cell
B. Identify the disease / condition

<p>A. Identify the cell<br>B. Identify the disease / condition</p>
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22

A. Aplastic anemia

B.

  • Idiopathic acquired aplastic anemia

  • Secondary acquired aplastic anemia

A. Identify the disease / Condition

B. What are the two major categories of this condition?

<p>A. Identify the disease / Condition </p><p>B. What are the two major categories of this condition?</p>
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23

A. Pure Red Cell Aplasia

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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24

A. Myelophthisic anemia (presence of tear drop cells)

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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25

A. Congenital Dyserythropoetic Anemia

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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26

A. Hereditary spherocytosis

B. Ankyrin and Spectrin

A. Identify the disease / Condition

B. The most common mutated proteins are those that code for ______ and ______

<p>A. Identify the disease / Condition </p><p>B. The most common mutated proteins are those that code for ______ and ______</p>
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27

A. Hereditary Elliptocytosis

B.

  • SPTA1

  • SPTB

  • EPB41

A. Identify the disease / Condition

B. What are the defective genes? (3)

<p>A. Identify the disease / Condition </p><p>B. What are the defective genes? (3)</p>
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28

A. Hereditary Pyropoikilocytosis

B. TRUE

A. Identify the disease / Condition

B. TRUE OR FALSE.
This is now considered as a severe form of HE

<p>A. Identify the disease / Condition </p><p>B. TRUE OR FALSE. <br>This is now considered as a severe form of HE</p>
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29

A. Overhydrated Hereditary Stomatocytosis
and Dehydrated Hereditary Stomatocytosis

B. RHAG Gene (Overhydrated); 16q23-24 (dehydrated)

A. Identify the disease / Condition

B. This has been linked with mutations in the __________

<p>A. Identify the disease / Condition </p><p>B. This has been linked with mutations in the __________</p>
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30

A. Spur Cell Anemia

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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31

A. Glucose-6-Phosphate Dehydrogenase Deficiency

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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32

A. Pyruvate Kinase Deficiency

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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33

A. Thrombocytopenic Purpura (presence of schistocytes)

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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34

A.

  • Idiopathic TTP

  • Secondary TTP

  • Inherited TTP (aka Upshaw-Schulman syndrome)

B. Von willebrand factor cleaving protease known as ADAMTS-13

A. What are three 3 classifications?

B. This is a deficiency in?

<p>A. What are three 3 classifications? </p><p>B. This is a deficiency in?</p>
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35

A. Traumatic Cardiac Hemolytic Anemia

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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36

A. Malaria

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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37

A. BABESIOSIS

A. Identify the disease / condition

<p>A. Identify the disease / condition</p>
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38
<p>A. Hyposegmented Neutrophils</p><p>B. Pelger-Huet Anomaly</p>

A. Hyposegmented Neutrophils

B. Pelger-Huet Anomaly

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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39

A. Hypersegmented Neutrophils

B. Megaloblastic Anemia

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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40

A. Auer Rods

B. Acute Myelogenous Leukemia

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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41

A. Dohle Bodies

B.

  • Food poisoining

  • Infections

  • Following chemotherapy

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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42

A. Atypical Lymphocytes

B.

  • Cytomegalovirus

  • Drugs

  • Epstein-Barr virus (infectious mononucleosis)

  • Syphilis

  • Toxoplasmosis

  • Viral hepatitis

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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43

A. Chediak-Higashi granules

B. Chediak-Higashi syndrome

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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44

A. Alder-Reilly granules

B.

  • Alder-Reilly anomaly

  • Mucopolysaccharidoses (Hurler’s)

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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45

A. Toxic Granules / Vacuoles

B.

  • Infections

  • Burns

  • Malignancy

  • Chemical poisoning

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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46

A. Smudge cells / Basket cells

B. Chronic Lymphocytic Leukemia

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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47

A. LE Cells

B. Lupus Erythematosus

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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48

A. Hairy Cells

B. Hairy Cell Leukemia

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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49

A. Sezary Cells

B.

  • Sezary syndrome

  • Mycosis Fungoides

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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50

A. Grape cells / Mott cells

B.

  • Multiple myeloma

  • Reactive states of lymphocytes

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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51

A. Hodgkin’s Lymphoma

B. Reed-Sternberg cell

C. Owl’s Eye Appearance

A. Identify the abnormality / cell

B. This is seen in what condition / disease

C. What is the appearance?

<p>A. Identify the abnormality / cell </p><p>B. This is seen in what condition / disease </p><p>C. What is the appearance?</p>
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52

A. Flame Cells

B. Multiple Myeloma

A. Identify the abnormality / cell

B. This is seen in what condition / disease

<p>A. Identify the abnormality / cell</p><p>B. This is seen in what condition / disease</p>
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53

Essential Thrombocytopenia

A. Identify the disease / Condition

<p>A. Identify the disease / Condition</p>
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54

A. Gaucher Cells

B. Gaucher Disease

C. β-glucocerebrosidase

A. Identify the cell
B. Identify the disease / condition
C. Enzyme deficient

<p>A. Identify the cell<br>B. Identify the disease / condition<br>C. Enzyme deficient</p>
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55

A. Niemann-Pick cells

B. Niemann-Pick disease

C. Sphingomyelinase

A. Identify the cell
B. Identify the disease / condition
C. Enzyme deficient

<p>A. Identify the cell<br>B. Identify the disease / condition<br>C. Enzyme deficient</p>
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56

Anisocytosis

- Hemolytic Anemia
- Megaloblastic Anemia
- Iron deficiency Anemia

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Abnormal variation in RBC volume or diameter Parameter: RDW (Normal: 11.6-14.6); 20% increased

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57

Macrocyte

- Megaloblastic anemia
- Myelodysplastic syndromes
- Chronic liver disease
- Bone marrow failure
- Reticulocytosis

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Large RBC (>8 mm in diameter) MCV: >100 fL

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58

Oval Macrocyte

Megaloblastic Anemia

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Large oval RBC

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59

Microcyte

- Anemia of chronic inflammation
- Sideroblastic anemia
- Thalassemia / Hb E disease and trait

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Small RBC (< 6 um in diameter)
MCV: < 80 fL

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60

Poikilocytosis

- Severe anemia; certain shapes helpful diagnostically

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Abnormal variation in RBC shape

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61

Spherocytes

- Hereditary spherocytosis
- Immune hemolytic anemia
- Extensive burns (along with schistocytes)

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Small, round, dense RBC with no central pallor

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62

Elliptocyte / Ovalocyte

- Hereditary elliptocytosis or ovalocytosis
- Iron deficiency anemia
- Thalassemia major
- Myelophthisic anemias

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Elliptical (cigar-shaped), oval (egg-shaped) RBC

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63

Stomatocytes

- Hereditary stomatocytosis
- Rh deficiency syndrome
- Acquired stomatocytosis (liver disease, alcoholism) - Artifact

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
RBC with slit-like area of central pallor

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64

Sickle cells

- Sickle cell anemia
- Sickle cell-β-thalassemia

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Thin, dense, elongated RBC pointed at each end; may be curved

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65

Hb C crystals

Hb C disease

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Hexagonal crystal of dense hemoglobin formed within the RBC membrane

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66

Hb SC crystals

Hb C disease

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Finger-like or quartz-like crystal of dense hemoglobin protruding from the RBC membrane

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67

Target cells (Codocytes)

- Liver disease
- Hemoglobinopathies
- Thalassemia

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
RBC with hemoglobin concentrated in the center and around the periphery resembling a target

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68

Schistocytes (Schizocytes)

- Microangiopathic hemolytic anemia* (along with microspherocytes)
- Macroangiopathic hemolytic anemia
- Extensive burns (along with microspherocytes)

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Fragmented RBC caused by rupture in the peripheral circulation

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69

Helmet cells (Keratocytes)

- Microangiopathic hemolytic anemia* (along with microspherocytes)
- Macroangiopathic hemolytic anemia
- Extensive burns (along with microspherocytes)

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
RBC fragment in shape of a helmet

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70

Folded cell

- Hb C disease
- Hb SC disease

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
RBC with membrane folded over

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71

Acanthocytes (Spur cells)

- Severe liver disease (spur cell anemia)
- Neuroacanthocytosis (abetalipoproteinemia, McLeod syndrome)

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
Small, dense RBC with few irregularly spaced projections of varying length

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72

Burr cells (Echinocytes)

- Uremia
- Pyruvate kinase deficiency

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
RBC with blunt or pointed, short projections that are usually evenly spaced over the surface of cell; present in all fields of blood film but in variable numbers per field

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73

Teardrop cells (Dacryocytes)

- Primary myelofibrosis
- Myelophthisic anemia
- Thalassemia
- Megaloblastic anemia

RBC Abnormality: ?
Commonly Associated Disease: ?

Cell Description:
RBC with a single pointed extension resembling a teardrop or pear

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74

Diffuse Basophilia

RNA

Hemolytic anemia after treatment for iron, vitamin B12, or folate deficiency

Inclusion: ?
Composition: ?
Associated Diseases: ?

Appearance in Supravital Stain:
Dark blue granules and filaments in cytoplasm (seen in reticulocytes)

Appearance in Wright Stain:
Bluish tinge throughout cytoplasm; also called polychromasia (seen in polychromatic erythrocytes)

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75

Basophilic Stippling

Precipitated RNA

- Lead poisoning
- Thalassemias
- Hemoglobinopathies
- Megaloblastic anemia
- Myelodysplastic syndromes

Inclusion: ?
Composition: ?
Associated Diseases: ?

Appearance in Supravital and Wright Stain:
Dark blue-purple, fine or coarse punctate granules distributed throughout cytoplasm

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76

Howell-Jolly Bodies

DNA (Nuclear Fragments)

- Hyposplenism
- Postsplenectomy
- Megaloblastic anemia
- Hemolytic anemia
- Thalassemia
- Myelodysplastic syndromes

Inclusion: ?
Composition: ?
Associated Diseases: ?

Appearance in Supravital and Wright Stain:
Dark blue-purple dense, round granule; usually one per cell; occasionally multiple

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77

Heinz Bodies

Denatured Hemoglobin

- G6PD Deficiency
- Unstable hemoglobins
- Oxidant drugs/chemicals

Inclusion: ?
Composition: ?
Associated Diseases: ?

Appearance in Supravital Stain:
Round, dark blue-purple granule attached to inner RBC membrane

Appearance in Wright Stain:
Not visible

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78

Pappenheimer Bodies

Iron

- Sideroblastic anemia
- Hemoglobinopathies
- Thalassemias
- Megaloblastic anemia
- Myelodysplastic syndromes
- Hyposplenism
- Postsplenectomy

Inclusion: ?
Composition: ?
Associated Diseases: ?

Appearance in Supravital and Wright Stain:
Irregular clusters of small, light to dark blue granules, often near periphery of cell

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79

Cabot Rings

Precipitated β-globin chains of hemoglobin

Hb H disease

Inclusion: ?
Composition: ?
Associated Diseases: ?

Appearance in Supravital Stain:
Rings or figure-eights

Appearance in Wright Stain:
Blue rings or figure-eights

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