RBC Abnormalities

• What is the shape of red blood cells?

  Non-nucleated, biconcave disc-like cell
• What is the diameter of red blood cells?

  
  

  6-8 microns
• What does normocytic and normochromic mean in relation to red blood cells?

  They have normal size and color
• What is the significance of the central area of pallor in red blood cells?

  It gives the cell an extra surface area
• What are the requirements for red blood cells to survive in circulation?

  • Healthy cell membrane (proteins, lipids, carbohydrates)
  • Deformability for oxygen release
  • Sufficient hemoglobin
  • Balanced intracellular and extracellular environment
  • Adequate nutrients, especially glucose via Embden-Meyerhof Pathway
• What are the nutritional requirements for red blood cells?

  • CHON and amino acids
  • Vitamin B12, folic acid, Vitamin B6
  • Iron (Fe++)
  • Riboflavin, pantothenic acid, nicotinic acid
• What is the mean cell volume (MCV) range for normocytic red blood cells?

  80-100 fL
• What does anisocytosis refer to?

  Any variation in red cell size
• What characterizes microcytic red blood cells?

  They are smaller than 80 fL
• What are some examples of conditions associated with microcytic anemia?

  Thalassemia, iron deficiency anemia, anemia of chronic disease, sideroblastic anemia
• What characterizes macrocytic red blood cells?

  They are larger than 100 fL
• What are common causes of macrocytic anemia?

  Nutritional deficiency, liver diseases, megaloblastic states
• What gives red blood cells their color?

  Hemoglobin
• What are the normal ranges for MCH and MCHC?

  MCH: 27-32 pg, MCHC: 32-36%
• What does hypochromic mean in relation to red blood cells?

  Pale red blood cells with low hemoglobin
• What are the grading levels of hypochromasia?

  1+ Central pallor is half of cell diameter

  2+ Central pallor is two-thirds of cell diameter

  3+ Central pallor is three-fourths of cell diameter

  4+ Thin rim of hemoglobin
• What characterizes hyperchromic red blood cells?

  They do not have a pallor area and are purely red
• What is polychromasia in red blood cells?

  Variation in hemoglobin content showing a slight blue tinge
• What are the grading levels of polychromasia?

  Slight: 1%

  1+: 3%

  2+: 5%

  3+: 10%

  4+: >11%
• What is the shape of red blood cells?

  Round and discoid
• What does poikilocytosis refer to?

  Any variation in red cell shape
• What are the types of poikilocytes secondary to developmental macrocytosis?

  • Oval Macrocytes
  • Round Hypochromic Macrocytes
  • Blue-tinged Macrocytes
• What are oval macrocytes associated with?

  Folic acid deficiency, Vitamin B12 deficiency, pernicious anemia
• What are acanthocytes also known as?

  Thorn cells or spur cells
• What causes echinocytes?

  Exposure to hypertonic solution or lack of energy
• What are codocytes also known as?

  Target cells or Mexican hat cells
• What characterizes spherocytes?

  Ball-shaped RBCs with low surface area to volume ratio
• What are stomatocytes also known as?

  Mouth cells or bowl-shaped cells
• What are elliptocytes characterized by?

  Elongated with narrow diameter
• What are schistocytes associated with?

  Microangiopathic hemolytic anemia
• What is a dacryocyte also known as?

  Crying cell
• What causes drepanocytes?

  Polymerization of abnormal hemoglobin S
• What are blister cells also known as?

  Helmet cells
• What causes degmacytes?

  Heinz bodies caused by oxidative stress
• What are the grading levels for the percentage of polychromatic red cells?

  • Slight: <1%
  • Moderate: 5-15%
  • Marked: >15%