Differentials

Anisocytosis

major variation in RBC size

Poikilocytosis

major variation in the shape of RBCs

High Anisocytosis and Poikilocytosis may be seen in patients with _______________________

Pyropoikilocytosis or burn patients

The presence of Reticulocytes (or Polychromatophilic RBCs) indicates hemorrhage or anemia; The Reticulocyte production Index (RPI) is a measurment of whether the lack of RBCs is being fully compensated for by the bone marrow and can be found using the formula _______________________________ (RPI>3=good; <2=bad)

RPI = %Reticulocytes (HCT/45) / maturation time

When making a stain, the proper pH for the color to be correct is _______

6.8

A ____________ is an increased amount of immature WBCs; implies an infection or Chronic Myelogenous Leukemia (CML)

left shift

If on the blood smear there are Microcytic and Hypochromic RBCs, the patient could have __________________________

Iron Deficiency anemia, Thalassemia, Sideroblastic anemia, or anemia chronic inflammation

The presence of target cells could imply _____________

Hgb C Disease, Thalassemia, or iron deficiency

__________________ are remnants of nuclear DNA on the RBCs; their presence may indicate megaloblastic anemia or spleen dysfunction

Howell-Jolly Bodies

Ovalocytes and Macrocytes together (Hypersegmented Neutrophils may be present aswell) indicates _______________________

megaloblastic anemia

Megaloblastic anemia is caused by a _________________

Vit B12 or Folate deficiency

If a patient has >20% blasts, Neutropenia, and decreased PLTs, they have a ___________________________

Acute leukemia

Plasma Cells are mature B cells that produce immunoglobulins, causing Rouleaux formation; seeing these two together is consistent with ____________

Multiple Myeloma

Schistocytes along with little to no platelets implies the patient has ______________________

DIC or Thrombotic Thrombocytopenic Purpura (TTP)

_____________________ increases the risk of DIC; caused by the lack of a Tyrosine-kinase receptor, keeping the WBCs as promyelocytes

Acute Promyelocytic leukemia (APL)

________________ are malignant T cell lymphs that invade the skin, causing a specific type of skin cancer, Mycosis Fungoides

Sezary cells

______________ is the proliferation of prolymphocytes of either T or B cell type

Prolymphocytic leukemia

_________ are the result of an influx of sodium into the cells; most commonly the result of cirrhosis

Stomatocytes

Hgb S/C Disease is a _______________; the result of the substitution of the amino acid glutamic acid (or glutamate) on the beta chain at the 6th position with valine; Hgb C disease is the same substitution but with lysine instead of valine

HGB defect causing Sickle cell

Acanthocytes are a result of the deficiency of fat-soluble vitamins (A, D, E, K), termed _______________

Abetalipoproteinemia

Coarse Basophilic stippling indicates ____________________ (BS is made of RNA)

lead poisoning

If >20% smudge cells are present a _________________ must be made

albumin slide

_________________ resemble toxic granulation but is in all cell lines (TG is only in neutrophils); caused by a lysosomal deficiency preventing the cell from breaking down mucopolysaccharides

Alder-Reilly Anomalies

__________________ resemble Dohle bodies but larger; patients have bleeding problems due to decreased, hypogranular, and giant platelets

May-Heglin anomalies

__________________ resemble green-slate inclusions in neutrophils; affects cell motility

Chediak-Higashi syndrome

The presence of Teardrop cells may indicate ______________

Myelofibrosis

______________________ can differentiate a leukemoid reaction from CML

Leukocyte Alkaline Phosphatase stain

________________________ are non dividing neutrophils; look overly clumpy and mature for the cell size

Pulger-Huet Anomalies

__________________ is an iron stain used to stain siderotic granules (siderotic granules are the same as pappenhiemer bodies but for some fucking reason has to have a different fucking name after this bullshit ass stain is used); helps diagnose sideroblastic anemia

Prussian Blue stain

__________________ presents a left shift (mainly myelocytes), a high WBC# (100,000+), and a high PLT count

Chronic Myelogenous Leukemia (CML)

________________ has a High WBC# (100,000+), low PLT count, a large amount of similar looking lymphocytes , and high smudge cells

Chronic Lymphocytic Leukemia (CLL)

__________________ is caused by malignant B lymphocytes; use of the TRAP stain can distinguish these cells from others due to its overabundance of isoenzyme 5

Hairy cell leukemia

A _______________________ is an infection; looks the same as CML but WBC# is <100,000 and Dohle bodies and Toxic Granulation is present

granulocytic leukemoid reaction

A ______________ is a viral infection; has a relatively high lymphocyte count alongside ATLs

lymphocytic leukemoid reaction

_________________ presents microcytic and hypochromic RBCs with a low MCV; iron deficiency is a common cause

Microcytic anemia

Normocytic anemia=____________

blood loss

______________ is caused by a Vit B12 or folate deficiency; commonly seen in liver disease

Macrocytic anemia

_________________ can lead to hemolytic anemia ; cells have high osmotic fragility and >MCHC because the decreased surface area of the RBCs causes Hgb to be more densley packed

Hereditary spherocytosis

Hgb C Disease: Target cells and weird ass crystal thingys; Hgb S Disease: classic sickle look with NRBCs present; Hgb SC Disease: Combo of both

what is the formula used to correct the wbc count if >5 NRBCs (or Megakaryocytes) are present

False WBC# x 100/ NRBC/MK +100

____________ are present in patients with lead poisoning or megaloblastic anemia

Cabot rings

The presence of bite cells in the peripheral blood is seen with ____________________________

G6PD Deficiency

___________ WBCs are generally hypogranular and hyposegmented

Myelodyplasia

Myeloblasts can be distinguished because of their _______

auer rods

_____________ require a supravital stain (methylene blue) to be seen

Heinz Bodies

If agglutination is seen; then smear should be remade after heating at 37C for 30 min because of a _______________ being present

cold agglutinin

_________________ is seen when EDTA anticoagulant causes platelets to attach to WBCs; fixed by redrawing in a Sodium Citrate tube

Platelet Satellitism