logy Theory Revision Sept 2010

8/8/2019 logy Theory Revision Sept 2010

1/14

Q. What is a pyknotic cell?

A. A dying cell

Q. Do myeloblasts have nucleoli? Do they have granules in the cytoplasm?

A. Yes. No

Q. How any milligrams of iron in the male body?

A. Approx. 3500 mg

Q. How any milligrams of iron in the female body?

A. Approx 2500 mg

Q. What is haemolysis?

A. The breakdown of red cells

Q. When blood is centrifuged, what is the buffy coat?

A. The layer between the red cell and plasma and contains the white cells and

platelets.

Q. What can you tell from this buffy coat?

A. You can get an idea if the patient is anaemic, leukaemic etc.


2/14

Q. In which conditions do you see eosinophilia.

A. Allergies and/or parasites in the bowel.

Q. Why does a red cell appear pale in the centre?.

A. It is biconcave and contains less haemoglobin in the centre.

Q. What controls iron absorption in the body?.

A. The small bowel under the influence of hepciden.

Q. What is the name of the condition when your ferritin is grossly increased?

A. Hemochromatosis.

Q. What is ferritin?

A. Storage iron

Q. Would ferritin be increased or decreased in iron deficiency?

A. Decreased

Q. Would ferritin be increased, decreased or normal in anaemia of chronic disease?

A. Normal or slightly increased.

Q. Which follow up test is done after iron therapy and why?

A. Reticulocytes. To see if the Bone Marrow is regenerating.


3/14

Q. What is the appearance of the blood film in iron deficiency anaemia?

A. Microcytic Hypochromic.

Q. Which follow up tests are done in iron deficiency anaemia?

A. Iron studies and reticulocytes.

Q. Name some of the causes of anaemia

A. Iron deficiency, Megaloblastic (B12/folate deficiency), chronic disease, blood loss.

Q. What is another name for a platelet?

A. Thrombocyte

Q. What would you expect to see in a blood film post splenectomy?

A. Howell Jolly bodies.

Q. What other conditions could you see Howell Jolly bodies and why?

A. Diseased spleen & Leukaemia.

Q. What is the normal reticulocyte count in the peripheral blood?

A. 0.5 to 2.5%

Q. Why does a patient with leukaemia become anaemic?

A. The large number of white cells produced crowd out the red cells.


4/14

Q. What is a leukemoid reaction?

A. A leukemoid reaction has a high white cell count above 50 x 109/L but never above

100 x 109/L due to a severe infection.

Q. Why is a Neutrophil alkaline phosphatase done?

A. To distinguish between a leukemoid reaction and leukaemia. High in bacterial

infections and low in leukaemia.

Q. Name one cause of neutropaenia.

A. Overwhelming infection suppressing the bone marrow. Aplastic anaemia, drugs.

Q. What is the name of the hormone that controls erythropoiesis?

A. Erythropoietin (EPO)

Q. Where does EPO originate?

A. The kidney. (juxta glomerular complex)

Q. What is haematopoiesis?

A. Production of all cells in the bone marrow.

Q. What is supravital staining?

A. Staining living cells.


5/14

Q. Where would you use a supravital stain?

A. To stain the RNA in reticulocytes.

Q. Which stain do you use to stain reticulocytes?A. New Methylene Blue.

Q. What is Poikilocytosis?

A. Variation in the shape of the red cells. Give examples.

Teardrop cells, elliptocytes, Oval cells etc.

Q. What is Anisocytosis?

A. Variation in the size of the red cells.

Q. What is the formula used to correct a reticulocyte count in anaemia?

A. No of retics x patients PCV divided by 45 (normal PCV)

Q. What is CLL? Would you expect to see blast cells or more mature cells?

A. Chronic lymphatic leukaemia. More mature cells.

Q. What is AML? Which cells would you expect to see?

A. Acute myeloid leukaemia. Myeloblasts (30 to 90%)


6/14

Q. Name two reasons why a Date of Birth and gender is needed?

A. The NRR is different for different ages and genders.

Q. What is the NRR for platelets?

A. 150 to 400 g/L. Note: In some labs, NRR is different for different ages.

Q. What is the term used for a platelet below the NRR? When can this term be used?

A. Thrombocytopaenia. When a count has been done.

Q. What does ESR mean? What does it measure?

A. Erythrocyte Sedimentation rate. Inflammation.

Q. Name the two stem cells in the Bone Marrow. Name the cells that originate from

these cells?

A. Myeloid stem cell and Lymphoid stem cell.

Myeloid: Myeloblast, Promyelocyte, Myelocyte, Metamyelocyte, Band & Segmented.

Lymphoid: Lymphocytes.

Q. In which condition affecting a major organ do you see target cells? Which other cell

do you see in this condition?

A. Liver disease. Round macrocytes..


7/14

Q. Which two tests would be done if rouleaux was seen on a blood film?

A. ESR & CRP (c-reactive protein)

Q. What are spherocytes? Which indices would be affected and how?

A. Small round red cells packed with haemoglobin. MCHC would be raised.

Q. What is the difference between Auto Agglutination and Rouleaux?

A. Auto agglutination is when the red cells stick together in clumps. Rouleaux is when

the red cells form a stacked cell formation. Direct and indirect coombs test & cold

agglutinins.

Q. In which condition do you see burr cells in the peripheral blood smear? Which

tests would you do to confirm your suspicion?

A. Renal failure. Renal function tests (RFT)

Q. What is a fragmented cell?

A. A broken damaged red cell.

Q. In which condition do you see them in the blood smear?

A. Microangiopathic Haemolytic Anaemia (MAHA).


8/14

Q. Why is it important to report fragmented urgently?

A. They can cause DIC (Disseminated Intravascular Coagulation)

Q. What is the other name for a fragmented cell?

A. Schistocyte.

Q. How do you know if teardrop are real?

A. They are facing in different directions.

Q. What is heredity elliptocytosis? How does it affect the red cell?

A. Numerous elliptocytes in the peripheral blood. The red cell had a weak

membrane and can haemolyse much easier that a normal red cell.

Q. What is the diameter of a microcyte?

A. About 5um

Q. What is a basket cell? Where are they seen?

A. A fragmented and degenerated WBC in a peripheral blood smear, with a bare

nucleus partially surrounded by a coarse network of splayed, red-purple

nucleoplasm, which might be seen in normal subjects and raised in atypical

lymphocytosis, CLL, AML, and CML, thus being similar in origin to 'smudge' cells.

Seen mainly in AML.


9/14


10/14

Q. What is platelet satellitism? When does it occur? How would you determine if it is

real or artefactual?

A. Platelet satellitism, an in vitro phenomenon of platelet rosetting around

polymorphonuclear neutrophils, is observed exclusively in blood treated with

EDTA as an anticoagulant at room temperature. Neither heparin nor citrate

produces rosetting.

Q. What is the difference between Acute & Chronic Leukaemia?

A. Acute leukaemia has a large number of blast cells ( usually greater than 30%. And

up to 90%. Chronic does not have many blast cells. It has more mature cells.

Q. Which inclusions do you see in some blast cells in Acute Myeloid Leukaemia?

A. Auer Rods.

Q. What are reticulocytes? Can you see them on an ordinary blood film? Name the

stain used to stain them. What is this stain staining? What does it indicate?A. Reticulocytes are immature red blood cells, typically composing 0.5 to 2.5% of the

red cells in the human body. Cannot be seen on an ordinary film. New Methylene

Blue. RNA. Bone marrow regeneration.


11/14

Q. What is polychromasia? What does it indicate? What does it look like on a blood

film?

A. An immature red cell containing RNA remnants. It indicated bone marrow

regeneration. It appears as a larger red cell with a blue tinge. 10 to 20% larger

than a mature red cell.

Q. What is a dimorphic film?

A. There are two populations of red cells present. One is normocytic, and the other

is microcytic. This occurs either because an iron-deficient patient has been

transfused or treated with iron.

Q. What is Malaria? What causes Malaria? In which part of the world is it seen? How

many types are there? Which two types enlarge the red cells? When should the

blood be taken to diagnose Malaria? What type of blood films are made and why?

A. Malaria is a mosquito borne disease. It is found in tropical countries. There are 4

types with a new one just discovered. Vivax & Ovale increase the size of the red

cell. The blood is taken when the temperature is rising. A thick and thin film ismade.

Q. In which cell does basophilic stippling occur? Name two conditions where it

occurs?

A. Basophilic stippling occurs in the red cell in Lead poisoning & Thalassaemia.


12/14

Q. What is Toxic Granulation? What causes it? In which cell does it occur? What is

a Dohle body? In which cells do you find them?

A. Toxic granulation neutrophils (TGNs), which have prominent azurophilic

cytoplasmic granules appear in blood when inflammation occurs.

Serum levels of C-reactive protein (CRP) are also increased in inflammation as is

the ESR.

Dohle Bodies

The presence of Dhle bodies in mature and immature neutrophils on a blood

smear can be normal if they are present only in small numbers.

They are also normally more abundant in cats and horses.

Dhle bodies are intra-cytoplasmic structures composed of agglutinated ribosomes;

they will increase in number with inflammation and increased

granulocytopoiesis.


13/14

Q. What are Pappenheimer Bodies? In which condition do you find them? How do

you confirm that they are Pappenheimer bodies?

A. Pappenheimer bodiesPappenheimer bodies appear as violet staining granules usually found along the

periphery of the red cells, often in clusters.

They must be confirmed with an iron stain.

These iron-staining granules are found in sideroblastic and megaloblastic anemias,alcoholism, following splenectomy, and in some hemoglobinopathies.

They are smaller than Howell-Jolly bodies.

Pappenheimer bodies are distinctive granules found in a blood stain that can indicate

an excess of iron.

They can interfere with platelet counts in electronic counters.


14/14

Q. What are Howell Jolly bodies? In which conditions do you see them?

A. A Howell-Jolly body is a nuclear remnant that results from incomplete nuclearexpulsion as the orthochromic normoblast exits the bone marrow.

Small numbers normally are released into the peripheral blood from the bone

marrow, but are not seen on a peripheral blood smear if the splenic function is

normal or near normal.

Howell-Jolly bodies are also seen in:

Severe haemolytic anaemia,

Megaloblastic anaemia,

Hereditary spherocytosis

Myelodysplastic syndrome( MDS).

If a small accessory spleen is present following splenectomy in an otherwise normal

patient, Howell-Jolly bodies usually are not present.

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logy Theory Revision Sept 2010