1Identify the visual display of cell size on the X-axis and cell frequency on the Y-axis.
RBC histogram
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2What are the two parameters specifically calculated from the RBC histogram?
MCV and RDW
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3Hematology instruments count cells as RBCs if they have volume sizes between what range?
36-360 fL
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4True or False: Cells counted in the 24 to 36 fL range are included in the final RBC count.
False
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5Identify the type of cells that are present in the diluted RBC fluid but are usually statistically insignificant unless their count is significantly elevated.
Leukocytes
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6Fill in the blank: If the RBCs are macrocytic, the RBC histogram curve will shift to the ________.
Right
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7Fill in the blank: If the RBCs are microcytic, the curve will shift to the ________.
Left
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8What does it indicate if the RBC histogram curve is bimodal?
Two populations of RBCs
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9Enumeration: List three examples of cases that may cause a bimodal distribution curve.
Blood transfusion, Cold agglutinin disease (CAD), and hemolytic anemia with schistocytes
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10Identify the term for the average volume of individual RBCs.
MCV
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11What is the formula for calculating MCV?
MCV = (Hct / RBC) x 10
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12Identify the MCV classification for values < 80 fL.
Microcytic
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13Identify the MCV classification for values between 80-100 fL.
Normocytic
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14Identify the MCV classification for values > 100 fL.
Macrocytic
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15Identify the term for an increased number of red cells with variation in size.
Anisocytosis
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16What is the diameter range of normal RBCs (normocytes)?
6-8 um
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17Identify the term for RBCs larger than 8.0 um, often associated with impaired DNA synthesis.
Macrocytes
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18Identify the term for RBCs smaller than 6.0 um, often associated with defective hemoglobin formation.
Microcytes
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19Enumeration: List the four ways to detect anisocytosis.
1) Using the nucleus of a small lymphocyte, 2) Using the MCV value, 3) Using the RBC histogram, 4) Using the RDW value
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20True or False: If the RBC size is equal to the nucleus of a small lymphocyte, there is no anisocytosis.
True
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21Fill in the blank: A ________ or ________ curve on a histogram indicates more variation in cell size.
Wider or flattened
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22What does a peak near 100 fL with a normal RDW (e.g., 14.1%) represent?
Normocytic RBC population
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23Identify the condition often associated with a microcytic RBC population and a normal RDW (e.g., 13.2%).
Anemia of chronic inflammation
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24In Figure C of the notes, a macrocytic population is shown with an MCV of 119.2 fL and an RDW of ________.
23.9%
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25Identify the type of curve shown in Figure D, which has an MCV of 80.2 fL and a markedly high RDW of 37.2%.
Bimodal curve (Dimorphic RBCs)
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26What is the reference range for RDW-CV in adults?
11.5-14.5%
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27True or False: Low RDW values have high clinical significance.
False
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28Identify the calculation method for RDW that is dependent on both the width of the distribution curve and the MCV.
RDW-CV
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29Identify the calculation method for RDW where the curve width is measured at 20% above the baseline and is not influenced by MCV.
RDW-SD
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30What is the reference range for RDW-SD?
39-46 fL
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31What is the RDW reference range for newborns?
14.2-19.9%
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32By what age does a newborn's RDW typically decrease to adult levels?
6 months
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33Identify the condition characterized by a decreased MCV and a normal RDW.
Anemia of chronic inflammation (ACI)
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34Identify the condition characterized by a normal MCV and an increased RDW.
Sickle cell anemia
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35Identify the condition characterized by an increased MCV and an increased RDW.
Megaloblastic anemia
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36Identify the general term for a variation in the normal coloration of RBCs.
Anisochromia
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37Normally, RBCs have a central area of pallor that is approximately ________ the diameter.
1/3
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38Identify the term for red cells with a central pallor greater than 1/3 of the diameter.
Hypochromic cells
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39In the grading of hypochromia, what grade is assigned when the area of central pallor is 3/4 of the diameter?
3+
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40What is the specific name for a hypochromic cell that appears as a thin rim of hemoglobin, also known as a ghost cell in urine?
Anulocyte
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41Identify the only disease in which the MCHC is genuinely increased (above 37 g/dL).
Hereditary Spherocytosis
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42Enumeration: What are the three key clinical manifestations of symptomatic Hereditary Spherocytosis (HS)?
Splenomegaly, Anemia, and Jaundice
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43True or False: The Direct Antiglobulin Test (DAT) is typically positive in Hereditary Spherocytosis.
False
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44Identify the confirmatory test for Hereditary Spherocytosis (HS) using flow cytometry.
EMA binding test (Eosin-5-maleimide)
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45Identify the term for larger than normal red cells with a bluish tinge when using Wright's stain.
Polychromatophilic erythrocytes
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46What causes the bluish tinge in polychromatophilic erythrocytes?
Residual RNA
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47In the grading of polychromasia, what grade is given for a 3% percentage of polychromatophilic RBCs?
1+
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48Identify the term for an increased number of red cells with variation in shape.
Poikilocytosis
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49Identify the cell that is almost spherical, lacks central pallor, and is associated with AIHA or burns.
Spherocyte
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50True or False: Spherocytes should be reported if found at the feathered edge of a blood film.
False
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51Identify the cell, also known as a "mouth cell," characterized by a slit-like central pallor.
Stomatocyte
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52Identify the dehydrated form of a stomatocyte that appears "puddled" at one end.
Xerocyte
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53What is another name for Dehydrated Hereditary Stomatocytosis?
Hereditary Xerocytosis