Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions (Online CE Course)

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C. William Reiquam, M. D., Elmer W. Koneman, M. D.

This collection of informative case studies covers many current topics in red cell disorders. Topics include macrocytosis, intracellular RBC inclusions, echinocytes and acanthocytes, schistocytes, ovalocytes, and rouleaux. Numerous high-quality photomicrographs and real-life situations help ensure learning and retaining needed information.

Continuing Education Credits

• P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 3 hour(s)
• Florida Board of Clinical Laboratory Science CE - General (Hematology): 3 hour(s)

Objectives

• Review normal and abnormal red blood cell morphologies.
• Recall the criteria for performing and reporting peripheral blood smear reviews.
• Demonstrate ability to evaluate red blood cell size, shape, and staining characteristics.
• Correlate observations of key red blood cell abnormalities on peripheral smears with associated clinical conditions.
• Recognize, via case studies, peripheral smear evaluations for red blood cell morphology and their clinical implications.

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Course Outline

• Introduction to Red Blood Cell Morphology
• Normal Red Blood Cell Morphology
• Normal Red Blood Cell (RBC) Morphology
• Evaluating Initial Red Blood Cell (RBC) Morphology
• Criteria for Peripheral Blood Smear Review
• The Peripheral Smear: Reviewing Red Blood Cell Morphology
• Introduction to Red Blood Cell Morphology Reporting
• Guidelines for Reporting Red Blood Cell Morphology
• This oil immersion field (1000x) is representative of the peripheral blood smear. Which report is the most appropriate for documentation of the findin...
• Abnormal Red Blood Cell Morphology Review
• Red Cell Morphology Reference Tables
• Size Variations in Red Blood Cells
• Anisocytosis Reference Table
• Variations in Hemoglobin Content
• Hemoglobin Content Reference Table
• Shape Variations in Red Blood Cells
• Poikilocytosis Review Table
• Abnormal Red Blood Cell Distribution
• Rouleaux and Agglutination
• Dimorphic (Double Cell) Population
• Case Studies in Red Blood Cell Nonneoplastic Conditions
• Introduction to Red Blood Cell Nonneoplastic Conditions Case Studies
• Hemolytic Conditions with Spherocytosis
• A 12-year-old child presents with jaundice and scleral icterus. The image to the right captures a representative section of the peripheral blood smear...
• Case continued:Which hematologic condition could be associated with the findings shown in these images?
• A known case of hemolytic disease of the newborn (HDN) is presented in the image on the right. Many different cellular morophologies are present. Apar...
• A 49-year-old male with pneumonia was treated with high-dose intravenous penicillin. He became jaundiced with yellow sclera. The image on the right is...
• Macrocytosis-Associated Conditions
• The complete blood count was obtained from a patient recently admitted to the emergency room. The red blood cell indices obtained revealed an MCV of 1...
• Conditions suggested by the macrocytes and the neutrophil in the photograph to the right include which of the following?
• Intracellular RBC Inclusions
• The RBC inclusions shown in the photograph represent which of the following?
• The peripheral blood smear represented by the image on the right was submitted for hematologic review. The identification of the RBC inclusions shown ...
• By utilizing a Prussian Blue stain, which of the following red blood cell inclusions would be identifiable if present? Note: Upper image = Wright-Giem...
• A ten-year-old boy came to a physician's attention because of recent jaundice and icteric sclerae after taking the medication Primaquine before a trip...
• Dimorphic Red Blood Cell Populations
• A blood smear represented by the photograph was submitted for hematologic review. Based on the erythrocyte morphology and the accompanying histogram, ...
• Target cells and Sickle Cells
• Hemoglobin E (Hb E) and HbE/Beta Thalassemia
• Case Study The image on the right is representative of the peripheral blood smear from a five-month-old immigrant from Asia. Her mother was concerned ...
• A peripheral smear with red blood cells photographed in a typical field was submitted for review. Which of the following conditions might be eliminate...
• A CBC performed on a 10-year-old African-American male who was brought to the emergency department with rapid, shallow breathing and fever provided th...
• Sickle cells along with target cells, as shown in this image, confirm a diagnosis of sickle cell disease (HbSS).
• Echinocytes and Acanthocytes
• The erythrocyte at the tip of the arrow in the image to the right is an echinocycte (burr cell).
• The peripheral blood picture shown in the image below is most consistent with an artifact of smear preparation.
• An isolated acanthocyte is most likely of little importance on an otherwise normochromic, normocytic peripheral blood smear.
• Schistocytes, Bite Cells, and Teardrop Cells
• The presence of erythrocytes with altered morphology (as indicated by the arrows in the image to the right) has a close association with each of the f...
• Which of the following conditions is associated with the defective erythrocytes that are indicated by the arrows in this image?
• The cells marked by blue arrows in the image below are associated with all of the following conditions except:
• A 5-year-old girl was brought to the emergency department with bloody diarrhea and severe abdominal pain. A complete blood count produced these result...
• Ovalocytes, Elliptocytes and Stomatocytes
• Ovalocytes/Elliptocytes
• Stomatocytes
• A teenage boy is visiting his doctor uder the suspicion of a viral illness. He has always been relatively healthy without many illness-related complai...
• Rouleaux and Erythrocyte Agglutination
• The arrangement of erythrocytes on this peripheral blood smear can be associated with each of the following conditions except:
• The arrangement of the erythrocytes in this peripheral smear should be reported out as rouleaux formation.
• Multiple Erythrocyte Abnormalities
• Case History
• Splenectomy Morphologies
• Poikylocytosis and Basophilic Stippling
• References
• References

Additional Information

Acknowledgements:
Appreciation is expressed to Ms. Bette Jamison, MT (ASCP); Ms. Annie Elrod, MT (ASCP); John Ryder, MD; Peter Shen, MD; and other members of the University of Colorado Health Sciences Center Clinical Laboratory for their assistance in the acquisition of images and the proof reading of a large amount of textual material.

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