Artifact Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Artifact and links to relevant pages within the course.
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| What best describes the cells seen in this illustration: | View Page |
| The abnormal RBC shape seen in this illustration is: | View Page |
| Cabot Ring Impersonation The cell in this field showing a dark refractile ring is an artifact which might be mistaken for a Cabot ring. | View Page |
| The colonies growing on the surface of this brain-heart infusion with blood agar plate were "converted" from a mold colony suspected of being Histoplasma capsulatum by incubating a subculture at 37°C for 5 days. The yeast forms that must be identified in mounts made from one of these colonies to confirm the identification are: | View Page |
| A hematology technologist observed the intracellular forms seen in the field of view of a Wright-Giemsa-stained peripheral blood smear shown in this photomicrograph. In consultation, the microbiology technologist advised that the form seen most likely represents: | View Page |
| The condition most likely associated with the peripheral blood picture shown in the photograph is: | View Page |
| Match the red cell shapes in each frame of the photograph with its most likely corresponding clinical condition. | View Page |
| The erythrocyte at the tip of the arrow is an echinocycte (burr cell). | View Page |
| The peripheral blood picture shown in the photograph is most consistent with an artifact of smear preparation. | View Page |
| The RBC inclusions shown in the photograph represent which of the following? | View Page |
| Smear with teardrop cells As previously mentioned, tear drop cells are present in disorders with altered splenic or bone marrow structure. Disrupted splenic cords and myelofibrosis with myeloid metaplasia are examples. Tear drop cells appear in the peripheral blood as a response to red cell alterations by thalassemia when red cell inclusions are expelled by a stripping process through splenic cords. A marrow disrupted by malignant cells may also set the stage for release of teardrop cells into the peripheral blood. Importantly, teardrop cells may arise as an artifact of improper smear preparation, identified by their uniformity in pointing in the same direction. In contrast, teardrops noted in the photograph are irregularly arranged and oriented in various directions. Teardrops always have pointed ends and disappear after splenectomy. | View Page |
| Cardiac hemolysis (Waring Blender Effect) Two photographs of a peripheral blood smear are submitted for review . The smears are from a 9-month-old baby with a heart valve replacement. In the upper photograph is a nucleated RBC and platelets are decreased. Nucleated red cells and occasional giant platelets indicate an active marrow response. In the process of forcing blood cells through the heart valve, erythrocytes are damaged, schistocytes are formed, and platelets are destroyed leading to thrombocytopenia. In the lower field are schistocytes, acanthocytes, echinocytes (burr cells), spherocytes, and the absence of platelets. The presence of burr cells could represent an artifact of smear preparation, but with the history of valve replacement, the red cell changes are likely the result of red cell damage as the cells circulate through the new valve. This situation is described as Waring Blender Effect because of damage to blood cells passing through the new valve, looking as if they had suffered the onslaught of a blender. Target cells and mild hypochromia may reflect iron deficiency through the loss of iron from destruction of RBC's. Iron loss through red cell destruction may be reflected in some hypochromia. | View Page |
| Rouleaux Rouleaux formation correlates with an increased concentration of serum monoclonal proteins. Rouleaux may be seen as an artifact in the thicker portions of blood smears. The addition of a drop of saline to the blood smear will serve to disperse any artifactual rouleaux formation. The presence of rouleaux formation or RBC agglutination may result in a falsely decreased electronic red blood count and falsely increased MCV, as these clusters may be read as one cell. | View Page |
| The arrangement of erythrocytes on this peripheral blood smear may be seen in each of the following conditions except: | View Page |
| You have been asked to review a peripheral blood smear. You note >10/OIF (oil immersion field) echinocytes (burr cells). Which of the following actions would be the most appropriate response? | View Page |
| Rouleaux and Autoagglutinaton Rouleaux and autoagglutination are considered forms of poikilocytosis, but differ from the forms discussed previously because groups of cells are involved rather than single forms. In addition, these types must be differentiated from similar-appearing artifacts caused by improperly made slides and/or examining morphology in an area which is too thick. | View Page |
| Another Target Cell Another example of a target cell (or codocyte) is seen in the center of this slide. Notice that the hemoglobin in the center of this cell is somewhat lighter in appearance than in the previous slide. A second codocyte can be seen in the upper left portion of the slide. Codocytes appear in conditions which cause the surface of the red cell to increase disproportionately to its volume. This may result from a decrease in hemoglobin, as in iron deficiency anemia, or an increase in cell membrane.
Target cells have excess membrane cholesterol and phospholipid and decreased cellular hemoglobin. Examples of other conditions in which target cells may be present include thalassemias, hgb C disease, post splenectomy and obstructive jaundice. Since their presence can be the result of an in vitro artifact, their value in clinical diagnosis is limited. | View Page |
| Notes about Poikolocytosis Some forms of poikilocytosis represent in vitro artifact rather than being the result of abnormal physiology within the body. Inconsistent terminology also hampers communication about red cell morphology, in that various terms are used to describe the same type of change. Uniform terminology based on Greek roots has been applied in an attempt to provide standardization, although it has not been widely accepted. | View Page |
| Abnormal forms There are a number of abnormalities of sperm morphology.
Abnormal heads can include enlarged head, double head, round head, constricted head, amorphous head, pinhead, and acute tapering forms. There are also heads with abnormal numbers of vacuoles.
Midpiece abnormalities include distended and thin midpiece regions.
Abnormal tails include short tails, double, triple or multiple tails, coiled tails, broken tails, or absent tail.
Cytoplasmic droplets are also seen in some specimens. These are large regions of cytoplasm just below the head assumed to represent failure of complete sperm maturation or a sign of either toxicity or oxidation. There have also been reports that cytoplasmic droplets may be artifacts from the fixation and staining for morphology analysis.
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| Which of the following artifacts may be mistaken for casts? | View Page |
| Which of the following are artifacts often confused with urinary elements? (Choose ALL of the correct answers.) | View Page |
| Contaminants and Artifacts There are several contaminants and artifacts which must be identified. This slide shows a fiber. Fibers may occur in any specimen from clothing, diapers, lint, toilet paper or lens paper. They are usually longer and wider than casts and have more distinct edges. Striation and blunt ends are distinguishing features of fibers. | View Page |
| Which of the following statements is true for hypersegmented neutrophils? (Choose ALL of the correct answers) | View Page |
| The smudge cells pictured in the photograph may be found in each of the following situations except: | View Page |