Megaloblastic Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Megaloblastic and links to relevant pages within the course.
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| Which of the following conditions might give rise to the red cell abnormality depicted here: | View Page |
| The abnormal RBCs seen in this smear, such as those shown by the arrow are typically seen in: | View Page |
| Coarse basophilic stippling in all of the following EXCEPT: | View Page |
| Identify the object contained in the cell in this illustration indicated by the arrow: | View Page |
| Identify the object contained in the cell in this illustration indicated by the arrow: | View Page |
| Which of the following conditions is frequently associated with these cells? | View Page |
| Pappenheimer bodies are usually seen in patients who have had: | View Page |
| Cabot rings may be seen in rare occasions in patients who have: | View Page |
| More on Howell-Jolly Bodies Under normal conditions, Howell-Jolly bodies are thought to be remnants of nuclear fragments due to incomplete expulsion of the nucleus. In pathological conditions, they are aggregates of chromosomes which have separated from the mitotic spindle during abnormal mitosis. Single or multiple Howell-Jolly bodies may be found in a red cell. A single HJ body in a red cell may be seen in megaloblastic anemia, hemolytic anemia such as sickle cell anemia and after splenectomy. Megaloblastic anemia or abnormal erythropoiesis is usually present when multiple Howell-Jolly bodies are observed in a single cell. | View Page |
| In which of the following conditions would you expect to find Howell-Jolly bodies? | View Page |
| Identify the conditions in which Cabot rings are occasionally seen. | View Page |
| What are Cabot rings? Thin, red-violet-staining strands in the shape of rings, figure eights, or shapes of the letter B may on rare occasions be seen in erythrocytes. These structures are called Cabot rings. Although the origin of Cabot rings continues to be illusive, they are not nuclear fragments since they test Feulgen negative. The rings are probably microtubules remaining from a mitotic spindle. Cabot rings have been observed in a few cases of megaloblastic anemia, lead poisoning and other disorders of erythropoiesis, as well as, after a splenectomy. | View Page |
| The peripheral blood smear represented by this field was submitted for hematologic review. The RBC inclusions most likely are: | View Page |
| Hereditary ovalocytosis and elliptocytosis Ovalocytes are rod shaped erythrocytes with nearly parallel lateral walls. If the long axis of an erythrocyte is no more than twice as long as the short axis, the cell is an ovalocyte. If the long axis is more than twice as long as the short axis, the cell is an elliptocyte. Hemoglobin tends to collect at each end of these cells. The ends of the cells are rounded and never pointed, to be differentated from sickle cells. Ovalocytes present in greater than 25% of red cells on the blood smear are characteristic of hereditary ovalocytosis. The oval shape is attributed to a defect in horizontal red cell membrane protein interactions. Lesser numbers of circulating ovalocytes may be present in various anemias including megaloblastic, sideroblastic, iron deficiency, and in thalassemias. A rare ovalocyte (less than 1%) may be found on almost any peripheral blood smear. Resistance to malarial infection may be a beneficial attribute of hereditary ovalocytosis. | View Page |
| Conditions suggested by the macrocytes and the neutrophil in the photograph to the right include: | View Page |
| Elliptocytes Another example of elliptocytes as seen in hereditary elliptocytosis. Other conditions which may have varying numbers of elliptocytes include thalassemias, iron deficiency, megaloblastic anemia and anemia associated with leukemia. | View Page |
| Conditions Associated with Hypersegmented Neutrophils There are a number of conditions in which hypersegmented neutrophils may be seen, such as megaloblastic anemias that include folic acid deficiency and pernicious anemia. Individuals who are receiving chemotherapy or have long-term chronic infections may also have hypersegmented neutrophils.The cells seen in these conditions would be classified as pathological since the body is responding abnormally as a result of either a deficiency of a component needed for DNA production or because of the toxic effect that chemotherapy drugs have on DNA. | View Page |
| The presence in the peripheral blood of an increased number of hypersegmented white blood cells as presented in the photograph serves as a marker for preleukemia. | View Page |
| A most useful follow-up test to consider when faced with hypersegmented neutrophils and oval macrocytes (see photograph) in a peripheral blood smear is: | View Page |