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Red cell morphology Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Red cell morphology and links to relevant pages within the course.

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Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions
A 10-year-old child presents with jaundice and scleral icterus. The photograph captures a section of the peripheral blood smear. The report should direct attention to:View Page
Iron Deficiency

Absorption of iron is interrupted in the absence of the stomach. Microcytic, hypochromic red cells are not conspicuous in the previous slides to reflect this deficiency. However, multiple factors influencing red cell morphology are so diverse in this case and therapy so uncontrolled that iron deficiency is not perfectly expressed morphologically.

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Red Cell Morphology
For red cell morphology examination, the field shown in this slide is:View Page
Red Cell Morphology

Red cell morphology can be defined as the appearance of the erythrocytes on a Wright's stained smear.Careful examination of the red cells for the purpose of identifying abnormalities is part of the differential procedure. This examination is important because it may provide valuable diagnostic information to the physician, as well as provide a quality control mechanism to verify red cell indices values as determined by automated or manual methods.Evaluating red cell morphology involves differentiating normal morphology from abnormal and artificial morphology. The abnormal morphology covered in this unit may be seen in a variety of disorders.

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Switch from Low Power to Oil Immersion

Once the correct area has been located on low power, switch to oil immersion, for the actual examination of red cell morphology. Notice the red cells are lying singly with occasional doublets.

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Which objective(s) are used for red cell morphology examination?View Page
Assessing Red Cell Morphology Procedure

The procedure for assessing red cell morphology includes examining the smear in the feathered (thinner) edge where the erythrocytes are randomly distributed and, for the most part, lie singly, with occasional doublets. This area is referred to as the "critical area." If the area is too thin, the red cells will appear flat and somewhat square (cobblestone effect) with no central pallor. If the area examined is too thick, the cells will be too close together to evaluate the morphology of individual cells. To begin the red cell morphology examination, use the low power (10X) objective to locate the "critical area." The oil immersion objective (100X) is used for the actual evaluation.

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Area of Evaluation

The area shown in this field is too thin for accurate red cell morphology evaluation. The cells have large spaces between them, show no central pallor and many are somewhat square, showing a "cobblestone effect."

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Artifactual Morphology

These cells are in an area which is too thick, and should not be used for red cell morphology assessment. Some of the cells appear to be stacked like coins because of the large number of cells present in this section of the slide. The morphology seen in the too thin and too thick areas of the smear is referred to as artificial morphology.

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Which of the following are reasons for evaluating red cell morphology as part of the differential procedure?View Page
Size Variation

Red blood cells can vary in size (diameter/volume) from smaller than normal, microcytes, to larger than normal, macrocytes. When red cells of normal size, microcytes and macrocytes are present in the same field, the term anisocytosis is used.Since the purpose of this unit is to acquaint you with the appearance (identification) of abnormal red cell morphology, percentages of abnormalities present will not be considered. It is important to be aware that rating red cell morphology for the purpose of reporting it is a skill which must be learned before you are able to complete this aspect of a differential count.

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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.

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