Question

1. What can you conclude about a patient exhibiting both hemoglobinemia and hemoglobinuria with respect to where his red blood cells are being destroyed?

2. Why would you predict that incorrect lysis of red blood cells in areas or organs that normally don’t break them down would result in jaundice?

3. You examine blood from a patient that you believe has some form of anemia.  Interestingly, you establish that his neutrophils have normal nuclei but the red blood cells can have irregular shapes and sizes.  Based upon this information, what can you conclude about the type of anemia this patient exhibits?

4. Hypersegmented neutrophils are often associated with which type of anemia?

5. Which type of hemolytic anemia will only affect newborns (and anyone past that developmental stage)?

Answer 1

4 = Neutrophil hypersegmentation can be defined as the presence of neutrophils whose nucleihave six or more lobes or the presence of more than 3% of neutrophils with at least five nuclear lobes.This is a clinical laboratory finding. It is visualized by drawing blood from a patient and viewing the blood smeared on a slide under a microscope. Normal neutrophils are uniform in size, with an apparent diameter of about 13 μm in a film. When stained, neutrophils have a segmented nucleus and pink/orange cytoplasm under light microscope. The majority of neutrophils have three nuclear segments (lobes) connected by tapering chromatin strands. A small percentage have four lobes, and occasionally five lobes may be seen. Up to 8% of circulating neutrophils are unsegmented

The presence of hypersegmented neutrophils is an important diagnostic feature of megaloblastic anaemias. Hypersegmentation can also be seen in many other condition but with relatively less diagnostic significance.

5 = Hemolytic disease of the newborn (HDN) is a blood problem in newborn babies. It occurs when your baby's red blood cells break down at a fast rate. It’s also called erythroblastosis fetalis.

# Hemolytic means breaking down of red blood cells.

# Erythroblastosis means making immature red blood cells.

# Fetalis means fetus.