Pathology · USMLE Step 1

USMLE Pathology: Hematologic System

Bone marrow and peripheral smear morphology for anemias, leukemias, and lymphomas, distinct from the clinical-management focus of the Hematology and Oncology deck.

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What is the classic peripheral smear finding in iron deficiency anemia?
Microcytic, hypochromic RBCs
What elongated RBC shape is seen in severe iron deficiency anemia?
Pencil cells (elliptocytes)
What neutrophil finding is characteristic of megaloblastic anemia?
Hypersegmented neutrophils (6+ lobes)
What large, oval RBCs are seen in megaloblastic anemia?
Macro-ovalocytes
What special stain and finding confirms sideroblastic anemia?
Ringed sideroblasts on Prussian blue (iron) stain
What RBC morphology is seen in hereditary spherocytosis?
Spherocytes (small, round cells lacking central pallor)
What RBC finding is characteristic of G6PD deficiency during a hemolytic episode?
Bite cells
What denatured hemoglobin inclusion is seen in G6PD deficiency?
Heinz bodies
What RBC shape defines sickle cell anemia on smear?
Sickle-shaped (crescent) RBCs
What nuclear remnant appears in RBCs after splenic dysfunction, as in sickle cell disease?
Howell-Jolly bodies
What RBC finding is seen in thalassemia?
Target cells
What fragmented RBCs are seen in microangiopathic hemolytic anemia?
Schistocytes
What is the characteristic bone marrow finding in aplastic anemia?
Hypocellular marrow with fatty replacement
What teardrop-shaped RBC is seen when marrow space is infiltrated by fibrosis or tumor?
Dacrocyte (teardrop cell)
What RBC inclusion is characteristic of lead poisoning?
Basophilic stippling

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