Cell with a horseshoe shaped nucleus and abundant cytoplasm in a peripheral blood smear is?

Appeared in: BHU NO - 2015

Explanation

Monocytes are the largest of the white blood cells found in a normal peripheral blood smear.
Their nucleus is characteristically indented, appearing kidney-shaped or often described as horseshoe-shaped.
They possess a large amount of cytoplasm relative to their nucleus, which typically stains a dull gray-blue color and may have a 'ground glass' appearance.

Option A: Neutrophils have a multi-lobed nucleus (typically 2-5 lobes connected by thin strands of chromatin), not a horseshoe-shaped one.
Option C: Lymphocytes are characterized by a large, round, dark-staining nucleus that occupies most of the cell, leaving only a thin rim of scant cytoplasm.
Option D: Eosinophils typically have a bilobed (two-lobed) nucleus and their cytoplasm is filled with large, prominent reddish-pink granules.

Clinical Relevance

Nursing practice connection: Knowing Identification of white blood cells based on their morphological features in a peripheral blood smear helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Correctly identifying monocytes is a fundamental skill in hematology. An increased number of monocytes (monocytosis) can be a clue to chronic infections (like tuberculosis), autoimmune diseases, or certain types of leukemia.
As precursors to macrophages, monocytes are central to the body's defense system. Nurses should understand that impaired monocyte/macrophage function can lead to increased susceptibility to infections and poor wound healing.
What if? If the nucleus was U-shaped or sausage-shaped but the cell was clearly a granulocyte, it would likely be a 'band' neutrophil. This indicates a 'left shift,' a sign that the bone marrow is rapidly producing new neutrophils in response to an acute infection.

How to Approach the Question

This is a factual recall question testing your knowledge of hematology.
First, identify the key descriptive features in the question stem: 'horseshoe shaped nucleus' and 'abundant cytoplasm'.
Mentally review the classic appearance of each type of white blood cell listed in the options.
Compare the features of a Neutrophil (multi-lobed nucleus), Monocyte (kidney/horseshoe nucleus, abundant cytoplasm), Lymphocyte (large round nucleus, scant cytoplasm), and Eosinophil (bilobed nucleus, red granules).
Select the cell type that directly matches the description provided in the question.

Concept Tested & Keywords

Concept Tested: Identification of white blood cells based on their morphological features in a peripheral blood smear.
Stem keywords: horseshoe shaped nucleus, abundant cytoplasm, peripheral blood smear
Lead-in keywords: is
Negative lead-in flag: false

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E6 Medicine Harrison 22e Part 1 p. 484-486

E6 Anatomy Grays 43e Vol 1 Part 1 p. 105-106

Practise the full BHU NO - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.