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clinical pathology > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

Where are RBC’s made?

A

Bone marrow

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2
Q

What organs are important in the production of RBC’s

A

Kidney produces erythropoetin
Liver - iron
other hormones support too: from gonads, adrenal cortex, pituitary, thyroid

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3
Q

What stimulates erythropoiesis?

A

Erythropoetin and iron travel to the bone marrow

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4
Q

What are the 3 major pools the erythron contains?

A

erythrocyte precursors
blood erythrocytes
splenic erythrocytes

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5
Q

How are erythrocytes made in the bone marrow?

A

EPO stimulates colony forming unit erythroid cells (CFU-E) to differentiate into rubriblasts (Rb), the Rb’s then undergo mitosis and pyramidal maturation (one Rb makes 16 eventual mature erythrocytes) that are released into the bloodstream

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6
Q

Where are RBC’s stored?

A

Spleen

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7
Q

How and where are RBC’s destroyed

A

the spleen and liver by macrophages

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8
Q

What are the functions of RBC’s?

A

Transport oxygen to the tissues
Carry C02 away from tissues
buffering of hydrogen ions

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9
Q

What increases the 02 carrying capacity of blood to 70x that of plasma

A

hemoglobin

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10
Q

what are the 3 things that affect the oxygen content in the blood

A

Hemoglobin content
partial pressure of 02
hemoglobin oxygen affinity (p50)

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11
Q

How do erythrocytes get rid of C02?

A

carbonic anhydrase

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12
Q

What is the normal morphology for erythrocytes in dogs?

A

biconcave disc with prominent central pallor

minimal anisocytosis with only a few polychromatophils

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13
Q

what is anisocytosis

A

differences in cell size

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14
Q

What do normal erythrocytes look like in cats?

A

slightly smaller than dogs with less central pallor

exhibit rouleaux

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15
Q

What is rouleax

A

RBC’s look like stacks of coins

non- specific binding of RBC’s due to protein coating

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16
Q

What do normal RBC’s look like in horses?

A

same size as cats also exhibit rouleaux

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17
Q

What do camelid RBC’s look like?

A

oval shaped

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18
Q

What is different about Bird/reptile RBC’s?

A

they are nucleated

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19
Q

True/False

we can use analyzers for non-mammal species

A

False - analyzer does not recognize the nucleated RBC’s

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20
Q

What do we use a microcentrifuge and refractometer for?

A

Microcentrifuge - PCV

refractometer - total protein concentration (TP)

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21
Q

What is the automated hematology analyzer used for?

A 
RBC count
HgB concentration
Calculated hematocrit 
Mean Cell volume (MCV)
Red cell distribution width (RDW)
Mean cell hemoglobin concentration (MCHC)
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22
Q

Why do we evaluate peripheral blood films?

A

Red blood cell density
Microscopy: size, shape, color and inclusions
Ex: parasites, RBC/WBC morphology, platelet clumping, inclusions, toxic changes
bone marrow evaluation

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23
Q

What does the PCV measure

A

RBC mass

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24
Q

What type of blood is used for PCV

A

Well-mixed/ anti-coagulated blood

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25
Q

What information do you get from spinning the microhematocrit tube?

A

plasma color and plasma protein concentration

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26
Q

True/False

there is species variation in PCV %

A

True

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27
Q

True/ False

Age may affect PCV% and Plasma protein

A

true

28
Q

Why would plasma protein concentrations be lower in juveniles

A

Haven’t been exposed to as many pathogens as adults have been so not as many globulins

29
Q

What is anemia of neonates

A

Low PCV in neonates because they have fetal RBC’s but need to start making their own

30
Q

what is a normal PCV% for mammals

A

Roughly 30-50%

31
Q

What is a normal plasma protein (TP)

A

Roughly 6-8 g/dl

32
Q

What does normal plasma color look like?

A

Dogs/cats - colorless

horses and ruminants - colorless to pale yellow depending on what they eat

33
Q

How does the hematology analyzer evaluate quantity of RBC’s

A

RBC - RBC count per microliter (measured)
Hgb - hemoglobin concentration per deciliter (measured)
HCT - hematocrit % calculated version of the spun PCV

34
Q

How does the hematology analyzer evaluate the quality of RBC’s

A

MCV - mean cell volume (size of RBC’s) Measured
RDW - Red cell distribution width (size variation among RBC’s) measured
MCHC - Mean cell hemoglobin concentration (hemoglobin within RBC’s) Calculated

35
Q

Which is more accurate measured or calculated values?q

A

MEASURED

36
Q

What 3 values should always go together if one is high all three should be high

A

PCV, RBC, and Hgb

37
Q

What is the Mean cell hemoglobin concentration

A

the ratio of hemoglobin to the number of RBC’s

expressed as grams of hemoglobin per 100ml of RBC’s

38
Q

what 2 types of anemia do you see with decreased MCHC (hypochromasia)

A

Anemia with a marked response by the marrow to regenerate new RBC’s (new RBC’s are lighter colored)

Anemia that is due to severe iron deficiency with very low hemoglobin in RBC’s (central pallor will be increased)

39
Q

What does increased MCHC mean?

A

usually always an artifact
hemolysis in vivo or in vitro
interference with hemoglobin measurement (Ex: lipemia)

40
Q

How does exercise affect PCV and TP in horses

A

During exercise, horses sweat so you will get hemoconcentration because the fluid component of blood has been reduced. PCV and TP may appear falsely high and can mask anemia

41
Q

What is the hallmark of dehydration?

A

Increased PCV and total protein

42
Q

What is anemia

A

Low RBC’s for the species, breed, gender, and age of the animal

43
Q

How do you base your diagnosis of anemia?

A

History
Physical Exam
Clinical signs
Diagnostics

44
Q

What are the clinical signs of anemia due to?

A

Decreased 02 delivery to the tissues

45
Q

What are the clinical signs of anemia influenced by?

A

Rate and severity of decrease in RBC number
Cardiopulmonary function
Age and activity of the animal
Cause of the anemia

46
Q

What are some things to ask about when taking a history in a possible anemic patient?

A 
Recent illness
drug or vaccine administration
exposure to toxice chemicals or plants
family or herd occurrence
recent transfusion or colostrum ingestion
age of onset of anemia
severity of anemia
47
Q

What are the clinical signs of anemia?

A 
Weakness, lethargy, exercise intolerance
Poor peripheral perfusion
 - pale mucous membranes
 - pale sclera
Cardiovascular
 - tachycardia
 - weak pulses
 - systolic murmur 
Pulmonary 
 - tachypnea, dyspnea
48
Q

What body systems are involved in the response to anemia?

A

Kidney, liver, thyroid, adrenal gland, sex hormones from gonads

49
Q

IF the body systems required for hematopoiesis are healthy, what should happen in response to the anemia?

A

3-4 days bone marrow should start making new RBC’s

Could take a week before you see regenerative changes

50
Q

What is an immature RBC called?

A

Polychromatophil

51
Q

What is an immature RBC stained with New methylene blue stain called?

A

Reticulocyte

52
Q

The more severe the anemia, the higher the what?

A

reticulocyte count

53
Q

how long do reticulocytes hang out in circulation before they are mature?

A

24-48 hours

54
Q

Why do we have to do a manual reticulocyte count in cats?

A

cats have aggregate reticulocytes that only stay in circulation for 12 hr. These become punctate reticulocytes which remain in circulation for 10-12 days. The analyzer does not pick up punctate reticulocytes and will greatly underestimate the response to anemia the body is having

55
Q

What are some hallmarks of a regenerative response to anemia?

A 
increased polychromasia 
increased anisocytosis 
increased nucleated RBC's 
increased Howell-Jolly bodies
basophilic stippling
56
Q

What is a normal finding in cats because their spleen does not remove them?

A

Howell- jolly bodies

57
Q

What is a normal feature of immature ruminant erythrocytes?

A

Basophilic stippling

58
Q

What is indicative of polychromasia in our lab results?

A

Increased MCV - polychromatophils are larger than mature RBC’s

Lower MCHC - polychromatophils contain less hemoglobin than mature RBC’s

Increase RDW will be greater variation in red cell size

59
Q

What lab findings indicate anemia?

A

Low PCV, Low Hgb, Low RBC

60
Q

What does increased polychromasia or reticulocytosis tell us?

A

Regenerative anemia

61
Q

What can cause a regenerative anemia?

A

Hemorrhage

Hemolysis

62
Q

What can appear as a non-regenerative anemia?

A

less than 4 days duration hemorrhage or hemolysis
extramarrow disease
intramarrow disease

63
Q

How do we describe mean cell volume in RBC’s

A

macrocytic, normocytic, microcytic

64
Q

How do we describe MCHC in RBC’s?

A

Hypochromic, normochromic, hyperchromic

65
Q

What are the pathophysiologic mechanisms of anemia?

A

Hemorrhage or blood loss
Increased erythrocyte destruction
decreased or defective erythropoiesis
hemodilution (not true anemia)

clinical pathology (6 decks)

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