Exam 1 Flashcards
(184 cards)
1
Q
Howell Jolly Bodies
A
nRBC
regenerative anemia
splenectomy (spleen helps remove nucleus from RBC), steroids, lead poisoning (affect spleen)
2
Q
Inherited Neutrophil abormalities
A
Pelger-Huet
Birman cat
Chediak Higashi
Lysosomal Storage
3
Q
What tube is a chemical analysis done with?
A
Heparin (green top)
4
Q
What is used for a coagulation test?
A
blue top- citrate w/ sterile needle
5
Q
What is used to collect blood for blood smear?
A
EDTA lavender top
6
Q
T/F Splenomegaly can cause thrombocytosis
A
FALSE
7
Q
What is responsible for initiating coagulation after tissue damage?
A
Tissue Factor 3
8
Q
What are the products from fibrinolysis?
A
FDPs Fibrin Degradation Products
D-dimers
9
Q
Increases in FDPs & D-dimers indicate increased
A
intravascular coag with clot breakdown
10
Q
What causes thrombocytopenia along with increased FDP & D-dimers?
A
DIC Disseminated Intravascular Coagulation
11
Q
What causes Heinz body anemia?
A
Onions, garlic, kale, WILTED red maple leaves, acetaminophen (aspirin), propylene glycol (feed additive), zinc
12
Q
What won’t have an affect on the refractometer reading?
A
Bilirubin
13
Q
What is true about reference intervals?
A
Includes 95% of the healthy population
14
Q
What are the indications for a BMA (bone marrow aspirate)? What would NOT be the cause?
A
Non reg anemia, neutropenia, thrombocytopenia, monoclonal gammaopathy
NOT: monocytosis
15
Q
Which species is neonatal isoerythrolysis most common in? Caused by?
A
Equine
caused by maternal antibodies against neonates bloodgroup antigen –> hemolysis
16
Q
Which is the main iron metabolism control?
A
Ferritin
17
Q
Increased plasma protein (TP)
A
CHUGL(cholesterol, hemolysis, urea, glucose, lipemia)
18
Q
Calc % to absolute
A
Tncc=10,000
80% segs
10,000 x .8= 8000 segs
just know concept
19
Q
Left shift
A
increased concentration of immature neutrophils (bands) can be seen w/ neutrophilia, neutropenia (SEVERE INFLAMMATION) or normal count
20
Q
Toxic Neutrophils
A
produced at an accelerated rate
increased basophilia of cytoplasm, dohle bodies {RNA aggregates}, cytoplasmic vacuolation
21
Q
Stress leukogram
A
lymphopenia with neutrophilia
22
Q
Inflammation from leukogram
A
2x normal reference of bands or left shift
23
Q
Excitement
A
neutrophilia w/ lymphocytosis (cats)
24
Q
Neutrophilia
A
inflammation, excitement, stress
25
Lymphocytosis
excitement, leukemia,
| ehrlichia
26
Monocytosis
inflammation, stress
27
Eosinophilia
parasite, hypersens, mass cell tumors
28
Neutropenia
inflammation consumption, BM problems
29
Lymphopenia
stress, immunodeficiency, STERIOD
30
Macrocytic RBC
increased MCV
| regenerative anemia
31
Microcytic RBC
decreased MCV
| iron deficient anemia
32
Polychromasia in RBC
reticulocytes
33
Hypochromasia in RBC
iron deficient anemia (not enough iron to make Hb so cells are pale)
34
Schistocytes
DIC, hemangiosarcoma (doberman), Iron def anemia
35
Spherocytes
IMHA!!!!!!!
| cocker spaniel
36
Heinz bodies are
oxidative denatured hemoglobin
37
Basophilic stippling
lead poisoning, normal in ruminants!
38
Rouleaux
normal in horses, increase globulin in small animal
| stickiness, not agglutination!
39
Agglutination is commonly seen with
IMHA
40
If you add saline and it disperses it is ____, if it persists it is____
rouleaux
| agglutination
41
MCV is increased by
reticulocytes & platelet clumping (agglutination)
42
IMHA commonly see what 2 things?
agglutination and spherocytes
43
Decreased MCV indicates
Iron deficient anemia
44
1/3 of platelets live in the ____
spleen
45
What produces TPO & why?
liver, kidney, muscle
| binds platelets, when increased free TPO platelet production from the bone marrow begins
46
6 Causes of thrombocytopenia
```
Decrease production
Destruction
Sequestration
Loss
Consumption
Pseudothrombocytopenia
```
47
Platelet count is in the single digits so it has to be
destruction! only way to get such a low number
48
Thrombocytosis caused by
increase production, increased distribution
49
Primary Hemostasis
```
AAA (takes 3-5 mins)
Adhesion
Activation
Aggregation
***Ca needed at all steps
```
50
Von Willebrand's
Dobermans
Defect in adhesion of platelets, cant bind!
will have normal platelet count
Ecchymosis
51
Secondary Hemostasis
Fibrin meshwork created via clotting cascade
Coag factors synthesized by liver
II, VII, IX, X are Vitamin K dependent!***
1972
52
What drives amplification & formation of fibrin?
Thrombin
| activates V & XI
53
Intrinsic
PTT
XII, XI, IX, VIII
12, 11, 9, 8
54
Extrinsic
Tissue factor
VII
PT
55
What initiates secondary hemostasis?
Tissue factor 3
56
Inhibitor of coagulation
antithrombin- 70% of anti-coag activity
57
Increase ___ and ___ = DIC
FDPs
| D-dimers
58
Warfarin Toxicosis
Attacks vit K (2, 7, 9, 10)
| no coag, bleeding, normal platelets, regnerative
59
DIC
IV coag throughout body
Phase 1 hypercoagulable
Phase 2 consume platelets, coag factors & antithrombin
Increased fibrinolysis
LABS: thrombocytopenia, PT & PTT increased, Schistocytes
60
2 month old puppy, remove a tooth and bleeds
Hemophilia A: issue w/ factor VIII
61
Decreased TP
blood loss :regenerative anemia (I
62
Increased TP
blood destruction :regenerative anemia
63
Non regenerative anemia caused by
```
bone marrow issue
erythroid hypoplasia
intrinsic: bone marrow issue
extrinsic: renal failure, anemia of inflam, endocrine probs
acute hemorrhage
```
64
Acute anemia 3 examples
trauma (HBC), Coag disorder (DIC), Thrombocytopenia
65
Chronic anemia 3 examples
GI ulcer, bleeding GI tumor, Parasites(hookworm), Iron def anemia***
66
Anemia of blood destruction examples
IMHA, Heinz body, RBC parasites (mycoplasma), Methemoglobinemia
67
Iron deficiency Anemia
- adults usually from chronic blood loss
- Decreased MCV, microcytosis
- Hypochromasia
- Schistocytes & Keratocytes
- regenerative
68
Hemangiosarcoma
- doberman, german shepard
- acute episodes of weakness
- regenerative anemia
- acanthocytes, schistocytes
69
IMHA
```
usually secondary, we never find true cause
COCKER SPANIELS
Inflammatory leukogram
SPHEROCYTES
agglutination
```
70
Heinz body anemia
oxidative denatured Hb
| Causes: onions, garlic, kale, WILTED red maple leaves, acetaminphen, propylene glycol**, zinc
71
Methemoglobinemia
chocolate brown blood
oxidative damage
causes: acetaminophen, nitrate poisoning, red maple leaves
72
4 possible causes of lymphocytosis
- antigen stimulation (Erhlichia)
- excitement
- addisons
- lymphocytic leukemia if >30,000
73
Erhlichia
anemia, Increase Hb, lymphocytosis, thrombocytopenia
74
Pancytopenia
all cell lines decreased
75
Aplastic anemia
not producing any RBCs, has to be in bone marrow
| Ehrlicia, IM destruction, drugs
76
Erythroid Hypoplasia
```
-intrinsic, see young RBCs
myelodysplasia
leukemia
IM destruction
similar to aplasia
-extrinsic factors
chronic renal failure
endocrine disorders
inflam dz
```
77
Anemia of Renal dz
lack of production of Erythropoietin (EPO)-
which stimulates the bone marrow to produce RBCs
Hypocalcemia
excess parathyroid hormone
78
Anemia of Inflammatory dz
mild anemia
increase storage or iron
low serum iron
CS: weak, fever, inflam leukogram, slight anemia, non regnerative, lots of neutrophils
79
Myeloid to Erythroid ratio
1:1, 3:1
interpret bone marrow
erythroid always stays 1!
80
Increased M:E ratio
increased WBC & decreased RBC
erythroid hypoplasia or aplasia
granulocytic hyperplasia or leukemia (neutrophils over 100,000)
81
Decreased M:E Ratio
increased RBC & decreased WBC
regenerative anemia
erythroid leukemia
82
Feline Type A
weak isoantibodies against Type B
83
Feline Type B
STRONG isoantibodies against Type A
| *do NOT give type B any type A blood
84
Neonatal isoerythrolysis
problem when giving birth to foal w/ different antibodies
85
Agglutination is a ___ rxn for blood typing
POSITIVE
86
Agglutination should NOT be confused with ____
rouleuax bc they are NOT the same
| Horse: rouleaux is normal
87
Agglutination is ____ rxn for cross matching
BAD
| if positive agglutination DO NOT give transfusion
88
What kind of parameter is MCHC?
calculated
89
RBCs that stand at room temp
swell & falsely increase MCV
90
RBC peak with right shift
indicates larger, immature RBC precursors
increase RDW (red cell distribution width)
regenerative anemia
91
Increased hemoglobin concentration causes?
artifactual hemolysis, lipemia, heinz body
| *w/ increase Hb, MCHC increases
92
Acetaminophen toxicosis causes
heinz bodies (stain w/ NMB)
93
Spherocytes are hallmark sign of
IMHA
| RBCs that appear dark, small, lack central pallor, volume is normal
94
What cells are a sign of Iron deficiency anemia?
Schistocytes (erythrocyte fragments) & Keratocytes (blister cells)
95
Lead poisoning causes
basophillic stippling
normal in ruminants!!
will see regenerative anemia in cats & dogs
96
Cells seen with hemangio sarcoma?
Acanthocytes
| spicules are large
97
What cells are seen with snake venom?
Echinocytes
| numerous short spicules
98
Left shift
increase concentration of immature neutrophils in the blood (usually bands)
99
Ruminants with a left shift
not a big worry bc they lack storage so extra bands in the peripheral blood isn't necessarily a bad sign
100
2 fold increase in lymphocytes
excitement response
| mostly cats
101
2 fold increase in neutrophils
stress leukogram or inflammation
102
Stress leukogram
neutrophilia 2x
lymphopenia
use of coricosteroids
103
Inflammation leukogram
Neutrophilia 2x
Bands
Left shift
104
Excitement leukogram
neutrophilia
lymphocytosis
cats
won't see increase in immatures bc spleen contraction increased lymphocyte count
105
What is the most common cause of lymphopenia?
steroid response
decreases concentration of WBCs
or acute viral infection or immunodeficiency
106
*What are 2 possible causes of thrombocytopenia when it is associated with IMHA?
```
Evans syndrome (immune mediated)
DIC
```
107
Polycythemia is the ___ of RBCs in the blood
increase
| increased PCV
108
Polycythemia can be caused by a ____ in plasma volume (____) or erythrocyte redistribution in ___ ___.
decrease plasma in dehydration
| splenic contration
109
Underfilling the EDTA tube results in
shrunk RBCs
| falsely decreased PCV and calculated MCV when microhematocrit is used
110
Why do neonates commonly have iron deficiency anemia?
because they drink milk which is low in iron and growth rates are high
especially piglets, iron def soil
111
Tx of iron deficiency anemia in adults and neonates
neonates: inject Fe
adults: find source of blood loss
112
Most common causes of iron deficiency anemia in adults
GI bleeds, tumors, ulcers (drugs)
| parasites (hookworms, ectoparasites: fleas)
113
Causes of heinz body anemia in cats
diabetes mellitus, lymphoma, hyperthyroidism, acetaminophen, onions/garlic
114
Pelger-Huet syndrome
neutrophil abnormality
| hyposegmented neutrophils, function normally
115
Chediak-Higashi syndrome
neutrophil abnormality
large fused lysosomes that stain pink
these cats have slight tendency to bleed due to abnormal PLT function
116
Acquired neutrophil abnormalities?
```
neutrophil hypersegmentation (aging)
neutrophil degeneration (bacT)
leukocyte agglutination (in blood tube when cold)
lymphocyte vacuolation (toxic plants)
```
117
Test _____is the ability of a test to correctly identify those with the disease (true positive rate), whereas test ____ is the ability of the test to correctly identify those without the disease (true negative rate).
sensitivity
| specificity
118
IMHA lab abnormalities
```
RBC destruction (immune mediated response)
regenerative anemia
polychromasia
cocker spaniels
SPHEROCYTES
bilirubinuria
agglutination
```
119
Simple way to differentiate blood loss from blood destruction?
Decreased TP = blood loss
| Increased TP or normal = blood destruction (proteins floating around in peripheral blood due to hemolysis)
120
Causes of increased MCV?
regenerative anemia
121
What would cause an increased MCV in a cat with NON-reg anemia?
macrocytosis if the cat has FeLV
122
Hematologic abnormalities in a dog with anemia of inflammatory dz?
non regen
inflam
mild anemia
123
Hematologic abnormalities in a dog with renal dz?
chronic/severe anemia
non regen
primary cause of anemia is lack of production of erythropoietin by kidney
124
What causes toxic neutrophils?
when neutrophils are produced at an accelerated rate so you will see a high number of immature neutrophils
(bact inflam?)
125
Red top used for
serum, chemical profile
126
Tiger top
serum separator, promotes clot formation, serology, chemistry-no toxin
127
Purple top
EDTA CBC, blood smear
128
Green top
heparin, exotic CBC, chem panel
129
Blue top
citrate, coag, PT, PTT, FDP
130
Gray top
sodium fluoride oxalate
131
Which tubes have a Ca2+ chelator?
Gray, Purple, Blue
| works by binding Ca to prevent clotting
132
If there is contamination of an EDTA tube with a chemistry tube, what 2 major abnormalities are seen on the chem panel?
Increase potassium
| Decrease Ca
133
Positive predictive value is the probability that a ____ test result truly identifies ___ in P
positive
| disease
134
Negative predictive value is the probability that a _____ test result truly identifies the _______ in a patient
negative
| absence of a dz
135
Low prevalence is the
most common cause of error
136
What is the major regulatory hormone for thrombopoiesis?
Thrombopoirtin TPO
137
Where is TPO produced?
kidney, liver, muscle
138
How does TPO work?
increases megakaryocyte production in bone marrow, producing more platelets
139
What changes are seen in healthy bone marrow when thrombocytopenia is present?
megakaryocytes in bone marrow will increase ploidy (nuclei), causing release of more platelets
140
What role do platelets play in hemostasis?
primary hemostatic plug
| Adhesion, activation, aggregation
141
When can spontaneous hemorrhage occur?
PLT count less than 30,000
142
When do you get falsely decreased platelet concentrations on the analyzer?
PLT clumping (cats/cows) and macroplatelets being counted as RBCs(increased production)
143
What lab test do we use to access platelet morphology?
blood smear & hematology analyzers
144
What does MPV mean?
measured platelet volume
145
What test is used to evaluate platelet function in a clinic?
bleeding time tests
buccal mucosal bleeding time, cuticle bleeding time
and specific platelet function tests
146
What test do we use to access platelet production?
Bone marrow aspirate (BMA)
147
In a thrombocytopenic patient, how should healthy bone marrow respond?
should have a ton of megakaryocytes w/ lots of ploidy and releasing cytoplasm to be platelets
148
What are the 5 causes of thrombocytopenia?
```
Production
Destruction
Sequestration
Loss
Consumption
```
149
Differentials for production
bone marrow hypoplasia
| neoplasia
150
Differentials for destruction
immune mediated thrombocytopenia
151
Differentials for sequestration
splenomegaly
152
Differentials for loss
hemorrhage but only mild loss in acute/severe cases
153
Differentials for consumption
DIC, FIP (viral)
154
What are your 2 primary differentials for severe thrombocytopenia?
ITP and bone marrow aplasia
ITP will have regen thrombocytopenia
Aplasia will not have any platelet precursors
Use a BMA to differentiate
155
Causes of thrombocytosis
increased production
increased distribution
primary neoplastic production
secondary
156
3 situations that may cause a relative thrombocytosis
post splenectomy
epinephrine (excitement)
splenic contraction
157
vWD von Willebrand's dz what changes would you see?
normal CBC bc platelet levels are not affected
bleeding time would drastically increase
petechia & ecchymosis
158
Secondary hemostasis
what initiates coag?
which factor drives amplification?
tissue factor is the initiator of coag in vivo
| Thrombin IIa drives amplification
159
What are the 4 vit K dependent factors?
2, 7, 9, 10
| 1972
160
What cofactor increases antithrombin activity?
Heparin (green)
161
Which dz is associated with antithrombin loss?
glomerular dz
162
When antithrombin is lost, are patients hypocoagulable or hypercoagulable?
hypercoag bc when thrombin is present it inhibits coag
163
What are two major end products of fibrinolysis?
fibrin degradation products & D-dimers
| they increase when there is increased IV coag w/ clot breakdown
164
What 2 tests assess the intrinsic/common pathway?
ACT & aPTT
165
What is the 1 test to assess the extrinsic/common pathway?
PT, prolonged clotting indicates a deficiency
166
What 2 tests do you use to assess fibrinolytic activity?
FDP & D-dimers quantitative tests
167
what toxin is commonly associated with vit K deficiency?
warfarin
168
Vit K deficiency bleeding pattern
severe hemorrhage
| PLT would be normal
169
Vit K deficiency
| what is abnormal on coag profile?
PLT normal
PT prolonged bc of factor 7 deficient
PTT prolonged bc factor 9 is effected
170
DIC common cause
sepsis
| but can also be tissue necrosis & neoplasia
171
2 phases of DIC
```
Hypercoagulable phase
Consumptive phase (bleeding occurs)
```
172
What bleeding pattern is associated with DIC
coagulation
173
DIC coag profile
mild thrombocytopenia***
174
Liver disease coagulopathies
liver produces 2, 7, 9, 10
| if it is diseased it may release abnormal coag factors
175
What test should be run prior to liver biopsy when liver disease is suspected?
screening for coag abnormalities!!!
176
Classic presentation of a inherited factor deficiency
young animal w/ bleeding disorder
177
What are the 3 most common inherited factor deficiencies?
Hemophilia A: factor 8 deficiency
Hemophilia B: factor 9 deficiency (dogs/cats)
Hagemans dz: factor 12 (cats)
178
Why are cats always blood typed?
if you give a B-typed cat A blood it severely reacts and is fatal
179
Blood typing card positive result
agglutination
180
Blood typing dipsticks work by
blood lines up on the correct blood type
181
Major crossmatch
Patient serum with donor RBC
182
A positive crossmatch is
agglutination but is BAD
183
Negative crossmatch means
go ahead and transfuse
184
Transfusion rxn symptoms
acute hemolytic transfusion rxns
delayed hemolytic transfusion rxns
non-hemolytic transfusion rxns
