Hematology Flashcards
What is the optimal number of saline washes to remove most RBC storage lesions without causing excessive RBC fragility?
One wash
JVIM 2021, Coll
Does K+ increase or decrease in a blood transfusion during storage and why? What are two scenarios where this could be clinically relevant?
K+ incr d/t declining Na/K ATPase
Usually not clinically relevant unless 1) already hyperkalemic or 2) massive xfusion
JVIM 2021, Coll
True or False:
A large prospective study of dogs receiving leukoreduced pRBC transfusions vs non-LR found that LR-pRBC dogs had fewer transfusion reactions and improved post-xfusion PCV.
False – no difference in xfusion reactions, PCV, hospitalization time, or survival.
JVIM 2021, Radulescu
What is the most common pRBC transfusion adverse reaction and its prevalence?
Febrile nonhemolytic transfusion reaction (FNHTR), 8%
JVIM 2021, Radulescu
True or False:
Peristaltic infusion pump (PIP) had slightly increased hemolysis compared with gravity delivered pRBC transfusion.
True
JVIM 2021, Blasi-Brugue
Are blood donations from first time or repeat donors more likely to contain infectious organisms?
First time donors
JVIM 2021, Nury
What are the unique features of greyhound blood?
–RBC size and number
–WBC number
–Plt number
–VCM clot strength and lysis
–Higher HCT, Hb, MCV –> higher viscosity
–Lower WBCs
–Lower plt
–VCM – weaker clot, incr lysis
JVIM 2021, Chang
What is the thrombin clotting time (TCT)?
Prolonged PT and PTT with normal TCT is nearly pathognemonic for what condition?
TCT: add thrombin to sample which converts F5 –> F5a, not affected by inhibitors
Acquired F5 inhibitors
JVIM 2020, Masciana
What is Glanzmann’s thrombasthenia?
Absent or low GP2b3a (fibrinogen receptor – needed for plt aggregation)
JVIM 2020, Li
What complications are expected with protein C deficiency?
How is congenital protein C deficiency diagnosed?
How is it treated?
–Thrombosis
–Repeatably low protein C + exclusion of acquired causes (liver failure, PSS, sepsis, DIC)
–Anticoagulants (such as rivaroxaban)
JVIM 2020, Kelly
What is eltrombopag and what condition can it help treat? When would you expect to see a response?
–Thrombopoietin receptor agonist – but also seems to stimulate multiple cell lines
–Tx idiopathic aplastic pancytopenia (along with immunosuppressives)
–Respond at ~1mo
JVIM 2020, Kelly
How do amounts of glutathione, ROS, and vit E compare in anemic vs non-anemic dogs?
Anemic: lower glutathione (antioxidant), slightly higher vit E
No difference ROS
JVIM 2020
A recent study compared a new formulation of lyophylized platelets (LP) with canine cryopreserved platelet concentrate (CPP).
–How did these compare with respect to bleeding scores, plt count, and TEG over time in thrombocytopenic dogs?
–What are some practical advantages of LP over CPP?
–Both had similarly decreasing bleeding scores, no change in plt or TEG (r/o similar efficacy vs no efficacy at all)
–LP is stable at room temp, longer shelf life, smaller volume
JVIM 2020, Goggs
How does the concentration of neutrophil extracellular traps (NETs) change in stored pRBCs over time and why?
What is the effect of prestorage leukoreduction on this?
What transfusion adverse effect implicates NETs as a contributor (in human studies)?
–NETs increase over time – poss due to hemolysis –> free Hb activating neuts. The supernatant does not activate them.
–Reduced by prestorage leukoreduction
–TRALI
JVIM 2020, Mcquinn
Regarding blood crossmatching (CM):
–What two basic reactions could indicate incompatibility?
–How do in house tube based kits compare with reference lab tube agglutination assay? Which of the above two reactions do the in house kits not look for?
–Agglutination and hemolysis
–IH kits don’t look for the latter
–IH kits missed the vast majority of incompatible CMs
JVIM 2020, Marshall
–What is the prevalence if incompatible crossmatch (CM) among transfusion naive vs previously transfused dogs?
–What were two risk factors for CM incompatibility? What was the most common underlying disease for both?
–True or false: Hemolytic transfusion reactions have not been reported in transfusion naive dogs.
–Naive 25%, prev transfusion 35%, similar magnitude of CM incompatibility reaction for both
–Hemolysis, low HCT – most were IMHA
–True – questions the clinical relevance of CM incompatibility in xfusion naive dogs
JVIM 2020, Marshall
A recent study found 5 novel naturally occurring Ab in cats apart from the already established blood types A, B, AB. What practical point does this make about our procedures for feline blood transfusions?
Always crossmatch, even if transfusion naive
JVIM 2020, Binvel
4yr FS lab 1hrs post op laparoscopic liver bx and still hasn’t recovered from anesthesia. Her mm are pale and her StO2 (tissue oxygen saturation) is <87%. What is wrong with her?
StO2 <87% –> shock (in this case, due to hemorrhage)
JVECCS 2019 Gray
How can hypocobalaminemia lead to megaloblastic anemia?
No B12 –> impaired DNA synth in RBC precursors –> apoptosis, phagocytosis
Some megaloblastic RBCs escape censor and make it to circulation
JFMS Olsen 2019
11yr MN mixed breed with 1 month hx vomiting, hyporexia, and rapid weight loss. Chronic enteropathy is a top ddx. Screening CBC showed moderate anemia, polychromasia, eccentrocytes, and keratocytes.
Does this increase or decrease suspicion for primary GI disease? If the former, is IBD or LSA more likely?
Anemia + at least 3 morphologic abnormalities (esp eccentrocytes) increases likelihood of chronic enteropathy, esp LSA
JAVMA 2019 Parachini-Winter
Which is true about samples obtained via pre-heparinized syringes? Jugular vs peripheral IVC?
A) It alters RBC indices
B) It alters plt morphology
C) It alters some biochemistry parameters
D) Some statistical, but no clinical differences for CBC and biochem values
D for both
JFMS 2021 Cook
JVIM 2022 Guarino
In an ICU setting, high RDW is a predictor of all-cause mortality for:
A) Dogs
B) Cats
C) Neither
C
JVECC 2022 Ludwik
JVECC 2022 Pfeifer
Procyte CBCs can underestimate neutrophil counts. How can you check for accuracy, OTHER than doing a manual diff?
Procyte misreads neuts as lymphs, monos esp in dogs with systemic inflammation
Look at dot plot. If the colored smears are all mashed together rather than distinct patches, it’s inaccurate.
JSAP 2022 Bergstrand
Which neoplastic phenotype is most common in cats with peripheral lymphocytosis?
Rank them from best to worst prognosis. For the one with the BEST px, list at least two factors that WORSEN px.
CD4+ T cell
CD4-CD8- (double neg) T cell
CD5 low expressing T cell
Most common: CD4+
CD4+ 2yrs > DN T cell 9mo > CD5 low <1mo
CD4+ – worse if abdominal lymphadenopathy, intestinal involvement, female
JVIM 2020 Rout
2yr FI Ragdoll with microcytic, hypochromic, nonregenerative anemia. She is mildly lethargic, otherwise aclinical. No GI signs. She is indoor only and fed a commercial raw diet.
What is your top differential?
Iron deficiency anemia due to aberrant diet
Most commercially available foods that are low in Fe, Cu, Zn are raw diets
JFMS 2022 Summers
True or False: Like handheld glucometers, handheld lactatometers are prone to error compared with tabletop analyzers.
False – lactatometers are very accurate
JVECC 2020 Acierno
True or False: IH ammonia tends to read lower than the reference lab but usually not significant enough to affect interpretation.
True – high agreement with interpretation as either normal or high
JAVMA 2018 Funes
In cats with pancytopenia due to myelodysplastic syndrome (MDS), which bone marrow cell line is usually most significantly affected?
A) Granulocytes
B) Lymphocytes
C) Erythrocytes
D) Megakaryocytes
E) All equally affected
C
JFMS 2019 Turinelli
What characteristics might be seen on LN sampling in dogs with sterile lymphadenitis?
A) Neutrophilic
B) Granulomatous
C) Pyogranulomatous
D) Necrotic
E) All of the above
F) None of the above
E) All of the above
JSAP 2019 Latre
