Hematology Flashcards
(162 cards)
1
Q
Normal blood separates into _____ formed elements and ____ plasma
A
45% formed elements; 55% plasma
2
Q
Formed elements separates into (2)
A
Buffy coat (WBC/platelets) and RBCs
3
Q
The composition of plasma is ____ water, ___ protein and ___ other solutes
A
90% water; 7% protein; 3% other solutes
4
Q
Of all protein in plasma, what makes up the majority; what about the second highest
A
albumin (60%); globulins (35%)
5
Q
What is the role of transient proteins in the bloodstream
A
No functional role; we use them as markers of damaged and dying cells
6
Q
plasma vs serum
A
plasma: anticoagulants added; contains clotting proteins
serum: allowed to clot; clotting proteins removed
7
Q
lipidemia looks
A
white
8
Q
hemoglobinemia looks
A
red
9
Q
bilirubinemia looks
A
yellow
10
Q
plasma of a healthy dog and cat is
A
colourless to light yellow (due to bilirubin)
11
Q
plasma of a healthy cow and horse is
A
medium yellow (due to carotenoids; horses also have a higher bilirubin concentration)
12
Q
plasma of a healthy sheep and pig is
A
colourless
13
Q
in what 2 organs is there secretion AND absorption of solutes in blood (as opposed to just outward)
A
kidney and liver
14
Q
Most enzymes in serum are usually
A
found in cells and leaked out
15
Q
what are examples of enzymes that are normally not in cells
A
clotting enzymes, lipoprotein lipase
16
Q
where in the cell can enzymes be localized
A
cytoplasm, mitochondria, ER, intracellular granules, cell membrane
17
Q
cell enzymes in what location are first to be released
A
cytoplasmic
18
Q
cell enzymes in what location are released after minor cell injury
A
granule
19
Q
cell enzymes in what location are released after severe insult
A
mitochondria
20
Q
cell enzymes in what location are not soluble and only released after severe insult
A
membrane
21
Q
ALT
A
alanine aminotransferase
22
Q
AST
A
aspartate aminotransferase
23
Q
SD
A
sorbitol dehydrogenase
24
Q
LD
A
lactate dehydrogenase
25
ALP
alkaline phosphatase
26
GGT
gamma glutamyltransferase
27
CK
creatine kinase
28
what impacts the levels of serum in enzyme (4)
tissue concentration of that enzyme; cellular location of the enzyme; amount and severity of tissue injured; rate of removal from the serum
29
how are enzyme levels commonly measured in blood
kinetic assays; add substrate that changes colour in presence of the enzyme
30
using heparin affects the results of what assay
BUN (since heparin is often in the form of ammonium salt)
31
EDTA, oxalate and citrate affect the results of what assay
calcium (since they chelate calcium)
32
hemolysis results in increased readings for analytes, such as (4)
iron, lactate dehydrogenase, potassium, total protein
33
why do you fast before a blood test
lipemia alters many serum factors
34
what characteristics of serum enzymes make them a useful clinical marker (6)
intermediate half-life
rise specifically when tissue is injured
do not rise under normal conditions
easy to measure
tissue-specific
concentration
35
what is the reference interval for a serum value
value (range) of a specific enzyme in a group of clinically healthy animals of the same species
36
reference intervals are accurate what percentage of the time
95%
37
how does error relate to measuring serum
for each test ordered, the chance of a false positive increases by roughly 5% (5% for one test, 9.75% for 2 tests...)
38
reference values are calculated based on the mean +/- ____ SD
mean (level in the healthy population) +/- 2 SD
39
name 5 factors that can impact test results
age, species, stress, lipemia, hemolysis
40
erythrocyte appearance in mammals
anucleate and biconcave
41
erythrocyte appearance in reptiles and birds
nucleated and oval
42
hemostatic cells in birds and reptiles are called
thrombocytes
43
instead of neutrophils, birds and reptiles have
heterophils
44
what special mononuclear cell is only present in reptiles
azurophils
45
T/F birds have azurophils
F; only reptiles
46
describe the progression of sites of hematopoiesis
yolk sac -> liver -> bone marrow
47
what determines lineage commitment
growth factors (GFs) and colony-stimulating factors (CSFs)
48
what are the sites of extramedullary hematopoiesis in adults
spleen, liver
49
IL-3, M-CSF and GM-CSF stimulate the production of
all CFU-Gemm types (everything but lymphocytes)
50
IL-11 stimulates
platelets (as does thrombopoietin)
51
myeloblasts are the precursor to all
granulocytes
52
the process of erythropoiesis takes
5-6 days
53
describe the stepwise process of erythropoiesis
pluripotent stem cell -> CFU-gemm -> BFU-E -> rubriblast -> prorubricyte -> rubricyte -> metarubricyte -> reticulocyte -> RBC
54
up to what stage are RBC precursors in the proliferative pool
up to pro-rubricyte
55
at what stage are RBC precursors in the maturation pool
rubricyte and onwards
56
what are factors that can impact erythropoiesis
the right environment, factors from macrophages and lymphocytes, EPO, cell-cell interactions
57
how does CKD cause anemia
lack of EPO produced by diseased kidneys; diseased kidneys release toxins that negatively impact RBCs
58
In fetuses _____________ is released by ______________, which is catalyzed into erythropoietin by _______________
erthropoietinogen; liver; erythrogenin
59
In adults, _______________ is released by _________________, which is catalyzed into erythropoietin by _______________.
proerythropioetin; kidney; plasma enzyme
60
what is the lifespan of RBCs in dogs
100 days
61
how many RBCs are replaced daily (%)
1%
62
where are RBCs removed
spleen
63
what is a major factor related to death of RBCs
decrease in deformability
64
heme is catabolized into
iron and biliverdin
65
what happens to biliverdin
reduced to bilirubin and released into circulation
66
what happens to bilirubin once it reaches the liver
conjugated to form bilirubin-glucuronide
67
what happens to conjugated bilirubin
excreted into the intestine and converted to urobiliogen
68
what are reticulocytes
immature enucleated erythroid cells that still contain some RNA; slightly bigger than RBCs
69
presence of reticulocytes indicates
a productive marrow response (it has all the iron and nutrients to function adaptively)
70
how do reticulocytes look histologically
slightly larger and more basophilic (due to RNA)
71
T/F observation of reticulocytes requires methylene blue
T
72
with a Wright's stain, what is observed in the presence of reticulocytes
polychromasia
73
polychromasia
variation in staining due to the presence of reticulocytes in blood
74
normocytic
normal RBC size
75
anisocytosis
variation in RBC size
76
macrocyte (macrocytic)
increased volume and diameter
77
microcyte (microcytic)
decreased volume and diameter
78
hypochromic
decreased hemoglobin content and staining
79
normochromic
normal staining intensity
80
with what condition is hypochromasia frequently seen
iron deficiency anemia
81
basophilic stippling
bluish inclusions in the cytoplasm
82
heinz bodies
refractile inclusions caused by precipitation of Hg; seen with onion toxicity
83
Howell-Jolly bodies
chromatin residues
84
acanthocyte, poikilocyte, leptocyte, spherocyte, etc.
morphological changes in the shape and size of RBCs associated with pathologic states
85
how is blood Hg measured
by lysing the cells in a volume of blood and then measuring the Hg chemically with a spectrophotometer (as cyanomethhemoglobin)
86
T/F hematocrit and PCV are interchangable terms (for this course)
T
87
when RBC numbers are low, PCV/Hct is
low
88
what is PVC/Hct
percentage of a volume of whole blood composed of RBCs in a centrifuged sample
89
MCV
mean corpuscular volume; average volume of each RBC
90
MCH
mean corpuscular Hg; average total amount of Hg in each RBC
91
T/F MCH measures the mean volume of Hg in each RBC
F; it measures mean total amount of Hg
92
MCHC
mean corpuscular Hg concentration; average concentration of Hg in each RBC
93
RDW
red cell distribution width; difference in size between largest and smallest RBCs in a sample; indicates increased number of reticulocytes OR smaller cells
94
if MCV is high, the cells are ______; if MCV is low, the cells are _______
macrocytic; microcytic
95
Is MCHC or MCH more useful
MCHC (corrects for size and volume differences)
96
if MCHC is high, the cells are _________; if MCHC is low, the cells are _________
hyperchromic; hypochromic
97
high RDW indicates
anisocytosis
98
polycythemia
increased number of RBC per ml of blood; associated with elevated PCV and Hb
99
what is a leukemic syndrome that causes polycythemia
polycythemia (rubra) vera
100
what is relative polycythemia; how can it be differentiated
polycythemia due to dehydration OR splenic contraction; if dehydrated, will also see elevated total protein
101
high PCV with normal protein suggests
polycythemia
102
high PCV with high protein suggests
dehydration
103
high PCV with decreased EPO suggests
polycythemia vera
104
high PCV with increased EPO suggests
tumor or hypoxia
105
causes of anemia
blood loss, iron deficiency, immune destruction, bone marrow pathologies, chronic inflammation/disease
106
decreased PCV with normal TP suggests
anemia
107
normal PCV with elevated TP may suggest
anemia with dehydration
108
T/F regenerative anemias have a better prognosis than non-regenerative anemias
F
109
what are the cytometric types of anemia
normocytic normochromic; macrocytic normochromic; macrocytic hypochromic; microcytic normochromic; microcytic hypochromic
110
what are the erythrokinetic types of anemia
regenerative and nonregenerative
111
when are regenerative anemias seen
hemolysis with recovery of the iron; single acute hemorrhage with sufficient time for a marrow response
112
what is always an indicator of regenerative anemia
anisocytosis and polychromasia
113
IMHA is a
regenerative anemia
114
what lab tests allow you to determine increased RBC turnover/production
reticulocyte count; bone marrow biopsy; serum unconjugated bilirubin or urine urobilinogen
115
causes of non-regenerative anemia
chronic or immediate blood loss (within past 24h); extra-marrow disease/deficiencies (ex. iron); intramarrow disease (ex. leukemia)
116
how long to platelets circulate
10 days
116
T/F you may likely see megakaryocytes in blood
F; RARELY ever occurs
117
where are megakaryocyte pools
spleen, lungs, bone marrow, liver
118
primary hemostasis involves ___________, secondary hemostasis involves __________, and tertiary hemostasis involves ___________
formation of the platelet plug; stabilization via fibrin clot; dissolution
119
what does the endothelium secrete to prevent hemostasis
prostacyclin (PGI2) and nitric oxide (NO)
120
with vessel injury, platelets
adhere to vWf
121
what do activated platelets release
ADP - attracts more platelets
serotonin - maintains vasoconstriction
TXA2 - promotes aggregation, degranulation, vasoconstriction
122
normal dogs have platelet counts greater than __________ and horses _________
200,000; 100,000
123
bleeding occurs when platelet counts are less than
30,000
124
coagulation enzymes commonly require (2) as cofactors
phospholipid and calcium
125
contact pathway is initiated by what factor
XII
126
tissue factor pathway is initiated by what factor
III (TF) -> IIIa
127
what factor causes fibrin cross-linking
XIII
128
what coagulation factors require gamma carboxylation by vitamin K
2, 7, 9, 10
129
what inhibits vitamin K (poison)
warfarin
130
antithrombin III inhibits factors
2, 7, 9, 10, 11, 12
131
T/F protein C inhibits coagulation
T
132
disorders with primary hemostasis manifest as ________ whereas disorder with secondary hemostasis manifest as _________
petechiae (on skin/MM); hemorrhage
133
ACT measures activity of
common pathway and contact pathwat
134
APTT measures activity of
contact pathway and common pathway
135
PT measures activity of
TF pathway and common pathway
136
where is tPA released from
endothelial cells
137
leukocytosis
elevated total number of WBCs
138
leukopenia
decreased total number of WBCs
139
what is the most common circulating granulocyte in dogs
neuts
140
what is the most common circulating agranulocyte in dogs
lymphocytes
141
what is the WBC equivalent of reticulocytes
band cells
142
what are the steps in WBC production
|myeloblast -> promyelocyte -> myelocyte -> | metamyelocyte -> band cell |
143
what is the normal neut lifespan
less than 24 h
144
in what cases do neutrophils accumulate in tissues
chronic inflammation or leukemia
145
what is the characteristic feature of band cells
unsegmented nuclei
146
a left shift indicates
infection, hypoxia, shock
147
what impact does the initial response have on neutrophils
decrease (increased margination and migration)
148
what impact does the intermediate phase have on neutrophils
increase (neutrophils in marrow reserve released)
149
what impact does the progressive phase have on neutrophils
increase (in marginal and circulating pools)
150
neutrophils usually make up ____% of circulating WBCs
50-70
151
where are most toxic changes observed; why do they occur
in band cells; intense stimulation of granulopoiesis with a shorter maturation window
152
what are toxic changes
less condensed chromatin, bluer cytoplasm (retention of RNA), doehle bodies (ribosomal protein)
153
stress induces decrease in the number of ________ and increase in the number of __________ and _________
lymphocytes; monocytes and neutrophils
154
what is the lifespan of a macrophage
months to years
155
T/F eosinophils can phagocytose bacteria, yeast, ab-coated RBCs, mycoplasma and mast cell granules
T
156
what is sometimes seen as an idiopathic infiltrate in lungs and muscle
eosinophils
157
glucocorticoids result in a decrease in
eosinophils
158
what two cell types are very similar
basophils and mast cells; both have histamine
159
basophils attract what cells via chemotaxis
eosinophils and neutrophils
160
T/F basophilia is associated with diseases that cause IgE production
T
161
what is associated with heartworm
basophilia
