Lect 2 - Haematology Flashcards
(202 cards)
1
Q
Haematology is divided into the study of [2]
A
Formed (cellular) elements
Soluble fraction of blood (plasma)
2
Q
The cellular components of haematology includes [3]
A
Erythrocytes, leukocytes and platelets
3
Q
Haematopoietic growth factors include [3]
A
Proteins, colony stimulating factors (CSF) and interleukins (ILs)
4
Q
At birth, almost all the bones of the body are involved in haematopoiesis, however, by adulthood, active haematopoiesis occurs mainly in the [5]
A
Marrow of the vertebrae, ribs, sternebrae, pelvis and metaphyses of long bones
5
Q
When there is great demand for blood cells or when there is unregulated blood cell proliferation, active haematopoiesis may return to [2]
A
Extramedullary sites e.g. liver, spleen
To the diaphyses of long bones
6
Q
Haemopoitic stem cells (HSC) are
A
Pluripotential stem cells that have the ability to differentiate into different cell types
7
Q
What are the daughter cells of HSC [2]
A
Myeloid and lymphoid
8
Q
How do HSC differ from daughter HSC
A
HSC are self renewing cell
HSC daughter cells commit to alt differentiation pathways and are not self renewing
9
Q
The erythrocyte mass in the body consists of [3]
A
The stem cell compartment - bone marrow
The maturation and proliferation compartment - bone marrow
Circulating erythrocytes
10
Q
A portion of the pluripotential stem cells becomes committed to erythropoiesis and differentiates into
A
Eryrthroid progenitor cells
11
Q
Name the two sets of erythroid progenitor cells identified [2]
A
Burst forming unit erythroid (BFU-E)
Colony forming unit erythroid (CFU-E)
12
Q
Erythropoiesis is regulated by [2]
A
Tissue hypoxia (main stimulus) and growth factors/hormones
13
Q
What regulatory hormone is elaborated in response to hypoxia and where does it come from
A
Erythropoietin (EPO) from the peritubular interstitial cells of the kidney
14
Q
What is the most important growth factor for maintenance of erythropoiesis
A
EPO
15
Q
What growth factors stimulate BFU-E to differentiate into CFU-E and the differentiation of CFU-E into the erythroblast (rubriblast) [4]
A
EPO, IL-3, G-CSF and GM-CSF
16
Q
EPO, IL-3, G-CSF and GM-CSF stimulate
A
Differentiation of BFU-E into CFU-E and CFU-E into erythroblast (rubriblast)
17
Q
The first recognizable erythroid precursor in the bone marrow
A
Rubriblast
18
Q
The maturation sequence of the erythroid cells is [6 steps]
A
Rubriblast > Prorubricytes > Rubricytes > Metarubricytes > Reticulocytes (Polychromatophil) > Mature erythrocyte
19
Q
Newly released blood cells stain blue/bluish grey with this stain? and are called what?
A
Wright/Wright Giemsa stain and are referred to as polychromatophils
20
Q
Newly released blood cells when stained with this basic dye? are referred to as what?
A
New Methylene Blue stain and referred to as reticulocytes
21
Q
These are aggregates of denatured hemoglobin cause by oxidative damage which also stain well using New Methylene Blue
A
Heinz bodies
22
Q
When are polychromatophilic cells usually seen
A
Regenerative anaemias
23
Q
<1% reticulocytes are normal in what species [3]
A
Dogs and pigs and sometimes cats
24
Q
Reticulocytes are absent in what species even with regenerative anaemia
A
Horse….they do not release reticulocytes into circulation
25
Early reticulocytes are called
Aggregate reticulocytes
26
Aggregate reticulocytes mature into
Punctate reticulocytes
27
What species has both aggregate and punctate reticulocytes...and which should be counted when doing reticulocyte count
Cats
| Aggregate
28
Reticulocytes are generally released when there is increased demand for RBCs, so an increased number can be seen in the peripheral blood with
Regenerative anaemias
29
The process from rubriblast to mature red cell takes
4-7days
30
The process from rubriblast to mature red cell takes 4 – 7 days but can be accelerated under erythroid marrow stimulation to
2-3days
31
Nucleated red blood cells ( e.g rubricytes and metarubricytes) can occasionally appear in the peripheral blood and can be a sign of a regenerative response ( increased demand for RBC). This is termed
An appropriate response
32
With “an appropriate response” to anaemia there is also a concurrent increase in
Reticulocytes
33
Inappropriate rubricytosis is
Rubricytosis without an concurrent increase in the reticulocyte count
34
Nucleated RBC are cleared by the
Spleen
35
Inappropriate rubricytosis can be a result of
Splenic dysfunction or neoplasia or bone marrow disease
36
In animals, the erythrocyte is shaped like
A biconcave disc
37
RBC biconcave disc shape is most prominent is what species
The dog
38
The diameter of canine RBC are
7microns - other species RBC are smaller
39
Which species has a prominent central pallor
Canine
40
What is poikilocytosis
Variation in RBC shape
41
Which species RBC has a marked poikilocytosis
Goats
42
What is anisocytosis
Variation in RBC size
43
Which species exhibit anisocytosis [2]
Cows and goat
44
The RBC of mammals lack a what
Nucleus (Non-nucleated)
45
What species have ellipsoidal shaped non nucleated RBC
Camelidae - camels, llamas, alpacas
46
What species of animals have oval/ellipsoidal nucleated RBC [4]
Avian, Fish, Amphibian and Reptile
47
Rouleaux formation is commonly seen in what species [3]
Horse
Cats may also show tendency in health
Dogs show little rouleaux unless inflammatory disease is present
48
Rouleaux formation should be differentiated from
Agglutination seen in cases of IMHA
49
What is basophilic stippling
Aggregates of RNA in RBC
50
What type of stain is used to view basophilic stippling
Wright's
51
When and in what species is basophilic stippling seen
Lead poisoning in dogs
| Regenerative anemias in cats and ruminants
52
Heinz bodies are usual observed in what species and why
Cats
| Their Hgb has more sulphdryl grps than other species and the spleen is less efficient at removing heinz bodies
53
Howell Jolly bodies are
Nuclear fragments seen in newly released RBC
54
What conditions are Howell Jolly bodies usually observed [2]
Regenerative anemias and splenectomized anemias
55
Howell Jolly bodies can be normally found in low numbers in which species [2]
Dogs and Cats
56
What is a hypochromic cell
Reduced volume of Hgb so that the area of pallor is exaggerated
57
Hypochromic cells are most noticeable in what condition
Dogs with iron deficiency
58
Hypochromasia is measured as a decrease in what
MCHC
59
What is a macrocyte
An erythrocyte with an increase volume
60
Macrocytosis detected as an
Increase in MCV
61
Macrocytosis/increase in MCV are usually seen in [3]
Regenerative anemia
Hereditary poodle marrow dyscrasia
FeLV infection
62
What is a microcyte
An erythrocyte with a decreased volume
63
Microcytosis is detected as a
Decrease in MCV
64
What condition is microcytosis observed concurrently with hypochromasia [2]
Iron deficiency anemia and hepatic failure in dogs
65
Some breed of dogs have natural lower MCV, give examples [4]
Akita, Shiba, Chow Chows, Shar Pei
66
What are spherocytes
Dense, spherical RBC
67
When can you find spherocytes [3]
IMHA
Coral Snake Bites
Zinc Toxicity
68
What are schistocytes
Irregular fragment of RBC
69
When can you find schistocytes [6]
```
DIC
Microangiopathic hemolytic anemia
CHF
Hemangiosarcoma
Glomerulonephritis
Myelonephritis
```
70
What is an echinocyte (Crenated cell, Burr cell)
RBC with several evenly spaced projections
71
When can you find echinocytes [3]
Electrolyte abnormalities
Uremia
In vitro change (artifact)
72
What is an acantocyte (Spur cell)
RBC with two or more unevenly spaced blunt projections
73
When can you find acanthocytes
Hemangiosarcoma
| Liver disease
74
What are keratocytes (2)
There are two types
| Blister which preceds Helmet
75
When can you find keratocytes
DIC
| Microangiopathic hemolytic anemia
76
What are codocytes (Target cell)
RBC containing a dense central area of Hgb
77
When can you find codocytes
Liver disease
| Regenerative anemia
78
What are dacrocyte
Tear shaped RBC
79
When can you see dacrocytes
Myleofibrosis
Pure red cell aplasia
Myeloproliferative disease
Artifact
80
What are stomatocytes
RBC with a slit like clear opening near the center
81
When can you find stomatocytes
Hereditary stomatocytosis in Malamutes
Chronic anemia
In vitro change (artifact)
82
In the body iron exists as many forms...list them (6)
```
Hemoglobin
Storage iron
Myoglobin
Labile iron
Tissue iron
Transport iron
```
83
Majority 55-65% of the body's iron exist in the form of
Hemoglobin
84
Most iron exist as hemoglobin, what is the second highest (33%) form
Storage iron
85
There are two types of storage iron, name them
Ferritin - iron protein complex
| Haemosiderin - more stable but less availble than ferritin
86
What form of iron is the best indicator of iron stores in the body
Ferritin
87
What is the ferritin lvl in true iron deficiency compared to anemia of inflammatory disease
True iron deficiency - low
| Anemia of inflammatory disease - normal or high
88
What causes the increase in ferritin lvl during anemia of inflammatory disease
Scavenging of iron from tranferrin to ferritin where it becomes less available to invading organisms
89
Inflammatory cytokines stimulate the production of what from hepatocytes
Hepcidin
90
What is the role of hepcidin
Inhibits absorption of iron from intestines and release from macrophages
91
How does haemosiderin differ to ferritin
Higher iron to protein ratio and is not water soluble
92
Haemosiderin can be observed under what stain
Prussian blue
93
What form is the iron in haeme
Ferrous (Fe2+) that can bind to O2
94
Where is myglobin found
Muscles
95
Myoglobin has what percent of iron
3-7%
96
Which species of animals is the iron content of myoglobin higher (2)
Dogs and Horses
97
The plasma iron pool is in dynamic with this pool
The labile iron pool
98
The iron in the tissue pool is important because
It forms an integral part of enzyme systems
99
Iron is transported in plasma bound to a protein called
Transferrin
100
Bound iron is measured as
Serum iron
101
Iron is transported as what to the red cell compartment
Ferrotransferrin
102
What is total iron-binding capacity (TIBC)
The measure of plasma to carry iron
103
TIBC is increased in chronic iron deficiency most species EXCEPT
Dog
104
Disorders of anaemia associated with chronic iron deficiency and inflammatory/chronic disease can usually be differentiated by examination of bone marrow for stainable iron EXCEPT in what species
Cat
| Stainable iron is not present in the bone marrow of normal cats
105
The main function of Hgb is
To carry O2, CO2 and buffer H+
106
95% of CO2 is transported as
HCO3-
107
CO2 + H2O ↔ H2C03 ↔ H+ + HCO3¯ is catalyzed by
Carbonic anhydrase
108
Which species have higher intracellular K+ concentrations [4]
Man, horse, pig and some ruminants (mainly among sheep)
109
Which species have low intracellular K+ conc [4]
Some sheep, goats, buffalo and cattle
110
Intracellular Na+ and K+ are similar to plasma in what species [2]
Dogs and Cats
111
Examples of defects in glycolytic enzymes? [2] and what may result
Pyruvate kinase deficiency and PFK deficiency
Hemolytic anemia
112
Pyruvate kinase deficiency are found in what breeds of animals [5]
Besenji, Beagle, West Highland white terrior and Abyssinian and Somali Cats
113
PFK deficiency are found in what breeds of animals [2]
English Springer Spaniels and American Cocker Spaniels
114
What factors cause a left shift in the O2 dissociation curve [4]
Decreased 2,3-DPG
Decreased CO2
Decreased Temp
Increased PH
115
What factors cause a right shift in the O2 dissociation curve
Increased 2,3-DPG
Increased CO2
Increased Temp
Decreased pH
116
A right shift in the O2 dissociation curve means
Lowering of O2 affinity of Hgb i.e fovouring release of O2 to tissues
Vice versa for left shift
117
The average RBC span for the following species are
| Cow, Sheep, Horse, Cat, Bird
```
Cow - 160
Sheep - 150
Horse -145
Cat - 70
Bird - 35
```
118
RBC are removed by [2]
Extravascular routes - phagocytosis by the MPS of the spleen
| Intravascular lysis - release of Hgb into the plasma
119
Iron from degraded RBC are stored as ferritin or haemosiderin in what
Macrophages
120
The protoporhyrin ring is catabolized by haema oxygenase to
Biliverdin
121
Biliverdin converted via biliverdin reductase to
Bilirubin
122
Bilirubin is transported to the liver by
Albumin
123
In the liver bilirubin is conjugated to
Bilirubin diglucuronide and excreted in bile into the intestines
124
The conjugated bilirubin by bacterial action in the intestines is degraded to
Urobilinogen which can be excreted in urine
125
Urobilinogen can be further degraded to
Stercobilinogen
126
What species final end product is biliverdin and why
Birds - they lack biliverdin reductase
127
Free oxidized form of haemoglobin is complexed to
Haemopexin which is cleared by the liver
128
What is hematocrit
The percent of RBC in blood
129
In what species, is the Hgb conc 3x the haematocrit
Dog
130
MCV is measured in
Femtoliters
131
MCHC is measured in
grams/L
132
As a general rule, regenerative anaemias are usually a result of? Describe it in terms of MCV and MCHC
Hemorrhage or hemolysis
Macrocytic, hypochromic
133
Reticulocytosis occurs in what type of anemia
Regenerative
134
How much time does it take for reticulocytes to appear in regenerative anemias
3-4days
135
The more severe the anemia the......reticulocyte response?
The greater the reticulocyte response
136
In anemias due to blood loss (hemorrhagic anemias) there is a decrease in what [2]
RBC and protein
137
In anemias due to accelerated RBC destruction (hemolysis), there is a decrease in what
RBC but normal plasma protein
138
Anemias due to reduced or defective erythropoiesis tend to be
Non regenerative
139
Hemorrhagic anemias may be [4]
Acute or Chronic,
| External or Internal
140
In hemorrhagic anemias -
| A low plasma protein lvl in a regenerative anemia is suggestive of what type of blood loss. Compare with alternative.
External
Internal blood loss - may be only mildly decreased as it is reabsorbed
141
In hemorrhagic anemias - What species may show an increase in Hct shortly after acute blood loss and why?
Horse - splenic contractions
142
In hemorrhagic anemia - Chronic blood loss is characterized by impaired what? why?
Erythropoiesis due to iron exhaustion
143
In hemorrhagic anemia - Anemia due to chronic blood loss gradually becomes (MCHC, MCV)
Hypochromic, Microcytic
*Iron deficiency anemia seen in dogs and ruminants
144
What evidence may you look for to determine is blood anemia is due to chronic blood loss
Bleeding into the gi tract (tarry stool/melena)
145
Hemolytic anemia which occurs as a result of increase red blood cell destruction within the body may be [4]
Congenital or Acquired
| Intravascular or Extravascular
146
In hemolytic anemia - in may disease conditions when intravascular hemolysis is present what else is occuring
Extravascular haemolysis
147
In hemolytic anemia - PCV (also hemoglobin, RBC) and protein lvl are
PCV (also hemoglobin, RBC) decreased
| Protein often normal
148
Hemolytic anemia - signs of extravascular hemolysis [2]
Icterus
| Bilirubinuria
149
Hemolytic anemia - signs of intravascular hemolysis [4]
Hemoglobinemia and hemoglobinuria
| Icterus and bilirubinuria
150
Hemolytic anemia - changes in RBC morphology...what so you look for [4]
Sperocytes
Acanthocytes
Parasites
Heinz bodies
151
Hemolytic anemia - Immune mediated: cause, diagnostic test, RBC morphology
Antibody reacts with target antigens on the RBC membrane or
reacts with drug/infectious agent which adheres to RBC
Coombs Test
Spherocytes or agglutination
152
Hemolytic anemia - Toxins/chemicals e.g. [7]
Acetaminophen, zinc, copper toxicity
Bacterial toxins from Leptospira/Clostridia
Snake/Spider bite venoms
153
Hemolytic anemia - RBC parasites e.g. [2]
Mycoplasma hemofelis
| Babesia
154
Hemolytic anemia - Mechanical injury of RBC e.g.
Hemangiosarcoma
155
Hemolytic anemia - Inherited RBC deficiency [2]
PK and PFK deficiency
156
Hemolytic anemia - exposure to oxidizing agents e.g. [3] What clues can you look for?
Acetaminophen
Garlic
Onion
Heinz bodies
157
Hemolytic anemia - Hypophosphatemia e.g.
Diabetic ketoacidotic cats receiving insulin therapy
158
What are some congenital causes of hemolytic anemia and the species in which they affect
Porphyrias - cattle, cat, swine
PK deficiecy - dogs and cats
PFK deficiency - dogs
159
In congenital/inherited hemolytic anemia the type of hemolysis is generally
Extravascular
160
Bovine congenital erythropoietic porphyria occurs at birth. What precaution is taken in calves
Protection from sunlight due to photosensitization
161
Deficiency of PFK results in
Decreased ATP and 2,3-DPG formation
162
Acquired haemolytic anemias are more common than congenital haemolysis and occur mainly
Extravascularly (MPS) system
163
Acquired haemolytic anemia - Viral - Equine infectious anemia..What is the most prominent CBC result.
How do you diagnose
Thrombocytopenia
AGID (Coggin's Test)
164
Acquired haemolytic anemia - Feline leukemia virus. Regenerative?MCHC? MCV?
Non regenerative, normochromic and sometimes macrocytic
165
Acquired haemolytic anemia - Leptospirosis common sign is
Icterus
166
Acquired haemolytic anemia - Icterus in Leptospirosis is a result of
Intravascular hemolysis due to the production of haemolysin
167
Acquired haemolytic anemia - Anemia from Leptospirosis is less pronounced in what species
Dogs
168
Acquired haemolytic anemia - Bacillary haemoglobinuria is caused by [2]
C. haemolyticum and C. novyii type D
169
Acquired haemolytic anemia - Bacillary haemoglobinuria affects what species [2]
Cows and Sheep
170
Acquired haemolytic anemia - Bacillary haemoglobinuria is result of what toxin?
Beta-toxin
171
Acquired haemolytic anemia - What species of Babesia is found in dogs [2]
B. canis and B. gibsoni
172
Acquired haemolytic anemia - What species of Babesia is found in cows [4]
B. bovis, B. bigemina, B. divergens and B. major
173
Acquired haemolytic anemia - What species of Babesia is found in horses [2]
Theileria equi and B. caballi
174
Acquired haemolytic anemia - What species of Babesia is found in cats [2]
B. felis and B. cati
175
Acquired haemolytic anemia - What species of Babesia is found in sheep [3]
B. ovis, B. foliata and B. motasi
176
Acquired haemolytic anemia - these piroplasms appear as signet ring bodies or bipolar safety pins
Cytauxzoon felis
177
Acquired haemolytic anemia - this is the only tick bourne vector
Dermacentor variablis
178
Acquired haemolytic anemia - Rickettsial disease - Anaplasmosis is the disease of what species [2]
Cattle and sheep
179
Acquired haemolytic anemia - Rickettsial disease - Anaplasma species in cattle are [2]
A. marginale and A. centrale (less pathogenic)
180
Acquired haemolytic anemia - Rickettsial disease - A. ovis infects [2]
Sheep and Goats
181
Acquired haemolytic anemia - What is the difference between Anaplasmosis and the other anemia causing Rickettsial disease
Anaplasmosis organism is found in the erythrocyte
Mycoplasmosis parasite is found on the surface of the erythrocyte
182
Acquired haemolytic anemia - Rickettsial disease - Haemoplasmosis appear in different forms, list them [3]
Coccoid, ring and rod-shaped
183
Acquired haemolytic anemia - Give examples of oxidizing agents and the species they affect
Acetaminophen - Dogs and Cats
Red maple leaves - Horse
Rape seed - Cows
184
Acquired haemolytic anemia - Copper toxicity occurs in which species [3]
Cattle, sheep and swine
185
Normocytic normochromic non regenerative anaemia with normal or increased neutrophils and platelets can be due to [6]
```
Lack of erythropoietin
Inflammatory disease/chronic disease
FeLV associated anemia
Immune mediated anemia
Liver Disease
Hypothyroidism/adrenocorticism
```
186
Normocytic normochromic non regenerative anaemia with decreased neutrophils and platelets can be due to [2]
Aplastic anemia
| Myelophthistic anemia
187
Causes of aplastic anemia
Damage to the multipotential stem cell or bone marrow
Ehrlichia, parvo virus, FeLV, FIV
Estrogen, chemotherapy, bracken fern
188
Causes of myelophthistic anemia
Bone marrow is replaced by neoplastic cells
189
Microcytic hypochromic non regenerative anaemias with variable neutrophils and platelets can be due to [3]
Iron deficiency
Anaemia of inflammatory disease
Portosystemic shunts/liver insufficiency
190
Macrocytic normochromic non regenerative anaemias with variable neutrophils and platelet
Vitamin B12 and folate deficiency
FeLV infection
Erythroid neoplasia
191
What is erythrocytosis
Is an increased [RBC] in peripheral blood. It is detected by finding an increased PCV/HCT, increased [RBC], or increased [Hgb]
192
What is polycythemia
Increase in red blood cells
193
What the types of erythrocytosis [2]
Relative and Absolute
194
What is the difference between relative and absolute erythrocytosis
Relative - no increase in total erythrocyte mass
| Absolute - increase erythrocyte mass
195
Relative erythrocytosis can be caused by [2]
Dehydration
| Splenic contraction and release of splenic blood into circulation
196
Explain how dehydration leads to erythrocytosis
Decreased plasma volume but no change in RBC numbers in body, causing a relative increase in the RBC count. The total protein will usually be increased as well
197
Explain how Splenic contraction and release of splenic blood into circulation leads to erythrocytosis
Contraction occurs due release of epinephrine in response to excitement, fright or exercise. Splenic blood contains a high concentration of RBCs and causes an erythrocytosis (common in dogs and horses)
198
What are the types of absolute erythrocytosis [2]
Primary and Secondary
199
Primary absolute erythrocytosis can be cause by
Myeloproliferative disease
200
What are the types of secondary absolute erythrocytosis [2]
Appropriate and Inappropriate
201
Appropriate secondary absolute erythrocytosis can be caused by
chronic hypoxia of cardiac and/or pulmonary disease leads to increased erythropoietin production
202
Inappropriate secondary absolute erythrocytosis can be caused by
Inappropiate EPO production by renal tissue because of renal cysts, renal neoplasms
Inappropriate EPO production by certain neoplasms e.g hepatoma, leiomyosarcoma
