Lecture 1: RBC’s I Flashcards
1
Q
Define hematology
A
evaluation of cells in circulation
2
Q
biochemistry is evaluating __
A
acellular component in circulation
3
Q
what is cytology
A
evaluation of cells within tissues and fluids
4
Q
what makes up the cellular component (hematology) of blood
A
erythrocytes
Buffy coat: leukocytes and platelets/ thrombocyte
5
Q
what makes up aqueous/ plasma component in blood
A
proteins, AA, electrolytes, nutrients, gases, waste
6
Q
what does refractometry of plasma measure
A
total solids
7
Q
what does PCV measure
A
direct measure of RBC mass
8
Q
what does blood smear evaluate
A
whole blood
9
Q
What hematology basic tests should you run with critical patients
A
- Gross evaluation (plasma color)
- Total solids
- PCV
- Analyzer
- Blood smear
10
Q
what cells are included in erythroid line and where are they located
A
- Precursor erythroid cells in bone marrow
- RBC’s in sinuses in the spleen, liver, and bone marrow
- RBC’s in circulation
11
Q
what is function of Hbg
A
carry oxygen
12
Q
what form of iron is required to carry oxygen
A
reduced, FE2+
13
Q
hemoglobin transports oxygen from ___ to __
A
lungs to tissues
14
Q
in healthy patients hgb is __% saturated with O2 in arterial blood
A
100%
15
Q
what is methemoglobin and what is the consequence of that
A
hemoglobin bound to oxidized iron/Fe3+
Can’t carry oxygen
16
Q
how does acetaminophen affect hgb function in cats
A
gets converted to toxic intermediate which leads to oxidation of iron to Fe3+ and therefore can’t carry oxygen
17
Q
Erythrocyte production depends on __which depends on available __
A
Hgb, iron
18
Q
where does hematopoiesis mostly occur in vertebrates
A
bone marrow
19
Q
what species does hematopoiesis not occur in bone marrow
A
amphibians and fish
20
Q
what is the first microscopically recognizable erythroid cell
A
CFU-E
21
Q
what are the major sites of extramedullary hematopoiesis
A
spleen, liver
22
Q
what hormones are promoters of erythropoiesis
A
erythropoietin, corticosteroids, thyroxine
23
Q
what nutritional factors are promoters of erythropoiesis
A
iron, copper, cobalamin (vit B12), vitamin B6, folate (vitB9)
24
Q
where is erythropoietin produced
A
kidney
25
what stimulates erythropoietin production
tissue hypoxia
26
how does chronic renal failure affect erythropoietin production
decreases and results in non-regenerative anemia
27
what are the 3 inhibitors of erythropoiesis
1. Estrogen (tumors, pills, creams)
2. TNF
3. IL-6
28
how does TNF and IL-6 inhibit erythropoietin and what is the result
inflammation causes reduction and you get anemia of inflammatory/chronic disease
Non-regenerative anemia
29
what is the name for the last stage in which developing RBC is nucleated
metarubicyte/ nRBC
30
what are the stages of erythrocyte development
1. Metarubicyte
2. Reticulocyte
3. Mature erythrocyte
31
what is the appearance of a reticulocyte
anucleate, less mature, more blue
32
how is erythrocyte maturation characterized
1. Decrease in cell size
2. Decrease in nuclear size
3. Decrease cytoplasmic basophilia
4. Extrusion of nuclei
33
why causes the decrease in cytoplasmic basophilia
loss of ribosomes, increased hemoglobin
34
what is time from erythropoietic progenitor cell to reticulocyte in most species
3-5 days
35
what are the stages of erythrocyte development indicated by 1-2
1. Metarubicyte
2. Reticulocyte
36
what are the two mechanisms of RBC removal
1. Major: phagocytosis by macrophages
2. Minor: intravascular lysis with release of Hgb into plasma
37
what are some indications for bone marrow cytology and bone marrow core biopsy
1. Persistent, unexplained leukopenia, thrombocytopenia, non-regenerative anemia
2. Bicytopenia or pancytopenia
3. Unexplained, inappropriate metarubicytosis
38
what does a CBC assess
erythrocytes, leukocytes, platelets
39
what tubes are used for CBC
1. EDTA (purple top)
2. Lithium heparin (green top)
3. Sodium citrate (blue top)
40
how does a EDTA tube work
anticoagulant that chelates calcium to stop clotting cascade
41
what is the most often tube used for mammal CBC
EDTA/ purple top
42
what is the preferred tube for CBC’s in reptiles, birds, amphibians and fish
lithium heparin (green top)
43
what is a sodium citrate tube used for
coagulation profiles (PT, PTT, ACT), platelet count
44
Reference intervals represent __% of healthy individuals in that species
95%
45
___% of healthy individuals will have above or below reference interval
2.5%
46
define anemia and what test do you use/what is result
decrease RBC mass
Tests: decrease PCV or HCT
47
what test do you trust more for evaluating anemia PCV or HCT
PCV
48
what is erythrocytosis and how do you measure/what is result
elevated RBC mass
Tests: elevated PCV or HCT
49
what is PCV and how do you determine it
direct measurement of RBC mass
Determined by centrifugal ion
50
what is hematocrit/HCT
calculated value of RBC mass
51
what is reticulocytosis and what does it indicate
increased reticulocytes in circulation
Indicates regeneration/none marrow response to anemia
52
what is mean corpuscular volume/MCV
average size of circulating RBC’s
53
what is mean corpuscular hemoglobin concentration (MCHC)
average hemoglobin concentration in circulating RBC’s
54
what is anisocytosis
change in RBC size
55
what are poikilocytes
atypical RBC morphology shapes
56
what is poikilocytosis
increased variation in RBC shape
57
what are polychromatophils
immature, anucleate RBC
58
how do polychromatophils appear on smear
larger, more purple and blue in color
59
all polychromatophils are __but not all __ are polychromatophils
reticulocytes, reticulocytes
60
what is polychromasia
variation of RBC color on the smear
61
PCV is percentage of __
blood volume filled by erythrocytes
62
HCT or PCV: percentage of blood volume filled by erythrocytes, calculated by analyzer
HCT
63
average size of patients RBCs= __
MCV
64
MCV above RI=
macrocytosis
65
MCV normal =
normocytosis
66
MCV below RI
microcytosis
67
chromasia is assessed via analyzer as __
MCHC (mean corpuscular hemoglobin concentration) (color)
68
If MCHC normal=
normochromia
69
if MCHC is below RI=__. What does that mean
hypochromasia
Less hemoglobin in RBC’s
70
if MCHC is above RI=__. What does that mean
hyperchromasia
LIAH!!
Lipemia, intravascular hemolysis, agglutination, Heinz bodies
71
MCHC indicates this sample as hyperchromasia. What is wrong
Hyperlipidemia- increased triglycerides
72
normal or abnormal plasma
normal
73
normal or abnormal serum in dog/cat. What is cause
abnormal/yellow- increased bilirubin
74
what species is yellow serum normal in
horse and cattle (Carotenoids)
75
normal or abnormal serum. What cause
abnormal/ pink to red
Increased free Hgb due to traumatic collection or intravascular hemolysis
76
what can artificially elevated total solids
dehydration, lipemia, marked hyperglycemia
77
if total solids is below RI what does that mean
loss or lack of production
78
if total solids is above RI what does that mean
increased production or hemoconcentration
79
what are the two ways to measure protein
1. Total solids/plasma protein in purple top tube on refractometer
2. Serum protein- red top tube
80
in healthy animals plasma protein and serum protein are __
the same
81
t or f: can determine PCV via CBC
false via centrifugal method
82
HCT and PCV should be ___x the hgb concentration
3x
83
what is the only way to determine RBC morphology
stained blood film made from blood collected in EDTA tube for a CBC
84
what does a stain blood film allow you to do
1. Confirm that CBC data from analyzer is correct
2. Determine cause of certain diseases
3. Helps identify infectious organisms
4. Identification of neoplastic cells
85
stained blood film/smear should be performed in who
1. Critically ill patients
2. Patients with suspected hemoparasites, neoplastic cells
86
what is average size of dog and cat normal erythrocyte
cat: 6um
Dog: 7um
87
what are the morphology details of dog RBC
7um, prominent central pallor
88
what are the morphology details of cat RBC
6um, slight central pallor in some RBC’s, <10% heniz bodies
89
what are the morphology details of horses RBC’s
5-6um, no central pallor, rouleaux
90
what are morphology details of cattle RBC’s
5um, no central pallor
91
match 1-4 with species the RBC’s are from and what is circled in 3
1. Dog
2. Cat
3. Horse (circle- rouleaux)
4. Cattle
92
what is the morphology of camelid RBC’s
oval shaped erythrocytes
93
what is morphology of deer erythrocytes
sickle shaped erythrocytes (in vitro change)
94
what species match erythrocytes 1-2
1. Camelids
2. Deer
95
what is morphology for birds, reptiles, amphibians and fish RBC’s
nucleated, oval shaped
96
what species do these RBC match
Birds, reptiles, amphibians and fish
97
what is shape for acanthocytes
erythrocytes with blunt or boot shaped spicules, tip of projection wider than base
98
what are some mechanisms for acanthocyte development
1. Alterations in erythrocyte membrane lipid content (liver disease)
2. Fragmentation injury (hemagiosarcoma, other cancer, iron deficiency anemia, DIC)
99
what cells are boxed
acanthocytes
100
what species are codocytes mostly seen in
dogs
101
t or f: codocytes can sometimes be normal finding and are often non-specific
true
102
what diseases can you see codocytes with
liver disease, hypothyroidism
103
what cells are seen here
Codocytes/target cells
104
what are echinocytes
erythrocytes with pointed spicules/projections, tip of projection is narrower than base
105
what is major mechanism for echinocyte development
Artifact!
106
what diseases are associated with echinocytes
1. Viperidae snake envenomation
2. Dogs with renal disease
107
what cells are seen here
Echinocytes
108
what are keratocytes
Erythocytes with ruptured blister vesicle
109
what are pre-keratocytes
erythrocytes with intact blister vesicle
110
what are keratocytes and pre-keratocytes associated with
1. Low numbers- normal
2. Liver disease in cats- hepatic lipidosis
3. Non specific to fragmentation injury
111
what cells are indicted by 1-2
1. Pre-keratocytes
2. Keratocytes
112
what are schistocytes
erythrocyte fragments
113
what is the mechanism for schistocytes
fragmentation process (only cell specific to fragmentation)
114
what diseases are associated with schistocytes
1. DIC
2. Severe iron deficiency
3. Severe hypophosphatemia
4. Diseases with turbulent blood flow: pyelonephritis, cardiac disease
115
what cells are indicated by arrows
Schistocytes
116
what are spherocytes
small erythrocytes that have no central pallor
117
what do spherocytes indicate and what disease associated with
extravascular hemolysis, IMHA
118
From dog- what cell types indicate by 1-3
1. Polychromatophils
2. Normal RBCs
3. Spherocytes- extravascular hemolysis/ IMHA
119
what are eccentrocytes
hemoglobin condensed at one side of cell and cytoplasm is eccentric to one side
120
what are some causes of eccentrocytes
Oxidative injury, intravascular hemolytic anemias
1. Acetaminophen toxicity
2. Red maple leaf toxicity (horses)
3. Zinc toxicity
4. Copper toxicity (sheep)
121
what indicated by arrows
eccentricities
122
what are Heinz bodies
denatured or precipitated hemoglobin
123
what are some causes of Heinz bodies
oxidative damage, intravascular hemolytic anemias
Acetaminophen toxicity, red maple leaf toxicity, zinc toxicity, copper toxicity
124
old cat diseases associated with endogenous oxidative injury see <__% Heinz bodies
30%
125
what are some causes of Heinz bodies <30% in old cats
1. DM
2. Hyperthyroidism
3. Lymphoma
126
what are ghost cells
represent RBC’s that have ruptured in the circulation, losing their hemoglobin but RBC’s remain
127
what are some causes of ghost cells
Intravascular hemolysis-
1. IMHA
2. Toxins/oxidative damage- acetaminophen, red maple, copper, zinc
3. Venom
128
what cells indicated by the arrows
Ghost cells
