neutrophils + inflammation causing changes - cytoplasmic basophilia - dohe bodies - cytoplasmic vacuolation - toxic granularity (less common)

Midterm 1: RBC/WBC/Hemostasis/Hepatobiliary/Effusions Flashcards by Emma J

How can you tell if a horse has regenerative anemia?

no reticulocytes produces

must obsreve the MCV
- macrocytosis indicated regeneration

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What are the 3 causes of anemia

hemorrhage

hemolysis

hypoplasia

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What are the types of hemorrhage that cause anemia

internal
- less likely to cause anemia because it can provide an ‘autotransfusion’

external
- acute: regenerative
- chronic: non regenerative (Fe deficiency anemia)

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What does a non regenerative microcytic hypochromic anemia with a concurrent thrombocytosis indicate?

iron deficiency anemia

it can also have keratocytes and schistocytes

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What are the types of hemolysis that cause anemia

extravascular: RBC phagocytosed by macrophages in spleen/liver
- will always occur with hemolysis

intravascular: destruction in peripheral blood

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Compare the signs of intravascular and extravascular hemolysis

extravascular
- mild - marked anemia
- hyperbilirubinemia/uria
(no excess hemoglobin)

intravascular
- marked/rapidly decreased anemia
- agglutination
- ghost cells
- hemoglobinuria/emia
if chronic = hyperbilirubinemia/uria

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List the types of extravascular hemolysis that can occur and some examples of causes for each

primary
- IMHA

secondary
- oxidative damage
- infecitous (mycoplasma)
- RBC fragmentation (DIC/valvular disease)
- congenital
- neoplastic

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What is a pathogneumonic sign for IMHA

spherocytes

also

regenerative anemia
ghost cells
inflammatory leukogram

positive coombs test

+/- agglutination and thrombocytopenia

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What are characteristic signs of oxidative damage

heinz bodies
eccentrocytes

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List 4 causes for oxidative damage

equine ingestion of wilted red maple

onion

acetaminophen

other drugs

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What are 2 types of non regenerative anemia ue to hypoplasia

primary: intramedullary

secondary: extramedullary

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What are the characteristics of an intramedullary lesion leading to non regenerative anemia

mild-marked anemia

normocytic and normochromic

bi or pan cytopenia

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What are 5 causes of non regenerative anemia

chronic iron deficiency

acute hemorrhage

acute hemolysis

intramedullar disease

extramedullary disease affecting the bone marrow

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What is the primary cause of extramedullary non regenerative anemia (what are some other causes)

inflammation!

also
CKD (low erythropoiten)
endocrine disease

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Why does inflammation cause anemia

increased cytokines

reduced RBC lifespan

reduced erythropoeitin

increase hepcidin (compound that ‘protects’ iron from pathogen)

low iron

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List 3 main causes of a neutrophilia

inflammation

stress

physiologic

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List 2 main causes of neutropenia

granulocytic hypoplasia and hemic neoplasia

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What is a left sheft

immature neutrophil release

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What is a degenerative left shift

when the band neutrophils outnumber the mature neutrophils

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What is toxic change

neutrophils + inflammation causing changes

cytoplasmic basophilia
dohe bodies
cytoplasmic vacuolation
toxic granularity (less common)

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What are 3 main causes of lymphocytosis

physiologic in young animals

chronic inflammation

post vaccination

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What is the primary cause of a lymphopenia

stress or steroids

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What characterizes an acute inflammatory leukogram

mature neutrophilia with a left shift

toxic change

lymphopenia due to stress

can have monocytosis

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What characterizes overwhelming acute inflammation

leukopenia due to neutropenia

degenerative left shift

+/- toxic change

lymphopenia due to stress

can have monocytosis

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What characterizes a chronic inflammation leukogram

all parameters elevated - neutrophils + bands - lymphocytes - monocytes - eosinophils

What characterizes a physiologic leukogram

all elevated except band neutrophils

What is the main disorder of primary hemostasis

von willibrand factor deficiency

What clotting factors are utilized in intrinsic pathway of hemostasis

contact factors factor - 8 - 9 - 11 - 12

What clotting factors are utilized in extrinsic pathway of hemostasis

factor 7

What clotting factors are utilized in common pathway of hemostasis

factor - 2 - 5 - 10 fibrinogen

List 4 methods to assess primary hemostasis

CBC/blood smear - platelet # eval buccal mucosal bleeding time - assess platelet fxn (don't do if thrombocytopenia) bone marrow aspirate vWF assay

What are 3 methods to assess secondary hemostasis

activated clotting time - intrinsic prothrombin time - extrinsic and common activated partial thromboplastin time - intrinsic and common

What sample tube do you use to collect blood for CBC and clotting factor evaluation?

CBC: purple top EDTA clotting factors: blue top citrated

What is your top differential? A king Charles cocker spaniel presents with a thrombocytopenia. On blood smear evaluation, there are much fewer but but bigger platelets.

inherited macrothrombocytopenia more common in king charles cocker spaniels

List 2 causes of SEVERE thrombocytopenia

myopthesis immune mediated thrombocytopenia

Define thrombopathia? Give one example of a disorder

reduced platelet function von willibrand factor disorder

What are the classical results of ACT/PT/aPTT from a dog with rodenticide toxicity? Why?

ACT - elevated PT - elevated aPTT- elevated rodenticide causes vitamin K reductase inhibition = inhibit... common = factor 2 and 10 extrinsic = 7 intrinsic = 9

How does liver disease relate to hemostasis disorders? What would you expect to see on test results?

Impair secondary hemostasis due to reduced production of coagulation factors ACT - elevated PT - elevated aPTT - elevated

Compare hemophilia A and B

A = factor 8 deficiency (intrinsic) B = factor 9 deficiency ( intrinsic) both ACT - elevated PT - wnl aPTT - elevated

What parameters do you look at to evaluate hepatocellular function

GUACC glucose urea albumin cholesterol coagulation factors if liver dysfxm all should be decreased

What parameters do you look at to evaluate hepatocellular injury

ALT AST (and CK - to ensure it is not form muscle damage) GLDH SDH LDH if hepatocellular injury all should be elevated

What parameters do you use to evaluate cholestasis

Bilirubin (Hct to ensure it is not hemolysis) ALP GGT if cholestasis all should be elevated

What might cause elevated ALP in normal dogs

breed associated (scottish terriers) growing/osteoblast activity high steroid levels - iatrogenic/cushings

What non - liver disease does elevated ALP in cats indicate

hyperthyroidism

What additional (non GUACC) parameters can you use to evaluate liver dysfunction

bile acids ammonia

What parameters do you use to confirm a portosystemic shunt

bile acids ammonia

If you suspect a portosystemic shunt with concurrent cholestasis what parameters can you use to confirm it?

ammonia cant use bile acids because they will be elevated by the cholestasis

Compare transudate, modified transudate and exudate

transdate: low protein and cells modified transudate: moderate protein and cells exudate: lots of protein and cells

What are 2 primary causes of transudate

high venous or arterial hypertension low OP (hypoalbuminemia)

What are 2 primary causes of modified transudates

CHF protal hypertension

What are 2 causes of exudates

inflammation neoplasia

What does red exudate indicate

blood - measure PCV

What does white exudate indicate

chyle - do cytology should see mature lymphocytes and triglycerides

What does brown or green exudate indicate

bile do cytology

What does 'septic' mean in the context of exudate cytology

It means that there are intracellular/phagocytosed bacteria within immune cells The presence of bacteria alone is not suggestive of infection - could be contamination

What is an echinocyte

drying artifact look like spiky RBC

Compare polychromatophils and reticulocytes

poly - stain purple - see on cytology retic - stain blue - counted by the CBC analyzer

What is a keratocyte and schistocyte?

keratocyte: crab shaped RBC schistocyte: weird and small ragment of RBC due to fragmentation

What is an acanthocyte

a RBC with random spikes (not ecchinocyte)

What is a metarubricyte

a nucleated RBC it is even more immature than a polychromatophil regeneration is down bad

What are sphererocytes

due to extravascular hemolysis IMHA small and dense RBC (macrophages have taken bits off)

What are ghost cells indicative of?

intravascular hemolysis

What is a heinz body?

a little nubbin on the RBC due to oxidative damage

What is poikilocytosis

a variety of different RBC shapes on the slide

What is a howell jolly body

a nuclear remnent inside the RBC (poly) signify regeneration

What is an accanthocyte

A RBC that has gotten a chunk taken out by a macrophage - loose cell membrane forms a 'pocket' oxidative damage

Midterm 1: RBC/WBC/Hemostasis/Hepatobiliary/Effusions Flashcards

(66 cards)