Abnormals Flashcards
Which dog breed can have hereditary Stomatocytosis?
Alaskan Malmute
Echinocytes is the medical term for?
Crenated erythrocytes
Lead Toxicity shows what on CBC?
Increased basophilic stippling with normal PCV
Which type of erythrocytes are seen in cases of IMHA?
Spherocytes
What condition is characterized by the overall decrease of erythrocytes?
Anemia
What condition/disease is common with an overall decreased Pack Cell Volume (PCV) on a CBC?
Anemia
What condition is characterized by the bloods overall decreased ability to transport oxygen to the tissues?
Anemia
Anemia clinical signs & symptoms?
Decreased excessive tolerance, Lethargy & Depression
How is Anemia evaluated & classified?
By the Indices: Essentially by:
1. RBC morphology
2. Disease Symptoms
3. Bone Marrow Response
What is a Regenerative Anemia?
Bone Marrow responding to a hypoxic event therefore erythropoiesis is taking place making immature neutrophils being pushed out into circulations
Define: Spherocyte
A smaller than normal red blood cell very circular in shape.
Erythroidaplasia means?
Alot of line of erthroycytes are in development
Regenerative Anemia is caused by what 2 things?
- Hemorrhage: Red Blood Cell Loss
- Hemolysis: Red Blood Cells Are Being Broken Apart
What is Non-Renerative Anemia?
This means the bone marrow is not responding
Would we see Polychromatophils with Non-Renerative Anemia?
No
What are the 2 causes of Non-Renerative Anemia?
- Decrease of the hormone Erythropoietin: Renal Failure - Common in Cats
- Inadequate Bone Marrow Response and/or Ineffective RBC Production
What is the most common reason for Non-Renerative Anemia in Cats?
FeLV
What are 2 things we must see in a differential to determine Renerative Anemia?
Nucleated Red Blood Cells & Polychromatophils. We Cannot just see one to determine
What is Hemorrhagic Anemia?
Rapid loss of large amounts of blood therefore a decrease in red blood cells
What are the Indices Values for Hemorrhagic Anemia?
Increase MCV and a Decrease MCHC: Macrocytic hypochromic
Do you see Polychromatophils in Hemmorgahic Anemia?
Yes
What is Iron Deficiency Anemia?
Excessive loss of iron from trauma, deficient intake in diet, and/or poor absorption of iron in the body
How does the body respond to Iron Deficiency Anemia
By pushing out smaller than normal red blood cells in size.
What are the indices values for Iron Deficiency Anemia?
Microcytic Hypochromic
Microcytic Hypochromic Cells in a differential/Indicis Values is specific to?
Iron Deficiency Anemia Always
Which breed have normal microcytic Hypochromic cells?
Akita
What is Vitamin B12 Deficiency?
Also called: Folic Acid Deficiency
Its the inability to absorb adequate amounts of the vitamin B12
How does the body respond to Vitamin B12 Deficiency?
Erythropoiesis is disrupted causing the body to produce a large number of red blood cells that are larger in size
What are the indices values for Vitamin B12 Deficiency?
Macrocytic Normochromic
(since there is a normal amount of hemoglobin)
What is Aplastic Anemia?
An inadequate production of red blood cells, white blood cells, and platelets due to destruction of the bone marrow.
Cattle with Cobalt Deficiency have what indices values?
Macrocytic Normochromic Cells
What are some common causes of Aplastic Anemia?
- Radiation
- Toxins
- Medications: ABX: Chlorophenicol
What is Autoimmune Hemolytic Anemia
∆ This is caused by a decrease of number of red blood cells due to the body producing antibodies against the antigens on the red blood cells surface causing them to be removed from circulation prematurely.
∆ May be primary disease or caused by underlying bacterial, viral, or rickettsial infection
What is the most common cause of regenerative anemia in dogs?
IMHA: Autoimmune Hemolytic Anemia
Are Spherocytes common to be seen in IMHA/Immune Mediated Hemolytic Anemia?
Yes
Define: Rouleux
Grouping of red blood cells slightly overtop of each other resembling a stack of coins
Rouleux tends to have an increase in what levels?
Fibrinogen Level
Which species is Rouleux common?
Equine: Horses
Which species is Rouleux rare in?
Ruminants
When is Rouleux exaggerated?
During inflammatory or neoplastic diseases
What is Rouleux often confused with & how do you differentiate?
Agglutination. Dilute the blood sample 1 part blood with 1 part saline and if they separate apart and become single than they are Rouleux but if they stay stuck together than its Agglutination
Define: Agglutination
The sticking together of red blood cells.
When is it common to see Agglutination?
Occurs sometimes in IMHA: Immune mediated anemia
Define: Polychromasia
∆ The variation of color in red blood cell with a blueish cytoplasm due to the residual RNA
∆ Larger than normal Red Blood Cells (Polychromatophils)
Define: Hypochromasia
Decrease central pallor in red blood cells and/or decrease staining intensity within the RBC meaning there is an insufficient amount of hemoglobin within the RBC
What anemia is most commonly associated with Hypochromasia?
Iron Deficiency
Define: Poikilocytes
Refers to any abnormally shaped red blood cells
Poikilocytes are often seen in which type of diseases?
Seen in diseases that are characterized by red blood cell fragmentation or increased fragility of the RBC such as liver, kidney, spleen, and vessel problems
Why is it common to see Poikilocytes in patients w/ Anemia?
Because the RBC are abnormally shape therefore the body is removing them prematurely decreasing the amount of RBC in circulation.
Define: Leptocytes
∆ Thin erythrocytes that are easily distorted or folded due their increased membrane but decreased hemoglobin volume.
∆ This is a poikilocytes since its an abnormally shaped RBC
Are Leptocytes common in Non-Regenerative Anemia?
yes
What are the 2 common types of Leptocytes?
- Target Cells/Codocyte
- Folded Cells/Knizocyte
Define: Target Cells
Also Called: Codocyte
∆ Red Blood Cells with round central area of hemogloobin surrounded by a clear zone with a dense ring of hemoglobin around the edge. AKA the Target Logo
∆ Small number of target cells seen in differential is considered normal
∆ Often seen in Iron Deficienty, Hepatocyte insufficiency
Define: Folded Cells
∆ Also Called: Knizocyte
Raised fold extending across the center almost looking like the RBC are folded in half or look like a coffee bean
Knizocyte is the name for?
Folded Cells
Codocyte is the name for?
Target Cells
Define: Spherocytes
Smaller than normal red blood cells that are dark and do NOT have a central pallor giving them a perfect spherical shape.
Spherocytes is commonly found only in dogs when?
- AIHA
- Zinc Toxicity: Penny & Suncreen
- Following transfusions
Define: Stomatocytes
Cup Shaped Red Blood Cells that make it look like a mouth giving the central pallor an oval shape appearance
Stomatocytes is commonly found in what type of disease?
Liver Disease
Stomatocytes are hereditary in which breed?
Alaskan Malamutes
Acanthocytes are also called?
Spur Cells
Schistocytes are also called?
Helmet Cells
Define: Echinocytes
∆ Sharp spiculated/projections coming off the red blood cells
∆ This is called: Crenation or Crenated RBC which is a lab error and/or artifact from increased EDTA exposure, Improper smear prep, and/or prolonged sample storage
Define: Basophilic Stipping
∆ An RBC Inclusions
∆ Presense of very small dark blue bodies within the red blood cells caused from residual RNA
Define: Howell Jolly Bodies
∆ An RBC Inclusions
∆ Basophilic nuclear remnants
∆ Seen frequently in responding anemia
Define: Heinz Bodies
∆ An RBC Inclusions
∆ RBC refractile bodies
∆ Round structures representing denatured hemoglobin
∆ Appears pale to clear in diff-quick, stains blue with methylene blue
∆ Caused by certain drugs, chemicals, toxins
Hemoglobin becomes attached to cell membrane
Heinz body anemia in cats is caused by?
Tylenol toxicity
Heinz Bodies Anemia in dogs is caused by?
onion toxicity
Cats may have up to what percent of Heinz bodies in normal blood profile?
10%
What is Polycythemia?
Refers to the appearance of an increase of red blood cells in circulation but in reality the bone marrow is not actually creating more red blood cells but the fluid within the blood is significantly less making that appearance of increased RBC.
What are the 3 types of Polycythemia?
- Relative Polycythemia
- Primary Polycythemia
- Secondary Polycythemia: Erythrocytosis
Explain: Relative Polycythemia
∆ Occurs when the animals is dehydrated due to a decrease water intake or excessive loss of fluids through diarrhea, commuting, or polyuria (increased urination)
∆ Common to see in sick animals & sweaty horses & humans
∆ Easily corrected once dehydration is corrected & is a normal occurrence
Explain: Primary Polycythemia
◦ Myeloproliferative Disorder at the stem cell level: Stem Cells abnormality where the stem cells just continue to produce RBC.
◦ To many Red Blood Cells in the circulation causing congestion in the capillaries where the RBC need to enter one at a time causing them to get backed up and clogging the entrance.
◦ The congestion leads to a sluggish/slow blood flow within circulation causing the blood viscosity to be much thicker in consistency which therefore decreases the cardiac output and decreases the oxygen inside the tissues.
◦ This leads to Cyanosis: Decreased oxygen levels which is expressed by blue mucus membranes
◦ Same clinical signs/symptoms as congested heart failure (CNS).
◦ Lifespan of RBC is normal: Erythropoietin Normal
◦ Very rare w/ poor prognosis generally results in death in vet med
‣ Human med have a little more options
Explain: Secondary Polycythemia
∆ Referred to as: Erythrocytosis
∆ An increase in the Erythropoietin hormone levels inside the body through the erythropoeisis feedback system in response to Hypoxia and/or anemia to request the stem cells inside the bone marrow to begin production of red blood cells.
∆ This is a self regulating process (transient) and will return to normal on its own through the erythropoeisis feedback loop.
Neutrophil Abnormals refer to?
∆ first defense against attack, once released into the blood stream to attack they do not come back. A pack of mature neutrophils that hang out near the vessel walls and are classified into:
1. Physiologic Neutrophilia
2. Stress Neutrophilia
Physiologic Neutrophilia is caused by?
◦ By Adrenaline aka Epinephrine | “Fight or Flight” Response
◦ Increase number of neutrophils being released into the bloodstream/circulation caused by a sudden increase/flush of adrenaline/epinephrine triggered by fear, exercise, excitement, etc…
◦ Once the Neutrophils get into the bloodstream and realize there is no infection and truly no need for them right now they will stick themselves to the vessel wall and just hang out for a while until they are truly needed. This is called: Marginal Neutrophil Pool (MNP)
◦ This is a transient event meaning that the body will self correct
Stress Neutrophilia is caused by?
- An increase of cortisol in the body either naturally through physiologic stress or by corticosteroid medication.
- The release of Cortisol which is a steroid causes the increase need of mature neutrophils transit time and decreases neutrophil movement into the tissues just keeping them in the blood stream. Therefore we look like we have an increase of mature neutrophils in the blood stream
Folic Acid Deficiency is also called?
Vitamin B12 Deficiency
Vitamin B12 Deficiency is also called?
Folic Acid Deficiency
Basophilic Stipping is common response to?
To Anemia (NOT horses) & Lead poisoning
What species do we not see Basophilic Stipping?
Equine - Horses
Howell Jolly Bodies are seen when responding to?
To anemia
Helmet Cells refer to?
Schistocytes
DEFINE: Microangiopathy disease
partial occlusion of vessels – cells forced through
Schistocytes are common to see in which disease?
Microangiopathy disease
Relative Polycythemia PCV %
PCV Value: 60-70%
Erythrocytosis is associated with which Polycythemia?
Secondary Polycythemia
What is a Marginal Neutrophil Pool (MNP)?
A Marginal Neutrophil Pool (MNP) is referring to once the Neutrophils get into the bloodstream after being triggered by epinephrine and realize there is no infection and truly no need for them right now they will stick themselves to the vessel wall and just hang out for a while until they are truly needed.
* This group of Activated Marginal Mature Neutrophils that have attached themselves along the vessel wall waiting to be needed are referenced as a Marginal Neutrophil Pool (MNP).
What species is Physiologic Neutrophilia common?
Feline: Cats
Stress Neutrophilia is commonly associated with which disease?
Cushing’s Disease
Stress Neutrophilia is commonly found in which species?
Middle age to older Dogs
True/False: Left shift is commonly seen in the presence of Stress Neutrophilia.
FALSE
True/False: Left shift is commonly seen in the presence of Physiologic Neutrophilia.
FALSE
What are the two main reasons of Neutropenia?
1: Excessive Usage
2: Decreased Production
Neutropenia in general refers to?
Decreased number of neutrophils found in circulation
Excessive Usage Neutropenia refers to?
An increased need for phagocytes/neutrophils in the tissues due to most commonly a bacterial infection therefore the amount of neutrophils moving to the tissues is higher than the bone marrow is pushing out new neutrophils causing a decrease quantity of neutrophils in circulation.
Is left shift common to see in Excessive Usage Neutropenia?
YES!
Decreased Production Neutropenia refers to?
◦ Decreased bone marrow production due to infectious agents such as:
‣ Parvovirus, Feline Panleukopenia, Distemper, FeLV, Chemical toxicities like Chemotherapy drugs & Estrogen hormones, Genetic disorders causing those stem cells to not get the neutrophils
Toxemia does what to the body?
• Toxemia can cause toxic changes to the neutrophils morphology or how they look
• Severe bacteria infections and/or inflammation may disturb neutrophil maturation & cause cytoplasmic changes
• Left Shift is common
• Septicemia is common
What are the cytoplasmic changed seen in a toxic neutrophil?
◦ Makes the neutrophil looks similar to Monocytes but the nucleus still stays dark & dense not being able to see any light though it
◦ Doehle Bodies: Blue Gray Cytoplasmic Inclusions
◦ Diffuse Cytoplasmic Basophilia
◦ Cytoplasmic Vacuoles (Foamy looking)
◦ Cytoplasm is a blue gray color
◦Increased in overall cell size
◦ Toxic Granulation: Prominent Purple cytoplasmic granules
Toxic granulation refer to which WBC? & which species is it most common?
Neutrophils & Most common in horses but can be seen in dogs & cats
Define: Lymphocytosis
◦ Increase of lymphocytes in the bloodstream/circulation
Define: Physiologic Lymphocytosis
◦An increase of lymphocytes in circulation due to the bodies transient response to epinephrine increase generally due to fear and/or excitement but can be caused by chronic infections.
Physiologic Lymphocytosis is commonly seen in which species?
◦ Cats & occasionally in dogs
What is commonly seen in Lymphosarcoma patients?
Physiologic Lymphocytosis
Define: Lymphosarcoma
is when the bone marrow is only wanting to make lymphocytes
TRUE/FALSE: Enlarged lymph nodes generally correlate with lymphocytosis.
FALSE - As something near the lymph nodes stimulated the B-Lymph cells to accumulate in that area. More common in localized infections versus Lymphocytosis as it’s a systemic issues.
Define: Stress Leukogram
• Increase levels of cortisol/Corticosteroids in the body causes increase an of neutrophils, decrease of lymphocytes, increase of monocytes & decrease of eosinophils which is called stress leukogram.
• Corticosteroids will always cause a Stress Leukogram which essentially means an increase of Neutrophils (neutrophilia) & Monocytes (monocytosis) in the bloodstream/circulation since the corticosteroid is preventing them from getting back into the tissues and/or lymph nodes. The corticosteroid is also at the same time decreasing the amount of lymphocytes (lymphopenia) & Eosinophil (eosinopenia)in circulation as the corticosteroid is preventing them from leaving the tissues and getting back into the bloodstream.
Define: Lymphopenia
Decreased number of Lymphocytes in circulation
Major cause of Lymphopenia?
◦Occurs during pain, stressful disorders when the body has increase cortisol/corticosteroid levels
◦ Loss of Lymph ducts
◦Impaired Lymphopoeisis
◦ Immunodeficiency Disease
‣ FeLV & FIV in cats
‣ Congenital T-Cell immunodeficiencies in Arabian Equine Breeds
A single injection of corticosteroid therapy causes maximum decrease of lymphocytes in what amount of time?
Max decrease 2-4 hours.
Back to normal/the corticosteroid wears off within 24 hours.
What Immunodeficiency Disease is associated with Lymphopenia in Felines?
‣ FeLV & FIV in cats
What Immunodeficiency Disease is associated with Lymphopenia in Equines?
‣ Congenital T-Cell immunodeficiencies in Arabian Equine Breeds
Impaired Lymphopoeisis is generally caused by?
‣ Cancer & chemotherapy can disrupts this process along with prolonged steroid treatment & irradiation.
What is the most common finding in animal leukograms?
Lymphopenia
Define: Lymphopoeisis
The production of lymphocytes
Mortality rate for dogs & cats with absolute lymphopenia?
◦ Poor prognosis: 1/3 of all dogs & 1/2 of all cats with Absolute lymphopenia will
Define: Monocytosis
◦ Increase number of monocytes in circulation
Monocytosis 2 main causes & why?
- Corticosteroid or Stress induced
- Tissue Demand
• Tissue demand for phagocytosis of large particulate debris
Define: Monocytopenia
• Decrease number of Monocytes in circulation
◦ Not clinically useful for us since 0-10% of Monocytes seen in circulation is normal
Why is monocytosis not clinically useful in vet med?
Because a decrease number of monocytes isn’t unusual since 0-10% of Monocytes seen in circulation is considered normal.
Acanocytes Refer to?
∆ Spiculated red blood cels w/ Blunt projections coming off them
Acanocytes are commonly associated with what diseases?
∆ liver disease
∆increased blood cholesterol
∆ Hemangiosarcoma
∆ DIC
∆ Glomerulonphritis
What are Schistocytes
∆ Irregularly shaped fragments of red blood cells giving them a sheared into pieces appearance or like a helmet appearance.
Autoimmune hemolytic anemia is also referred to as?
∆ Often referred to as: IMHA: Imune Mediated Hemolytic Anemia
Eosinophilia means?
◦ Increase of Eosinophil in circulation
◦ Stimuli causing increases are not precisely defined
‣ Thereore they have no idea why this happens
Eosinophilia is common to see during which type of infections?
◦ Can result from antigen-antibody interactions in the tissues such as the skin, lungs & GI infections.
◦ Common to see in parasite infections and allergies.
‣ Finding parasites in fecal samples of adults is not always the cause of the increase
Eosinopenia means?
Decrease of Eosinophil in the circulation
why is Eosinopenia not generally clinically relevant? & when is it clinically relevant?
Normal range of eosinophils seen in the blood stream is 0-10% which is why this isn’t clinically revlant unless the Eosinopenia is accompanied with Neutrophilia, &/or Lymphopenia
Clinically relevant Eosinopenia is caused by?
◦ Corticosteroid induced since it will be accompanied with the Neutropil and/or Lymphocyte cortisol abnormality
‣ causes decreases 2-3 hours after adminstration
◦ Pretreatment levels return w/in 24 hours (72 hours if long term)
Basophilia means?
Increased number of Basophils in circulation
Basophilia is accompanied with?
◦ Hyperlipemia
◦ Eosinophilia
◦ Chronic Dirofilariasis
Basopenia means?
Decreased number of basophils in circulation
Basopenia is considered clinical irrelevant why?
Seeing basophils in circulation is extremely rare normally.
Thrombocythemia means?
Increase number of platelets seen in circulation that are larger than normal but functionless - not able to clot.
This is a bleeding disorder/Hemorrhagic syndrome.
Causes
‣ Myeloproliferative disorders – proliferation of megakaryocytes
• An increase production of Megakaryocytes in the bone marrow
• megakaryocytes are not seen in the bloodstream since they break apart
‣ Megakaryocytic leukemia in cats and dogs
Spontaneous hemorrhage disorder means? & is associated with?
This means its a spontaneous bleeding disorder because the platelets that are being pushed out of the bone marrow are larger than normal but lost their ability to function correctly - not able to to clot & Thrombocythemia.
Thrombocytopenia
◦ Decrease number of platelets in circulation
◦ This can be caused by a few different reasons:
‣ Decreased platelet production in the bone marrow
‣ Increased destruction or utilization of the platelets
‣ Abnormal distribution of the platelets
‣ Hemmorrhage: Excessive loss of blood due to enlarged platelet size
‣ Hypoproliferative:
• Bone Marrow Issue: Stem cells issue
‣ Hyperdestruction:
• The bone marrow is functioning correctly & pushing out the platelets normally in circulation but the platelets are being destroyed prematurely.
‣ Decreased platelet production:
• Hereditary
• Drug toxicity
• Radiation
• Viral infection
• Rickettsial Infection
• Protozoal infection
• Abnormal production of platelets due to Vitamin B12 deficiency, Uremia, Aplastic Anemia, and severe iron deficiency.
‣ Destruction or Utilization of Platelets:
• Immune mediated, bacterial, viral, rickettsial, drug induced
• Anaphylaxis
• DIC: Disseminated Intravascular Coagulation
◦ Spotaneous blood clots forming all over the body
• Microangiopathies
◦ Breaks apart the RBC causing “helmet cells” which inadertantly breaks apart the platelets
• Acute Infections
◦ Any form of inflammation attracts platelets
• Hereditary structural defects
‣ Abnormal Distruption of Platelets in the body:
• Platelets like to hang out in the spleen causing Splenomegaly(enlarged spleen)
• Hypothermia: Cold temperatures causes the platelets to go move towards the deeper tissues/organs to regulate body temperatures
• Excessive Blood Loss: Trauma
◦ Symptoms:
‣ Hemorrhage
‣ Prolonged Bleeding time
‣ Failure of clot retraction
‣ Petechiae: Surface capillaries breaking apart causing bruising
‣ GI Bleeding: blood in stool
