CBC Review Flashcards
Erythrocytosis
- Relative - hemoconcentration
- Absolute
- Primary: polycythemia Vera
- Secondary: hypoxia, cardio/pulm disease, hyperthyroid, high altitude, renal cyst/neoplasia, EPO prod neoplasia - Redistribution - splenic contraction
- Breed - greyhound, daschund, chihuahua
- Artifact - poorly mixed
RBC regeneration
3-5 days minimum; may take 5-7 with comorbitities
Reticulocytosis without anemia
hypoxic? other secondary causes?
reference interval
drugs - NSAIDs, immunosuppressives
supplements - zn, glucosamine
exercise related
Macrocytic
regeneration poodles hyperthyroid Cats with FeLV Marrow Disease Artifact - transit, agglutination Hyperosmolar patient
microcytic
iron deficiency inflammation liver disease (shunt) shiba inu/akita hypoosmolar underfilled edta tube
Hyperchromic
Artifact only
hypochromic
regeneration fe deficiency inflammation liver disease (shunt) (macrocytic due to hyperosmolar blood or prolonged storage/swelling in transit)
Calculated vs. Measured Hb
MCHC = calculated (lyses cells and divides Hb/# cells) CHCM = measured (directly measure Hb in red cells with laser)
MCHC and CHCM don’t match?
MCHC artifactually increased due to lipemia/hemolysis.
Trust CHCM more!
Nonregenerative Anemia
- Decreased erythropoeisis
- inflammmation, CKD, Endocrine diseases, marrow failure - Ineffective erythropoiesis
- PIMA, Fe deficiency, Pb toxicity, EPO neoplasia, myelodysplastic syndromes, macrocytic anemias
Regenerative Anemia
hemorrhage Hemolytic - parasite - IMHA - Heinz body - fragmentation - RBC metabolic defects (Zn, dec. Phosphate, envenomation, congenital disorder)
Thrombocytosis
- Secondary (inflammation, Fe deficiency, hypercortisol, Vincristine, exercise/epinephrine, post-splenectomy, marrow disease)
- artifact (fragment, ghosts, lipemia)
- Neoplastic - essential thrombocythemia
Increased MPV
regeneration
KCKS, Norfolk/Cairn Terrier
Artifact
thrombocytopenia
- consumption (DIC)
- Destruction (immune mediated)
- Decreased production (marrow)
- severe hemorrhage
- sequestration (splenomegaly, hypothermia)
- Envenomation
- dilution
Artifact (clotted)
Breed (greyhound, whippet, KCKS, Norfolk)
Neutropenia
- shift to marginating pool (due to acute endotoxemia, hypothermia)
- Marrow Diseases (trapped neutrophil syndrome, drug/toxin/virus, cytokine deficiency, severe inflammation, immune mediated destruction, cobalamin deficiency
Neutrophilia
- shift to circulating (corticosteroids, epinephrine)
- release from storage and delayed death (steroids, inflammation)
- leukocyte adhesion deficiency
lymphocytosis
- physiologic leukogram (epinephrine)
- young animal
- antigenic stimulation (e.canis, FeLV/FIV, mycoplasma) or immune-mediated anemia in cats
- hypoadrenocorticism
- hyperthyroidism
- paraneoplastic (to thymoma)
- lymphocytic leukemia or stage 5 lymphoma
lymphopenia
- stress leukogram
- acute infection
- loss of lymph (chylous effusion, lymphangiectasia)
- lymphocytolysis (steroids, viral infection)
- immunodeficiencies
eosinophilia
allergy/hypersensitivity parsites hypoadrenocorticism paraneoplastic (worms, wheezes, weird diseases)
monocytosis
stress, inflam, monocytic leukemia
basophilia
machines can’t even count them accurately
physiologic/excitement leukogram
mature neutrophilia
lymphocytosis
+/- eos, baso
stress leukogram
neutrophilia lymphopenia monocytosis eosinopenia (SMILED)
inflammatory leukogram
- Neutrophilia (may be with left shift and toxicity)
- monocytosis
- may be lymphopenia
- eosinopenia
(regenerative immature neuts DON’T outnumber segs, but in degenerative they do)
granulocytes
neutrophils, eosinophils, basophils
Echinocytes
(regular spikes)
storage
envenomation
codocytes
(target cells)
probably artifact
may be hypothyroid
stomatocytes
(central pallor is rectangular)
acanthocyte
(irregular spicules) fragmentation lipid disorders hemangiosarcoma Fe deficiency
Fragmentary change
pre/keratocyte
acanthocytes
schistocytes (ripped)
oxidative damage
- eccentrocyte, pyknocyte(weird membranes) , keratocyte
- methemoglobinemia
- heinz bodies
Cats
normally have up to 10% heinz bodies because they have more SH groups and a non-sinusoidal spleen
heinz bodies
oxidative damage
secondary without hemolysis (hyperthyroid, DM, lymphoma)
average platelets
5 platelets in a high power(100x) field
75-100,000/uL
When do you need to correct an analyzers leukocyte count?
if theres greater than 5 nRBC per 100 WBC
Bands, basophilia, and dohle bodies indicate
toxic neutrophils
hypersegmented
5 or more lobes. hung in circulation too long/right shifted.
- steroids, cushings, chronic inflammation
- prolonged storage
- heat stroke, adderall toxicity
causes of toxic neutrophils
inflammation
infectious disease
endo/exogenous toxins
ghosts
IV hemolysis
- oxidants, envenomation, infectious agents
- artifact (difficult draw, prolonged storage)
spherocytes
fragmentation/microangiopathy Zn toxicity hypophosphatemia (dec. ATP -> can't hold shape -> discocyte -> spherocyte) envenomation blood transfusion burns inherited disorder artifact (looking at a thin area of the smear)
