clin path 1st quiz Flashcards
What are the 3 pre-analytical factors that may influence test results?
Fixed animal factors
transient animal factors - pregnancy, fear
clinician related - techniques.
What is an analytical factor that can influence results?
type of equipment, quality control
What are some post analytical factors that may influence results?
incorrect transcription
wrong reference ranges
interpretation errors
Which anticoagulant is the best to use for hematology such as morphology and CBC? What color is the tube?
EDTA
Purple
What anticoagulant should be used for clinical biochemistry? Color of tube?
Lithium Heparin
Green
What color tube has no anticoagulant?
red
What anticoagulant is used for coagulation tests? What color is the tube?
Na-Citrate
Blue
What anticoagulant is preferred for glucose estimation? Color of tube?
Fl-Oxalate
Grey
What gauge needle should be used for large animals? What time should the sample be collected?
18-20
in the morning
What vein should be used for big dogs and what gauge?
Cephalic
21-22
What vein should be used for small dogs and what gauge needle?
jugular
19-20
What gauge needle should be used in a cat?
21-24
What vein and what gauge needle should be used for pigs?
Anterior vena cava
18-19
How long are blood and fluids stable at room temperature? What about at 4C in a fridge?
RT- 24 hours
Fridge - 2-3 days
What must be done before blood samples are stored for biochemistry later on?
plasma must be seperated
What kind of blood samples must be processed within 30 minutes?
ammonia, acid-base (bilirubin)
and if lithium heparin was used to anticoag
What can in vitro hemolysis change in the blood analysis?
decreased RBC and PCV values
inaccurate MCHC
Turbidity from in vitro hemolysis can interfere with what kind of tests?
colorimetric and spectrophotometric
What analytes may increase as a result of in vitro hemolysis?
postassium
inorganic phosphates
enzymes
What kind of tubes should body fluids be split into?
EDTA - preserve morphology
Sterilin tubes - permit culture
What body fluid must be analyzed immediately?
CSF
What is the definition of accuracy in laboratory assays?
closeness of measured value and true value
What is the defintion of precision in laboratory assays?
gives same result over and over
What is the definition of reliability in laboratory assays?
ability to be accurate and precise
How is positive predictive value calculated and what does it mean?
TP/FP+TP
suggests presence of dz in population of animals
How is negative predictive value calculated and what does it mean?
TN/TN+FN
suggests absence of dz in population
What happens to the PPV and NPV if the prevalence of a disease drops?
PPV decreases
NPV increases
What are sinusoids in bone marrow?
thin walled capillaries
reticular cells on outside where hematopoeisis occurs
What system is present in BM, spleen, and liver and facilitates hematopoiesis by removing aged RBCs?
mononuclear phagocytic system (MPS)
What organs are places besides BM, spleen and liver is the MPS found?
CNS (microglia)
lungs (alveolar macrophages)
What organs does hematopoiesis occur after birth?
Liver, spleen and bone marrow, then becomes restricted to bone marrow
What three things(hormones/molecules) are involved in regulating hematopoesis?
erythropoietin (EPO)
thrombopoietin (TPO)
colony stimulation factors (CSF)
What two types of cells make up the majority in the bone marrow?
myeloid (granulocytic) and erythroid precursors
What is the lifespan of cat RBCs?
70 days
Where can extramedullary hematopoisesis take place?
spleen and liver
What “activities” do neutrophils possess?
phagocytic and bacteriocidal
What “activities” do eosinophils (and basophils) possess?
parasiticidal and allergic
How long does it take for a myelocyte to become a neutro, eosin or basophil?
7 days
What makes up myeloid precursors?
granulocytes and monocytoid precursors
Which WBC can re-enter the blood stream directly?
lymphocytes
What ways may reversible bone marrow abnormalities manifest themselves? (3)
neutropenia (b/c of life span)
non-regenerative anemia
thrombocytopenia
What ways may irreversible bone marrow be manifested?
cytopenia or unregulated proliferation (neoplasia)
What may be the causes of atrophy of the bone marrow?
toxins, neoplasia, virus or protozoal infection or idiopathic
Which irreversible bone marrow abnormality is non-selective?
atrophy of bone marrow
Which irreversible bone marrow abnormality is selective?
hyperplasia of bone marrow
What are the causes of hyperplasia of bone marrow?
inflammation, acute blood loss, hemolysis
Which syndrome is where one or more stem cells have maturation defects?
myelodysplastic syndrome (MDS)
What effect does myelodysplastic syndrome have on the blood?
cytopenias of the affected cell line
What conditions does selective MDS (myelodysplastic syndrome) lead to?
non-regenerative anemia
leukopenia
thrombocytopenia
What does non-selective MDS lead to?
aplastic pancytopenia
What is it called when normal hematopoietic tissue in bone marrow is replaced by abnormal tissue usually fibrous or malignant?
myelopththisis
What disease is cancer of the bone marrow stem cells?
Myeloproliferative disease (MDS)
How is MDS(maturation defect) different than acute MPD(cancer)?
blast cell percentage in bone marrow is less than 30% in MDS
How is MDS different than chronic MPD?
MDS will have leukopenia
Which species is susceptible to MDS?
cats
What characterizes MPD (cancer) in the bone marrow?
hypercellular bone marrow (one cell type)
distorted maturation sequence
How is acute leukemia characterized?
presence of more than 30% blast cells in marrow
short survival time (of animal)
What characterizes chronic leukemia?
high number of mature cells in blood and bone marrow
long survival time (of animal)
Which dog breed takes 3 days to clear blood of lipids?
mini schnauzer
Low PCV + low protein =
hemorrhagic anemia
Low PCV + normal protein =
hemolytic anemia
Low PCV + high protein =
inflammatory anemia (dyshemopoiesis)
high PCV + high protein =
dehydration (high albumin confirms)
normal pcv + low protein =
reduced protein production (liver dz)
increased protein loss
long pink buffy coat means what?
RBC regeneration (nucleated rbcs)
What may cause horse plasma to be yellow besides jaundice?
anorexia or illness
MCV is within reference intervals means?
normocytic
MCV is above RI means?
macrocytic
MCV is below RI means?
microcytic - iron deficiency anemia
MCHC below RI means?
Hypochromic - immature RBCs
MCHC above RI means?
Hyperchromic - artefactual
Which RBC indices is the least accurate?
MCH
How do you calculate MCV?
MCV = PCV*10/RBC in femtoliters
How do you calculate MCHC?
MCHC = Hb*100/PCV (%)
What type of anemia always stays normocytic and normochromic?
anemia from low RBC production (dyshemopoiesis)
When do you see immature RBCs after hemorrhage or hemolysis?
72 hours
What types of anemia are microcytic and hypochromic?
prolonged small losses of blood, no iron, regeneration poor
What error in RBC indices may occur if there is inadequate centrifugation?
artificially elevated PCV and lower MCHC
What technique measures reticultocytes more accurately?
flow cytometry
What % of reticulocytes indicates RBC regeneration in ORP?
greater than 3%
What % for RBC regeneration using CRP (corrected reticulocyte percentage?
greater than 1%
What stains are used to stain RNA and identify reticulocytes, intracellular blood parasites and heinz bodies?
new methylene blue
What stain is is used for mast cells?
Toludine blue
What stain is used for iron storage?
prussian
What stain is used for fungal hypae and spores?
periodic acid schiff (PAS)
What species is rouleaux formation normal?
horses, dogs, cats
What conditions are considered if there is agglutination of RBCs in a smear?
inflammatory dz, toxemia, immune mediated anemia
Which species have normal anisocytosis?
ruminants
What term is used when RBCs stain blue?
polychromasia (RNA from immature RBC)
What does hypochromasia indicate?
iron deficiency anemia
What conditions increase holly jolly bodies?
regenerative anemias and splenectomized animals
What are holly jolly bodies made of?
DNA remnants of nucleus
What conditions/species have basophilic stippling in their RBCs?
RBC regeneration especially ruminants
What is the term used for abnormally shaped RBCs above 30%?
poikilocytosis
What species has type 1 echinocytes?
ruminants
What are type 2 echinocytes associated with?
toxemia, electrolyte imbalance, snake bites, glomerularnephritis
What is the term used for RBCs with a few blunt irregularly spaced projections?
acanthocytes
What condition makes acanthocytes occur?
cholesterol/phospholipid ratio is altered on RBCs membrane
What is the term used for RBCs that are small, dense and without central pallor?
spherocytes
What term is used for RBCs that are thin with an increased membrane to volume ratio?
leptocytes (codocytes) - target cells
What conditions are leptocytes usually seen?
toxemias
iron deficiency anemia
What are heinz bodies?
denatured clumps of precipitated hemoglobin
What can high amounts of heinz bodies transform a RBC into after removal?
spherocyte
What do avian blood smears have with a routine blood stain?
polychromasia
What do avian blood smears have with new methylene blue stain?
up to 5% reticulocytosis
What kind of reticulocytes do cats have?
punctate and aggregate reticulocytes
What term is used for an increase in all blood cells above RI?
polycythemia
What term is used for RBCs above RI?
erythrocytosis
What chronic diseases cause absolute pathological erythrocytosis?
chronic lung or heart disease
What type of erythrocytosis is associated with a myeloproliferative tumor(MPD)/erythrocytic sarcoma?
absolute, pathological and primary
What do dogs show during erythrocytic sarcoma?
erythrocytosis in absence of dehydration, lung/heart dz, kidney disorder or high EPO. Also lots of immature RBCs in absence of anemia
What do cats show that have erythrocytic sarcoma?
non-regenerative anemia, severe, immature RBCs, hepatomegaly, and splenomegaly
What are the 3 mechanisms that lead to true anemia?
hemorrhage
hemolysis
dyshemopoiesis
What clinical signs are present when there is a sudden rapid loss of blood?
collapse, hemorrhagic shock or heart failure
What is pure red cell aplasia?
dyshemopoietic anemia effecting only RBC precursors
What is aplastic pancytopenia?
non-selective simultaneous destruction of all stem cells in bone marrow
What are the 2 types of primary dyshemopoietic anemia?
pure red cell aplasia
aplastic pancytopenia
What pathologies cause secondary dyshemopoiesis?
inflammation, infection, endocrine disorders, neoplasia
What is the most common mechanism of non regenerative anemia?
anemia of inflammatory disease (AID) - body sequesters iron in response to inflammation
What is a classic example of AID in small animals?
chronic renal failure –> low EPO
What is the main difference between primary and secondary dyshemopoiesis
primary - bone marrow failure
secondary - iron sequestration
Which drug toxicity in particular can lead to reversible bone marrow abnormality?
estrogen
What does suffix -penia mean?
decrease/deficiency
What is monocytopoiesis regulated by?
granulocyte-macrophage colony stimulating factor (GM-CSF)
What is granulopoiesis regulated by?
G-CSF
What are schistocytes?
erythrocyte fragments with sharp extremities when there is turbulent blood flow
What are blast cells?
very big, high nuclear to cytoplasmic ratio, pale nucleui, one to several nucleoli and blue cytoplasm
What does the prefix -cytosis mean?
increase in those cells
Where does hemopoiesis occur in adult animals?
flat bones and epiphysis of long bones
What indicates RBC regeneration in horse?
mild macrocytic
Band cells are precursors of what 3 cells?
neutro, eosinophil, and basophil
Monocytes are precursors of what cell?
macrophage
What are the 3 primary RBC tests for an erythrogram?
PCV, Hb, and RBC count
What are specific diseases that indicate a CBC should be done?
babesiosis
heartworm
leukemia
