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Hematology > Erythrocytes > Flashcards

Erythrocytes Flashcards

1
Q

Order of erythropoeisis

A
  1. Rubriblast
  2. Prorubricyte
  3. Rubricyte
  4. Metarubricyte
  5. Polychromatophil
  6. Erythrocyte
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2
Q

Acanthocytes

A

Projections of variable length, unevenly spaced on surface of the RBC.

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3
Q

Keratocytes

A

Crescent shaped. Formed by mechanical shearing. The fragment that comes off is a schiztocyte.

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4
Q

Leptocyte

A

thin macrocytic RBC with membrane surface area > Hgb. Tend to wrinkle, fold, or twist into figure-8 cells. Sometimes seen with hepatic disease.

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5
Q

Codocyte

A

Target cells. Darck central area of Hgb surrounded by pale zone and darker rim. Up to 50% in dogs. May be present with hepatic disease.

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6
Q

Dacrocytes

A

Tear drop shaped. 1. Artifactual - all point same direction. 2. 2’ to membrane distortions as cells pass through narrow sinusoids (myelofibrosis, bone marrow dz, splenic dz)

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7
Q

Eccentrocyte

A

Eccentric Hgb distribution. Indicate oxidative damage to the RBC membrane.

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8
Q

Echinocytes

A

Either due to RBC dehydration, or expansion of outer leaflet of the RBC membrane.

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9
Q

Echinocyte I

A

RBC with angular shape; short, blunt projections. Often due to artifact (sample aging, excess EDTA)

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10
Q

Echinocytes III

A

Spherical RBCs with sharp projections of equal length evenly spaced on the surface. Artifact, renal dz, elect. changes, crenation/dehydration.

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11
Q

Echinoelliptocytes

A

Oval to cigar shaped RBCs w/ projections of equal length evenly spaced on surface of the RBC. Cats with hepatobiliary dz.

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12
Q

Elliptocytes

A

oval to cigar shaped RBCs. Normal in camelids. Reported in other species with hereditary RBC disorders.

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13
Q

Heinz bodies

A

Eccentrically located refractile bodies or blebs on the periphery of the RBC.

Best seen with Romanowsky stains.

Indicate oxidative damage to RBCs. The denatured globin portion of the Hgb precipitates to form the visible body.

Cats are more susceptible d/t:

  1. nonsinusoidal spleen does not efficiently remove the HzBs from RBCs
  2. Increased content of sulfhydryl groups in the Hgb of cats is more susceptible to exogenous oxidizing agents.
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14
Q

Shizocytes

A

RBC fragments attributed to mechanical red cell injury/shearing

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15
Q

Spherocyte formation

A

Formed by removal of altered RBC membrane without concurrent loss of Hgb.

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16
Q

Poikilocytes

A

This is the term used when RBC shape defies description. Can be abundant in normal calves, deer, goats, and pigs. May be in vitro artifact.

17
Q

RBC skeletal proteins

A

Spectrin, ankyrin, actin.

These link to the lipid bilayer via

  1. spectrin-ankyrin band 3 (aka AE1)
  2. spectrin-actin band (aka 4.1)
18
Q

Embden Meyerhof pathway

A

Anaerobic metabolism of glucose to lactate provides energy for RBCs

19
Q

Rapoport-Luebering pathway

A

Production of 2,3 diphosphoglycerate

20
Q

Methemoglobin reduction pathway

A

Returns methemoglobin (oxidized form) to the reduced state (ferrous/Fe2+) which is capable of carrying oxygen.

21
Q

Hexose monophosphabe shunt

A

Maintains glutathione in the reduced state.

22
Q

Glutathione

A

Intracellular buffer that protects RBCs from oxidant injury, esp. by H2O2 and superoxide, and helps stabilize reactive sulfhydryl groups of Hgb.

23
Q

RPI

A

Reticulocyte Production Index

a calculation designed to correct the retic. count for severity of anemia and longer maturation period for early-released reticulocytes

24
Q

Hematocrit

A

= MCV x RBC count

gives the volume of RBC per liter whole blood

25
Q

MCH

A

Mean Cell Hemoglobin

average amount of Hgb per RBC

= Hgb/ RBC count

in picograms (pg)

26
Q

MCHC

A

Mean Cell Hemoglobin Concentration

average conc. Hgb per erythrocyte

= Hgb/ Hct

in g/L

27
Q

RDW

A

Red Cell Distribution

describes the coefficient of variation of the RBC sizes

= std dev. of MCV / MCV

in principle, correlates with degree of RBC anisocytosis

28
Q

Absolute reticulocyte count

A

= % of reticulocytes x RBC count

gives the absolute # reticulocytes in a volume of blood

29
Q

Grading anemia in common domestic species.

A
30
Q

nRBCs without anemia

A

DDX:

  • hypoxia
  • necrosis
  • lead
  • acute RBC neoplasia
  • non-hemopoietic neoplasia with metastasis to the marrow
31
Q

Tests for iron deficiency

A
  1. Serum iron
  2. Total iron binding capacity (TIBC) - measures transferrin
  3. Serum ferritin ***
  4. Visual exam of bone marrow iron stores ***
32
Q

Anemia of

Iron Deficiency vs. Inflammatory Disease

A
33
Q

Microcytosis with normal body iron

A
  • Copper deficiency
  • PSS
  • Japanese breeds
  • Calves
34
Q

Intra vs Extravascular Hemolysis

A

Intravascular: MAC directly on RBC surface. Hemoglobinemia, hemoglobinuria. Autoagglutination. Ghost cells.

Extravascular: Mononuc. phagocytic system. Hyperbilirubinemia, hyperbilirubinuria. Spherocytes.

35
Q

Oxidative Damage

A
  • Heinz Bodies
  • Lipid peroxidation - eccentrocytes, ghost cells
  • Methemoglobinemia
  • Agents
    • zinc
    • copper
    • onions
    • garlic
    • acetaminophen
    • red maple
    • benzocaine
    • napthalene
    • skunk spray
    • propylene glycol
    • Brassica plants (kale, rape, turnips - Cattle)
36
Q

Nonregenerative anemia

A
  1. Neoplasia
  2. Renal disease
  3. Inflammatory disease
  4. Endocrine
    • Hypothyroid
    • Hypoadrenocorticism
37
Q

Anemia of Inflammatory Disease

A

AID

Most common nonregen. anemia in veterinary medicine.

2/2 cytokines, especially: IL-1, TNF, TGF-ß, and IFN-gamma

Factors:

  • reduced availabilty of iron
  • decreased RBC life span
  • decreased response of erythroid lineage to presence of erythropoeitin
38
Q

Primary bone marrow disease

DDX for non-regenerative anemia

A
  • erythroid hypoplasia or aplasia
    • drugs, toxins
    • hormones, chemicals
    • irradiation
    • etiology often unidentified
  • dyserythropoiesis resulting in defective maturation
  • marrow necrosis
  • neoplastic infiltrate
  • fibroblastic infiltrate
  • viral (FelV, FIV)
  • immune mediated destruction of erythroid precursors (IMHA @ marrow)
39
Q

Erythrocytosis

A
  1. Relative
    • dehydration (increased TP)
    • splenic contraction/ epinephrine response (normal TP)
  2. Absolute
    • Primary
      • neoplasia in the erythroid precursor line.
      • rare. normal to low circulating EPO conc.
    • Secondary
      1. Physiologic: chronic hypoxia causes increased EPO
        • cardiac
        • pulmonary
        • high altitude
        • increased EPO 2/2 physiologic need because of chronic hypoxia
      2. Non-physiologic: inappropriate EPO synthesis from neoplasias (esp. renal tumors) = “inappropriate erythrocytosis”

Hematology (4 decks)

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