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Clin Path > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Howell Jolly Bodies

A

nRBC
regenerative anemia
splenectomy (spleen helps remove nucleus from RBC), steroids, lead poisoning (affect spleen)

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2
Q

Inherited Neutrophil abormalities

A

Pelger-Huet
Birman cat
Chediak Higashi
Lysosomal Storage

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3
Q

What tube is a chemical analysis done with?

A

Heparin (green top)

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4
Q

What is used for a coagulation test?

A

blue top- citrate w/ sterile needle

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5
Q

What is used to collect blood for blood smear?

A

EDTA lavender top

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6
Q

T/F Splenomegaly can cause thrombocytosis

A

FALSE

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7
Q

What is responsible for initiating coagulation after tissue damage?

A

Tissue Factor 3

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8
Q

What are the products from fibrinolysis?

A

FDPs Fibrin Degradation Products

D-dimers

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9
Q

Increases in FDPs & D-dimers indicate increased

A

intravascular coag with clot breakdown

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10
Q

What causes thrombocytopenia along with increased FDP & D-dimers?

A

DIC Disseminated Intravascular Coagulation

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11
Q

What causes Heinz body anemia?

A

Onions, garlic, kale, WILTED red maple leaves, acetaminophen (aspirin), propylene glycol (feed additive), zinc

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12
Q

What won’t have an affect on the refractometer reading?

A

Bilirubin

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13
Q

What is true about reference intervals?

A

Includes 95% of the healthy population

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14
Q

What are the indications for a BMA (bone marrow aspirate)? What would NOT be the cause?

A

Non reg anemia, neutropenia, thrombocytopenia, monoclonal gammaopathy
NOT: monocytosis

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15
Q

Which species is neonatal isoerythrolysis most common in? Caused by?

A

Equine

caused by maternal antibodies against neonates bloodgroup antigen –> hemolysis

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16
Q

Which is the main iron metabolism control?

A

Ferritin

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17
Q

Increased plasma protein (TP)

A

CHUGL(cholesterol, hemolysis, urea, glucose, lipemia)

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18
Q

Calc % to absolute

A

Tncc=10,000
80% segs
10,000 x .8= 8000 segs
just know concept

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19
Q

Left shift

A

increased concentration of immature neutrophils (bands) can be seen w/ neutrophilia, neutropenia (SEVERE INFLAMMATION) or normal count

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20
Q

Toxic Neutrophils

A

produced at an accelerated rate

increased basophilia of cytoplasm, dohle bodies {RNA aggregates}, cytoplasmic vacuolation

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21
Q

Stress leukogram

A

lymphopenia with neutrophilia

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22
Q

Inflammation from leukogram

A

2x normal reference of bands or left shift

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23
Q

Excitement

A

neutrophilia w/ lymphocytosis (cats)

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24
Q

Neutrophilia

A

inflammation, excitement, stress

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25
Q

Lymphocytosis

A

excitement, leukemia,

ehrlichia

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26
Q

Monocytosis

A

inflammation, stress

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27
Q

Eosinophilia

A

parasite, hypersens, mass cell tumors

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28
Q

Neutropenia

A

inflammation consumption, BM problems

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29
Q

Lymphopenia

A

stress, immunodeficiency, STERIOD

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30
Q

Macrocytic RBC

A

increased MCV

regenerative anemia

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31
Q

Microcytic RBC

A

decreased MCV

iron deficient anemia

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32
Q

Polychromasia in RBC

A

reticulocytes

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33
Q

Hypochromasia in RBC

A

iron deficient anemia (not enough iron to make Hb so cells are pale)

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34
Q

Schistocytes

A

DIC, hemangiosarcoma (doberman), Iron def anemia

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35
Q

Spherocytes

A

IMHA!!!!!!!

cocker spaniel

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36
Q

Heinz bodies are

A

oxidative denatured hemoglobin

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37
Q

Basophilic stippling

A

lead poisoning, normal in ruminants!

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38
Q

Rouleaux

A

normal in horses, increase globulin in small animal

stickiness, not agglutination!

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39
Q

Agglutination is commonly seen with

A

IMHA

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40
Q

If you add saline and it disperses it is ____, if it persists it is____

A

rouleaux

agglutination

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41
Q

MCV is increased by

A

reticulocytes & platelet clumping (agglutination)

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42
Q

IMHA commonly see what 2 things?

A

agglutination and spherocytes

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43
Q

Decreased MCV indicates

A

Iron deficient anemia

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44
Q

1/3 of platelets live in the ____

A

spleen

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45
Q

What produces TPO & why?

A

liver, kidney, muscle

binds platelets, when increased free TPO platelet production from the bone marrow begins

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46
Q

6 Causes of thrombocytopenia

A 
Decrease production
Destruction
Sequestration
Loss
Consumption
Pseudothrombocytopenia
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47
Q

Platelet count is in the single digits so it has to be

A

destruction! only way to get such a low number

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48
Q

Thrombocytosis caused by

A

increase production, increased distribution

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49
Q

Primary Hemostasis

A 
AAA (takes 3-5 mins)
Adhesion
Activation
Aggregation
***Ca needed at all steps
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50
Q

Von Willebrand’s

A

Dobermans
Defect in adhesion of platelets, cant bind!
will have normal platelet count
Ecchymosis

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51
Q

Secondary Hemostasis

A

Fibrin meshwork created via clotting cascade
Coag factors synthesized by liver
II, VII, IX, X are Vitamin K dependent!***
1972

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52
Q

What drives amplification & formation of fibrin?

A

Thrombin

activates V & XI

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53
Q

Intrinsic

A

PTT
XII, XI, IX, VIII
12, 11, 9, 8

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54
Q

Extrinsic

A

Tissue factor
VII
PT

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55
Q

What initiates secondary hemostasis?

A

Tissue factor 3

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56
Q

Inhibitor of coagulation

A

antithrombin- 70% of anti-coag activity

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57
Q

Increase ___ and ___ = DIC

A

FDPs

D-dimers

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58
Q

Warfarin Toxicosis

A

Attacks vit K (2, 7, 9, 10)

no coag, bleeding, normal platelets, regnerative

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59
Q

DIC

A

IV coag throughout body
Phase 1 hypercoagulable
Phase 2 consume platelets, coag factors & antithrombin
Increased fibrinolysis
LABS: thrombocytopenia, PT & PTT increased, Schistocytes

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60
Q

2 month old puppy, remove a tooth and bleeds

A

Hemophilia A: issue w/ factor VIII

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61
Q

Decreased TP

A

blood loss :regenerative anemia (I

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62
Q

Increased TP

A

blood destruction :regenerative anemia

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63
Q

Non regenerative anemia caused by

A 
bone marrow issue
erythroid hypoplasia
intrinsic: bone marrow issue
extrinsic: renal failure, anemia of inflam, endocrine probs
acute hemorrhage
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64
Q

Acute anemia 3 examples

A

trauma (HBC), Coag disorder (DIC), Thrombocytopenia

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65
Q

Chronic anemia 3 examples

A

GI ulcer, bleeding GI tumor, Parasites(hookworm), Iron def anemia***

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66
Q

Anemia of blood destruction examples

A

IMHA, Heinz body, RBC parasites (mycoplasma), Methemoglobinemia

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67
Q

Iron deficiency Anemia

A
  • adults usually from chronic blood loss
  • Decreased MCV, microcytosis
  • Hypochromasia
  • Schistocytes & Keratocytes
  • regenerative
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68
Q

Hemangiosarcoma

A
  • doberman, german shepard
  • acute episodes of weakness
  • regenerative anemia
  • acanthocytes, schistocytes
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69
Q

IMHA

A 
usually secondary, we never find true cause
COCKER SPANIELS
Inflammatory leukogram
SPHEROCYTES
agglutination
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70
Q

Heinz body anemia

A

oxidative denatured Hb

Causes: onions, garlic, kale, WILTED red maple leaves, acetaminphen, propylene glycol**, zinc

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71
Q

Methemoglobinemia

A

chocolate brown blood
oxidative damage
causes: acetaminophen, nitrate poisoning, red maple leaves

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72
Q

4 possible causes of lymphocytosis

A
  • antigen stimulation (Erhlichia)
  • excitement
  • addisons
  • lymphocytic leukemia if >30,000
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73
Q

Erhlichia

A

anemia, Increase Hb, lymphocytosis, thrombocytopenia

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74
Q

Pancytopenia

A

all cell lines decreased

75
Q

Aplastic anemia

A

not producing any RBCs, has to be in bone marrow

Ehrlicia, IM destruction, drugs

76
Q

Erythroid Hypoplasia

A 
-intrinsic, see young RBCs
myelodysplasia
leukemia
IM destruction
similar to aplasia
-extrinsic factors
chronic renal failure
endocrine disorders
inflam dz
77
Q

Anemia of Renal dz

A

lack of production of Erythropoietin (EPO)-
which stimulates the bone marrow to produce RBCs
Hypocalcemia
excess parathyroid hormone

78
Q

Anemia of Inflammatory dz

A

mild anemia
increase storage or iron
low serum iron
CS: weak, fever, inflam leukogram, slight anemia, non regnerative, lots of neutrophils

79
Q

Myeloid to Erythroid ratio

A

1:1, 3:1
interpret bone marrow
erythroid always stays 1!

80
Q

Increased M:E ratio

A

increased WBC & decreased RBC
erythroid hypoplasia or aplasia
granulocytic hyperplasia or leukemia (neutrophils over 100,000)

81
Q

Decreased M:E Ratio

A

increased RBC & decreased WBC
regenerative anemia
erythroid leukemia

82
Q

Feline Type A

A

weak isoantibodies against Type B

83
Q

Feline Type B

A

STRONG isoantibodies against Type A

*do NOT give type B any type A blood

84
Q

Neonatal isoerythrolysis

A

problem when giving birth to foal w/ different antibodies

85
Q

Agglutination is a ___ rxn for blood typing

A

POSITIVE

86
Q

Agglutination should NOT be confused with ____

A

rouleuax bc they are NOT the same

Horse: rouleaux is normal

87
Q

Agglutination is ____ rxn for cross matching

A

BAD

if positive agglutination DO NOT give transfusion

88
Q

What kind of parameter is MCHC?

A

calculated

89
Q

RBCs that stand at room temp

A

swell & falsely increase MCV

90
Q

RBC peak with right shift

A

indicates larger, immature RBC precursors
increase RDW (red cell distribution width)
regenerative anemia

91
Q

Increased hemoglobin concentration causes?

A

artifactual hemolysis, lipemia, heinz body

*w/ increase Hb, MCHC increases

92
Q

Acetaminophen toxicosis causes

A

heinz bodies (stain w/ NMB)

93
Q

Spherocytes are hallmark sign of

A

IMHA

RBCs that appear dark, small, lack central pallor, volume is normal

94
Q

What cells are a sign of Iron deficiency anemia?

A

Schistocytes (erythrocyte fragments) & Keratocytes (blister cells)

95
Q

Lead poisoning causes

A

basophillic stippling
normal in ruminants!!
will see regenerative anemia in cats & dogs

96
Q

Cells seen with hemangio sarcoma?

A

Acanthocytes

spicules are large

97
Q

What cells are seen with snake venom?

A

Echinocytes

numerous short spicules

98
Q

Left shift

A

increase concentration of immature neutrophils in the blood (usually bands)

99
Q

Ruminants with a left shift

A

not a big worry bc they lack storage so extra bands in the peripheral blood isn’t necessarily a bad sign

100
Q

2 fold increase in lymphocytes

A

excitement response

mostly cats

101
Q

2 fold increase in neutrophils

A

stress leukogram or inflammation

102
Q

Stress leukogram

A

neutrophilia 2x
lymphopenia
use of coricosteroids

103
Q

Inflammation leukogram

A

Neutrophilia 2x
Bands
Left shift

104
Q

Excitement leukogram

A

neutrophilia
lymphocytosis
cats
won’t see increase in immatures bc spleen contraction increased lymphocyte count

105
Q

What is the most common cause of lymphopenia?

A

steroid response
decreases concentration of WBCs
or acute viral infection or immunodeficiency

106
Q

*What are 2 possible causes of thrombocytopenia when it is associated with IMHA?

A 
Evans syndrome (immune mediated)
DIC
107
Q

Polycythemia is the ___ of RBCs in the blood

A

increase

increased PCV

108
Q

Polycythemia can be caused by a ____ in plasma volume (____) or erythrocyte redistribution in ___ ___.

A

decrease plasma in dehydration

splenic contration

109
Q

Underfilling the EDTA tube results in

A

shrunk RBCs

falsely decreased PCV and calculated MCV when microhematocrit is used

110
Q

Why do neonates commonly have iron deficiency anemia?

A

because they drink milk which is low in iron and growth rates are high
especially piglets, iron def soil

111
Q

Tx of iron deficiency anemia in adults and neonates

A

neonates: inject Fe
adults: find source of blood loss

112
Q

Most common causes of iron deficiency anemia in adults

A

GI bleeds, tumors, ulcers (drugs)

parasites (hookworms, ectoparasites: fleas)

113
Q

Causes of heinz body anemia in cats

A

diabetes mellitus, lymphoma, hyperthyroidism, acetaminophen, onions/garlic

114
Q

Pelger-Huet syndrome

A

neutrophil abnormality

hyposegmented neutrophils, function normally

115
Q

Chediak-Higashi syndrome

A

neutrophil abnormality
large fused lysosomes that stain pink
these cats have slight tendency to bleed due to abnormal PLT function

116
Q

Acquired neutrophil abnormalities?

A 
neutrophil hypersegmentation (aging)
neutrophil degeneration (bacT)
leukocyte agglutination (in blood tube when cold)
lymphocyte vacuolation (toxic plants)
117
Q

Test _____is the ability of a test to correctly identify those with the disease (true positive rate), whereas test ____ is the ability of the test to correctly identify those without the disease (true negative rate).

A

sensitivity

specificity

118
Q

IMHA lab abnormalities

A 
RBC destruction (immune mediated response)
regenerative anemia
polychromasia
cocker spaniels
SPHEROCYTES
bilirubinuria
agglutination
119
Q

Simple way to differentiate blood loss from blood destruction?

A

Decreased TP = blood loss

Increased TP or normal = blood destruction (proteins floating around in peripheral blood due to hemolysis)

120
Q

Causes of increased MCV?

A

regenerative anemia

121
Q

What would cause an increased MCV in a cat with NON-reg anemia?

A

macrocytosis if the cat has FeLV

122
Q

Hematologic abnormalities in a dog with anemia of inflammatory dz?

A

non regen
inflam
mild anemia

123
Q

Hematologic abnormalities in a dog with renal dz?

A

chronic/severe anemia
non regen
primary cause of anemia is lack of production of erythropoietin by kidney

124
Q

What causes toxic neutrophils?

A

when neutrophils are produced at an accelerated rate so you will see a high number of immature neutrophils
(bact inflam?)

125
Q

Red top used for

A

serum, chemical profile

126
Q

Tiger top

A

serum separator, promotes clot formation, serology, chemistry-no toxin

127
Q

Purple top

A

EDTA CBC, blood smear

128
Q

Green top

A

heparin, exotic CBC, chem panel

129
Q

Blue top

A

citrate, coag, PT, PTT, FDP

130
Q

Gray top

A

sodium fluoride oxalate

131
Q

Which tubes have a Ca2+ chelator?

A

Gray, Purple, Blue

works by binding Ca to prevent clotting

132
Q

If there is contamination of an EDTA tube with a chemistry tube, what 2 major abnormalities are seen on the chem panel?

A

Increase potassium

Decrease Ca

133
Q

Positive predictive value is the probability that a ____ test result truly identifies ___ in P

A

positive

disease

134
Q

Negative predictive value is the probability that a _____ test result truly identifies the _______ in a patient

A

negative

absence of a dz

135
Q

Low prevalence is the

A

most common cause of error

136
Q

What is the major regulatory hormone for thrombopoiesis?

A

Thrombopoirtin TPO

137
Q

Where is TPO produced?

A

kidney, liver, muscle

138
Q

How does TPO work?

A

increases megakaryocyte production in bone marrow, producing more platelets

139
Q

What changes are seen in healthy bone marrow when thrombocytopenia is present?

A

megakaryocytes in bone marrow will increase ploidy (nuclei), causing release of more platelets

140
Q

What role do platelets play in hemostasis?

A

primary hemostatic plug

Adhesion, activation, aggregation

141
Q

When can spontaneous hemorrhage occur?

A

PLT count less than 30,000

142
Q

When do you get falsely decreased platelet concentrations on the analyzer?

A

PLT clumping (cats/cows) and macroplatelets being counted as RBCs(increased production)

143
Q

What lab test do we use to access platelet morphology?

A

blood smear & hematology analyzers

144
Q

What does MPV mean?

A

measured platelet volume

145
Q

What test is used to evaluate platelet function in a clinic?

A

bleeding time tests
buccal mucosal bleeding time, cuticle bleeding time
and specific platelet function tests

146
Q

What test do we use to access platelet production?

A

Bone marrow aspirate (BMA)

147
Q

In a thrombocytopenic patient, how should healthy bone marrow respond?

A

should have a ton of megakaryocytes w/ lots of ploidy and releasing cytoplasm to be platelets

148
Q

What are the 5 causes of thrombocytopenia?

A 
Production
Destruction
Sequestration
Loss
Consumption
149
Q

Differentials for production

A

bone marrow hypoplasia

neoplasia

150
Q

Differentials for destruction

A

immune mediated thrombocytopenia

151
Q

Differentials for sequestration

A

splenomegaly

152
Q

Differentials for loss

A

hemorrhage but only mild loss in acute/severe cases

153
Q

Differentials for consumption

A

DIC, FIP (viral)

154
Q

What are your 2 primary differentials for severe thrombocytopenia?

A

ITP and bone marrow aplasia
ITP will have regen thrombocytopenia
Aplasia will not have any platelet precursors
Use a BMA to differentiate

155
Q

Causes of thrombocytosis

A

increased production
increased distribution
primary neoplastic production
secondary

156
Q

3 situations that may cause a relative thrombocytosis

A

post splenectomy
epinephrine (excitement)
splenic contraction

157
Q

vWD von Willebrand’s dz what changes would you see?

A

normal CBC bc platelet levels are not affected
bleeding time would drastically increase
petechia & ecchymosis

158
Q

Secondary hemostasis
what initiates coag?
which factor drives amplification?

A

tissue factor is the initiator of coag in vivo

Thrombin IIa drives amplification

159
Q

What are the 4 vit K dependent factors?

A

2, 7, 9, 10

1972

160
Q

What cofactor increases antithrombin activity?

A

Heparin (green)

161
Q

Which dz is associated with antithrombin loss?

A

glomerular dz

162
Q

When antithrombin is lost, are patients hypocoagulable or hypercoagulable?

A

hypercoag bc when thrombin is present it inhibits coag

163
Q

What are two major end products of fibrinolysis?

A

fibrin degradation products & D-dimers

they increase when there is increased IV coag w/ clot breakdown

164
Q

What 2 tests assess the intrinsic/common pathway?

A

ACT & aPTT

165
Q

What is the 1 test to assess the extrinsic/common pathway?

A

PT, prolonged clotting indicates a deficiency

166
Q

What 2 tests do you use to assess fibrinolytic activity?

A

FDP & D-dimers quantitative tests

167
Q

what toxin is commonly associated with vit K deficiency?

A

warfarin

168
Q

Vit K deficiency bleeding pattern

A

severe hemorrhage

PLT would be normal

169
Q

Vit K deficiency

what is abnormal on coag profile?

A

PLT normal
PT prolonged bc of factor 7 deficient
PTT prolonged bc factor 9 is effected

170
Q

DIC common cause

A

sepsis

but can also be tissue necrosis & neoplasia

171
Q

2 phases of DIC

A 
Hypercoagulable phase 
Consumptive phase (bleeding occurs)
172
Q

What bleeding pattern is associated with DIC

A

coagulation

173
Q

DIC coag profile

A

mild thrombocytopenia***

174
Q

Liver disease coagulopathies

A

liver produces 2, 7, 9, 10

if it is diseased it may release abnormal coag factors

175
Q

What test should be run prior to liver biopsy when liver disease is suspected?

A

screening for coag abnormalities!!!

176
Q

Classic presentation of a inherited factor deficiency

A

young animal w/ bleeding disorder

177
Q

What are the 3 most common inherited factor deficiencies?

A

Hemophilia A: factor 8 deficiency
Hemophilia B: factor 9 deficiency (dogs/cats)
Hagemans dz: factor 12 (cats)

178
Q

Why are cats always blood typed?

A

if you give a B-typed cat A blood it severely reacts and is fatal

179
Q

Blood typing card positive result

A

agglutination

180
Q

Blood typing dipsticks work by

A

blood lines up on the correct blood type

181
Q

Major crossmatch

A

Patient serum with donor RBC

182
Q

A positive crossmatch is

A

agglutination but is BAD

183
Q

Negative crossmatch means

A

go ahead and transfuse

184
Q

Transfusion rxn symptoms

A

acute hemolytic transfusion rxns
delayed hemolytic transfusion rxns
non-hemolytic transfusion rxns

Clin Path (6 decks)

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