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Clin Path > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Anemia

A

Decrease in red cell mass

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2
Q

Anemia causes 3

A

Loss of RBC, Destruction of RBC (Hemolysis), Failed production of RBC

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3
Q

reticulocytes

A

immature RBC, see increase In bone marrow at 2-3 days and peak at 7 to 10 days

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4
Q

Definitive of regenerative anemia

A

reticulocyte counts

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5
Q

Subjective of regenerative anemia

A

polychromatophil

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6
Q

Best Regenerative Indicator

A

Reticulocytes for Cats and DOGs

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7
Q

Reticulocyte Above RI

A

regenerative

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8
Q

Reticulocyte within or below RI

A

Non-regenerative

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9
Q

4 descriptions of anemia

Red Cell Indices

A

Severity, RBC size, Hgb Concentration, regeneration status

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10
Q

Of the causes which are regenerative?

A

Loss of RBC, Destruction of RBC

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11
Q

Of the causes which are not regenerative?

A

Failure of production

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12
Q

Phase 1 of Anemia

A

CBC, Retic Count, plasma proteins

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13
Q

Phase 2 Anemia

A

Chemistry, Coombs, Iron panel

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14
Q

Phase 3 Anemia

A

Bone marrow evaluation

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15
Q

Iron deficiency is regenerative or not?

A

both, gray area

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16
Q

Hemorrhage

A

Both RBC and Proteins are lost.

Internal hemorrhage may not change proteins

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17
Q

Hemorrhage lost not in proportion

A

Loss of blood and the Plasma volume will increase with fluid. HCT and plasma proteins will not decrease until the volume is replaced.
Once volume returns this will be when ANEMIA sets in.

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18
Q

Acute hemorrhage

A

onset within the first 24 to 72 hours

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19
Q

Hemolysis

A

decreased RBC life due to increased RBC destruction

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20
Q

Extravascular hemolysis

A

RBC destroyed by macrophages (spleen)

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21
Q

intravascular hemolysis

A

RBC destroyed in circulation

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22
Q

pathophysiologic mechanisms of hemolysis (4)

A

Immune-mediated, oxidative damage, fragmentation, RBC parasites

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23
Q

Immune-mediated hemolytic anemia

A

Anti-erythrocyte Abs bind to RBC, often regenerative (non regenerative is when it happens to up stream cell types) and either intra or extra vascular.
idiopathic or secondary
PRIMARY more common

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24
Q

Diagnosing Immune-mediated Hemolytic anemia

A

Find Spherocytes, +/- agglutination, Positive Coomb’s Test (measure of surface immunoglobulin)

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25
Q

Oxidative (Heinz Body) Anemia

A

Oxidative damage to erythrocytes, intra or extra vascular hemolysis

May see eccentrocytes

Heinz bodies are descriptive

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26
Q

Causes of Oxidative Damage to RBC

A

Toxins, acetominophen, onion/garlic, zinc, proplyene Glycol, zinc

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27
Q

Endogenous Oxidants

A

Mild anemia with evidence of RBC lysis, minor morph change

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28
Q

exogenous oxidants

A

Magnitude of anemia can vary, associated with toxicity

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29
Q

Neonatal Isoerythrolysis

A

Form of IMHA in neonates due to alloantibodies from colostrum

30
Q

Fragmentation Anemia

A

Direct physical trauma to RBC (DIC, Vasculitis, Hemangiosarcoma)

See Schistocytes and keratocytes

31
Q

Erythrocyte Enzyme deficienies

A

G6PD - horses
Pk - dogs and cats
PFK - dogs

32
Q

Iron deficiency Anemia

A

Chronic GI Blood Loss, large parasite burden, coagulopathies, neonates

33
Q

Lymphocyte production

A

in lymphoid tissues and NOT bone marrow dependent

34
Q

Lymphoid pool

A

1:1 of marginated to circulating pools

35
Q

Lymphocytosis

A

increase in concentration above RI

36
Q

Lymphopenia

A

Decrease in concentration to less than RI

37
Q

Mechanism of Lymphocyte changes

A

chronic inflammatory lymphocytosis

38
Q

chronic inflammatory lymphocytosis

A

Look up, adult animals

39
Q

Physiologic (shift) lymphocytosis

A

shift in the pool. Young excitable animals

40
Q

Lymphocyte morphology

A

dog: small relative to neutrophils, persistent is probable of neoplasia

41
Q

lymphoblast vs. Small Lymphocyte

A

Lymphoblast is probable of neoplasia (larger)

small is normal

42
Q

Bovine Lymphocytes

A

very prone to large lymphocyte population and larger in size

43
Q

Reactive Lymphocyte (abnormal)

A

increase cell size/cell volume, irregular shape, considered to be reactive with antigenic stimulation

44
Q

epinephrine (cause of lymphocytosis)

A

due to catecholamines (fear, stress, exercise), short lived.
Cats and young horses.
Shift from marginated to circulating pool (doubling is max)

45
Q

Lymphoproliferative disorders (cause lymphocytosis)

A

leukemia or lymphoma
can be viral or not
neoplastic production of lymphocytes

46
Q

Chronic inflammation (cause of lymphocytosis)

A

link is largely anecdotal (dogs).
Difficult to separate from epinephrine.
Cats are more complex.
Should be VERY LOW ON DDX especially if it is persistent

47
Q

Other Causes of lymphocytosis

A

Hypoadrenocorticism (addison’s dz may have increase)
Thymoma
Canine ehrilichiosis
Young animals (post Vx) 4 MO

48
Q

All causes of Lymphocytosis

THEY LIVE

A 
Thymoma
Hypoadrenocorticism
Ehrlichiosis 
Young Animals
Lymphoproliferative Dz
Inflammation
Vaccine (post)
Excitement/Epinephrine
49
Q

Cause of Lymphopenia

A

STEROID/STRESS LYMPHOPENIA

50
Q

Less common causes of lymphopenia

A

Acute bacterial/viral infections, Depletion/loss,

Congenital

51
Q

Monocyte production/kinetics

A

from bone marrow into circulation into tissues (where they mature to macrophages or dendritic cells)
long lifespan of years in tissues

52
Q

Causes of Monocytosis 3

A

Inflammation, steroids (more common, stress in dogs more common than cats), neoplasia

53
Q

Monocytopenia

A

Not diagnostically significant (nobody cares)

54
Q

Eosinophils Production/kinetics (more pink)

A

from bone marrow and from peripheral blood they circulate for minutes to hours and die in the tissues
FOR ANTI-PARASITIC, HYPERSENSITIVITY REACTIONS

55
Q

Causes of Eosinophila 7

A

parasitism, hypersensitivity (allergy) rxn, mast cell degranulation, Paraneoplastic,
idiopathic conditions
neoplasia
hypoadrenocorticism

56
Q

Eosinopenia

A

Do not care (possible stress)

Not significant

57
Q

Basophil Production/kinetics (more purple)

A

originate from bone marrow, circulate and after 6 hours they go to tissues and die. Similar to mast cells
Rare to encounter
THEY DON’T MATTER

58
Q

Basophilia

A

Similar to eosinphilia

Parasitism, hypersensitivity, neoplasia-basophilic leukemia(rare)

59
Q

Basopenia

A

No one cares

60
Q

Mastocytemia

A

rarely identified in peripheral blood
Associated with: inflammatory/allergic Rxn, skin and mucosal surfaces
Mast Cell Neoplasia (typically larger #)

61
Q

Leukogram patterns 4 major ones

A

VERY IMPORTANT
use direction change and magnitude of change.
Patterns will be superimposed.
Species will have differences

62
Q

Leukogram changes

A

There is a (severity) (change in WBC concentration) characterized by/resulting from (lineage specific finding).

63
Q

Epinephrine Leukogram

A 
Mild to moderate leukocytosis (increase).
Mature Neutrophilia (toxic not expected)

Lymphocytosis: cats and young horses transient change

64
Q

Steroid leukogram

A

Mild/moderate leukocytosis, mature neutrophilia (toxic not expected and rare bands possible).
Neutrophils have normal morph.
LYMPHOPENIA (MOST COMMONLY SEEN)

65
Q

Inflammatory leukogram 1

A

neutrophilia (+/- left shift hallmark, +/- toxic change),
Mild to marked neutrophil magnitude,
+/- monocytosis
+/- lymphopenia

66
Q

Inflammatory leukogram 2

A

Neutropenia (+/- left shift, +/- toxic
Species differences are vital (ruminants lack the reserve compared to others)
Demand for neutrophils is being outpaced by bone marrow production and release

67
Q

LYMPHOPENIA SHOULD RESPOND:

A

STRESS AND STEROID

68
Q

Endotoxin leukogram

A 
Acute effects (hours)
leukopenia/neutropenia.
Later effects are endotoxin + inflammation (overlapping)
69
Q

Bone marrow failure/suppression

A

neutropenia (+/-anemia, +/- thrombocytopenia) both due to longer half life

Lymphocyte is normally WNL
Not dependent on marrow production

70
Q

666 rules Lifespan

A

6 hours (neutrophils), 6 days (platelets), 60 days (RBC)

71
Q

superimposed patterns

A

steroid + inflammatory
marrow suppression masking an inflammatory leukogram

Patterns are additive

72
Q

other scenarios

A

left shift w/normal neutrophil count or normal segmented count. left shift alone could mean inflammation

Clin Path (3 decks)

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