Exam 1: Week 3

Question 1

real world problems

When do (could, likely) you see acanthocytes on a slide?

Answer 1

liver disease or inherited disorder of cholesterol metabolism (which leads to excess cholesterol in RBC outer membranse leading it to form folds)

Also seen in iron deficiency anemia, DIC, some neoplasia, degenerative valve disease

Question 2

real world problems

When do (could, likely) you see keratocytes on a slide?

Answer 2

If seen in large numbers, may be due to shear stress: microangiopathic (hemolysis, DIC, Hemangiosarcoma, Vasculitis)
May be due to RBC fragility (Iron deficiency, Oxidant injury)
Feline liver disease (unknown pathogenesis)

Question 3

real world problems

When do (could, likely) you see schistocytes on a slide?

Answer 3

Imply mechanical damage to erythrocytes (DIC, HEMANGIOSARCOMA, Portosystemic shunts, vasculitis)
Due to turbulent blood flow, or shearing strands of fibrin in the vessel lumen

Question 4

real world problems

When do (could, likely) you see spherocytes on a slide?

Answer 4

If in high numbers, think: Immune mediated hemolytic anemia (IMHA) Due to partial phagocytosis of antibody-coated RBCs (Leads to decreased surface area to volume, thus the cell ‘balls up’)
Can confirm with a Coombs test, or observation of agglutination on blood film

can also happen in Prolonged storage of blood

Question 5

real world problems

When do (could, likely) you see eccentrocytes on a slide?

Answer 5

Formed in cases of oxidant stress (Induces cross-linking of membrane proteins: Onions (Dog and cat), Red Maple (horse), Brassica plants (cattle), Copper (sheep). Zinc pennies/shot (dogs), Skunk spray)
Often affiliated with hemolytic anemia

Question 6

real world problems

When do (could, likely) you see target cells on a slide?

aka codocytes

Answer 6

Have a lump of hemoglobinized cytoplasm (Young erythrocytes with a high surface area: volume ratio - Regenerative anemia)
Increased normochromic target cells: Indicates an increase in cholesterol and phospholipid in RBC membrane (Liver disease, Hypothyroid in dogs)

Question 7

When do (could, likely) you see stomatocytes on a slide?

Answer 7

Due to abnormal phospholipid composition in RBC membrane (Increased sphingomyelin and decreased cholesterol and phosphatidylcholine)

Die of hemolytic anemia
Normal in woodchucks, manatees and dolphins. Hereditary in Alaskan Malamutes, Schnauzers. (Also macrocytic, hypochromic. RBC numbers lower than normal, but since cells are bigger, the HCT within normal range. Associated with chondrodysplasia, dwarfism. Autosomal recessive)

Question 8

Which species is IMHA most common in?

when is it common in cats and horses?

Answer 8

Auto-immune = more common in dogs than other species (or easier to recognize). Incidence highest in Cocker spaniels, Incidence slightly higher in females, Usually middle aged to old, but also young.

Cats = more commonly associated with Mycoplasma haemofelis, FeLV, neoplasia

Horses = more commonly associated with penicillin, Clostridial infections, post-Streptococcal infections, neoplasia

Question 9

What happens during Neonatal isoerythrolysis?

Answer 9

Similar to Rh disease in humans
Most common in horse and mule foals.
Fetus has a blood type incompatable with its mother’s (Qa, Aa)
If the dam has been previously sensitized to this blood type, antibody production is ramped up, concentrating antibodies in colostrum

Foal nurses, ingesting colostrum containing antibodies to its RBCs
Within few hours or days: Weak and lethargic, Anemic, Icteric, May see hemoglobinemia / hemoglobinuria, May see thrombocytopenia (esp. mules)

Best Tx is prevention

Question 10

What is one sign of regnerative anemia in cattle?

Answer 10

basophilic stippling

Question 11

a tick born disease that causes the same signs as IMHA

Answer 11

Babesiosis

Question 12

Name and understand the different types of polycythemia

What is polycythemia?

Answer 12

increased erythrocyte mass

Question 13

Name and understand the different types of polycythemia

Relative polycythemia

Answer 13

Relative: Transient increase in circulating concentration (PCV). The total number of RBCs in the body stays the same. (Dehydration, Splenic contraction)

*“relative” to hydration and spleen contraction

Question 14

hypothetical example

There are two blood tubes with 3 erythrocytes. One has a PCV of 50% one has a PCV of 80%… how?

Answer 14

The plasma line is lower in one due to dehydration.

Question 15

Who is in the buffy coat?

Answer 15

white blood cells, leukocytes.

Question 16

Name and understand the different types of polycythemia

absolute polycythemia

and types, and types of types

Answer 16

Absolute: The total number of RBCs in the body increases and PCV increases.
Primary: Polycythemia vera
Secondary (Appropriate and Inappropriate)

actual real increase of RBCs in body.

Question 17

Name and understand the different types of polycythemia

primary absolute polycythemia

Answer 17

Polycythemia vera
Uncontrolled production of erythrocytes in bone marrow
Diagnosis of exclusion

Question 18

Name and understand the different types of polycythemia

secondary absolute polycythemia

Answer 18

Bone marrow is responding to increased erythropoietin
Appropriate increase
Inappropriate increase

Question 19

Name and understand the different types of polycythemia

Secondary Appropriate Absolute Polycythemia

Answer 19

Hypoxia-driven
Bone marrow is responding to increase in erythropoietin
Appropriate response to hypoxia (lung, cardio disease)
Measure arterial PO2 (to determine hypoxia) > PO2 low = hypoxia

Question 20

Name and understand the different types of polycythemia

Secondary Inappropriate Absolute Polycythemia

Answer 20

Hypoxia independent
Kidney inappropriately produces erythropoietin : Due to local hypoxia in kidney (Renal injury), Due to renal tumor
Arterial PO2 = normal (again, not hypoxia driven)

Question 21

What is tetralogy of fallot?

Answer 21

ventricular septal defect, overriding aorta, pulmonary stenosis and right ventricular hypertrophy.

Question 22

When do (could, likely) you see echinocytes on a slide?

Answer 22

As an artifact:
RBC dehydration(excess EDTA)
increased pH
decreased ATP (aged blood)

Pathophysiologic:
Snake/ bee envenomation
Body electrolyte depletion (such as intracellular K+), or low Na+
Dog renal disease (unknown path)
Inherited in some breeds of dogs (still healthy)
Severe burns in horses

Question 23

erythrocyte maturation

What are the 8 stages of erythrocyte maturation?

Answer 23

1. rubriblast
2. prorubricyte
   3,4,5. (early, middle, late) rubricyte
3. metarubricyte
4. reticulocyte
5. erythrocyte

Question 24

erythrocyte maturation

when does hemoglobin production start?

Answer 24

early rubricyte

Question 25

erythrocyte maturation

When does critical (Hb) shut off division?

Answer 25

late rubricyte

Question 26

erythrocyte maturation

when is Hb production nearly done?

Answer 26

metarubricyte

Question 27

erythrocyte maturation

What stage has the nucleus been extruded?

Answer 27

reticulocyte

contians residual RNA, mito, ribos

Question 28

two reasons for anemia with normal protein

basic

Answer 28

eryhtrocyte destruction and bone marrow impairment

Question 29

a reason for anemia with hypoproteinemia

basic

Answer 29

blood loss

Question 30

two reasons for regenerative anemia

basic

Answer 30

blood loss and erythrocyte destruction

Question 31

a reason for nonregenerative anemia

basic

Answer 31

bone marrow impairment

Question 32

two reasons for microcytic anemia

basic

Answer 32

iron deficiency and a portosystemic shunt

Question 33

non-regenerative anemia is usually…

what type?

Answer 33

normocytic and normochromic and usually no significant shape changes

Question 34

if non-regenerative anima is macrocytic think…

Answer 34

feline leukemia virus, myeloproliferative disorder

Question 35

What shape are nucleated camelid RBCs?

Answer 35

round. become oval when nucelus is gone.