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Clinical Pathology > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

causes of normocytic, normochromic
anemia

A
  1. normal-increased neutrophils & platelets (functional bone marrow)
  2. decreased neutrophils & platelets (non-functional BM)
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2
Q

normocytic, normochromic anemia with functional bone marrow could be a result of?

A

a. chronic renal disease (decrease EPO)
b. endocrinopathies (hypoadrenocorticism, hypoandrogenism, hypopituitarism)
c. anemia of chronic disease
d. pure RBC Aplasia (loss of precursors from toxins like estrogen)
e. other - trichostrongyles, hepatopathy, vit E def

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3
Q

causes of microcytic, hypochromic anemia

A
  1. Fe def (most common, usually secondary to blood loss)
  2. dyserythropoiesis
  3. portosystemic shunt
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4
Q

what types of things can cause dyserythropoiesis (abnormal RBC production)

A

myeloproliferative disorders
FELV, FIV
folate def (cats)
anticonvulsant drug therapy like phenobarbital (dogs)
congenital dyserythropoiesis
chemotherapy

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5
Q

causes of macrocytic, normochromic anemia

A

FELV (most common)
regenerative anemia in horses

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6
Q

causes of macrocytic, hypochromic anemia

A

reticulocytosis (regenerative anemia)

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7
Q

causes of an increased MCHC “hyperchromasia”

A

artifact
hemolysis, lipemia, heinz bodies, oxyglobin administration

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8
Q

what automated method is [hemoglobin] measured

A

spectrophotometry (% light absorbed is proportional to [Hgb])

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9
Q

what automated method is cell counts measured

A

impedance “the coulter principle” (resistance proportional to cell size)

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10
Q

what could cause a questionable platelet & RBC histogram

A

XL platelets or clumps
XS RBC fragments
or both

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11
Q

what are the type of differentials for WBC histograms

A

3 part: lymph, mono, granulocytes
5 part: lymph, mono, neutrophil, eos, baso

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12
Q

what is flow cytometry and what is the difference between forward and side scatter

A

flow cytometry: laser light scatter
- forward: cell size
- side: fluorescent stain intensity, complexity or granularity

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13
Q

describe the relationship between density and cluster size to concentration on a leukocyte cytogram

what is important about a leukocyte cytogram?

A

density/cluster size proportional to concentration

SPECIES SPECIFIC

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14
Q

what stain should you confirm a reticulocyte count with

A

cresyl blue stain is recommended

new methylene blue not as recommended bc liquid

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15
Q

what can a high or erratic MCHC be due to

A

sample or instrument problem

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16
Q

what can make the numerator [Hgb] be falsely high

A

lipemia, heinz bodies, increased WBC

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17
Q

what can make the denominator HCT falsely low

A

hemolysis, agglutination, small RBCs

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18
Q

when would you find a bone marrow aspiration and core biopsy necessary?

A
  1. hematologic abnormalities such as unexplained cytopenias or abnormal cell morph
  2. investigating/diagnosing, staging or monitoring neoplasia such as leukemia/lymphoma or multiple myeloma
  3. investigating history/PE findings such as unexplained finding or possible findings
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19
Q

FNA bone marrow cytology
advantages

A

better cell morph
better identification
faster

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20
Q

FNA bone marrow cytology
disadvantages

A

no differentiation if poorly cellular
no architectural organization

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21
Q

core biopsy of bone marrow (histopathology) advantages

A

better cellularity
better for fibrosis or amyloidosis
architectural organization
recuts for IHC

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22
Q

core biopsy of bone marrow (histopathology) disadvantages

A

poor cell morphology

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23
Q

if you do a core biopsy what should you also do

A

an FNA of BM

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24
Q

what is the main complication when doing a bone marrow FNA or core biopsy?

A

doing the procedure when it is NOT indicated

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25
Q

what should you do to the slides with BM samples on them

A

do NOT push down, weight of slide does the spreading

26
Q

what can be seen with low magnification of BM sample

A

cellularity
presence of megakaryocytes
Fe stores

27
Q

what can be seen with high magnification of BM sample

A

M:E ratio
orderly vs disorderly maturation
presence of atypical cells

28
Q

why is a fresh concurrent CBC required with bone marrow sample

A

Concurrent CBC is required because you want to examine peripheral blood to tell the difference between M:E ratios

29
Q

what causes primary non-regenerative anemia

A

erythroid precursors are not proliferating & differentiating normally

30
Q

what causes secondary non-regenerative anemia

A

nutrient deficiencies
growth factor levels are inadequate or imbalanced

31
Q

anemia of chronic disease (chronic inflam, endocrinopathies)
bone marrow damage (drugs, toxins)
decreased EPO (renal failure)
immune mediated destruction of erythroid precursors
myelophthisis
all of these would result in what type of non-regenerative anemia?

A

reduced erythropoiesis

32
Q

abnormal erythroid maturation (myelodysplasia)
lack of erythroid production (aplastic anemia or pure red cell aplasia)
abnormal heme synthesis (Fe def)
all of these would result in what type of non-regenerative anemia?

A

defective erythropoiesis

33
Q

what is iron most stored as?

A

55-65% hemoglobin
30% stored as Ferritin, some Hemosiderin
3-7% myoglobin
1% other proteins

34
Q

list some causes of decreased Fe levels

A

Fe deficiency
inflammation
hypoproteinemia
hypothyroidism
renal disease
excess glucocorticoids in cattle

35
Q

requirements of hemoglobin

A

Fe
vitamin B6, B9 (Tetrahydrofolic Acid), and B12
amino acids
Cu (mostly needed in liver)

36
Q

feline fetal Hb

A

placenta has countercurrent blood flow allowing adequate O2 to fetus

Hb does NOT have higher affinity for O2

37
Q

ruminant/human fetal Hb

A

Hb has affinity for O2

38
Q

dog/horse/pig fetal blood

A

fetal blood has lower 2,3-DPG which increases Hb affinity for O2

39
Q

fetal blood effects on…
PCV
Hb
RBC
nRBCs
MCV
plasma proteins

A

PCV increased until birth
Hb increased until birth
RBC increased until birth
nRBCs normal in circulation
MCV high
plasma proteins low until ingestion of colostrum

40
Q

describe anemia in newborns with regard to
PCV & Hb
plasma volume
EPO levels
2,3-DPG
lifespan
growth
Fe levels

A

NORMAL IN NEWBORNS
decreased PCV & Hb
plasma volume increases
EPO levels low
2,3-DPG increased
short lifespan of RBC
growth expands volume of circ system
Fe levels low in milk = decreased Hb production

41
Q

How are RBC normally removed from the body

A
  1. mononuclear phagocyte system (MPS) esp splenic macrophages
  2. intravascular lysis
42
Q

causes of relative erythrocytosis

A

dehydration
endotoxic shock
splenic contractility

43
Q

causes of primary absolute erythrocytosis

specific affect on EPO and pO2

A

EPO normal or decreased
pO2 normal

erythroleukemia/FeLV
erythremic myelosis
chronic arythroid leukemia “polycythemia vera”

44
Q

causes of secondary absolute erythrocytosis

specific affect on EPO and pO2

A

EPO increased
normal pO2 = increased EPO due to a tumor

decreased pO2 = increased EPO due to hypoxia (high altitude, heart disease, pulmonary disease, Hb disorder)

45
Q

what type of hemorrhage is characterized by the rapid blood loss due to trauma or clotting abnormalities

A

peracute and acute hemorrhage

46
Q

normal HCT
thrombocytosis
neutrophilia

characterizes what type of hemorrhage?

A

peracute hemorrhage

47
Q

what type of hemorrhage is characterized by a decreased HCT, RBC, Hb, plasma proteins due to the shift of interstitial fluid into vessels

A

acute hemorrhage (3 hours -2-7 days)

48
Q

at how many days should you be able to see a reticulocytosis (polychromasia, macrocytosis, hypochromasia)

A

2-7 days

49
Q

cause of acute hemorrhage

A

GI ulcers
defects in hemostasis
vascular neoplasm
trauma

50
Q

responses of chronic hemorrhage

A

mild regenerative response
hypoproteinemia
thrombocytosis

51
Q

causes of occult external blood loss

A
  1. GI tract - parasites
  2. urinary
  3. skin - flea infestation, ulceration
52
Q

signs of extravascular hemolysis

A

reticulocytosis
normal-increased PP
neutrophilia
monocytosis
platelet abnormalities
hyperbilirubinemia, bilirubinuria
splenomegaly
heinz body, parasites, poikilocytosis

53
Q

signs of intravascular hemolysis

A

reticulocytosis
hemoglobinemia
hemoglobinuria
proteinuria
hyperbilirubinemia
heinz bodies, parasites, poikilocytes

54
Q

what signs do extravascular and intravascular hemolysis share

A

reticulocytosis
hyperbilirubinemia
heinz bodies
RBC parasites
poikilocytes

55
Q

causes of extravascular hemolysis

A
  1. decreased RBC deformability
  2. decreased RBC metabolism
  3. increased macrophage phagocytosis
  4. IMHA
56
Q

causes of intravascular hemoylsis

A
  1. complement-mediated RBC lysis
  2. osmotic hemolysis
  3. membrane damage via physical damage from fibrin or IC parasites, and oxidative damage
  4. toxins
57
Q

which IMHA is classified by “antibody from another member of same species reacts with antigen on affected individual’s cells” ; provide examples

A

alloimmune IMHA

e.g. neonatal isoerythrolysis or mismatched blood transfusion

58
Q

which IMHA is classified by “Ab directed against self-antigen”

A

primary IMHA

59
Q

which IMHA is classified by “Ab is directed against absorbed antigen on the cells”

A

secondary IMHA

60
Q

which type of IMHA is more common, warm or cold?

A

warm - depression, lethargy, weakness/syncope, pale mm, icterus (from hemolysis), spleno-hepatomegaly, lymphadenopathy, pyrexia, vomiting, PTE/DIC

Clinical Pathology (7 decks)

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