Haematology Flashcards
Haematology is…
the study of blood and blood disorders
Haematopoeisis
formation of blood cells - platelets, WBCs, RBCs
occurs in bone marrow
maturation and activation of lymphoid cells in spleen, thymus, and lymph nodes
RBCs in liver and spleen
erythropoeisis
RBC formation
stimulated by low oxygen levels
especially in kidneys - erythropoeitin - kidney disease –> anemia
myelopoeisis
production of WBCs
bone marrow
stimulated by variety of factors
trigger differentiation to myeloblasts
increased production with inflammation
thrombopoeisis
production of platelets
bone marrow - from megakaryocytes
stimulated by thrombopoietin - produced in liver
leukocytes - neutrophils
first response
acute inflammation
bacterial infection
granulated
phagocytosis
leukocytes - eosinophils
pink granules
parasitic infection
allergic response
leukocytes - basophils
usually don’t see
parasitic and allergy (with eosinophils)
histamine release
lymphocytes
adaptive immune response
b and t cells
b - humoral, antibody
t - cell mediated
natural killer - innate immune response
leukocytes - monocytes
biggest leukocytes
larger than neutrophils, greyer cytoplasm
cytokine release
become macrophages in tissue
regenerative vs non-regenerative anemia
regenerative - will see immature RBCs (reticulocytes/polychromatophils) - regenerating the lost RBCs
non-regenerative - cells largely same size
Spherocytes
RBCs with no central pallor - indicate immune mediated hemolytic anemia
rouleux vs agglutination
agglutination - RBCs stick together - grapes - IMHA
rouleux - stack of coins - increased blood protein
hypochromia
pale staining, increased central pallor of RBCs
iron deficiency
left shift
release of granulocyte precursors from marrow
increased neutrophil
inflammation/infection
CBC Parameters
measured:
haemoglobin
red blood cell concentration
mean cell volume - average size of RBCs
calculated:
hemocrit -how likely they are anemic (MCV*RBC)
mean corpuscular hemoglobin
mean corpuscular hemoglobin concentration
Also:
red cell distribution width
reticulocyte % - measure of regeneration
reticulocyte hemoglobin concentration
plateletcrit - indicative of number of platelets
Packed cell volume
blood in capiliary tube
split into red cells, buffy coat, plasma
visual indication of % of each - eg. more buffy coat –> high WBCs
RBC morphological abnormalities - spherocytes
small, dark, no central pallor
agglutination - IMHA
rouleux - high protein
RBC morphological abnormalities - heinz bodies and eccentrocytes
oxidative injury
hemoglobin pushed to cell margin
toxins
heinz bodies - look like tiny head snowmen
eccentrocytes - darker ring around edge of cell
RBC morphological abnormalities - acanthocytes
alterations ti lipid metabolism of rbc membranes
wobbly shape
RBC morphological abnormalities - schistocytes
rbc fragments - secondary to being pushed through abnormal blood vessels or being fragile
RBC morphological abnormalities - hypochromic RBCs
increased central pallor
iron deficiency
Anemia
reduced RBCs
evidenced by - reduced hb, packed cell volume, hemocrit, rbc count
normal variation by breed and age
influenced by some drugs
Anemia - compensatory mechanisms (4)
increased oxygen delivery
increased cardiac output
increased rbc production
vasoconstriction