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vet med primary rotations > heamatology > Flashcards

heamatology Flashcards

1
Q

MCV

A

Mean cell volume

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2
Q

MCH

A

Mean corpuscular haemoglobi

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3
Q

MCHC

A

Mean corpuscular haemoglobin concentration
takes into acound size of cell

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4
Q

RDW

A

Red cell distribution width

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5
Q

Wintrobe’s Erythrocytes Indices

A

Used to characterised erythrocytes in peripheral
circulation
* Represent average values of all RBC’s
* MCV- Mean cell volume
* MCH- Mean corpuscular haemoglobin
* MCHC- Mean corpuscular haemoglobin concentration
* RDW- Red cell distribution width

measure the size, shape, and quality of your red blood

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6
Q

measured parameters on a haemotology analyser

A

Haemoglobin (Hb) (g/del)- Haemoglobin content tested by biochemical method

  • Red blood cell count (RBC) (1012/L)
  • Mean cell volume (MCV) femtoliters (fl)- Average size of RBC
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7
Q

calculated parameters on a haemotology analyser

A

Haematocrit (HCT)- Calculated from those measured (HCT = MCV x RBC)
* Some analysers measure HCT directly

Mean corpuscular haemoglobin (MCH) picograms (10-12 grams)
* Calculated: (MCH = Hb x10 / RBC)

Mean corpuscular haemoglobin concentration (MCHC)
* MCHC=Hb/HCT (Grams/Deciliter (g/dL)

RDW : Red Cell distribution width
* Reflect the range of variation of red blood cell (RBC) volume (MCV)

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8
Q

Indication about red cell mass (Anaemia or erythrocytosis)

A

 Haemoglobin (HGB/Hb)
 Packed cell volume (PCV)
 Haematocrit (HCT)
 Red blood cell count (RBC

Normocytic-
 Erythrocytes of unremarkable size (MCV within normal range)

Microcytic (low MCV):
 Breed specific (Japanese breeds)
 Red cell haemoglobin concentration determines when division stops – iron
deficiency allows one more division: smaller red cells.
 Other disease process which interfere with haemoglobin synthesis (vitamin B6
deficiency/Liver disease)

Macrocytic (high MCV)
Presence of immature RBCs (larger than mature
RBCs
* Breed specific, giant poodles,
* In some bone marrow disorders
* Vitamin/nutritional deficiencies (Vitamin B12)
* A common artefact in stored/old (usually
posted) blood samples (RBCs swell up

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9
Q

Normochromic/hypochromic

A

Nomenklatura which reflects variation in haemoglobin concentration

Reflected by MCHC / MCH values

  • Normochromic
  • Hypochromic (low MCHC/MCH):
  • In iron deficiency/ poor iron incorporation (with
    microcytosis)
  • Presence of immature RBCs (are not fully
    haemoglobinised)

Hyperchromic (high MCHC/MCH):
* Not physiologically possible
* Always artefact (i.e. haemolysis), yet could be clinically
informative

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10
Q

measurements to help to classify anaemias

A
  • Mild (>30), moderate (>20), <20 severe
  • Normocytic, microcytic, macrocytic
  • Normochromic, hypochromic (hyperchromic)
  • Regenerative or non-regenerative
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11
Q

dot plots

A

e.g fluresense vs granularity (neuclear material vs complexity)

neutrophils- comact nuclei so dont florese massivly
esinophils- more complex than neutrophils
basophils- floresance high
monocytes- some complexity and lots of florecese

red cell run-
flourecence vs size

erythrocytes- vast majority have no nuclie and therefore no flurecence
polychromatophils- do florese, indicates rejenerative anemia
platlets- small flurecense and size

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12
Q

regenerative anemia

A

blood loss

haemolysis- IMHA, oxidative damage, microangioplastic anemia

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13
Q

non- regenerative anemia

A

mild- chronic disease
hypothyroidism

renal disease
underlying bone marrow disese
multifactoral
acute anemia ahead of regeneration

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14
Q

WBC morphological abnormalities

A

Neutrophils:
* Left-shift
* Toxicity

Lymphocytes:
* Reactive
* Atypical

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15
Q

Poikilocytosis

A

no analyser will provide this information

an increase in abnormal red blood cells of any shape that makes up 10% or more of the total population. Poikilocytes can be flat, elongated, teardrop-shaped, crescent-shaped, sickle-shaped, or can have pointy or thorn-like projections, or may have other abnormal features.

oxidative damage- centrocytes, spherocytes, keratocytes, heinz bodies

IMHA- aglutination, spherocytes, ghost cells

metabolic/ genetoc deifiencies-target cells, ovalecytes (refferal case)

fragmentation/ sheering damage- ecanthocytes, shistocytes, microspherocyts

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16
Q

When should you prepare and review a blood film

A
  • Anaemic patients
  • High WBC counts
  • Low WBC/PLT counts
  • Investigation of sick patients
  • Flags in dot plot/indistinct segregation of clusters
17
Q

Preparing a fresh blood film

A

Overt anaemia:
* Increase the angle
* Use more blood
* Make the smear shorter

Suspect erythrocytosis:
* Decrease the angle
* Use less blood
* Make the smear longee

18
Q

Film examination: Platelet estimate

A

Rough estimate
 Look at a number of fields
 In the monolayer
>8-10 per HPF = normal
<2 per HPF = marked
thrombocytopenia

No clumping
* No clot

Manual PLT estimate:
* Count PLT in 10 100X fields
* Take the mean (/10)
* X 20
* = [PLT] x 109/L

19
Q

Film examination:

A

1.Platelets
2.Erythrocytes
3.Leukocytes
* Initially scan at 10X
* Film quality
* Density
* Atypical features
* Go to higher power to confirm
features/assess morphology
* Go to 100X HPF for quantification in
the monolaye

20
Q

Regeneration without anaemia

A
  • Compensation
  • Splenic contraction
  • Chronic hypoxia
  • Anaemia obscured by dehydration
  • Breed appropriate Hct?
21
Q

Assessment of regeneration in cats

A
  • Cats are not small dogs!
  • Reticulocytes = aggregate and punctate
  • Punctate reticulocytes:
  • In dogs are short-lived in circulation
  • In cats, circulate >1 week- Not a good measure of acute regeneration But may be contributing to recovery
22
Q

RBC morphology: Features of IMHA

A

Spherocytosis (Dogs)

  • Ghost cells- Ideally on a fresh smear
  • Questionable results?
  • In-saline agglutination
  • +/- Coomb’s test
  • Regenerative vs Non-regenerative
23
Q

Coombs test

A

Utilisation of antibodies
which target IgG, IgM and
complement to bridge between
erythrocytes coated with
antibodies and enhance
agglutination

igm gross aglutination is obvious
igg doesnt creat a lot of aglutination so coobs is good for this- also apears with spherocytes

24
Q

Poikilocytes / shearing damage

A

Significance?
* >1/2 per 100X field?
* Associated anaemia?
* Polychromasia?
* Keratocytes in cats?
Common differentials:
* Vascular tumour
* Hepatic/splenic disease
* DIC
* ++

25
Q

nterpretation of acanthocytosis

A

Acanthocytes (from the Greek word acantha, which means thorn), or spur cells, are spiculated red cells with a few projections of varying size and surface distribution

  • Highly significant in dogs:
  • Splenic neoplasia
  • Commonly vascular tumours/ marked splenic
    dysfunction,
  • Ddx: DIC, vasculitis, cardiovascular disease, iron def.,
    Angiostronglyosis ++
  • In cats:
  • Less specific (mostly associated with liver
    disease)
26
Q

Morphological features of iron deficiency

A
  • Microcytic, hypochromic
  • +/- Codocytosis
  • +/- Shear injury
27
Q

Morphological features of oxidative insult

A

Heinz bodies-
Oxidative denaturation and precipitation of
globin by oxidation of Thiol (sulfhydryl) groups

Eccentrocytes-
Adhesion of opposing areas of the cytoplasmic
face of the erythrocyte membrane and the
formation of eccentrocytes

Pyknocytes-
* Develop from eccentrocytes following the loss of
fused membrane leaf; Pyknocytes are irregularly
spheroid with only a tag of fused membrane
remaining

28
Q

Haemolytic anaemia due to oxidative damage

A

Ingestion of oxidative substances-
* Onion
* Garlic
* Moth ball
* Zinc
* Paracetamol

  • Metabolic diseases
  • Acid base disorders
29
Q

Nucleated cells

A
  • Low power:
  • Do numbers agree with [WBC]?
  • Is distribution even?
  • High power:
  • Does the spread agree with
    WBC differential counts?
  • Are there morphological
    abnormalities
30
Q

Neutrophil morphology and left-shift

A

Neutrophils:
* Segmented nuclei
* Poorly staining granules
* Coarse chromatin

Bands
* Hypo segmented
* Fine chromatin

Left-shift = active inflammation

31
Q
A

vet med primary rotations (15 decks)

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