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VTS > Hematology > Flashcards

Hematology Flashcards

1
Q

What is MCV?

A

Mean Corpuscular Volume
- The mean volume of a group of erythrocytes
- Anemia may be normocytic, macrocytic, or microcytic

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2
Q

What is MCH?

A

Mean Corpuscular Hemoglobin
- The mean weight of Hb contained in an average RBC

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3
Q

What are polychromatophils?

A

Immature RBC

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4
Q

What is MCHC?

A

Mean Corpuscular Hemoglobin Concentration
- The concentration of Hb in an average RBC
- Normal MCHC = normochromic anemia
- Low MCHC = hypochromic anemia = low iron levels

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5
Q

What are Howell Jolly bodies?

A

Nuclear remnants

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6
Q

What can acanthocytes indicate?

A

Liver disease

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7
Q

What do echinocytes indicate?

A
  • Kidney failure
  • Snakebites
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8
Q

What do schistocytes indicate?

A
  • DIC
  • Uremic syndromes
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9
Q

What are Heinz bodies?

A

Precipitates of oxidized Hb

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10
Q

What is Mycoplasma hemofelis?

A
  • Hemobartonella felis
  • Bacteria
  • Results in regenerative anemia
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11
Q

What is Hemobartonella canis?

A
  • Bacteria
  • Occurs rarely, and only in the immunosuppressed
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12
Q

What is Cytauxzoon Felis?

A
  • Protozoal
  • Intracellular
  • Cats
  • Causes non regenerative anemia
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13
Q

What is babesia?

A
  • Tick borne disease
  • Causes intravascular hemolysis
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14
Q

What is the best indicator of effectiveness or bone marrow activity?

A
  • Reticulocyte count
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15
Q

What reticulocytes are counted in the dog and cat?

A
  • Cats: only aggregate
  • Dogs: all forms
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16
Q

How much ATP is produced in aerobic metabolism?

A
  • 38 ATP molecules from a single glucose molecule
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17
Q

How much ATP is produced in anaerobic metabolism?

A
  • 2 ATP molecules from a single glucose molecule
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18
Q

What are some causes of secondary failure of EPO?

A
  • Hypothyroidism
  • Hypoadrenocorticism
  • Neoplasia
  • Chronic inflammatory disease
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19
Q

What is the oxidizing component in onions?

A

n-propyl disulfide

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20
Q

Why can cats show Heinz bodies without anemia?

A

Cats are more prone to HB formation, but also more forgiving towards the RBC containing HB, allowing longer survival

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21
Q

DM or HL in cats can lead to the development of what?

A

Hypophosphatemia, resulting in fragile membranes and hemolysis

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22
Q

Methemoglobinemia occurs when….?

A

When ferrous iron (Fe2+) undergoes oxidation to ferric iron (Fe3+) which cannot bind oxygen and does not contribute to oxygen carrying capacity

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23
Q

How long do neutrophils live in circulation?

A
  • About 10 hours
  • Bone marrow stores 5 day supply
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24
Q

Hypersegmentation of neutrophils can be seen in what 5 states?

A
  • Age related change in neut
  • Prolonged exposure to EDTA
  • Glucocorticoids
  • Hyperadrenocorticism
  • Chronic infection
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25
Q

Eosinophils

A
  • Essential for reduction of local allergic and anaphylactic reactions because granules contain anti inflammatory substances
  • Release of histamine from mast cells attracts them to the area of allergen
  • Minimal phagocytic, bactericidal function - their phagocytosis is very effective against protozoa and some parasitic worms
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26
Q

Basophils

A
  • Rare
  • Granules contain histamine and heparin, making them effective at roles in allergic or hypersensitive reactions
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27
Q

Which WBC stays in the circulation the longest?

A

Monocytes

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28
Q

Which WBC lacks phagocytic capability?

A

Lymphocytes

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29
Q

What are the 3 types of lymphocytes?

A
  • T cells
  • B cells
  • Natural killer (NK)
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30
Q

What are two possible reason to have low lymphocytes?

A
  • Chylous effusion
  • Lymphosarcoma
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31
Q

High does of glucocorticoids can cause a mild __

A

lymphopenia

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32
Q

Felines have a physiologic ____ from excitement

A

lymphocytosis

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33
Q

What does a left shift indicate?

A

It is a sign of inflammation or infection as the body increases neutrophil release in response to injury

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34
Q

What does a stress leukogram consist of?

A
  • Neutrophilia
  • Lymphopenia
  • Eosinopenia
  • Potentially monocytosis
  • Occurs mostly in dogs
  • ‘stress’ denotes increased cortisol release from adrenals in systemic illness etc
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35
Q

Where do platelets live?

A
  • Most live in circulation but the rest are stored in the spleen
36
Q

What can platelets release?

A
  • Endothelial growth factor
37
Q

How long do platelets live?

A

3-7 days

38
Q

What can cats do with platelets?

A

Increase their platelets when excited

39
Q

Initiation of the extrinsic pathway is usually mediated by__?

A

Tissue factor/Factor III via thromboplastin

40
Q

Which factor triggers the common pathway?

A

X

41
Q

Where are all the factors (except for one) produced?

A
  • The liver
  • But not F VIII
42
Q

Which factor is required for most reactions?

A

F IV (Calcium), which is why calcium chelators such as citrate and EDTA are used for blood collection

43
Q

What is responsible for the dissolution of a fibrin clot?

A

Plasmin, a cleaving enzyme

44
Q

Plasmin exists in circulation as ___?

A

The proenzyme plasminogen

45
Q

What activate plasminogen?

A
  • Tissue-type plasminogen activator (t-PA)
  • Urokinase-type plasminogen activator (u-Pa)
46
Q

Thrombin and plasmin are OPPOSING enzymes

A
  • Thrombin coagulates
  • Plasmin dissolves
47
Q

What serves as the initiator for coagulation?

A

Tissue factor expressed by cells located outside the vasculature

48
Q

At what platelet level can spontaneous bleeding be seen?

A

<30,000 - 40,000

49
Q

ARF/CRF can cause what platelet reaction?

A

Platelet dysfunction secondary to uremia

50
Q

What is the most common hereditary bleeding defect in dogs?

A

von Willebrand’s disease

51
Q

What will coagulation tests show in vWd?

A

vWd is a platelet function defect, so all coagulation tests, including platelet count, will be normal. IF aPTT is prolonged, it is likely due to reduced levels of F VIII

52
Q

What are the 3 different types of vWd?

A
  • Type 1: mild to moderate dz (Dobermans). Low amount of vWF, normal multimer distribution
  • Type 2: moderate to severe dz (GSP & GWP). Low amount of vWF and abnormal protein structure)
  • Type 3: severe dz (CBR, Shelties, Scotties). Complete absence of vWF
53
Q

Why do vWb patients often have low levels of FVIII?

A

F VIII bonds to vWF which then protects F VIII from rapid breakdown. A deficiency of vWf means a decrease in protection to F VIII and a reduction in their levels

53
Q

What disease may exacerbate bleeding tendencies in vWb dogs?

A

Hypothyroidism - consider if vWd is dx in an older dog with only recent hx of bleeding

54
Q

What is the ideal product to administer for vWd?

A

Cryoprecipitate - contains vWf, FVIII, fibrinogen, fibronectin

55
Q

How can DDAVP be used in vWd?

A
  • It may control bleeding in some (not all) Type 1 dogs
  • It results in the release of body vWf stores and causes a significant increase in plasma vwF, but tachyphylaxis occurs quickly
56
Q

What is Hemophilia A?

A

F VIII deficiency

57
Q

What is Hemophilia B?

A

F IX deficiency

58
Q

What can be used to treat Hemophilia A

A

Cryoprecipitate

59
Q

What can be used to treat Hemophilia B

A

Cryosupernatant

60
Q

Anticoagulant rodenticides inhibit activity of__?

A

Coumarins, the toxic component, inhibits activity of KO reductase
- Inhibition of this enzyme results in depletion of K2 and subsequent depletion of functional Vit K dependent coagulation factors

61
Q

Describe the recycling of Vitamin K

A

Vit K2 is oxidized to Vit K epoxide (KO). Vit KO reductase converts KO back to K2, which recyles the limited supply of Vit K in the body

62
Q

What are PIVKAs?

A
  • Proteins induced by Vit K antagonism
  • Once hepatic Vit K stores are depleted, production of functional Vit K dependent coagulation ceases and forms PIVKAs
  • They are incapable of chelating Ca and therefore unable to partake in secondary hemostasis
63
Q

What method of Vit K administration is most rapidly effective?

A

PO

64
Q

Which coagulation factor will be depleted first in liver dysfunction?

A

F VII - shortest half life

65
Q

Bilateral epistaxis often indicates what kind of cause?

A

Systemic

66
Q

German Shepherds are predisposed to what fungal disease?

A

Aspergillosis

67
Q

What breed is predisposed to Hemophilia A?

A

GSD

68
Q

What breed is predisposed to Hemophilia B?

A

Cairn terriers, Coonhounds, St. Bernards

69
Q

What initiates DIC?

A
  • A supraphysiologic expression of TF through severe endothelial injury
  • TF expression on intravascular cells stimulated by proinflammatory cytokines
  • TF independent triggers do exist
70
Q

What blood tube should be used for platelet counts?

A

EDTA

71
Q

Why should heparin not be used for a platelet count?

A

Heparin will cause the platelets to clump

72
Q

What is the normal BMBT for dogs and cats?

A
  • Dogs <4 min
  • Cats <3 min
73
Q

What does ACT check?

A

The time it takes for a fibrin clot to form

74
Q

What does the PT check?

A
  • Assess secondary hemostasis, specifically the extrinsic and common pathway
  • Normal PT does NOT rule out factor deficiencies
75
Q

What does the aPTT check?

A
  • Assesses secondary hemostasis, specifically the intrinsic and common pathway
76
Q

What are FDPs?

A
  • Fragment D and E are end products of cleavages from fibrinogen and fibrin
  • Assesses patient’s fibrinolytic activity
77
Q

What are D-Dimers?

A
  • A specific plasmin mediated breakdown product of criss linked fibrin
  • Assesses patient’s fibrinolytic activity
  • More specific than FDPs
78
Q

What does a left shift and a high neutrophil count mean?

A

The bone marrow is able to respond to inflammation

79
Q

What does a left shift and a normal or low neutrophil count mean?

A

The marrow is umnable to meet increased demand

80
Q

What are Dohle bodies?

A
  • Intracytoplasmic basophilic precipitates of RNA
  • In dogs = significant toxicity
  • In cats = can be seen in healthy animals
81
Q

What do toxic neutrophils indicate?

A

Indicates that circulating toxins are interfering with neutrophil development in the bone marrow as a result of increased peripheral demand

82
Q

What do reactive lymphocytes indicate?

A

They are antigen stimulated so their presence indicates that the immune system has been engaged

83
Q

What factors does Heparin inhibit?

A

Antithrombin
IIa
IXa
Xa
XIa
XIIa

84
Q

What factors do LMWH inhibit?

A

Xa

85
Q

What medications are direct factor Xa inhibitors?

A

Rivaroxaban, apixaban. They do not require antithrombin for clinical effect

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