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Clinical Pathology > Hematology > Flashcards

Hematology Flashcards

0
Q

What is a Mean Cell Volume (MCV)?

A

Measures number and size of RBCs.

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1
Q

What are 10 direct measurements in a CBC?

A

PCV, hemoglobin, red cell count, mean cell volume, white cell count, plasma protein, platelet count, mean platelet volume, retoculocyte count, reticulocyte MCV.

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2
Q

What can a small retic MCV mean?

A

Small reticulocyte cell volume can mean that you have an iron deficiency anemia.

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3
Q

What procedures do we do microscopically for the CBC?

A

WBC differential, cell morphology, retic count (if anemic).

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4
Q

Why do we do a differential?

A

Because electronic counters can’t distinguish nucleated cells or bands from segmented neuts.

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5
Q

What is a red top tube for?

A

Serum sample, for biochem panels because no additives in tube.

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6
Q

What is the purple top tube for?

A

CBC because it has potassium-EDTA to prevent clotting and preserves cell morphology.

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7
Q

What must you be cautions with when using red and purple top tubes together?

A

Be careful that you don’t contaminate the red top sample with EDTA from the purple top. Will give abnormally high potassium, and very low calcium.

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8
Q

What is the green top tube for?

A

Specific tests because it contains heparin.

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9
Q

Hat is the blue top tube for?

A

For coagulations tests because it contains citrate.

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10
Q

What is the grey top tube for?

A

Good for if sample can’t be spun or looked at right away, especially where glucose is important. It contains fluoride to inhibit glucose metabolism.

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11
Q

What is the tiger-top tube for?

A

Serum separator tube.

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12
Q

How much blood does a CBC and biochem profile require?

A

5 mL

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13
Q

What is important to avoid with venipuncture?

A

Tissue contamination.

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14
Q

How do you handle blood for a CBC?

A

Analyze within one hour or make a blood film and refrigerate sample.

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15
Q

What happens if blood sits for 24+ hours at room temp?

A

RBCs swell resulting in elevated MCV.

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16
Q

How do you handle blood for a biochem profile?

A

Let sot for 15-30 minutes, centrifuge, separate serum and refrigerate until analysis. Freeze serum if can’t analyze within 2 days.

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17
Q

What does it mean to have yellow plasma?

A

If small animal, icterus. If large animal, can be due to carotene pigments associated with diet.

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18
Q

What does it mean to have white, milky serum?

A

Lipemia, likely due to postprandial collection OR can be from abnormalities in lipid metabolism.

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19
Q

What does red serum mean?

A

Hemolysis.

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20
Q

How can you get hemolysis?

A

In-vitro due to technique or presence of lipemia.

In-vivo due to hemolytic anemia.

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22
Q

How can you tell if hemolysis is in-vivo or in-vitro?

A

If PCV is low, likely in-vivo. If PCV doesn’t decrease, likely in-vitro.

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23
Q

Is plasma protein by refractometry an exact number?

A

No, it’s an estimate.

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24
Q

What will you see with plasma protein values in a lipemic sample?

A

Plasma protein will be artificially increased.

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25
Q

What values will artificially increase the plasma protein?

A

Urea, glucose, cholesterol and lipemia.

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26
Q

What should you do to follow up the plasma protein value obtained from the refractometer?

A

A biochemical measurement of albumin and globulin in serum. These two values should add up to total protein.

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27
Q

T/F: Increased albumin is not always due to dehydration.

A

False. Increased albumin is always due to dehydration.

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28
Q

What is suggested if total protein and the PCV are both elevated?

A

Suggests dehydration.

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29
Q

What is suggested if total protein and PCV are both decreased?

A

Suggests blood loss.

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30
Q

What 2 things are a blood smear essential for?

A

Differential cell count

Evaluating morphology of WBCs, RBCs and platelets.

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31
Q

What 5 things are required for a successful blood smear.

A 
Quality of the smear
In the right counting zone
Recognition of morphologic abnormalities
Recognition of artifacts
Ability to interpret diagnostic significance.
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32
Q

How to you convert % of WBCs to absolute numbers?

A

Multiply the total nucleated cell concentration by the percentage of each WBCs type.

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33
Q

How do you evaluate platelets?

A

Should have 6-10/oif, check feathered edge for clumps, check size relative to RBCs (if they approach RBC size, they are called macroplatelets.

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34
Q

What are the 6 counting and sizing techniques done with a machine?

A 
RBC Count (x 10^6/uL)
MCV (fL)
Nucleated cell count (uL)
Differential cell count (uL)
Platelet count (uL)
Reticulocyte count (uL, fL)
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35
Q

What automated measurement is done using spectrophotometry?

A

Hemoglobin concentration (g/dL)

*Usually approx. 1/3 of the PCV

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36
Q

What factors can affect the hemoglobin concentration?

A

Intravascular hemolysis, lipemia, Heinz bodies

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37
Q

How do you calculate the hematocrit?

A

(MCV x RBC)/10 = Hematocrit

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38
Q

How do you calculate MCHC?

A

(Hgb (g/dL) x 100)/PCV = MCHC (g/dL)

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39
Q

Is the MCHC helpful?

A

Not particularly diagnostic. An increase tells you there’s a glitch somewhere because red cells can only hold so much hemoglobin.

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40
Q

What can cause an increased MCHC?

A

High readings caused by hemolysis, lipemia or presence of Heinz bodies.

41
Q

What can cause a decreased MCHC?

A

May be due to iron deficiency, or due to presence of many reticulocytes.

42
Q

What is a decreased MCHC usually associated with?

A

Regenerative anemia.

43
Q

What is light scatter measurement?

A

Cells pass through a laser beam and the physical properties of the cells scatter the light to tell you the cell type.

44
Q

What is impedence measurement?

A

Cells are suspended in an electrolyte medium that conducts electricity. Cells are poor conductors and deflections in current are proportional to the cell size.

45
Q

What is a size distribution curve?

A

A curve for each cell type of each species that shows the number of cells above average, average and below average.

46
Q

What is the normal size of dog RBCs?

A

60-72fL

47
Q

What is the normal size of cat, horse and cow RBCs?

A

39-52fL

48
Q

What is the normal size of sheep?

A

25-35fL

49
Q

What is the normal size of llama RBCs?

A

21-29fL

50
Q

What is special about camelid RBCs?

A

Higher MCHC and they’re oval.

51
Q

What is the normal size of goat RBCs?

A

15-25fL

52
Q

What is the normal size of human RBCs?

A

80-100fL

53
Q

From largest to smallest, rank the domestic species by RBC size.

A

Dog > cat=horse=cow > sheep > llama > goat

54
Q

What can cause RBCs to agglutinate?

A

Igs attached to the cell wall of RBCs will cause them to clump.

55
Q

What is the red cell distribution width (RDW)?

A

Describes the relative width of the size distribution curve.

56
Q

How do you calculate the RDW?

A

Standard deviations of most of the RBCs divided by the MCV.

57
Q

How can reticulocyte concentrations be determined?

A

Flow technology or manually.

58
Q

What do reticulocytes look like with Wright’s stain?

A

Polychromatics

59
Q

What do certain stains to do the reticulocytes?

A

Cause the residual organelles to clump and be seen.

60
Q

How do you count reticulocytes?

A

Count 1000 RBCs, percentage that are reticulocytes is multiplied by the RBC count to get an absolute retic count.

61
Q

What are normal reticulocyte counts for dogs, cats, cows and horses?

A

Dogs: 0-60000/uL
Cats: 0-40000/uL
Cows: 0, but can respond
Horses: DO NOT RELEASE RETICULOCYTES

62
Q

Above what number can we say that the cells are regenerating?

A

60000

63
Q

How long do dog reticulocytes take to mature?

A

24-48 hours from release to maturation

64
Q

How long do cat reticulocytes take to mature?

A

Trickier…
Aggregates become punctate (which are not counted)
Aggregate - punctate in ~12 hours
Punctates persist for ~12 days

65
Q

What is a leukogram?

A

Numeric data + morphologic abnormalities.

66
Q

What species has nucleoli in their normal lymphocytes?

A

Cows.

67
Q

What suffix is given for reduced concentration?

A

“-penia”

68
Q

What suffix(s) is/are given for increased concentration?

A

“-philia” or “-cytosis”

69
Q

What is a “left shift”?

A

Increased concentration of bands

70
Q

What does disorderly maturation tell you?

A

Consumption is severe or a neoplastic process is present.

71
Q

What are the three toxic changes of leukocytes?

A

Increased basophilia
Dohle bodies
Cytoplasmic vacuolation

72
Q

How significant is hypersegmentation?

A

Not very.

73
Q

What is neutrophil degeneration?

A

Cytoplasmic vacuolation, nuclear swelling and cell lysis in neuts that are no longer in circulation.

74
Q

List 4 inherited neutrophil anomalies.

A

Pelger-Huet Anomaly
Birman cat neutrophil granulation anomaly
Chediak-Higashi Syndrome
Lysosomal storage disorders with neutrophil granulation

75
Q

What is a Pelger-Huet anomaly?

A

Failure of the neutrophil nucleus to segment. Can be mistaken for bands, but eos also fail to segment.

NOTE: It’s a heterozygous gene, homozygous die in utero.

76
Q

What must you distinguish Pelger-Huet from (d/t granules in the lymphocytes)?

A

Lysosomal storage disease

77
Q

What is Chediak-Higashi Syndrome?

A

Lysosomes fuse and look like large pink granules.

78
Q

What does Chediak-Higashi cause with the coat?

A

Melanin granules also fuse and give the coat a grey colour.

79
Q

What happens to the neutrophils in Chediak-Higashi?

A

They don’t function normally and don’t phagocytize or kill bacteria as effectively.

80
Q

What happens to platelets in Chediak-Higashi?

A

Granules can be abnormal and animal may have a tendency to bleed.

81
Q

What causes acquired lymphocyte vacuolation?

A

Plant toxin swainsonine (locoweed), inhibits lysosomal enzymes = acquired lysosomal storage disease.

82
Q

What do you commonly see in ruminants that have inflammation and why?

A

Neutropenia because they don’t have a large pool of neuts in bone marrow reserve.

83
Q

What species needs a huge inflammatory focus to cause a neutropenia?

A

Horses

84
Q

What in cats will cause a very high neutrophil count?

A

Walled-off abscesses.

85
Q

What does an excitement leukogram look like?

A

Lymphosytosis, can also see two-fold leukocyte concentrations.

86
Q

What does a stress leukogram look like?

A

Lymphopenia, neutrophilia, eosinopenia

87
Q

What 3 leukograms will have a neutrophilia?

A

Inflammation
Excitement
Stress

88
Q

What should you see on a CBC with inflammation?

A

Left shift or neutrophilia 2x greater than the upper limit

89
Q

What 2 diseases should be on your differential with a lymphocytosis?

A

Ehrlichia
Lymphoid leukemia

NOTE: Not all dogs with ehrlichia have a lymphocytosis.

90
Q

Over what number of lymphocytes is it pretty safe to say you have a leukemia?

A

35 000

91
Q

What are 3 causes for a neutropenia?

A

Consumption
Immune mediated destruction
Lack of production

92
Q

What is the lifespan of a neutrophil?

A

6-8hrs

93
Q

What causes a reversible bone marrow injury?

A

Viral injury

94
Q

What causes an irreversible bone marrow injury?

A

FeLV

95
Q

What are 3 causes for a lymphopenia?

A

Steroid response
Acute viral infectinos
Immunodeficiency (RARE)

96
Q

What are 2 causes for a monocytosis?

A

Inflammation

Stress response

97
Q

What are 3 causes for an eosinophilia?

A

Parasitism
Hypersensitivity
Lesions producing eosinophil attractants (eg. Mast cell tumor)

98
Q

What doesn’t normally cause an eosinophilia?

A

RBC parasites

99
Q

What causes a basophilia?

A

Usually accompanies an eosinophilia

Clinical Pathology (9 decks)

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