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Clin Path > Hematology > Flashcards

Hematology Flashcards

1
Q

What is hematology?

A

Study of blood, blood-forming organs, and blood diseases.

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2
Q

Cell lines of blood

A

Erythrocytes, leukocytes, platelets

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3
Q

Blood forming organs

A

Bone marrow, spleen, thymus

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4
Q

Hematopoiesis

A

Formation and development of blood cells

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5
Q

Sites of hematopoiesis

A

Embryo - yolk sac
Fetus - liver, spleen, bone marrow, lymph nodes
Neonates/juveniles - marrow of long bones
Adults - marrow of flat bones, end of long bones

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6
Q

Erythropoiesis

A

Production of erythrocytes

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7
Q

Myelopoiesis

A

Production of granulocytes

Neutrophils, eosinophils, basophils

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8
Q

Thrombopoiesis

A

Production of platelets

Also called megakaryocytes

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9
Q

Lymphopoiesis

A

Production of lymphocytes

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10
Q

Monocytopoiesis

A

Production of monocytes

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11
Q

Why are rbcs important?

A

Transport oxygen

Decrease in rbc mass can result in hypoxia –> tissue damage

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12
Q

Rbc life span

A

Relatively short

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13
Q

Late stage and mature cells undergo mitosis?

A

No

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14
Q

Stem cells must be….

A

Continually replenished

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15
Q

Steps needed to produce adequate numbers of functional cells

A

Proliferation through mitosis

Differentiation with maturity

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16
Q

Hematopoietic compartments of bone marrow

A

Proliferative pool - 3 to 5 mitosis
Maturation pool - no mitosis, final differentiation
Storage pool

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17
Q

As RBC mature

A

Cell size decreases
N:C ratio decreases
Decreased cytoplasmic basophilia
Decrease in RNA

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18
Q

RBC maturity

A

Rubriblast > prorubricyte > basophilic rubricyte > polychromatic rubricyte > metarubricyte > reticulocyte > erythrocyte (RBC)

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19
Q

Morphology of polychromatophils

A

Anucleate cells (mammals), blue grey to red orange cytoplasm, identified as reticulocyte with NMB stain, reticulum is retained RNA

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20
Q

Polychromatophils stain

A

Wright’s stain - polychromatophils

New methylene blue stain - reticulocytes

21
Q

Morphology of mature reticulocytes

A

Anucleate cell (mammals), red-orange cytoplasm, no organelles or RNA - not reticulocyte, maximum hemoglobin concentration

22
Q

Primary stimulus of erythropoiesis

A

Hypoxia! Hypoxia inducible factor HIF-1a, degraded in oxygen
Hypoxia > increase HIF > increase erythropoietin
Signals transcription thru JAK-STAT
Erythropoietin produced by peritubular fibroblasts of renal cortex

23
Q

Time from rubriblast to mature erythrocyte

A

3-5 days

24
Q

Erythropoietin stimulates proliferation of…

A

Committed erythroid cells
Increases hemoglobin synthesis
Increases erythroid cell maturation rate
Stimulates early release of reticulocytes

25
Q

Tubes!

A

Purple top (with EDTA anticoagulant)
Underfiling > PCV decreased, looks like anemia
Overfilling > develop clots

26
Q

Recommended fill order

A 
Blue top (citrate) for coagulation tests
Red top (no anticoagulant) for chemistry 
Purple top (EDTA) for hematology
27
Q

Turtle

A

Green top tube lined wi heparin

28
Q

CBC directly measured

A

Red blood cell count

Hemoglobin concentration

29
Q

CBC calculated components

A

Hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width

30
Q

RBC count

A

Determined by automated analyzers
Reported as x 10^6/uL
Polycythemia v. Anemia

31
Q

Hb concentration is

A

1/3 Hct or PCV (most mammals)
Measurement assumes all Hgb is within erythrocyte - hemolysis may falsely increase value
Heinz bodies and lipemia ma falsely increase value

32
Q

PCV

A

Reported as %
Determined by centrifuging blood in small tube
Measure percentage of blood that is RBCs

33
Q

HCT

A

Reported as %
Calculated by automated analyzers
Based upon average RBC size and number
HCT = RBC x MCV

34
Q

Why might HCT and PCV differ?

A

Plasma gets trapped between RBCs when spinning a HCT, so PCV is slightly higher than HCT.

MCV - measure of RBC size

35
Q

RBC indices - used to classify anemia

A

MCV - mean corpuscular volume
MCH - mean corpuscular hemoglobin
MCHC - mean corpuscular hemoglobin concentration
RDW - red cell distribution width

36
Q

MCV

A

Average volume of erythrocytes
Reported in femtoliters (10^-15)
Normocytic, macrocytic, microcytic

37
Q

Macrocytosis

A

Increased MCV - reticulocytosis most common cause
FeLV infected cats, congenital in poodles
Vitamin B12 or folic acid deficiency - in giant schnauzers
RBC agglutination (false increase)

38
Q

Microcytosis

A

Decreased MCV - immature animals
Iron deficiency primary cause
Portosydtemic venous shunts (dogs)
Japanese and Korean breeds (Akitas, shiba inus, jindos)

39
Q

MCH - mean corpuscular hemoglobin

A

Avg wt of Hgb per RBC, reported as picograms (10^-12)
No additional info over MCHC, reported on all CBCs,
Largely ignored
MCH= (Hgb x 10)/RBC

40
Q

MCHC - mean corpuscular hemoglobin concentration

A

Average concentration of RBC Hb on a wt to volume basis
Reported as %
Normochromic, hypochromic

41
Q

Hypochromasia causes (decrease MCH and MCHC)

A 
Reticulocytosis
Iron deficiency (except -cats)
42
Q

Hyperchromasia

A

Increased MCHC is artifactual

43
Q

RDW - red cell distribution width

A

Determined by automated instruments

Statistical expression of RBC size variation (anisocytosis)

44
Q

Reticulocytes reported on CBC if…

A

The patient is anemic

45
Q

Reporting reticulocytes

A

Reticulocyte percentage - increases = regeneration
CRP = retic% x (patient’s HCT/ normal HCT)
ABsolute count = retic% x RBC count = retics/uL

46
Q

Nucleated RBCs (NRBCs)

A

Includes any circulating erythroid precursor
Only determined by smear evaluation
Typically reported as nRBCs per 100 WBCs

47
Q

Appropriate release of nRBCs

A

In response to anemia (must have reticulocytes)
Extramedullary hematopoiesis (EMH)
Low numbers in some breeds (miniature schnauzer)

48
Q

Inappropriate release of nRBCs

A

Lead poisoning, splenic or hepatic HSA, IVDD (type 1), Fe or Cu deficiency, myelophthisis, erythroleukemia, bone marrow injury, bone injury (fractures)

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