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Clin Path 2 > Hematology & Hemostasis > Flashcards

Hematology & Hemostasis Flashcards

1
Q

Agranulocytes

A

The white blood cell group that has no visible cytoplasmic granules

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2
Q

Erythropoiesis

A

The production of erythrocytes

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3
Q

Erythropoietin

A

The hormone that stimulates erythropoietic activity in the bone marrow

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4
Q

Granulocytes

A

Any cell with distinct cytoplasmic granules

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5
Q

Hematopoiesis

A

The production of blood cells and platelets

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6
Q

Left shift

A

The presence of increased numbers of immature cells in a peripheral blood sample

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7
Q

Leukemia

A

A condition characterized by the presence of neoplastic cells in the blood or bone marrow

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8
Q

Leukemoid Response

A

The exhibition of blood counts (particularly leukocytosis) and sometimes other clinical findings that resemble those of leukemia

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9
Q

Leukocytosis

A

The presence of increased numbers of leukocytes in the blood

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10
Q

Leukopoiesis

A

The production of leukocytes

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11
Q

Lymphopenia

A

The presence of decreased numbers of leukocytes in a peripheral blood sample

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12
Q

Pancytopenia

A
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13
Q

Pluripotent Stem Cell

A

A cell capable of differentiating into one of many cell types

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14
Q

Thrombocytes

A

Platelets
Cytoplasmic Fragments of bone marrow megakaryocytes

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15
Q

Thrombopoiesis

A

The production of platelets

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16
Q

Thrombopoietin

A
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17
Q

List the organs involved in hematopoiesis

A

Prenatal: liver, spleen, thymus, red bone marrow
Adult: primarily red bone marrow but may revert to liver and spleen if stressed

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18
Q

Differentiate between hematopoiesis in prenatal and adult animals

A

In the adult animal, blood cells are formed in the bone marrow.
In the prenatal animal, blood cells are formed at multiple organ sites, such as the liver and spleen.

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19
Q

Explain the role of erythropoietin in hematopoiesis

A

Erythropoiesis is stimulated by the hormone erythropoietin. Cells in the kidney monitor the tissue oxygen levels and stimulate the release of erythropoietin in response to tissue hypoxia. Erythropoietin acts directly on the erythrocyte stem cell located in the bone marrow, the hemocytoblast, and stimulates it to differentiate into a rubriblast.

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20
Q

List the cells in the erthyrocyte maturation series.

A

Rubriblast
Prorubricyte
Basophilic rubricyte
Polychromatophilic rubricyte
Metarubricyte
Reticulocyte

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21
Q

List the cells in the leukocyte maturation series.

A
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22
Q

Describe the formation of platelets

A

Thrombopoietin is produced primarily in the liver.
The progenitor cell develops into a megakaryoblast and then develops into a promegakaryocyte and then a megakaryocyte
The cytoplasm extends into marrow sinuses where it is sheared off by the flow of blood
These proplatelets eventually fragment further into platelets

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23
Q

Anticoagulants

A

Any substance that inhibits or prevents clotting

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24
Q

Citrate

A

Any salt of citric acid
Citrate salts are used as temporary anticoagulants for studies of blood coagulation

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25
Q

Ethylenediaminetetraacetic acid

A

An anticoagulant that binds calcium

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26
Q

Heparin

A

An acid mucopolysaccharide that is present in many tissues especially the liver and lungs and that has potent anticoagulant properties

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27
Q

Oxalate

A

Am anion of oxalic acid

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28
Q

Plasma

A

The fluid portion of the blood

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29
Q

Serum

A

The fluid portion of blood after it has clotted
It doesn’t contain cells or coagulation proteins

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30
Q

Sodium fluoride

A
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31
Q

Vacutainer

A

A glass tube with a rubber stoprr from which air can be removed to create a vacuum
Usually used to draw blood

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32
Q

Describe the procedures for the collection of blood samples from small and large animals

A

The collection site should be cleaned and swabbed with alcohol. The animal must be restrained, preferably with minimal manual control.
The preferred method of blood collection is the use of a vacuum system (e.g., Vacutainer) that’s composed of a needle, a needle holder, and collection tubes. The collection tubes can be plain sterile tubes with or without anticoagulants.

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33
Q

List the commonly used blood collection sites for various species

A

Dog: cephalic, jugular, and saphenous
Cat: cephalic and jugular
Horse: jugular
Cattle: coccygeal and jugular
Bird: jugular and medial metatarsal
Rabbit: ear
Rodent: tail

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34
Q

List the commonly used anticoagulants and the purpose and mode of action for each

A

Heparin: used for critical RBC measurements - MOA: antithrombin
EDTA: used for hematology - MOA: chelates calcium
Oxalates: used for coagulation - MOA: chelates calcium
Citrates: used for coagulation and transfusions - MOA: chelates calcium
Sodium fluoride: used for preserving blood glucose - MOA: chelates calcium

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35
Q

List the equipment needed for the collection of blood samples

A

Needle and syringe
- largest needle comfortable for animal
- syringe must be closest to sample size needed
Vacutainer
- select the correct size and fill the correct volume

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36
Q

Describe the procedures for preparing blood samples for evaluation.

A
  • Remove the needle from the syringe before transferring the blood from the syringe to the tube
  • Gently invert any tubes containing anticoagulant to ensure proper mixing with blood
  • Label the tube with date and time, patient name and ID number, and owner name
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37
Q

List the safe blood volumes that be withdrawn from patients

A

Well-hydrated animal with a PCV 50%
- 10mL blood = 5mL fluid
Dehydrated animals with a PCV 70%
- 10mL blood = 5mL fluid

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38
Q

Calculate safe blood volumes that can be withdrawn from patients

A

Well-hydrated animal (PCV 50%)
- 10mL blood = 5mL fluid
Dehydrated animal (PCV 70%)
- 10mL blood = 3mL fluid

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39
Q

Anemia

A
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40
Q

Complete blood count

A
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41
Q

Neubauer rulings

A

A specific pattern of precise markings in a hematocytometer slide that facilitates the counting of leukocytes, erythrocytes, and platelets in the blood and of all cells in other fluids

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42
Q

Polycythemia

A

Increased number of RBCs

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43
Q

Red cell distribution width

A
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44
Q

List the types of hematology analyzers available for use in the veterinary practice

A

Impedance analyzers
Laser flow cytometry analyzers
Quantitative Buffy coat analysis system

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45
Q

Describe the principle of the electrical impedance analyzer

A
  1. Passage of electric current across 2 electrodes separated by a glass tube with a small opening or aperture
  2. Electrolyte fluid conducts the current
  3. Counting by moving a specific volume of cells in the Electrolyte solution through the aperture by use of a vacuum or positive pressure
  4. Cells are poor conductors and impede the flow of the current (cell size based on change in current)
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46
Q

Describe the laser flow cytometry test principles

A

Uses focused laser beams to evaluate the size and density (cells scatter light differently)

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47
Q

Describe the principle of quantitative buffy coat analysis

A

Uses differential centrifugation and staining to estimate cells
Uses a specialized microhematocrit tube
Gives hematocrit value and estimates WBC and platelet concentrations

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48
Q

Describe the care and maintenance of automated hematology analyzers

A

Cleaning and quality control are essential for assuring the accuracy of the test results

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49
Q

Describe the procedures for the manual counting of cells

A

Performed with a hematocytometer

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50
Q

Define histogram and explain the use of histogram

A

A graphic display of a frequency distribution that is represented by a series of rectangles that divide the data into classes
Provides a visual representation of the numbers and sizes of the cells present kn a sample

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51
Q

Buffy coat

A

A layer of material above the packed erythrocytes after centrifugation
Consists primarily of leukocytes and thrombocytes

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52
Q

Erythrocyte indices

A

Calculated values that provide the average volume and hemoglobin concentrations of erythrocytes in a peripheral blood sample

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53
Q

Hemoglobin

A

The oxygen-carrying pigment of erythrocytes, which is formed by developing erythrocytes in the bone marrow

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54
Q

Icterus

A

Abnormal yellowish discoloration of skin, mucous membranes, or plasma as a result of an increased concentration of bile pigments

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55
Q

Lipemia

A

The presence of fatty material in plasma or serum

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56
Q

Mean corpuscular hemoglobin (MCH)

A

Mean weight of hemoglobin contained in the average RBC
Divide the hemoglobin concentration by the RB concentration of multiply by 10

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57
Q

Mean corpuscular hemoglobin concentration

A

Concentration of hemoglobin in the average RBC
Divide the hemoglobin concentration by the PCV and multiply by 100

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58
Q

Mean corpuscular volume

A

Measures the average size of RBCs
Divide PCV by RBC concentration and multiply by 10

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59
Q

Methemoglobin

A

The form of hemoglobin that contains oxidized iron
Inefficient at oxygen transport

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60
Q

Microhematocrit

A

Refers to the use of a capillary tube and a high-speed centrifuge to determine the PCV

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61
Q

Oxyhemoglobin

A
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62
Q

Packed cell volume

A

The ratio of RBCs to total plasma volume

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63
Q

Describe the procedure for performing a PCV test with the microhematocrit method

A

The procedure requires that an anticoagulated blood sample be placed in a capillary tube. The tube is then placed in the centrifuge and spun for five minutes. The blood components separate into different layers according to their relative weights. The PCV represents the ratio of the height of the column of red blood cells relative to the total volume in the capillary tube. The color and clarity of the plasma column is also reported as part of the PCV test.

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64
Q

Describe the procedure for calibrating the centrifuge for optimum MCT spin time

A
  1. Use a stopwatch to verify the centrifuge timer operation. Run several trdtd at different time intervals and repeat each at least twice to verify reproducibility.
  2. Use a tachometer to check the centrifuge speed
  3. Verify the min time required to obtain an accurate PCV
  4. The min time needed to achieve optimal packing of the RBCs should be checked with a Hematocrit Calibration Plot Chart
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65
Q

List the layers in the centrifuge microhematocrit tube in order from bottom to top

A

Clay plug
RBCs
Buffy coat (WBCs and platelets)
Plasma

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66
Q

Explain the significance of reddish, yellow, and cloudy plasma colors in the centrifuged microhematocrit tube

A

Normal - clear to pale yellow
Cloudy - lipemic
Reddish tinge - hemolyzed
Deep yellow - icteric

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67
Q

Differentiate among oxyhemoglobin, methemoglobin, and sulfhemoglobin

A

Oxyhemoglobin - oxygen replaces CO2 in respiration
Methemoglobin - occurs naturally
Sulfhemoglobin - results from cell aging

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68
Q

Absolute value

A

The number of each type of leukocyte in peripheral blood
Calculated by multiplying the relative percentage from the differential count by the total WBC count

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69
Q

Basophil

A

A granular leukocyte with an irregularly shaped, relatively pale-staining nucleus that is partially constricted into 2 lobes and with cytoplasm that contains coarse bluish-black granules of variable size

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70
Q

Coverslip smear

A

A method of preparing a blood film with the use of 2 coverslips

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71
Q

Eosin

A

A type of pink to red acid dye that is a component of differential stains
Primarily used for the routine staining of blood films

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72
Q

Eosinophil

A

A granulocyte with granules that have an affinity for the acidic components of stains

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73
Q

Heterophil

A

A leukocyte of avian, reptile, and some fish species that contains prominent eosinophilic granules
Functionally equivalent to the mammalian neutrophil

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74
Q

Lymphocyte

A

A leukocyte that is involved in the inflammatory process and that also has roles in humoral and cell-mediated immunity

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75
Q

Megathrombocytes

A

Abnormally large platelets that are usually newly formed
Seen in greater numbers during an increase in platelet production

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76
Q

Methanol

A

Methyl alcohol

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77
Q

Methylene blue

A
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78
Q

Monocyte

A

A precursor cell representing a stage in the development of the tissue macrophage
After a monocyte leaves the bloodstream and enters tissue at the site of inflammation, it becomes an activated macrophage

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79
Q

Neutrophil

A

A leukocyte that functions to phagocytize infectious agents and cellular debris
Plays a major role in the inflammatory process

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80
Q

Neutrophilia

A

An abnormal increase in the number of neutrophils seen in a peripheral blood sample

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81
Q

Platelet

A

Irregular, disc-shaped fragments of mrgakaryocytes in the blood that assist with blood clotting

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82
Q

Romanowsky stain

A
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83
Q

Wedge smear

A
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84
Q

Wright’s stain

A
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85
Q

Wright-Giemsa stain

A
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86
Q

Describe the procedure for preparing a Wedge smear to perform a differential blood cell count

A
  1. Place a small drop of blood at the end of a clean glass slide using a microhematocrit tube or the end of a wooden applicator stick. Place the slide on a flat surface or suspend it in midair between the thumb and forefinger
  2. Hold a second slide at a 30-degree angle and pull it back into contact with the drop of blood, spreading the blood along the edge of the spreader slide. Push the spreader slide forward in a rapid, steady, even motion to produce a blood smear that is thick at one end and tapers to a thin, feathered edge.
  3. Air dry the smear by air waving to fix the cells.
  4. Label the slide at the thick end of the smear.
  5. Stain the smear with Wright’s stain or a Romanowsky stain.
  6. After staining, rinse the slide with distilled water.
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87
Q

Describe the procedure for preparing a coverslip smear to perform a differential blood cell count.

A
  1. Place a small drop of blood in the center of a clean, square coverslip
  2. Place the second coverslip diagonally on top of the first
  3. Allow the blood to spread evenly between the 2 surfaces until the blood almost fills the area between coverslips
  4. Pull the coverslips apart in a single smooth motion
  5. Wave the coverslips gently to allow them to air dry.
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88
Q

Describe the procedure for the proper staining of the blood smear.

A

Fix the slide with methanol for at least 60 seconds before staining
Depending on the stain, the average time to immerse the slide is 30 seconds for each component

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89
Q

Troubleshoot stain quality on a blood smear.

A

Excessive blue staining
Excessive pink staining
Weak staining
Uneven staining
Precipate on preparation

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90
Q

Describe the procedure for performing a leukocyte absolute value calculation.

A

The differential count is referred to as the relative cell count because it provides enumeration of the percentage of each type of white blood cell present in the sample (relative to 100 cells). The absolute cell count for each type of cell is then calculated by multiplying the relative percentage by the total white blood cell count.

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91
Q

Describe the procedure for performing a platelet estimate.

A

A platelet estimate is performed by counting the number of platelets seen on differential blood film as averaged over 10 oil-immersion fields. The presence of an average of seven to ten platelets is reported as adequate. Another indirect measure of platelet numbers is performed by counting the number of platelets seen per 100 WBCs on the differential blood film. This number is then used to calculate the platelet estimate according to the equation (thrombocytes per 100 leukocytes x WBC count per microliter = thrombocytes per microliter

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92
Q

Acanthocyte

A

An erythrocyte with spiny projections of varying lengths distributed irregularly over its surface

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93
Q

Anisocytosis

A
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94
Q

Anulocyte

A
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95
Q

Apoptosis

A

The death of single cells by a process involving shrinkage, rapid fragmentation, and the engulfment of the fragments by neighboring cells and macrophages

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96
Q

Atypical lymphocyte

A

A lymphocyte with morphologic abnormalities, including azurophilic granules, increased cytoplasmic basophilia, overly abundant cytoplasm, or a larger and more convoluted nucleus than seen in normal lymphocytes

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97
Q

Autoagglutination

A

The clumping or agglutination of an individual’s cells by that individual’s own serum, usually because of the presence of antibodies

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98
Q

Basophilic stippling

A

Erythrocytes that are characterized by small, blue-staining granules
This represents the presence of residual RNA

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99
Q

Codocyte

A

An erythrocyte that is characterized by an increased membrane surface area relative to the cell’s volume

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100
Q

Dacryocyte

A

An abnormal erythrocyte that is shaped like a teardrop

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101
Q

Döhle body

A

Small, gray-blue areas that represent ribosome and that are seen in cytoplasm of some immature and toxic granulocytes

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102
Q

Drepanocyte

A

A morphologic abnormality of erythrocytes that is characterized by sickle-shaped cells

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103
Q

Echinocyte

A

An erythrocyte with multiple small projections that are evenly spaced over the cell circumference

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104
Q

Heinz body

A

Round structures of erythrocytes that represent denatured hemoglobin and that appear as a pale area when stained with Wright’s stain

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105
Q

Howell-Jolly body

A

Basophilic inclusions of young erythrocytes that represent nuclear remnants

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106
Q

Hyperchromatophilic

A

A term that refers to a cell that appears darker than normal on a peripheral blood sample

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107
Q

Hypersegmented

A

A neutrophil with more than 5 nuclear lobes

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108
Q

Hypochromasia

A

The presence of erythrocytes with decreased staining intensity as a result of a decrease in hemoglobin concentration

109
Q

Hyposegmentation

A

A leukocyte with a nucleus with fewer than the normal number of nuclear lobes

110
Q

Karyolysis

A

The degeneration or dissolution of a cell nucleus

111
Q

Karyorrhexis

A

The fragmentation of a cell nucleus

112
Q

Keratocyte

A

An abnormally shaped erythrocyte that appears to have horns

113
Q

Leptocyte

A

An erythrocyte that is characterized by an increased membrane surface area relative to the cell volume

114
Q

Macrocytosis

A

A condition in which a cell is abnormally large

115
Q

Microcytosis

A

A cell that appears much smaller than normal

116
Q

Nucleated erythrocyte

A

An immature red blood cell that still contains a nucleus

117
Q

Pelger-Huët anomaly

A

An inherited anomaly that is characterized by the appearance of bilobed neutrophils in a peripheral blood sample

118
Q

Poikilocytosis

A

Any abnormal cell shape

119
Q

Pyknosis

A

The presence of condensed nuclear chromatin in a degenerating cell

120
Q

Reactive lymphocyte

A
121
Q

Rouleaux

A

An arrangement of erythrocytes that appears as a column or stack

122
Q

Schistocyte

A

Fragmented erythrocytes that are usually formed as a result of shearing of the red cell by intravascular trauma

123
Q

Smudge cell

A

A leukocyte that has ruptured

124
Q

Spherocyte

A

An intensely stained erythrocyte that has reduced or no central pallor

125
Q

Stomatocyte

A

An erythrocyte with a linear area of central pallor

126
Q

Target cell

A

A leptocyte with a peripheral ring of cytoplasm surrounded by a clear area and a dense, central, rounded area of pigment

127
Q

Torocyte

A
128
Q

Toxic granulation

A

Appearance of numerous large granules in the cytoplasm of neutrophils that range in color from purplish-blue to red
Seen in most infectious diseases

129
Q

Describe methods for semiquantifying morphologic changes.

A

2 Methods:
- Scale of 1+, 2+, 3+, 4+ toindicated relative percentages of cells with changes
- 1+ = 5-10%
- 2+ = 10-25%
- 3+ = approx 50%
- 4+ = more than 75%
- Slight, moderate, marked
- slight = 10%
- moderate = 25%
- marked = 50%

130
Q

List the types of morphologic changes seen in WBCs.

A

Hypersegmentation
Karyorrhexis/karyolysis/pyknosis
Döhle bodies
Vacuolization
Toxic granulation
Parasites
Juvenile forms
Reactive lymphocytes
Atypical lymphocytes
Basket cells

131
Q

Hypersegmentation

A

Neutrophil nucleus with more than 5 lobes
Associated with a variety of conditions such as chronic infection, pernicious anemia, and steroid use

132
Q

Karyorrhexis/Karyolysis/Pyknosis

A

Condensed, lysed, or damaged nucleus
When seen in WBCs in the peripheral circulation, caused by the use of inappropriate anticoagulants (Ex. Artifact)

133
Q

Döhle Bodies

A

Coarse cytoplasmic inclusions representing ribosome material
Common in felines
Might be seen with chronic bacterial infection and some viral diseases

134
Q

Vacuolization

A

One of several toxic changes seen in both lymphocytes and neutrophils
Associated with septicemia
Also produced as an artifact if a sample is held for an extended time in anticoagulant

135
Q

Toxic granulation

A

Appearance of large granules in the cytoplasm of neutrophils that range in color from purplish-blue to red
Seen in most infectious diseases

136
Q

Parasites

A

A number of parasites, including Ehrlichia and Histoplasma, might be seen within leukocytes, but they’re usually so small in number that they’re best demonstrated with a Buffy coat smear

137
Q

Juvenile forms

A

Immature WBCs seen in a variety of conditions resulting from increased bone marrow activity
In most species, small numbers of band neutrophils can normally be seen in peripheral circulation
The appearance of increased numbers of band cells and/or more immature forms of any of the leukocytes is referred to as a left shift

138
Q

Reactive lymphocytes

A

Cells with dark blue cytoplasm and darker nucleus
Seen in chronic infection

139
Q

Atypical lymphocytes

A

Represent a variety of changes within lymphocytes, including eosinophilic cytoplasm and changes in nuclear texture

140
Q

Basket cells

A

Common term used to describe degenerative WBCs that have ruptured
Also referred as smudge cells
Can be an artifact if blood is held too long before making a smear
Also associated with leukemia

141
Q

Describe the types of morphologic changes seen in RBCs

A

Size changes
Shape changes
Color changes
Cell behavior changes
Appearance of inclusion bodies

142
Q

Discuss what is meant by the term toxic change

A

Common disease-induced cytoplasm changes in neutrophils
Associated with inflammation, infection, drug toxicity
Dogs- bacterial infection
Cats- common in not severely ill cats
Ex. Cytoplasmic basophilia, Döhle bodies, toxic granulation, giantism
Caused by decreased length of time in the neutrophil maturation process with bone marrow

143
Q

List the terms used to describe abnormal changes in RBC size

A

Anisocytosis
Macrocytosis
Microcytosis

144
Q

Anisocytosis

A

Variation in RBC size seen in splenic or liver disorders
A sign of regeneration of anemia

145
Q

Macrocytosis

A

Larger-than-normal immature RBCs that appear as reticulocytes when new methylene blue stain is used

146
Q

Microcytosis

A

Smaller-than-normal RBCs often seen in iron-deficient patients

147
Q

List the terms used to describe abnormal changes in RBC shape.

A

Normocytes
Poikilocytes
Schistocytes
Acanthocytes
Echinocytes
Spherocytes
Stomatocytes
Leptocytes

148
Q

Normocytes

A

Biconcave disks in canines
Round cells in felines

149
Q

Poikilocytes

A

A genetic term for any abnormally shaped cell
Specific abnormality should be further characterized as appropriate

150
Q

Schistocytes

A

Fragmented RBCs caused by vascular trauma
Seen in disseminated intravascular coagulation and neoplasia

151
Q

Acanthocytes

A

RBCs with long, irregular projections from the cell surface

152
Q

Echinocytes

A

RBCs with a scalloped border (regular projections) from the cell surface

153
Q

Spherocytes

A

Small, dense RBCs with no area of central pallor

154
Q

Stomatocytes

A

RBCs with a slitlike center opening
Seen in the regeneration of anemia

155
Q

Leptocytes

A

RBCs with an increase in membrane surface relative to cell volume
Also called target cells or codocytes

156
Q

List the terms used to describe abnormal changes in RBC arrangement.

A

Rouleaux
Autoagglutination

157
Q

Rouleaux formation

A

Stacking of erythrocytes
Normal in horses and may be present in cats and pigs
Artifact of prolonged storage

158
Q

Autoagglutination

A

Occurs in immune-mediated disorders
Cells coat with antibodies, which result in bridges and clumps
Differentiate from Rouleaux by a drop of saline

159
Q

List the terms used to describe abnormal changes in RBC color.

A

Polychromasia
Hypochromasia
Hyperchromic or hyperchromatophilic

160
Q

Polychromasia

A

Cells that exhibit a bluish tint

161
Q

Hypochromasia

A

Cells with an increase in the area of central pallor

162
Q

Hyperchromic or hyperchromatophilic

A

Cells that appear darker than normal
Gives appearance of too much hemoglobin
Usually microcytes or spherocytes

163
Q

List and describe the parasites that may be seen on a blood smear

A

Dirofilaria immitis
Mycoplasma haemofelis- small, coccoid, rod-shaped or ringlike, and dark
Erhlichia- monocytes and neutrophils
Anaplasma- small, dark-stained cocci at margin of RBC
Eperythrozoa- swine, cattle, and llamas
Cytauxzoon- feline
Babesia- cattle, horses, and dogs

164
Q

Aspiration biopsy

A

Used at several sites - head of femur or humerus
Aseptic
Needle rotated and pressure applied - attach syringe and aspirate

165
Q

Core biopsy

A

Sometimes provides better sample quality
Use different sites if done in conjunction with aspiration biopsy
Similar procedure but no aspiration - rotate needle to cut piece of bone from the cortex

166
Q

Erythrocyte sedimentation rate

A

The rate RBCs fall in their own plasma will be altered in some disease states

167
Q

Illinois sternal needle

A
168
Q

Jamshidi needle

A
169
Q

New methylene blue

A

A supravital stain that contains no fixatives

170
Q

Reticulocyte production index

A

Involves the maturation time values
Divide the corrected retic percentage by the maturation time for the observed patient’s PCV(Reticulocyte maturation index)

171
Q

Reticulocytes

A

Immature erythrocytes that contain organelles that are lost as the cells mature

172
Q

Rosenthal needle

A
173
Q

Describe the procedure for performing the reticulocyte count.

A

An expression of the percentage of RBCs that are reticulocytes
The percentage of reticulocytes per 1000 erythrocytes is determined with the use of an oil-immersion lens

174
Q

Differentiate between aggregate and punctate reticulocytes.

A

Aggregate - large clumps of reticulum
Punctate - contains 2 to 8 small singular basophilic granules (unique to cats)

175
Q

Discuss indications for bone marrow evaluation.

A

Determined by findings of the differential blood count
- persistent unexplained pancytopenia, neutropenia, or thrombocytopenia, and nonregenerative anemia
- abnormal morphologic changes ir unexplained immature cells
- stages neoplastic diseases
- diagnosis parasitic infections - ehrlichiosis, leishmaniasis

176
Q

Describe the collection of bone marrow aspiration and core samples.

A

Aspiration or removal of bone marrow core
Restraint, sedation, or local or general anesthesia are needed
Aseptic technique
Supplies:
- EDTA prepared syringes
- bone marrow needle
- no. 11 scalpel
- about 12 slides
- sutures (if needed)

177
Q

Describe methods for preparing bone marrow samples for evaluation.

A

Smears must be made immediately if not mixed with EDTA (1 hour with EDTA)
Aspirate samples are prepared like blood smears
Air dry and stain with Romanowsky-type stain

178
Q

Describe the criteria used to characterize a bone marrow sample as acellular, hypercellular, or hypocellular.

A

Acellular - aplasia
Hypercellular - hyperplasia
Hypocellular - hypoplasia

179
Q

List the cells that are commonly seen in bone marrow samples.

A

Myeloid cells
Erythroid cells
Megakaryocytes
Macrophages
Lymphocytes
Plasma cells
Mast cells
Osteoblasts
Osteoclasts

180
Q

Myeloid cells

A

Tend to be larger and stain paler than erythroid cells
Include myeloblasts, promyelocytes, myelocytes, and metamyelocytes

181
Q

Erythroid cells

A

Smaller and more basophilic
Include rubriblasts, prorubricytes, rubricytes, and metarubricytes

182
Q

Aplastic

A

Description of marrow with all blood cell types being decreased or absent

183
Q

Chronic granulomatous inflammation

A

Increased numbers of macrophages

184
Q

Chronic inflammation

A

Increased numbers of plasma cells, mature lymphocytes, and mast cells

185
Q

Chronic pyogranulomatous inflammation

A

Both macrophages and neutrophils are present

186
Q

Fibrinous inflammation

A

Typically involves the infiltration of the bone marrow with fibrin exudate without the presence of inflammatory cells

187
Q

Hypercellular

A

Increase in overall cellularity

188
Q

Hypocellular

A

Decreased cellularity

189
Q

Lymphoproliferative disease

A
190
Q

Myeloproliferative disease

A
191
Q

Nonregenerative anemia

A

Bone marrow is unable to respond to blood loss
Reticulocytes are absent in blood

192
Q

Regenerative anemia

A

Increased erythrocyte production

193
Q

Describe the types of abnormalities seen in bone marrow samples.

A

Cell number
Cell morphology
Hypercellular
Hypocellular
Aplastic

194
Q

Aplasia

A

Less than 25% myeloid cells

195
Q

Basophilic hyperplasia

A

Basophilia in bone marrow and peripheral blood

196
Q

Dyserythropoiesis

A

Abnormal erythrocyte maturation

197
Q

Dysgranulopoiesis

A

Abnormal granulocyte maturation

198
Q

Dysmegakaryopoiesis

A

Abnormal megakaryocyte or thrombocyte maturation

199
Q

Eosinophilic hyperplasia

A

Eosinophilia in bone marrow and peripheral blood

200
Q

Erythroid hyperplasia

A

Normal or increased cellularity with a normal or increased absolute neutrophil count and a low M:E ratio

201
Q

Erythroid hypoplasia

A

Normal or decreased cellularity with a normal or decreased absolute neutrophil count and a high M:E ratio

202
Q

Granulocytic hyperplasia

A

Normal or increased cellularity with a normal or increased PCV and a high M:E ratio

203
Q

Hyperostosis

A

Thickening of cortical bone

204
Q

Megakaryocyte emperipolesis

A

Presence of intact, viable blood cells within the cytoplasm of megakaryocytes

205
Q

Megakaryocytic hyperplasia

A

Increase in numbers of megakaryocytes in bone marrow

206
Q

Monocytic hyperplasia

A

Increased presence of precursor cells of the monocyte series

207
Q

Myelodysplasia

A

Atypical cells with less than 30% blast cells present

208
Q

Myelofribrosis

A

Increased presence of fibrous tissue that displaces hematopoietic tissue

209
Q

Neoplasia

A

Atypical cells with more than 30% blast cells present

210
Q

Neutrophilic hyperplasia, effective

A

Neutrophilia in bone marrow concurrent with neutropenia in peripheral blood

211
Q

Neutrophilic hyperplasia, ineffective

A

Neutrophilia in bone marrow concurrent with neutropenia in peripheral blood

212
Q

Osteosclerosis

A

Thickening of trabecular bone

213
Q

Reactive macrophage hyperplasia

A

Increased presence of active macrophages often containing phagocytized material

214
Q

Describe the procedures for the evaluation of bone marrow samples

A

Use a systemic approach and evaluate for overall cellularity
M:E ratio
Presence or absence of hemosiderin
The number of megakaryocytes present
Morphologic abnormalities

215
Q

List the classification of anemia according to erythrocyte indices

A

Normocytic normochromic
Macrocytic hypochromic
Macrocytic normochromic
Microcytic normochromic/hypochromic

216
Q

List the classification of anemia according to etiology

A

Hemolytic
Hemorrhagic
Iron deficiency
Production disorders

217
Q

D-dimers

A

A protein fragment that is formed from the breakdown of fibrin

218
Q

Fibrin degradation products

A

Protein fragments formed from the breakdown of fibrin

219
Q

Microparticles

A
220
Q

Phosphatidylserine

A
221
Q

Thrombin

A

An enzyme that is formed from prothrombin, calcium, and thromboplastin in plasma during the clotting process
Causes fibrinogen to change to fibrin which is essential during the formation of a clot

222
Q

von Willebrand disease

A

An inherited disorder that is characterized by the abnormally slow coagulation of the blood as well as spontaneous epistaxis and gingivitis bleeding
Caused by a deficiency of a component of factor VIII
Excessive bleeding is common after injury or surgery

223
Q

Explain the classical view of hemostasis

A

The ability of the body’s systems to maintain the integrity of the blood and blood vessels

224
Q

Describe the cell-based model of hemostasis

A
225
Q

Explain the role of platelets in the initiation of coagulation.

A

Platelets are attracted to the charged surface of the subendothelium of a ruptured blood vessel
The platelets adhere to each other and the endothelium
Activated platelets expose phospatidylserine on their outer membrane

226
Q

Describe the role of von Willebrand factor in blood coagulation

A

Stabilizes the platelet plug

227
Q

Discuss the formation of coagulation complexes.

A
228
Q

Describe the role of thrombin in hemostasis

A

Continued to recruit and activate more platelets and triggers the conversion of fibrinogen to fibrin

229
Q

Discuss the formation of fibrin degradation products and D-dimers.

A

The clot undergoes dissolution
As it breaks down, D-dimers and fibrin degradation products are released

230
Q

Fibrometer

A

An instrument used for the hemostatic evaluation of samples

231
Q

Hypercoagulable

A

Characterized by abnormally increased coagulability

232
Q

Hypocoagulable

A

Characterized by abnormally decreased coagulability

233
Q

Monovette

A

a sterile glass or plastic test tube with a colored rubber stopper creating a vacuum seal inside of the tube, facilitating the drawing of a predetermined volume of liquid

234
Q

Thromboelastography

A

shows the interaction of platelets with the coagulation cascade (aggregation, clot strengthening, fibrin cross-linking and fibrinolysis)

235
Q

Describe the proper sample collection procedures for coagulation testing.

A

Use careful techniques to minimize tissue damage and cause minimal venous stasis
Never use an indwelling catheter
Use a Vacutainer or Monovette

236
Q

List the anticoagulants that are used for blood coagulation tests.

A

Sodium-citrate-anticoagulated plasma
EDTA-anticoagulated

237
Q

Describe the method used to determine the proper ratio of blood to citrate anticoagulant.

A

1 part citrate to 9 parts whole blood
Calculate with the equation:
Volume of citrate required = 0.00185 x Blood volume to be collected x (100-Hematocrit [%])

238
Q

Discuss proper sample handling of samples for coagulation testing.

A

The sample should be labeled and transported rapidly to the lab
Tubes should be held at room temp, remain tightly capped, and be kept upright
Tests should be performed within 2 hours of collection
Sample can be centrifuged and then the collected plasma is frozen in a plastic tube

239
Q

Describe the instrumentation available for coagulation testing in vet practices and referral labs.

A

Coag Dx Analyzer
Fibrometer
Thromboelastograph
Platelet function analyzers
Point-of-care analyzers

240
Q

Mean platelet volume

A

Mathematical average of the size of the individual platelets counted by the analyzer

241
Q

Platelet distribution width

A

Assess the variation in the size of platelets

242
Q

Platelet-large cell ratio

A

a percentage of all platelets with a volume measuring over 12 fL circulating in the bloodstream

243
Q

Plateletcrit

A

the volume occupied by platelets in the blood as a percentage and calculated according to the formula PCT = platelet count × MPV / 10,000 (25-27)

244
Q

Thrombocrit

A

Measure of the percentage of the total blood volume that is comprised of platelets

245
Q

Thrombocytopenia

A

Decreased platelets

246
Q

Thrombocytosis

A

Increased platelets

247
Q

Thrombopathia

A

A condition in which there is a deficiency of clotting ability for reasons other than thrombocytopenia

248
Q

Describe methods for the counting of platelets

A

Automated hematology analyzers
Manual counting with a hemacytometer

249
Q

Describe platelet estimation methods

A

Use a differential blood film and count the number of platelets in 10 fields, then multiply the average number by 15,000 or 20,000
Or
Count the number of platelets per 100 WBCs on a film then calculate using the equation:
Thrombocytes x WBC count/100 leukocytes = thrombocytes/mL

250
Q

List and describe the platelet indices.

A

Mean platelet volume (MPV)
Plateletcrit or thrombocrit

251
Q

Activated clotting time

A

A test of the intrinsic and common pathways of blood coagulation that involves the use of diatomaceous earth or kaolin tube to initiate clotting

252
Q

Activated partial thromboplastin time

A

A test of intrinsic and common coagulation pathways
An intrinsic pathways activator is added to plasma and the time taken for clot formation is measured

253
Q

Buccal mucosa bleeding time

A

A test that uses a standardized shallow incision into the buccal mucosa of the upper lip to evaluate primary hemostasis

254
Q

Clot retraction

A

A crude but simple test that allows for the evaluation of platelet number and function and intrinsic and extrinsic pathways

255
Q

PIVKA

A

Proteins induced by vitamin K deficiency or antagonists
The nonfunctional precursor forms of vitamin-K-dependent coagulation factors

256
Q

Prothrombin time tests

A

A one-stage test for detecting certain plasma coagulation defects that are caused by deficiency of factors V, VII, or X

257
Q

Describe the procedure for performing the buccal.mucosa bleeding time test

A

Tie the upper lip back with a gauze to help act as a tourniquet
Make a 1-mm-deep incision
Blot the incision sure every 5 seconds until bleeding has stopped
Normal is 1 to 5 mins

258
Q

Describe the procedure for performing the activated clotting time test

A

Prewarm the vacutainer to 37° C
Collect 2mL via venipuncture
Timed from collection to presence of clot
Normal is 60 to 90 seconds

259
Q

Describe the principles of the activated partial thromboplastin time test and the prothrombin time test (aPTT and PTT)

A

It evaluates the intrinsic pathway and requires several reagents

260
Q

Describe the procedure for performing the heat precipitation fibrinogen test

A

2 hematocrit tubes are centrifuged
The total solids in one tube are then determined with a refractometer
The second tube is incubated at 58°C for 3 minutes, then recentrifuged, and the total solids are measured

261
Q

Disseminated intravascular coagulation

A

An acquired secondary coagulation disorder that is characterized by the depletion of thrombocytes and coagulation factors

262
Q

Hemophilia

A

A genetic abnormality of hemostasis that results in many tissues, especially the liver and lungs, and that has potent anticoagulant properties

263
Q

von Willebrand factor

A

a blood glycoprotein involved in hemostasis, specifically, platelet adhesion

264
Q

Describe the types of hemostatic disorders seen in veterinary species.

A

Primary coagulation disorders or secondary coagulation disorders

265
Q

Differentiate between hereditary and acquired defects of hemostasis

A
266
Q

List and describe the common clinical signs of hemostatic disorders

A

Superficial petechia
Ecchymotic hemorrhage
Epistaxis
Melena
Prolonged bleeding

267
Q

List the common inherited disorders of coagulation and the species and breeds usually affected

A

Prothrombin deficiency - cocker spaniel, beagle
Factor VII deficiency - beagle, malamute
Factor VIII deficiency - many breeds
Factor IX deficiency - many breeds
Factor X deficiency - cocker spaniel
Factor XI deficiency - great Pyrenees, English springer spaniel
Factor XII deficiency - poodle, shar pei

268
Q

Describe the mechanisms involved in disseminated intravascular coagulation (DIC)

A

Consumptive coagulopathy that occurs secondary to other disease conditions
May manifests as systemic hemorrhage or microvascular thrombosis
Microthrombi result in tissue hypoxia, which consumes platelets and coagulation factors, which leads to an increased tendency for hemorrhage
Fibroblasts of the microthrombi leads to the formation of excess fibrin degradation products and D-dimers

Clin Path 2 (3 decks)

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