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Clinical Skills > Intro to Hematology > Flashcards

Intro to Hematology Flashcards

1
Q

“QUATS”

A
  • Lingo that denotes the following:
    • Packed cell volume (PCV)
    • Total Solids (TS)
    • Blood Glucose (BG)
    • Blood Urea Nitrogen (BUN)
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2
Q

Importance of QUATS

A
  • Quick, cage-side assessment that provides a general overview of your patients metabolic status
  • Generally reserved for use on patients we suspect are healthy
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3
Q

What is Packed Cell Volume

A
  • Percentage of blood to plasma
  • Hematocrit vs. PCV
    • Hct is calculated by a machine using the cell count and the average diameter of the red blood cells.
    • PCV spins the blood down and calculates the ratio
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4
Q

Normal Ranges of PVC for companion animals

A
  • Adult dog: 37-55%
  • Puppy: 25-34%
  • Adult Cat: 24-45%
  • Kitten: 24-34%
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5
Q

What can cause Anemia

A
  • Not enough RBCs
  • Causes:
    • Loss - hemorrhage, parasitism
    • Destruction- apoptosis
    • Inability to produce- faulty bone marrow
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6
Q

What can cause polycythemia

A
  • Too many RBCs
  • Causes:
    • Overproduction
    • O2 demand
    • Dehydration
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7
Q

What color should plasma be?

A
  • Transparent or straw colored (slightly yellow)
  • It can come in many colors:
    • White/cloudy: fatty
    • Red: destroyed RBCs
    • Dark Yellow/Orange: Liver disease
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8
Q

What is in Plasma?

A
  • Water - largest component
  • Electrolytes
  • Proteins
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9
Q

What is Total Solids measurement?

A
  • TS is sometimes referred to as Total Protein, or Serum Total Protein
  • Performed with a refractometer OR can be measured in a lab
  • Refractometry is an estimate of albumin and globulin in a plasma sample since these proteins have the most effect on the refractive index
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10
Q

Range for TS

A

Range: 6.5 - 8.0 g/dL

Highly variable

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11
Q

What could cause high total solids

A

diabetes

infection

bacteremia

dehydration

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12
Q

What would cause low TS?

A

Protein losing Renal failure

Protein losing GI disease

Liver failure

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13
Q

Supplies for a PCV

A

Blood sample to be tested

Microhematocrit tube

Clay sealant

Centrifuge

Microhematocrit reader or ruler

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14
Q

What Microhematocrit tube to use?

A
  • Heparinized: when you are taking direct from the patient
  • Non-heparinized: when you are taking from a purple top tube
  • Glass: more common, easier to access for TS
  • Plastic: safer, less likely to break
    • Some centrifuges require plastic tubes
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15
Q

How to prepare a PCV?

A
  • Fill tube ¾ full
    • Place sample horizontally to allow tube to fill via capillary action
    • Once filled, place finder over the end of the tube to prevent sample from dumping out
  • Wipe tube with KimWipe to remove blood from the outside of the tube
  • Seal the end of the amount of clay
  • Centrifuge
  • Read
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16
Q

Centrifuging PCV sample

A
  • Place sample with the clay on the outside
  • Spin for 3-5 minutes
    • at 2,500 rpms
17
Q

How to read a PCV

A
  • Hct Reading Card
    • align the top of the serum with the top line
    • Align the top of the clay with the bottom line
  • Ruler
    • Measure top of clay to top of the serum (total sample)
    • Measure top of clay to top of red cells (packed cells)
    • Dived Packed cell by Total sample = PVC%
18
Q

Blood Glucose Metabolism

A
  • Complex
  • Regulated by several hormones (insulin, glucagon, cortisol)
  • Euglycemia - normal
  • Hyperglycemia - high
  • Hypoglycemia - low
  • Collect sample from vein or capillary blood from a skin prick
19
Q

Euglycemia

A
  • Variable
  • Range 75 - 150 mg/dL
  • Most of the time ~100 mg/dL
20
Q

Hyperglycemia

A
  • Physiologic:
    • Usually mild hyperglycemia (120 - 150 mg/dL)
    • Can be profound
      • >200 in acutely stressed cats on rare occasion
    • Postprandial (after food) - generally the 2-4 hours after food
    • Epinephrine mediated (Acute Stress)
    • Cortisol mediated (chronic stress) - can be seen in illness
  • Pathologic:
    • Persistently elevated
    • Glucose in urine (glucosuria)
    • Diabetes mellitus
    • Modifications (steroids)
    • Toxins (Antifreeze)
21
Q

Hypoglycemia <75 mg/dL

A
  • Spurious:
    • Blood sitting in tube, generally >1 hour
    • Cells are alive and consuming the glucose - particularly patients with high WBC counts
  • Physiologic:
    • Juvenile toy breed dogs
  • Pathologic:
    • too much insulin
      • gave too much
      • Pancreas makes to much
      • Toxin (xylitol/artificial sweetener)
    • To little cortisol
      • Hypoadrenocorticism (Addison’s Disease)
22
Q

What could cause high BUN

A

High protein diet

Kidney failure

23
Q

Where can cat owners get blood from?

A

Use the lancet to prick between the marginal ear veins and the edge of the ear

24
Q

Who can get blood from a paw pad?

A
  • Both cat and dog owners
  • yield excellent samples
  • Use the non-weight-bearing pad (the pisiform pad) to alleviate pain, generally well tolerated in animals okay with having their feet handled.
25
Q

What could cause low BUN

A

Low protein diet

Liver failure

26
Q

Kidney Function

A
  • BUN is cleared renally
  • Once kidneys loses about 66% of their overall functions patients lose ability to concentrate urine
    • BUN will remain normal
  • Once a patient loses 75% or more of their kidney function, the BUN will increase
27
Q

What is BUN

A
  • Blood Urea Nitrogen
  • A product of protein (Amino Acid) digestion/breakdown by the liver
  • BUN is cleared by the kidneys
  • Normal Range:
    • Canines- 5 - 35 mg/dL
    • Felines - 5 - 35 mg/dL
28
Q

Blood Smear

A
  • Critial component of a complete blood count
  • Allows for confirmation of cell count, differential, and evaluate morphology
  • Allows for evaluation of some infectious agents (Cytauxzoonosis)
29
Q

Where do dog owners get blood from?

A
  • The inside of the dog’s ear flap often yields a more consistent sample than using the outside of the ear flap as you would in a cat.
  • Elbow calluses are not usually sensitive and generally yield excellent blood samples
    • Think skin scraping: lightly pinch and hold the callus for a few seconds before you attempt blood collection, then allow blood to bubble to form before attempting to take the sample.
  • Lip
    • Can be dangerous
    • best for large lip folds or for very gentle dogs
    • consistently yield excellent blood sample
30
Q

What are the steps for a blood smear?

A
  1. Gently mix blood sample
  2. Use a microhematocrit ¾ full with blood and place a 4mm drop of blood on the slide
  3. Back a clean slide into the blood drop and allow to spread along edge of slide
  4. maintain firm contact and push the top slide in one motion
  5. Air Dry
  6. Dip 10-15 seconds in Methanol (blue)
  7. Dip 10-15 seconds in Eosinophilic (red)
  8. Dip 10-15 seconds in Basophilic (blue/purple)
  9. Rinse gently with water
  10. Air Dry
31
Q

How to evaluate slide quality

A

A good quality smear should have:

  • A dense body; takes up about ⅔ of the entire smear and should blend smoothly into the monolayer
  • A well-developed feathered edge. This should have a fine, feathery appearance
  • A monolayer are just behind the feathered edge. If held to the light, there is a rainbow effect in this area
32
Q

What are some common errors while making blood smears?

A
  • Excessive downward pressure
    • short slides with hesitation marks and a poorly developed feather edge and monolayer region
  • Slow spreading motion
    • long thin smears, lack dense body, thin monolayer and well-developed feathered edge
  • wobbling the spreader slide
    • due to inexperience or trying to exert pressure on the slide rather than letting it rest on the surface
33
Q

What do you need to perform a blood glucose test?

A
  • Veterinary glucometer
  • Lancets - spring loaded device that pricks the skin

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