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Lab D > Lab 5 > Flashcards

Lab 5 Flashcards

1
Q

Normal Hemoglobin measurement?

A

18-20 mol/l

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2
Q

Oxygen binding capacity of Hemoglobin is increased by?

A
  • Decreased 2,3 DPG level in RBCs.
  • Decreased pCO2 level in the blood (ex. in case of respiratory alkalosis)
  • Decreased temperature of blood (hypothermia)
  • Increased pH of the blood.
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3
Q

Oxygen binding capacity of Hemoglobin is decreased by?

A
  • Increased 2,3 DPG level in RBCs.
  • Increased pCO2 level in the blood (ex. in case of respiratory acidosis)
  • Increased temperature of blood (hyperthermia)
  • Decreased pH of the blood (acidosis, respiratory or metabolic).
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4
Q

What is oxygen saturation (SAT%)?

A

The percentage of oxygenated Hemoglobin molecules compared to the whole amount of Hemoglobin molecules in one unit blood.

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5
Q

Normal values of SAT%?

A

Arterial blood: 95-99%

Venous blood: 80-90%

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6
Q

Methemoglobin?

A

Hemoglobin molecules containing oxidized iron (3+ form).

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7
Q

Causes of increased hemoglobin concentration?

A
  • Usually associated with different types of relative (dehydration)
  • Absolute polycythemia.
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8
Q

Causes of decreased hemoglobin concentration?

A
  • Usually associated with relative (hyperhydration)

- Absolute oligocythemia (anaemia).

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9
Q

Normal RBC count?

A

4.5-8 x 10^12/IT/l

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10
Q

In order to calculate the indices we must measure?

A

Ht or PCV (hematocrit, packed cell volume), red blood cell count, hemoglobin concentration.

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11
Q

Normal Mean Corpuscular Hemoglobin (MCH) value?

A

12-30pg

In young animals it (and MCV) can be increased 28-32pg

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12
Q

Decreased Mean Corpuscular Hemoglobin (MCH)?

A

Hypochromasia

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13
Q

Increased Mean Corpuscular Hemoglobin (MCH)?

A

Hyperchromasia

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14
Q

Mean Corpuscular Volume (MCV) indicates the average size of the RBCs, which is?

A
  • Increased: Macrocytic
  • Normal: Normocytic
  • Decreased: Microcytic
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15
Q

Normal Mean Corpuscular Volume (MCV) value?

A

60-70fl

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16
Q

Causes of microcytosis?

A
  • Chronic blood loss
  • Iron, copper, pyridoxine (vitamin B6) deficiency.
  • Portosystemic shunt
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17
Q

Causes of macrocytosis?

A

(mostly regenerative anaemia)

  • Polycythemia absolute vera (erythroleukemia)
  • Vitamin B12, folic acid, cobalt deficiency.
  • Erythroleukemias
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18
Q

Mean Corpuscular Hemoglobin Concentration (MCHC) indicates?

A

The average concentration of hemoglobin in erythrocytes (Hb concentration)

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19
Q

Normal Mean Corpuscular Hemoglobin Concentration (MCHC)?

A

300-350g/l (30-35%) - Normochrom

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20
Q

Decreased Mean Corpuscular Hemoglobin Concentration (MCHC) - hypochromasia?

A
  • Newborn animals
  • Regenerative anaemias
  • Iron deficiency anamias
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21
Q

Increased Mean Corpuscular Hemoglobin Concentration (MCHC) - hyperchromasia?

A
  • Erythroleukemia (polycythemia absolute vera)
  • Vitamin B12, folic acid, cobalt deficiency
  • Immunhemolytic anaemia (spherocytosis)
  • Lead poisoning
  • Splenectomy
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22
Q

Typical changes in deviated parameters?

A
  • Macrocytic, hypochromic
  • Noromocytic, normochromic
  • Microcytic, hypochromic
  • Microcytic, normochromic
  • Macrocytic, normochromic
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23
Q

Macrocytic, hypochromic: Increased MCV, decreased MCHC, (increased reticulocytes)?

A

Regenerative anaemias

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24
Q

Noromocytic, normochromic: Normal MCV, normal MCHC, normal or decreased MCH?

A

Non regenerative anaemias

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25
Q

Microcytic, hypochromic: Decreased MCV, decreased MCHC, (decreased Hb synthesis)?

A

Iron, copper, pyridoxine deficiency anaemias, liver failure, portosystemic shunt.

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26
Q

Microcytic, normochromic: decreased MCV, normal MCHC?

A

Japanese Akita (normal)

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27
Q

Macrocytic, normochromic: increased MCV, normal MCHC, impaired DNA synthesis?

A

FeLV infection, vitamin B12, Co or folic acid deficiency, erythroleukemia, poodle macrocytosis

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28
Q

Normal Red Cell Distribution (RDW) values?

A

Dog: 12-16%
Cat: 14-18%

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29
Q

Normal Platelet Distribution Width (PDW) values?

A

Dog: 6-8%
Cat: 7-12%

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30
Q

Normal Corrected Reticulocyte Percentage (CRP) values?

A

<1-2% (without anaemia)

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31
Q

Cause of increased reticulocyte count?

A

Different types of regenerative anaemia:

  • Acute blood loss (approx. 3-5 days are needed for the bone marrow to increase the reticulocyte count in the blood).
  • Haemolytic anaemia
  • Chronic blood loss
  • Nutrient deficiency anaemias.
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32
Q

What is osmotic resistance of RBC dependent on?

A
  • The pH of plasma
  • The reagents
  • Temperature
  • Osmotic concentration of plasma
  • Reagents (NaCl concentration)
  • RBC membrane status
  • Regenerative status (reticulocytes are more resistant)
  • HbF (fetal hemoglobin) content of the RBCs (fetal RBCs, containing HbF are more resistant)
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33
Q

Proper staining methods?

A

May-Grünwald staining, Giemsa staining, Diff Quick staining

34
Q

Check gross signs?

A
  • Rouleau formation: coin arrangement (horse often, dog, cat, swine sometimes, cattle rare)
  • RBC aggregates
  • Large cells (horse often)
  • Thrombocyte aggregates
35
Q

Intensity of staining of RBCs?

A
  • Polychromasia, hyperchromosia: more intensive staining

- Hypochromasia: Weak staining

36
Q

Polychromasia, hyperchromasia?

A

More intensive staining

  • RNA, or nuclear remnants,
  • more Hb -regenerative process
37
Q

Hypochromasia?

A

Weak staining

  • Decreased Hb-content
  • or other nutrient deficiency
38
Q

Size of RBCs?

A
  • Macrocytosis: many big cells
  • Microcytosis: many small cells
  • Anisocytosis: variable cell size - iron deficiency and regenerative process
  • Poikylocytosis: variable size and color
39
Q

RBC types?

A
  • Young and nucleated RBCs (in order of malnutrition):
    #Proerythroblast
    #Basophil erythroblast (normocyte, normoblast)
    #Polychromatophil eryhtoblast (normocyte, normoblast)
    #Acidophil erythroblast (normocyte, normoblast)
  • Young but mature RBC without nucleus:
    #Reticulocyte
  • Appearance of young RBCs:
    #Increased production (regenerative anaemia), spleen
    or bone marrow disease, leukemia, extra medullar
    erythrocyte production, Pb toxicosis (with basophil
    punctates), hyperadrenocorticism.
40
Q

Reticulocyte - appearance?

A

Increased production (regenerative anaemia) - chronic Fe deficiency anaemia, hemolysis, acute blood loss, chronic blood loss.

41
Q

Inclusion bodies in RBCs?

A
  • Heinz body
  • Howell-Jolly body
  • Basophilic punctuates
  • Hb inclusions
42
Q

Heinz body - appearance?

A

Heinz body (NMB - new methylene blue stain): denatured HgB
Appearance:
- O2 effect,
- oxidative damage to RBCs (cat!, ex. methaemoglobinaemia),
- GSH deficiency

43
Q

Howell-Jolly body - appearance?

A 
Nuclear membrane remnants.
Appearance: 
- Vitamin B12 deficiency, 
- increased production of red cells, 
- splenectomy
44
Q

Basophilic punctuates - appearance?

A 
Nuclear remnants
Appearance:
- Regenerative process
- Young RBCs of cat
- Physiological in ruminants
- Lead poisoning
45
Q

Hb inclusions - appearance?

A
  • Hb damage
  • Increased RBC production
  • Regenerative anaemia
46
Q

RBC parasites?

A
  • Haemobartonella canis, felis, bovis
  • Babesia spp. (canis, gibsoni), B. canis is very common in
    Hungary
  • Ehrlichia canis, Equipment etc.
  • Dirofilaria immitis, repens
  • Anaplasma marginale, centrale, ovis
  • Eperythrozoon wenyoni, ovis, suis, parvum
  • Citauxzoon felis
  • Theileria parva, mutans, annulata, hirci, ovis
  • Trypanosoma cruzi, congolense, vivas, rucei, evans, suis,
    equiperdum
  • Leishmania donovani
47
Q

Normal serum iron (SeFe) value?

A

18-20 umol/l

48
Q

Causes of low serum iron concentration?

A
  • Chronic blood loss
  • Decreased intake (piglets, calves)
  • Impaired gastric, duodenal, jejunal function (reduction,
    transport, absorption)
49
Q

Causes of high serum iron concentration?

A
  • Iron toxicosis (overload)
50
Q

Total iron binding capacity (TIBC)?

A

50-68 umol/l

51
Q

Causes of low Total iron binding capacity (TIBC)?

A
  • Chronic inflammation (negative acute phase protein)
  • Chronic liver failure (decreased transferring synthesis in
    the liver)
  • Neoplastic disease
52
Q

Causes of high Total iron binding capacity (TIBC)?

A
  • Iron deficiency anaemia (not severe: normal iron level + high TIBC, severe: low iron level + high TIBC)
53
Q

Laboratory findings in hemolysis?

A
  • Decreased PCV
  • Decreased haptoglobin
  • Decreased RBC osmotic resistance
  • Increased reticulocytes (regenerative anaemia)
  • Increased total bilirubin
  • Increased indirect bilirubin
  • Increased lactate dehydrogenase (LDH) I, II.
  • Increased urobilinogen and Hgb in urine
  • Polychromasia, poikilocytosis
  • Leukocytosis, (neutrophilis)
  • Spherocytosis
  • Jaundice
  • Hyperchromic stool
54
Q

How do we measure haemoglobin concentration of the blood?

A

By using Spectrophotometric method (Drabkin-method). Or by calculating: PCV (l/l)/3 * 1000 = HGB (g/l)

55
Q

What is included in the measured haemoglobin result?

A

It is a sum of Hgb molecules from the haemolysed RBCs and the very small amount of free Hgb content of the plasma, which is usually bound to a carrier protein (haptoglobin).

56
Q

What is haptoglobin?

A

A carrier protein of free Hgb content of plasma.

57
Q

Is there an increase of haemoglobin concentration in blood in case of intravascular haemolysis?

A

There is NO notable increase in Hgb concentration in case of intravascular hemolysis.

58
Q

What does the oxygen dissociation curve describe and what can shifts to the left or right show?

A

Its a curve that plots the proportion of hemoglobin in its saturated (oxygen-laden) form on the vertical axis against the prevailing oxygen tension on the horizontal axis.
Left shift: Decreased temp., decreased 2-3 DPG, decreased H+.
Right shift: (reduced affinity), increased temp., increased 2-3 DPG, increased H+.

59
Q

What is methaemoglobin? What is the mechanism of methaemoglobin and can it carry oxygen?

A

Hgb molecules containing oxidized form (3+ form) are called methaemoglobin.
These are unable to carry oxygen.

60
Q

Can methaemoglobin be converted to normal haemoglobin?

A

Yes. They are reduced to normal hemoglobin by methaemoglobin-reductase enzyme.

61
Q

Which animal has a lower haemoglobin concentration in younger animals?

A

Swine. Young pigs have much lower Hgb concentrations than older ones.

62
Q

Does the haemoglobin affinity for oxygen change with age?

A

Usually not, except pigs.

63
Q

What method(s) are used to count red blood cells?

A

Bürker-chamber method, automatic cell counter, or calculations: (Ht l/l)/(5) x 100 = RBC count x 10^12/l.

64
Q

How do the sizes of red blood cells of young animals, the Japanese Akita and Poodles differ?

A

Japanese Akita have small RBCs (55-65 fl).

Poodles have very large RBC (75-80 fl).

65
Q

What is red cell distribution width and platelet distribution width?

A

Give a number that is correlated with the range of the average size of the RBCs and platelets.

66
Q

What do a large and a short RDW suggest?

A

Short RDW: non regenerative processes.

Large RDW: regenerative process.

67
Q

How do we perform a reticulocyte count?

A

Staining: Brilliant-cresil stain.
Counting: Count 100-1000 RBCs and take the percent of the reticulocytes.

68
Q

What animals do not have reticulocytes in their plasma and where do they have them?

A

No reticulocytes appear in horses or ruminants, they appear only in the bone marrow, not in the peripheral blood.

69
Q

Which animals commonly have more punctuated forms of reticulocytes?

A

Cats.

70
Q

What are the differences between nucleated and non-nucleated reticulocytes?

A

Nucleated RBCs are too young to carry oxygen.

71
Q

What is the normal reticulocyte count?

A

2-3%

72
Q

Why would a reticulocyte count or percentage sometimes need to be corrected?

A

Because mature RBCs are more sensitive to any damage than young RBCs and reticulocytes, therefore in case of RBC damage, usually more mature RBCs are died than young ones.

73
Q

What is the normal corrected reticulocyte count (CRC) value?

A

<0,06 x 10^12/l (without anaemia)

74
Q

What can damage red blood cell membranes?

A
  • Nephropathy (uremia)
  • Specific membrane damage (immunohemolytic anaemia)
  • Increased physical damage (Ex. long-distance running)
75
Q

What other lab measures could be taken in connection with RBCs?

A
  • Serum iron measurement

- Total iron binding capacity (TIBC)

76
Q

What is and how do we measure the serum iron concentration?

A

Serum samples are needed for this analysis, because fibrinogen content of the plasma may disturb the measurement.
Fe3+ is reduced to Fe2+ by ascorbic acid.
Fe2+ reacts with ferrosin and forms a red colored chelate (complex molecule) which can be measured photometrically.

77
Q

What should serum iron measurement always be performed together with?

A

TIBC (Total iron binding capacity) analysis

78
Q

In which species can we use reticulocyte count?

A

All except horses and ruminants?

79
Q

What are the reticulocytes?

A

Young, dont have nucleus or granules.

80
Q

What is MCH?

A

Mean corpuscular hemoglobin indicates average Hb content of RBCs.

81
Q

What is MCHC?

A

Mean corpuscular hemoglobin concentration indicates the average concentration of hemoglobin in erythrocytes .

Lab D (2 decks)

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