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VETM Clinical Pathology > Lect 2 - Haematology > Flashcards

Lect 2 - Haematology Flashcards

1
Q

Haematology is divided into the study of [2]

A

Formed (cellular) elements

Soluble fraction of blood (plasma)

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2
Q

The cellular components of haematology includes [3]

A

Erythrocytes, leukocytes and platelets

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3
Q

Haematopoietic growth factors include [3]

A

Proteins, colony stimulating factors (CSF) and interleukins (ILs)

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4
Q

At birth, almost all the bones of the body are involved in haematopoiesis, however, by adulthood, active haematopoiesis occurs mainly in the [5]

A

Marrow of the vertebrae, ribs, sternebrae, pelvis and metaphyses of long bones

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5
Q

When there is great demand for blood cells or when there is unregulated blood cell proliferation, active haematopoiesis may return to [2]

A

Extramedullary sites e.g. liver, spleen

To the diaphyses of long bones

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6
Q

Haemopoitic stem cells (HSC) are

A

Pluripotential stem cells that have the ability to differentiate into different cell types

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7
Q

What are the daughter cells of HSC [2]

A

Myeloid and lymphoid

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8
Q

How do HSC differ from daughter HSC

A

HSC are self renewing cell

HSC daughter cells commit to alt differentiation pathways and are not self renewing

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9
Q

The erythrocyte mass in the body consists of [3]

A

The stem cell compartment - bone marrow
The maturation and proliferation compartment - bone marrow
Circulating erythrocytes

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10
Q

A portion of the pluripotential stem cells becomes committed to erythropoiesis and differentiates into

A

Eryrthroid progenitor cells

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11
Q

Name the two sets of erythroid progenitor cells identified [2]

A

Burst forming unit erythroid (BFU-E)

Colony forming unit erythroid (CFU-E)

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12
Q

Erythropoiesis is regulated by [2]

A

Tissue hypoxia (main stimulus) and growth factors/hormones

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13
Q

What regulatory hormone is elaborated in response to hypoxia and where does it come from

A

Erythropoietin (EPO) from the peritubular interstitial cells of the kidney

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14
Q

What is the most important growth factor for maintenance of erythropoiesis

A

EPO

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15
Q

What growth factors stimulate BFU-E to differentiate into CFU-E and the differentiation of CFU-E into the erythroblast (rubriblast) [4]

A

EPO, IL-3, G-CSF and GM-CSF

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16
Q

EPO, IL-3, G-CSF and GM-CSF stimulate

A

Differentiation of BFU-E into CFU-E and CFU-E into erythroblast (rubriblast)

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17
Q

The first recognizable erythroid precursor in the bone marrow

A

Rubriblast

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18
Q

The maturation sequence of the erythroid cells is [6 steps]

A

Rubriblast > Prorubricytes > Rubricytes > Metarubricytes > Reticulocytes (Polychromatophil) > Mature erythrocyte

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19
Q

Newly released blood cells stain blue/bluish grey with this stain? and are called what?

A

Wright/Wright Giemsa stain and are referred to as polychromatophils

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20
Q

Newly released blood cells when stained with this basic dye? are referred to as what?

A

New Methylene Blue stain and referred to as reticulocytes

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21
Q

These are aggregates of denatured hemoglobin cause by oxidative damage which also stain well using New Methylene Blue

A

Heinz bodies

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22
Q

When are polychromatophilic cells usually seen

A

Regenerative anaemias

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23
Q

<1% reticulocytes are normal in what species [3]

A

Dogs and pigs and sometimes cats

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24
Q

Reticulocytes are absent in what species even with regenerative anaemia

A

Horse….they do not release reticulocytes into circulation

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25
Q

Early reticulocytes are called

A

Aggregate reticulocytes

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26
Q

Aggregate reticulocytes mature into

A

Punctate reticulocytes

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27
Q

What species has both aggregate and punctate reticulocytes…and which should be counted when doing reticulocyte count

A

Cats

Aggregate

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28
Q

Reticulocytes are generally released when there is increased demand for RBCs, so an increased number can be seen in the peripheral blood with

A

Regenerative anaemias

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29
Q

The process from rubriblast to mature red cell takes

A

4-7days

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30
Q

The process from rubriblast to mature red cell takes 4 – 7 days but can be accelerated under erythroid marrow stimulation to

A

2-3days

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31
Q

Nucleated red blood cells ( e.g rubricytes and metarubricytes) can occasionally appear in the peripheral blood and can be a sign of a regenerative response ( increased demand for RBC). This is termed

A

An appropriate response

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32
Q

With “an appropriate response” to anaemia there is also a concurrent increase in

A

Reticulocytes

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33
Q

Inappropriate rubricytosis is

A

Rubricytosis without an concurrent increase in the reticulocyte count

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34
Q

Nucleated RBC are cleared by the

A

Spleen

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35
Q

Inappropriate rubricytosis can be a result of

A

Splenic dysfunction or neoplasia or bone marrow disease

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36
Q

In animals, the erythrocyte is shaped like

A

A biconcave disc

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37
Q

RBC biconcave disc shape is most prominent is what species

A

The dog

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38
Q

The diameter of canine RBC are

A

7microns - other species RBC are smaller

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39
Q

Which species has a prominent central pallor

A

Canine

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40
Q

What is poikilocytosis

A

Variation in RBC shape

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41
Q

Which species RBC has a marked poikilocytosis

A

Goats

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42
Q

What is anisocytosis

A

Variation in RBC size

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43
Q

Which species exhibit anisocytosis [2]

A

Cows and goat

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44
Q

The RBC of mammals lack a what

A

Nucleus (Non-nucleated)

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45
Q

What species have ellipsoidal shaped non nucleated RBC

A

Camelidae - camels, llamas, alpacas

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46
Q

What species of animals have oval/ellipsoidal nucleated RBC [4]

A

Avian, Fish, Amphibian and Reptile

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47
Q

Rouleaux formation is commonly seen in what species [3]

A

Horse
Cats may also show tendency in health
Dogs show little rouleaux unless inflammatory disease is present

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48
Q

Rouleaux formation should be differentiated from

A

Agglutination seen in cases of IMHA

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49
Q

What is basophilic stippling

A

Aggregates of RNA in RBC

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50
Q

What type of stain is used to view basophilic stippling

A

Wright’s

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51
Q

When and in what species is basophilic stippling seen

A

Lead poisoning in dogs

Regenerative anemias in cats and ruminants

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52
Q

Heinz bodies are usual observed in what species and why

A

Cats

Their Hgb has more sulphdryl grps than other species and the spleen is less efficient at removing heinz bodies

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53
Q

Howell Jolly bodies are

A

Nuclear fragments seen in newly released RBC

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54
Q

What conditions are Howell Jolly bodies usually observed [2]

A

Regenerative anemias and splenectomized anemias

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55
Q

Howell Jolly bodies can be normally found in low numbers in which species [2]

A

Dogs and Cats

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56
Q

What is a hypochromic cell

A

Reduced volume of Hgb so that the area of pallor is exaggerated

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57
Q

Hypochromic cells are most noticeable in what condition

A

Dogs with iron deficiency

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58
Q

Hypochromasia is measured as a decrease in what

A

MCHC

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59
Q

What is a macrocyte

A

An erythrocyte with an increase volume

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60
Q

Macrocytosis detected as an

A

Increase in MCV

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61
Q

Macrocytosis/increase in MCV are usually seen in [3]

A

Regenerative anemia
Hereditary poodle marrow dyscrasia
FeLV infection

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62
Q

What is a microcyte

A

An erythrocyte with a decreased volume

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63
Q

Microcytosis is detected as a

A

Decrease in MCV

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64
Q

What condition is microcytosis observed concurrently with hypochromasia [2]

A

Iron deficiency anemia and hepatic failure in dogs

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65
Q

Some breed of dogs have natural lower MCV, give examples [4]

A

Akita, Shiba, Chow Chows, Shar Pei

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66
Q

What are spherocytes

A

Dense, spherical RBC

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67
Q

When can you find spherocytes [3]

A

IMHA
Coral Snake Bites
Zinc Toxicity

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68
Q

What are schistocytes

A

Irregular fragment of RBC

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69
Q

When can you find schistocytes [6]

A 
DIC
Microangiopathic hemolytic anemia
CHF
Hemangiosarcoma
Glomerulonephritis
Myelonephritis
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70
Q

What is an echinocyte (Crenated cell, Burr cell)

A

RBC with several evenly spaced projections

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71
Q

When can you find echinocytes [3]

A

Electrolyte abnormalities
Uremia
In vitro change (artifact)

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72
Q

What is an acantocyte (Spur cell)

A

RBC with two or more unevenly spaced blunt projections

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73
Q

When can you find acanthocytes

A

Hemangiosarcoma

Liver disease

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74
Q

What are keratocytes (2)

A

There are two types

Blister which preceds Helmet

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75
Q

When can you find keratocytes

A

DIC

Microangiopathic hemolytic anemia

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76
Q

What are codocytes (Target cell)

A

RBC containing a dense central area of Hgb

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77
Q

When can you find codocytes

A

Liver disease

Regenerative anemia

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78
Q

What are dacrocyte

A

Tear shaped RBC

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79
Q

When can you see dacrocytes

A

Myleofibrosis
Pure red cell aplasia
Myeloproliferative disease
Artifact

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80
Q

What are stomatocytes

A

RBC with a slit like clear opening near the center

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81
Q

When can you find stomatocytes

A

Hereditary stomatocytosis in Malamutes
Chronic anemia
In vitro change (artifact)

82
Q

In the body iron exists as many forms…list them (6)

A 
Hemoglobin
Storage iron
Myoglobin
Labile iron
Tissue iron
Transport iron
83
Q

Majority 55-65% of the body’s iron exist in the form of

A

Hemoglobin

84
Q

Most iron exist as hemoglobin, what is the second highest (33%) form

A

Storage iron

85
Q

There are two types of storage iron, name them

A

Ferritin - iron protein complex

Haemosiderin - more stable but less availble than ferritin

86
Q

What form of iron is the best indicator of iron stores in the body

A

Ferritin

87
Q

What is the ferritin lvl in true iron deficiency compared to anemia of inflammatory disease

A

True iron deficiency - low

Anemia of inflammatory disease - normal or high

88
Q

What causes the increase in ferritin lvl during anemia of inflammatory disease

A

Scavenging of iron from tranferrin to ferritin where it becomes less available to invading organisms

89
Q

Inflammatory cytokines stimulate the production of what from hepatocytes

A

Hepcidin

90
Q

What is the role of hepcidin

A

Inhibits absorption of iron from intestines and release from macrophages

91
Q

How does haemosiderin differ to ferritin

A

Higher iron to protein ratio and is not water soluble

92
Q

Haemosiderin can be observed under what stain

A

Prussian blue

93
Q

What form is the iron in haeme

A

Ferrous (Fe2+) that can bind to O2

94
Q

Where is myglobin found

A

Muscles

95
Q

Myoglobin has what percent of iron

A

3-7%

96
Q

Which species of animals is the iron content of myoglobin higher (2)

A

Dogs and Horses

97
Q

The plasma iron pool is in dynamic with this pool

A

The labile iron pool

98
Q

The iron in the tissue pool is important because

A

It forms an integral part of enzyme systems

99
Q

Iron is transported in plasma bound to a protein called

A

Transferrin

100
Q

Bound iron is measured as

A

Serum iron

101
Q

Iron is transported as what to the red cell compartment

A

Ferrotransferrin

102
Q

What is total iron-binding capacity (TIBC)

A

The measure of plasma to carry iron

103
Q

TIBC is increased in chronic iron deficiency most species EXCEPT

A

Dog

104
Q

Disorders of anaemia associated with chronic iron deficiency and inflammatory/chronic disease can usually be differentiated by examination of bone marrow for stainable iron EXCEPT in what species

A

Cat

Stainable iron is not present in the bone marrow of normal cats

105
Q

The main function of Hgb is

A

To carry O2, CO2 and buffer H+

106
Q

95% of CO2 is transported as

A

HCO3-

107
Q

CO2 + H2O ↔ H2C03 ↔ H+ + HCO3¯ is catalyzed by

A

Carbonic anhydrase

108
Q

Which species have higher intracellular K+ concentrations [4]

A

Man, horse, pig and some ruminants (mainly among sheep)

109
Q

Which species have low intracellular K+ conc [4]

A

Some sheep, goats, buffalo and cattle

110
Q

Intracellular Na+ and K+ are similar to plasma in what species [2]

A

Dogs and Cats

111
Q

Examples of defects in glycolytic enzymes? [2] and what may result

A

Pyruvate kinase deficiency and PFK deficiency

Hemolytic anemia

112
Q

Pyruvate kinase deficiency are found in what breeds of animals [5]

A

Besenji, Beagle, West Highland white terrior and Abyssinian and Somali Cats

113
Q

PFK deficiency are found in what breeds of animals [2]

A

English Springer Spaniels and American Cocker Spaniels

114
Q

What factors cause a left shift in the O2 dissociation curve [4]

A

Decreased 2,3-DPG
Decreased CO2
Decreased Temp
Increased PH

115
Q

What factors cause a right shift in the O2 dissociation curve

A

Increased 2,3-DPG
Increased CO2
Increased Temp
Decreased pH

116
Q

A right shift in the O2 dissociation curve means

A

Lowering of O2 affinity of Hgb i.e fovouring release of O2 to tissues

Vice versa for left shift

117
Q

The average RBC span for the following species are

Cow, Sheep, Horse, Cat, Bird

A 
Cow - 160
Sheep - 150
Horse -145
Cat - 70
Bird - 35
118
Q

RBC are removed by [2]

A

Extravascular routes - phagocytosis by the MPS of the spleen

Intravascular lysis - release of Hgb into the plasma

119
Q

Iron from degraded RBC are stored as ferritin or haemosiderin in what

A

Macrophages

120
Q

The protoporhyrin ring is catabolized by haema oxygenase to

A

Biliverdin

121
Q

Biliverdin converted via biliverdin reductase to

A

Bilirubin

122
Q

Bilirubin is transported to the liver by

A

Albumin

123
Q

In the liver bilirubin is conjugated to

A

Bilirubin diglucuronide and excreted in bile into the intestines

124
Q

The conjugated bilirubin by bacterial action in the intestines is degraded to

A

Urobilinogen which can be excreted in urine

125
Q

Urobilinogen can be further degraded to

A

Stercobilinogen

126
Q

What species final end product is biliverdin and why

A

Birds - they lack biliverdin reductase

127
Q

Free oxidized form of haemoglobin is complexed to

A

Haemopexin which is cleared by the liver

128
Q

What is hematocrit

A

The percent of RBC in blood

129
Q

In what species, is the Hgb conc 3x the haematocrit

A

Dog

130
Q

MCV is measured in

A

Femtoliters

131
Q

MCHC is measured in

A

grams/L

132
Q

As a general rule, regenerative anaemias are usually a result of? Describe it in terms of MCV and MCHC

A

Hemorrhage or hemolysis

Macrocytic, hypochromic

133
Q

Reticulocytosis occurs in what type of anemia

A

Regenerative

134
Q

How much time does it take for reticulocytes to appear in regenerative anemias

A

3-4days

135
Q

The more severe the anemia the……reticulocyte response?

A

The greater the reticulocyte response

136
Q

In anemias due to blood loss (hemorrhagic anemias) there is a decrease in what [2]

A

RBC and protein

137
Q

In anemias due to accelerated RBC destruction (hemolysis), there is a decrease in what

A

RBC but normal plasma protein

138
Q

Anemias due to reduced or defective erythropoiesis tend to be

A

Non regenerative

139
Q

Hemorrhagic anemias may be [4]

A

Acute or Chronic,

External or Internal

140
Q

In hemorrhagic anemias -

A low plasma protein lvl in a regenerative anemia is suggestive of what type of blood loss. Compare with alternative.

A

External

Internal blood loss - may be only mildly decreased as it is reabsorbed

141
Q

In hemorrhagic anemias - What species may show an increase in Hct shortly after acute blood loss and why?

A

Horse - splenic contractions

142
Q

In hemorrhagic anemia - Chronic blood loss is characterized by impaired what? why?

A

Erythropoiesis due to iron exhaustion

143
Q

In hemorrhagic anemia - Anemia due to chronic blood loss gradually becomes (MCHC, MCV)

A

Hypochromic, Microcytic

*Iron deficiency anemia seen in dogs and ruminants

144
Q

What evidence may you look for to determine is blood anemia is due to chronic blood loss

A

Bleeding into the gi tract (tarry stool/melena)

145
Q

Hemolytic anemia which occurs as a result of increase red blood cell destruction within the body may be [4]

A

Congenital or Acquired

Intravascular or Extravascular

146
Q

In hemolytic anemia - in may disease conditions when intravascular hemolysis is present what else is occuring

A

Extravascular haemolysis

147
Q

In hemolytic anemia - PCV (also hemoglobin, RBC) and protein lvl are

A

PCV (also hemoglobin, RBC) decreased

Protein often normal

148
Q

Hemolytic anemia - signs of extravascular hemolysis [2]

A

Icterus

Bilirubinuria

149
Q

Hemolytic anemia - signs of intravascular hemolysis [4]

A

Hemoglobinemia and hemoglobinuria

Icterus and bilirubinuria

150
Q

Hemolytic anemia - changes in RBC morphology…what so you look for [4]

A

Sperocytes
Acanthocytes
Parasites
Heinz bodies

151
Q

Hemolytic anemia - Immune mediated: cause, diagnostic test, RBC morphology

A

Antibody reacts with target antigens on the RBC membrane or
reacts with drug/infectious agent which adheres to RBC
Coombs Test
Spherocytes or agglutination

152
Q

Hemolytic anemia - Toxins/chemicals e.g. [7]

A

Acetaminophen, zinc, copper toxicity
Bacterial toxins from Leptospira/Clostridia
Snake/Spider bite venoms

153
Q

Hemolytic anemia - RBC parasites e.g. [2]

A

Mycoplasma hemofelis

Babesia

154
Q

Hemolytic anemia - Mechanical injury of RBC e.g.

A

Hemangiosarcoma

155
Q

Hemolytic anemia - Inherited RBC deficiency [2]

A

PK and PFK deficiency

156
Q

Hemolytic anemia - exposure to oxidizing agents e.g. [3] What clues can you look for?

A

Acetaminophen
Garlic
Onion

Heinz bodies

157
Q

Hemolytic anemia - Hypophosphatemia e.g.

A

Diabetic ketoacidotic cats receiving insulin therapy

158
Q

What are some congenital causes of hemolytic anemia and the species in which they affect

A

Porphyrias - cattle, cat, swine
PK deficiecy - dogs and cats
PFK deficiency - dogs

159
Q

In congenital/inherited hemolytic anemia the type of hemolysis is generally

A

Extravascular

160
Q

Bovine congenital erythropoietic porphyria occurs at birth. What precaution is taken in calves

A

Protection from sunlight due to photosensitization

161
Q

Deficiency of PFK results in

A

Decreased ATP and 2,3-DPG formation

162
Q

Acquired haemolytic anemias are more common than congenital haemolysis and occur mainly

A

Extravascularly (MPS) system

163
Q

Acquired haemolytic anemia - Viral - Equine infectious anemia..What is the most prominent CBC result.
How do you diagnose

A

Thrombocytopenia

AGID (Coggin’s Test)

164
Q

Acquired haemolytic anemia - Feline leukemia virus. Regenerative?MCHC? MCV?

A

Non regenerative, normochromic and sometimes macrocytic

165
Q

Acquired haemolytic anemia - Leptospirosis common sign is

A

Icterus

166
Q

Acquired haemolytic anemia - Icterus in Leptospirosis is a result of

A

Intravascular hemolysis due to the production of haemolysin

167
Q

Acquired haemolytic anemia - Anemia from Leptospirosis is less pronounced in what species

A

Dogs

168
Q

Acquired haemolytic anemia - Bacillary haemoglobinuria is caused by [2]

A

C. haemolyticum and C. novyii type D

169
Q

Acquired haemolytic anemia - Bacillary haemoglobinuria affects what species [2]

A

Cows and Sheep

170
Q

Acquired haemolytic anemia - Bacillary haemoglobinuria is result of what toxin?

A

Beta-toxin

171
Q

Acquired haemolytic anemia - What species of Babesia is found in dogs [2]

A

B. canis and B. gibsoni

172
Q

Acquired haemolytic anemia - What species of Babesia is found in cows [4]

A

B. bovis, B. bigemina, B. divergens and B. major

173
Q

Acquired haemolytic anemia - What species of Babesia is found in horses [2]

A

Theileria equi and B. caballi

174
Q

Acquired haemolytic anemia - What species of Babesia is found in cats [2]

A

B. felis and B. cati

175
Q

Acquired haemolytic anemia - What species of Babesia is found in sheep [3]

A

B. ovis, B. foliata and B. motasi

176
Q

Acquired haemolytic anemia - these piroplasms appear as signet ring bodies or bipolar safety pins

A

Cytauxzoon felis

177
Q

Acquired haemolytic anemia - this is the only tick bourne vector

A

Dermacentor variablis

178
Q

Acquired haemolytic anemia - Rickettsial disease - Anaplasmosis is the disease of what species [2]

A

Cattle and sheep

179
Q

Acquired haemolytic anemia - Rickettsial disease - Anaplasma species in cattle are [2]

A

A. marginale and A. centrale (less pathogenic)

180
Q

Acquired haemolytic anemia - Rickettsial disease - A. ovis infects [2]

A

Sheep and Goats

181
Q

Acquired haemolytic anemia - What is the difference between Anaplasmosis and the other anemia causing Rickettsial disease

A

Anaplasmosis organism is found in the erythrocyte

Mycoplasmosis parasite is found on the surface of the erythrocyte

182
Q

Acquired haemolytic anemia - Rickettsial disease - Haemoplasmosis appear in different forms, list them [3]

A

Coccoid, ring and rod-shaped

183
Q

Acquired haemolytic anemia - Give examples of oxidizing agents and the species they affect

A

Acetaminophen - Dogs and Cats
Red maple leaves - Horse
Rape seed - Cows

184
Q

Acquired haemolytic anemia - Copper toxicity occurs in which species [3]

A

Cattle, sheep and swine

185
Q

Normocytic normochromic non regenerative anaemia with normal or increased neutrophils and platelets can be due to [6]

A 
Lack of erythropoietin
Inflammatory disease/chronic disease
FeLV associated anemia
Immune mediated anemia
Liver Disease
Hypothyroidism/adrenocorticism
186
Q

Normocytic normochromic non regenerative anaemia with decreased neutrophils and platelets can be due to [2]

A

Aplastic anemia

Myelophthistic anemia

187
Q

Causes of aplastic anemia

A

Damage to the multipotential stem cell or bone marrow
Ehrlichia, parvo virus, FeLV, FIV
Estrogen, chemotherapy, bracken fern

188
Q

Causes of myelophthistic anemia

A

Bone marrow is replaced by neoplastic cells

189
Q

Microcytic hypochromic non regenerative anaemias with variable neutrophils and platelets can be due to [3]

A

Iron deficiency
Anaemia of inflammatory disease
Portosystemic shunts/liver insufficiency

190
Q

Macrocytic normochromic non regenerative anaemias with variable neutrophils and platelet

A

Vitamin B12 and folate deficiency
FeLV infection
Erythroid neoplasia

191
Q

What is erythrocytosis

A

Is an increased [RBC] in peripheral blood. It is detected by finding an increased PCV/HCT, increased [RBC], or increased [Hgb]

192
Q

What is polycythemia

A

Increase in red blood cells

193
Q

What the types of erythrocytosis [2]

A

Relative and Absolute

194
Q

What is the difference between relative and absolute erythrocytosis

A

Relative - no increase in total erythrocyte mass

Absolute - increase erythrocyte mass

195
Q

Relative erythrocytosis can be caused by [2]

A

Dehydration

Splenic contraction and release of splenic blood into circulation

196
Q

Explain how dehydration leads to erythrocytosis

A

Decreased plasma volume but no change in RBC numbers in body, causing a relative increase in the RBC count. The total protein will usually be increased as well

197
Q

Explain how Splenic contraction and release of splenic blood into circulation leads to erythrocytosis

A

Contraction occurs due release of epinephrine in response to excitement, fright or exercise. Splenic blood contains a high concentration of RBCs and causes an erythrocytosis (common in dogs and horses)

198
Q

What are the types of absolute erythrocytosis [2]

A

Primary and Secondary

199
Q

Primary absolute erythrocytosis can be cause by

A

Myeloproliferative disease

200
Q

What are the types of secondary absolute erythrocytosis [2]

A

Appropriate and Inappropriate

201
Q

Appropriate secondary absolute erythrocytosis can be caused by

A

chronic hypoxia of cardiac and/or pulmonary disease leads to increased erythropoietin production

202
Q

Inappropriate secondary absolute erythrocytosis can be caused by

A

Inappropiate EPO production by renal tissue because of renal cysts, renal neoplasms

Inappropriate EPO production by certain neoplasms e.g hepatoma, leiomyosarcoma

VETM Clinical Pathology (4 decks)

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