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Clinical Pathology > Lecture 1: RBC’s I > Flashcards

Lecture 1: RBC’s I Flashcards

1
Q

Define hematology

A

evaluation of cells in circulation

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2
Q

biochemistry is evaluating __

A

acellular component in circulation

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3
Q

what is cytology

A

evaluation of cells within tissues and fluids

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4
Q

what makes up the cellular component (hematology) of blood

A

erythrocytes
Buffy coat: leukocytes and platelets/ thrombocyte

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5
Q

what makes up aqueous/ plasma component in blood

A

proteins, AA, electrolytes, nutrients, gases, waste

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6
Q

what does refractometry of plasma measure

A

total solids

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7
Q

what does PCV measure

A

direct measure of RBC mass

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8
Q

what does blood smear evaluate

A

whole blood

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9
Q

What hematology basic tests should you run with critical patients

A
  1. Gross evaluation (plasma color)
  2. Total solids
  3. PCV
  4. Analyzer
  5. Blood smear
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10
Q

what cells are included in erythroid line and where are they located

A
  1. Precursor erythroid cells in bone marrow
  2. RBC’s in sinuses in the spleen, liver, and bone marrow
  3. RBC’s in circulation
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11
Q

what is function of Hbg

A

carry oxygen

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12
Q

what form of iron is required to carry oxygen

A

reduced, FE2+

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13
Q

hemoglobin transports oxygen from ___ to __

A

lungs to tissues

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14
Q

in healthy patients hgb is __% saturated with O2 in arterial blood

A

100%

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15
Q

what is methemoglobin and what is the consequence of that

A

hemoglobin bound to oxidized iron/Fe3+

Can’t carry oxygen

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16
Q

how does acetaminophen affect hgb function in cats

A

gets converted to toxic intermediate which leads to oxidation of iron to Fe3+ and therefore can’t carry oxygen

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17
Q

Erythrocyte production depends on __which depends on available __

A

Hgb, iron

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18
Q

where does hematopoietic mostly occur in vertebrates

A

bone marrow

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19
Q

what species does hematopoiesis not occur in bone marrow

A

amphibians and fish

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20
Q

what is the first microscopically recognizable erythroid cell

A

CFU-E

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21
Q

what are the major sites of extramedullary hematopoiesis

A

spleen, liver

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22
Q

what hormones are promoters of erythropoiesis

A

erythropoietin, corticosteroids, thyroxine

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23
Q

what nutritional factors are promoters of erythropoiesis

A

iron, copper, cobalamin (vit B12), vitamin B6, folate (vitB9)

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24
Q

where is erythropoietin produced

A

kidney

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25
Q

what stimulates erythropoietin production

A

tissue hypoxia

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26
Q

how does chronic renal failure affect erythropoietin production

A

decreases and results in non-regenerative anemia

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27
Q

what are the 3 inhibitors of erythropoiesis

A
  1. Estrogen (tumors, pills, creams)
  2. TNF
  3. IL-6
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28
Q

how does TNF and IL-6 inhibit erythropoietin and what is the result

A

inflammation causes reduction and you get anemia of inflammatory/chronic disease

Non-regenerative anemia

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29
Q

what is the name for the last stage in which developing RBC is uncleared

A

metarubicyte/ nRBC

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30
Q

what are the stages of erythrocyte development

A
  1. Metarubicyte
  2. Reticulocyte
  3. Mature erythrocyte
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31
Q

what is the appearance of a reticulocyte

A

anucleate, less mature, more blue

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32
Q

how is erythrocyte maturation characterized

A
  1. Decrease in cell size
  2. Decrease in nuclear size
  3. Decrease cytoplasmic basophilia
  4. Extrusion of nuclei
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33
Q

why causes the decrease in cytoplasmic basophilia

A

loss of ribosomes, increased hemoglobin

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34
Q

what is time from erythropoietic progenitor cell to reticulocyte in most species

A

3-5 days

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35
Q

what are the stages of erythrocyte development indicated by 1-2

A
  1. Metarubicyte
  2. Reticulocyte
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36
Q

what are the two mechanisms of RBC removal

A
  1. Major: phagocytosis by macrophages
  2. Minor: intravascular lysis with release of Hgb into plasma
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37
Q

what are some indications for bone marrow cytology and bone marrow core biopsy

A
  1. Persistent, unexplained leukopenia, thrombocytopenia, non-regenerative anemia
  2. Bicytopenia or pancytopenia
  3. Unexplained, inappropriate metarubicytosis
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38
Q

what does a CBC assess

A

erythrocytes, leukocytes, platelets

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39
Q

what tubes are used for CBC

A
  1. EDTA (purple top)
  2. Lithium heparin (green top)
  3. Sodium citrate (blue top)
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40
Q

how does a EDTA tube work

A

anticoagulant that chelates calcium to stop clotting cascade

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41
Q

what is the most often tube used for mammal CBC

A

EDTA/ purple top

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42
Q

what is the preferred tube for CBC’s in reptiles, birds, amphibians and fish

A

lithium heparin (green top)

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43
Q

what is a sodium citrate tube used for

A

coagulation profiles (PT, PTT, ACT), platelet count

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44
Q

Reference intervals represent __% of healthy individuals in that species

A

95%

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45
Q

___% of healthy individuals will have above or below reference interval

A

2.5%

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46
Q

define anemia and what test do you use/what is result

A

decrease RBC mass
Tests: decrease PCV or HCT

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47
Q

what test do you trust more for evaluating anemia PCV or HCT

A

PCV

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48
Q

what is erythrocytosis and how do you measure/what is result

A

elevated RBC mass
Tests: elevated PCV or HCT

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49
Q

what is PCV and how do you determine it

A

direct measurement of RBC mass
Determined by centrifugal ion

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50
Q

what is hematocrit/HCT

A

calculated value of RBC mass

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51
Q

what is reticulocytosis and what does it indicate

A

increased reticulocytes in circulation
Indicates regeneration/none marrow response to anemia

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52
Q

what is mean corpuscular volume/MCV

A

average size of circulating RBC’s

53
Q

what is mean corpuscular hemoglobin concentration (MCHC)

A

average hemoglobin concentration in circulating RBC’s

54
Q

what is anisocytosis

A

change in RBC size

55
Q

what are poikilocytes

A

atypical RBC morphology shapes

56
Q

what is poikilocytosis

A

increased variation in RBC shape

57
Q

what are polychromatophils

A

immature, anucleate RBC

58
Q

how do polychromatophils appear on smear

A

larger, more purple and blue in color

59
Q

all polychromatophils are __but not all __ are polychromatophils

A

reticulocytes, reticulocytes

60
Q

what is polychromasia

A

variation of RBC color on the smear

61
Q

PCV is percentage of __

A

blood volume filled by erythrocytes

62
Q

HCT or PCV: percentage of blood volume filled by erythrocytes, calculated by analyzer

63
Q

average size of patients RBCs= __

64
Q

MCV above RI=

A

macrocytosis

65
Q

MCV normal =

A

normocytosis

66
Q

MCV below RI

A

microcytosis

67
Q

chromasia is assessed via analyzer as __

A

MCHC (mean corpuscular hemoglobin concentration) (color)

68
Q

If MCHC normal=

A

normochromia

69
Q

if MCHC is below RI=__. What does that mean

A

hypochromasia
Less hemoglobin in RBC’s

70
Q

if MCHC is above RI=__. What does that mean

A

hyperchromasia
LIAH!!
Lipemia, intravascular hemolysis, agglutination, Heinz bodies

71
Q

MCHC indicates this sample as hyperchromasia. What is wrong

A

Hyperlipidemia- increased triglycerides

72
Q

normal or abnormal plasma

73
Q

normal or abnormal serum in dog/cat. What is cause

A

abnormal/yellow- increased bilirubin

74
Q

what species is yellow serum normal in

A

horse and cattle (Carotenoids)

75
Q

normal or abnormal serum. What cause

A

abnormal/ pink to red
Increased free Hgb due to traumatic collection or intravascular hemolysis

76
Q

what can artificially elevated total solids

A

dehydration, lipemia, marked hyperglycemia

77
Q

if total solids is below RI what does that mean

A

loss or lack of production

78
Q

if total solids is above RI what does that mean

A

increased production or hemoconcentration

79
Q

what are the two ways to measure protein

A
  1. Total solids/plasma protein in purple top tube on refractometer
  2. Serum protein- red top tube
80
Q

in healthy animals plasma protein and serum protein are __

81
Q

t or f: can determine PCV via CBC

A

false via centrifugal method

82
Q

HCT and PCV should be ___x the hgb concentration

83
Q

what is the only way to determine RBC morphology

A

stained blood film made from blood collected in EDTA tube for a CBC

84
Q

what does a stain blood film allow you to do

A
  1. Confirm that CBC data from analyzer is correct
  2. Determine cause of certain diseases
  3. Helps identify infectious organisms
  4. Identification of neoplastic cells
85
Q

stained blood film/smear should be performed in who

A
  1. Critically ill patients
  2. Patients with suspected hemoparasites, neoplastic cells
86
Q

what is average size of dog and cat normal erythrocyte

A

cat: 6um
Dog: 7um

87
Q

what are the morphology details of dog RBC

A

7um, prominent central pallor

88
Q

what are the morphology details of cat RBC

A

6um, slight central pallor in some RBC’s, <10% heniz bodies

89
Q

what are the morphology details of horses RBC’s

A

5-6um, no central pallor, rouleaux

90
Q

what are morphology details of cattle RBC’s

A

5um, no central pallor

91
Q

match 1-4 with species the RBC’s are from and what is circled in 3

A
  1. Dog
  2. Cat
  3. Horse (circle- rouleaux)
  4. Cattle
92
Q

what is the morphology of camelid RBC’s

A

oval shaped erythrocytes

93
Q

what is morphology of deer erythrocytes

A

sickle shaped erythrocytes (in vitro change)

94
Q

what species match erythrocytes 1-2

A
  1. Camelids
  2. Deer
95
Q

what is morphology for birds, reptiles, amphibians and fish RBC’s

A

nucleated, oval shaped

96
Q

what species do these RBC match

A

Birds, reptiles, amphibians and fish

97
Q

what is shape for acanthocytes

A

erythrocytes with blunt or boot shaped spicules, tip of projection wider than base

98
Q

what are some mechanisms for acanthocyte development

A
  1. Alterations in erythrocyte membrane lipid content (liver disease)
  2. Fragmentation injury (hemagiosarcoma, other cancer, iron deficiency anemia, DIC)
99
Q

what cells are boxed

A

acanthocytes

100
Q

what species are codocytes mostly seen in

101
Q

t or f: codocytes can sometimes be normal finding and are often non-specific

102
Q

what diseases can you see codocytes with

A

liver disease, hypothyroidism

103
Q

what cells are seen here

A

Codocytes/target cells

104
Q

what are echinocytes

A

erythrocytes with pointed spicules/projections, tip of projection is narrower than base

105
Q

what is major mechanism for echinocyte development

106
Q

what diseases are associated with echinocytes

A
  1. Viperidae snake envenomation
  2. Dogs with renal disease
107
Q

what cells are seen here

A

Echinocytes

108
Q

what are keratocytes

A

Erythocytes with ruptured blister vesicle

109
Q

what are pre-keratocytes

A

erythrocytes with intact blister vesicle

110
Q

what are keratocytes and pre-keratocytes associated with

A
  1. Low numbers- normal
  2. Liver disease in cats- hepatic lipidosis
  3. Non specific to fragmentation injury
111
Q

what cells are indicted by 1-2

A
  1. Pre-keratocytes
  2. Keratocytes
112
Q

what are schistocytes

A

erythrocyte fragments

113
Q

what is the mechanism for schistocytes

A

fragmentation process (only cell specific to fragmentation)

114
Q

what diseases are associated with schistocytes

A
  1. DIC
  2. Severe iron deficiency
  3. Severe hypophosphatemia
  4. Diseases with turbulent blood flow: pyelonephritis, cardiac disease
115
Q

what cells are indicated by arrows

A

Schistocytes

116
Q

what are spherocytes

A

small erythrocytes that have no central pallor

117
Q

what do spherocytes indicate and what disease associated with

A

extravascular hemolysis, IMHA

118
Q

From dog- what cell types indicate by 1-3

A
  1. Polychromatophils
  2. Normal RBCs
  3. Spherocytes- extravascular hemolysis/ IMHA
119
Q

what are eccentrocytes

A

hemoglobin condensed at one side of cell and cytoplasm is eccentric to one side

120
Q

what are some causes of eccentrocytes

A

Oxidative injury, intravascular hemolytic anemias
1. Acetaminophen toxicity
2. Red maple leaf toxicity (horses)
3. Zinc toxicity
4. Copper toxicity (sheep)

121
Q

what indicated by arrows

A

eccentricities

122
Q

what are Heinz bodies

A

denatured or precipitated hemoglobin

123
Q

what are some causes of Heinz bodies

A

oxidative damage, intravascular hemolytic anemias
Acetaminophen toxicity, red maple leaf toxicity, zinc toxicity, copper toxicity

124
Q

old cat diseases associated with endogenous oxidative injury see <__% Heinz bodies

125
Q

what are some causes of Heinz bodies <30% in old cats

A
  1. DM
  2. Hyperthyroidism
  3. Lymphoma
126
Q

what are ghost cells

A

represent RBC’s that have ruptured in the circulation, losing their hemoglobin but RBC’s remain

127
Q

what are some causes of ghost cells

A

Intravascular hemolysis-
1. IMHA
2. Toxins/oxidative damage- acetaminophen, red maple, copper, zinc
3. Venom

128
Q

what cells indicated by the arrows

A

Ghost cells

Clinical Pathology (6 decks)

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