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rbc Flashcards

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1
Q

what are the most important parameters?

A

rbc count and hemoglobin concentration and or function

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2
Q

sample for spectrophotometric hgb count

A

whle blood sample

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3
Q

spectrophotometric hgb count - what is reagent and what does it do?

A

K3Fe(SCN)6

hemolyse rbc and turn fe2+ to fe3+

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4
Q

spectrophotometric hgb count - equation and normal range

A

(Esample/Estandard)x standard conc

normal: 18-20 mmol/l or 12-18 g/dl

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5
Q

spectrophotometric hgb count - what is measured?

A

sum of hgb from hemolysed blood and free hgb from plasma

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6
Q

ox binding capacity of hgb increased by:

A
  • decreased 2,3 dgp level in rbc
  • decreased pCO2 in blood - resp alkalosis
  • increased pH in blood - alkalosis
  • decreased temp - hypothermia
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7
Q

ox binding capacity of hgb decreased by:

A
  • increased 2,3 dpg level in rbc
  • increased pCO2 - resp acidosis
  • decreased pH - acidisis
  • increased temp - hyperthermia
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8
Q

oxygen saturation

A

amount of oxygenated hgb compared to whole sample

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9
Q

a/v sat

A

arterial: 95-99%
venous: 80-90%

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10
Q

methemoglobinemia

A

high amt of methemoglobin due to oxidative damage
nitrite, free radicals, paracetamol, onion
improper function of methemoglobin reductase enzyme

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11
Q

causes of increased hgb conc

A
  • relative polycytaemia - dehydration

- absolute polycytaemia

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12
Q

causes of decreased hgb conc

A
  • relative oligocytaemia - hyperhydration

- absolute oligocytaemia - anemia

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13
Q

rbc burker chamber

A
  • edta anticoagulated blood
  • 200x dilution
  • divide nr of counted cells by 100, that give the number in tetra per litre
  • poor accuracy10-25% error
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14
Q

estimated rbc

A
  • if normal rbc volume is suspected

- (ht l/l / 5) x 100 = rbc terra/l

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15
Q

rbc by automatic cell counter

A
  • impedance correlated with size
  • counted as rbc if between 40-100 fl
  • aggregated rbc not counted (immunohaemolytic anemia)
  • cold agglutination
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16
Q

normal rbc count

A

4,5-8 tera per liter

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17
Q

derivative parameters - what test do we need?

- what information do we get?

A
  • ht
  • packed cell volume
  • rbc count
  • hgb concentration
  • info about avg size and colour of rbc
  • humn, dogs, maybe cats
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18
Q

Mean corpuscular haemoglobn - mch

A
  • indicate average hgb content of rbc

- hgb g/L / rbc count terra per liter = mch

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19
Q

normal mch

A
  • 12-30 pg

- young animals 28-32 pg

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20
Q

increased/ decreased mch

A
  • inc: hyperchromasia

- dec: hypochromasia

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21
Q

mch value horse, rominant, dog, cat

A
  • horse: 12-20 pg
  • ru: 8-17 pg
  • dog: 15-24 pg
  • cat: 13-17
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22
Q

mean corpuscular volume

A
  • indicate average size of rbc
  • macro, normo, micro - cytic rbc
  • pcv / rbc count x 1000 = mvc fl
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23
Q

mcv horse, ru, dog, cat

A
  • horse: 37-58 fl
  • ru: 42-52 fl
  • dog: 63-75 fl
  • cat: 40-53 fl
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24
Q

normal mvc

A

60-70 fl

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25
variation in mvc
- horse, cat have smaller rbc - young have larger, old have smaller - akita have small - poodle have large
26
causes of microcytosis
- chronic blood loss - iron, copper, pyridoxine deficiency - portosystemic shunt
27
causes of macrocytosis
- !! mostly regenerative anemia - polycytaemia absoluta vera - vit b12, folic acid, cobalt deficiency - erythroleukemias
28
mean corpuscular hemoglobin concentartion
- indicate avrg hgb conc of erythrocytes - hyper, normo, hypo chromic rbc - hgb/ pcv = mch/mcv = mchc
29
mchc horse, ru, dog, cat
- horse: 31-37 % - ru: 30-36% - dog: 32-36% - cat: 30-36%
30
normal mchc
300- 350 g/l aka 30-35%
31
decreased mchc
- hypochromasia - new born - regenerative anemia - iron deficiency anemia
32
increased mchc
- hyperchromasia - erythroleukemia - b12, folic acid, cobbalt deficiency - immunohemolytic anemia - lead poisoning - splenectomy
33
what happens if the animal has macrocytemia, hypochromasia and high number of erythrocytes?
high mvc, low mchc | regenertive anemia
34
what happens if the animal has normocytemia, normochromasia and normal or decreased mch
normal mvc and mchc | non regenerative anemia
35
what happens if the animal has microcytaemia, hypochromasia (decreased hb synthesis)
low mvc, low mchc - iron, copper, piridoxine deficiency anemias - liver failiure - portosystemic shunt
36
what happens if the animal has microcytaemia, normochromasia
low mvc, normal mchc | a normal japanese akita doggo
37
what happens if the animal has macrocytaemia, normochromasia (impaired dna synth)
high mvc, normal mchc - felv - b12, copper, folic acid deficiecy - erythroleukemia - poodle macrocytosis
38
red cell distribution width, platelet distribution width
where the curve crosses the 20% line -> p1, p2
39
rdw dog and cat
- rdw dog: 12-16% | - red cat: 14-18%
40
pdw dog, cat
- pdw dog: 6-8% | - pdw cat: 7-12 %
41
what does short/long rdw mean?
- short rdw means non regenerative process | - long rdw means regenerative process
42
how does brylliant-cresil stained rbcs look like?
- reticulocytes are young differentiated rbc with basophil punctates after rrna - reticulocytes with big blue aggregates are younger - cats have punctated form . horse and ru dont have reticulocytes in peripheral blood
43
what is appearance of reticulocytes a sign of?
regenerative process
44
function of rbcs
- reticulocytes work as mature rbc, bind o2 | - young nucleated rbc cannot bind o2
45
what can cause maturation arrest?
- b12 deficiency - folic acid deficiency - felv
46
wich cell do we count to check if its regen or non regen
reticulocytes, not nucleated rbc
47
regenerative anemia
- good prognosis - enough new rbcs produced in bone marrow to replace loss - severe anemia - more intensive prod
48
what smaple is used for brylliant cresin staining
1:4 na-citrate whole blood
49
what sample is used for vital staining
1:4 fresh whole EDTA blood
50
how do we count reticulocytes?
count 100-1000 rbc and take percentage of reticulocytes
51
normal reticulocyte count
2-3%
52
why should we double check the reticulocyte count or pvc? correction
- older rbcs are more sensitive to damage and may die faster, then we can only find younger cells - when we need to concider the severity of the anemia. to differentiate regenerative and non regenerative anemias
53
corrected reticulocyte count
- reticulocyte % x rbc count | - normal is less than 0,06 x terra per litre
54
corrected reticulocyte percentage
- (Ht patient / Ht average) x reticulocyte % - normal: less than 1-2 % - ( normal Ht dog 0,45, cat 0,37)
55
causes of increased reticulocyte count
- regenerative anemias: acute or chronic blood loss, haemolytic anemia, nutrient deficiencies
56
what does osmotic resistance of rbc depend on?
- ph of plasma - temperature - osmotic concentration of plasma and reagents - rbc membrane status - regenerative status - hbf content of rbc
57
what does osmotic resistance analysis test?
- membrane function - specific damage - physical damage
58
what causes decreased rbc membrane resistance?
- chronic haemolytic anemia: extravascular hemolysis, - chronic immunomediated hemolytic anemia - pyruvate kinase or glucose 6P dehydrogenase deficiency methemoglobin reductase deficiecy
59
dilution line test
make nacl dilution line 0,3% to 2,5% drip blood samples into different concentrations centrifuge and check upper layer for hemolysis
60
three test tube test
- tube one 0,9% nacl and sick animal blood - tube two: 0,54% nacl and sick dog, 0,72%nacl and sick cat - tube 3 0,54 or 0,72% nacl and healthy animal
61
what do we expect to happen in tube 1
some hemolysis occur if there is an intravasal hemolytic crisis eg babesia
62
what do we expect to happen in tube 2
severe hemolysis
63
what do we expect to happen in tube 3
nothing should happen, this is control tube! if anything happens, you fucked up hehe
64
what sample do you use for smears
fresh samples
65
what gross signs do we check in a smear
- rouleau formation - coin formation often in horse - rbc aggregates - large cells often in horse - thrombocyte aggregations
66
explain intense staining of smear
- polychromasia and hyperchromasia - more hgb in rbc - rna or nuclear remnants - regenerative
67
explaine weak staining of smear
- hypochromasia - low hgb content - iron and other nutrient deficiency
68
name the different size/shapes of rbc
- macrocytosis: large cells - microcytosis: small cells - anisocytosis: variable size, iron def, regenerative - poikylocytosis: variable shape and color
69
name young nucleated rbcs
- proerythroblast - basophil erythroblast: normocyte, normoblast - polychromatophil erythroblast: normocyte/blast - acidophil erythroblast: normo..,
70
young but mature rbc
reticulocyte
71
what does appearance of young rbc tell us?
- regenerative anemia - spleen or bone marrow disease - leukemia - extramedullar erythrocyte prod - lead toxicosis
72
name the various forms of adult rbcs
- reticulocyte - spherocyte - stomatocyte - acanthocyte - schysocyte - anulocyte - codocyte - echynocyte - sickle cell
73
reticulocyte
- regenerative anemia - chronic iron def - hemolysis - acute or chronic blood loss
74
spherocyte
sensitive rbc membrane | - immunomediated hemolysis
75
stomatocyte
- increased prod, regenerative
76
acanthocyte
- rbc membrane failiure - lipid metabolism disorder - hepatopathies
77
schysocyte
traumatic or toxic damage | - uremia, parasites, dic
78
anulocyte
iron deficiency anemia
79
codocyte
regenerative process
80
echynocyte
lab error
81
sickle cell
rbc damage | hb globin chain malformation
82
name the inclusion bodies
- heinz body - howell-jolly body - basophilic punctuates - hb inclusions
83
heinz body
- o2 effect, oxidative damage to rbc | - cat, methemoglobinaemia
84
howell-jolly body
- b12 deficiency - increased production - splenectomy
85
basophilic punctuates
- regenerative process - young rbc of cat - physiological in ruminants - lead poisoning
86
hb inclusions
- hb damage - increased rbc prod - regenerative anemia
87
name three rbc parasites
- babesia spp - ehrlichia canis - dirofilaria immitis
88
serum iron measurement what do we test, normal value
- if we suspect iron deficiency, this test proves it | - normal sefe 18-20 mikromol/l
89
iron metabolism
- fe3 complexes in food - stomach acid frees iron 3 from complex - duodenum: fe3 to fe2 by ascorbic acid - jejunim mucosa: iron bind to apoferritin, stored as ferritin - in plasma iron is oxidised to fe3 and transported by transferrin
90
transferrin
only 30% saturated | acute phase protein produced in liver
91
ferritin
store iron in spleen, liver and bone marrow | also in macrophage cells but less utilizable
92
what sample do we need for serum iron measrement and why
serum sample, because fibrinogen content of plasma may disturb measurement
93
causes of low serum iron conc
- chronic blood loss - decreased intake - impaired gastric, duodenal, jejunal function
94
causes of high iron content
iron toxicosis
95
total iron binding capacity test
- give info about transferrin content - first measure serum iron, then add fe solution to serum to fully saturate all transferrins - tibc is serum iron content + free transferrin
96
normal tibc
50-80 mikromol per litre
97
causes of low tibc
- chronic inflammation - chronic liver failiure - neoplastic disease
98
causes of high tibc
- iron deficiency anemia - not severe: normal iron level, high tibc - severe: low iron level, high tibc
99
iron saturation equation and normal value
- (sefe / tibc) x 100 | - normal 20-55%
100
lab findings in hemolysis
decreased: - pcv - haptoglobin - rbc osmotic resistance increased: - reticulocytes - total bilirubin - indirect bilirubin - lactate dehydrogenase 1 and 2 - urobillinogen and hgb in urine shape and color: - polychromasia, poikilocytosis - leukocytosis - spherocytosis - jaundace - hyperchromatic stool

lab d (1 decks)

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