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lab d > rbc > Flashcards

rbc Flashcards

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
Q

variation in mvc

A
  • horse, cat have smaller rbc
  • young have larger, old have smaller
  • akita have small
  • poodle have large
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26
Q

causes of microcytosis

A
  • chronic blood loss
  • iron, copper, pyridoxine deficiency
  • portosystemic shunt
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27
Q

causes of macrocytosis

A
  • !! mostly regenerative anemia
  • polycytaemia absoluta vera
  • vit b12, folic acid, cobalt deficiency
  • erythroleukemias
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28
Q

mean corpuscular hemoglobin concentartion

A
  • indicate avrg hgb conc of erythrocytes
  • hyper, normo, hypo chromic rbc
  • hgb/ pcv = mch/mcv = mchc
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29
Q

mchc horse, ru, dog, cat

A
  • horse: 31-37 %
  • ru: 30-36%
  • dog: 32-36%
  • cat: 30-36%
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30
Q

normal mchc

A

300- 350 g/l aka 30-35%

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31
Q

decreased mchc

A
  • hypochromasia
  • new born
  • regenerative anemia
  • iron deficiency anemia
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32
Q

increased mchc

A
  • hyperchromasia
  • erythroleukemia
  • b12, folic acid, cobbalt deficiency
  • immunohemolytic anemia
  • lead poisoning
  • splenectomy
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33
Q

what happens if the animal has macrocytemia, hypochromasia and high number of erythrocytes?

A

high mvc, low mchc

regenertive anemia

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34
Q

what happens if the animal has normocytemia, normochromasia and normal or decreased mch

A

normal mvc and mchc

non regenerative anemia

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35
Q

what happens if the animal has microcytaemia, hypochromasia (decreased hb synthesis)

A

low mvc, low mchc

  • iron, copper, piridoxine deficiency anemias
  • liver failiure
  • portosystemic shunt
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36
Q

what happens if the animal has microcytaemia, normochromasia

A

low mvc, normal mchc

a normal japanese akita doggo

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37
Q

what happens if the animal has macrocytaemia, normochromasia (impaired dna synth)

A

high mvc, normal mchc

  • felv
  • b12, copper, folic acid deficiecy
  • erythroleukemia
  • poodle macrocytosis
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38
Q

red cell distribution width, platelet distribution width

A

where the curve crosses the 20% line -> p1, p2

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39
Q

rdw dog and cat

A
  • rdw dog: 12-16%

- red cat: 14-18%

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40
Q

pdw dog, cat

A
  • pdw dog: 6-8%

- pdw cat: 7-12 %

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41
Q

what does short/long rdw mean?

A
  • short rdw means non regenerative process

- long rdw means regenerative process

42
Q

how does brylliant-cresil stained rbcs look like?

A
  • 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
Q

what is appearance of reticulocytes a sign of?

A

regenerative process

44
Q

function of rbcs

A
  • reticulocytes work as mature rbc, bind o2

- young nucleated rbc cannot bind o2

45
Q

what can cause maturation arrest?

A
  • b12 deficiency
  • folic acid deficiency
  • felv
46
Q

wich cell do we count to check if its regen or non regen

A

reticulocytes, not nucleated rbc

47
Q

regenerative anemia

A
  • good prognosis
  • enough new rbcs produced in bone marrow to replace loss
  • severe anemia - more intensive prod
48
Q

what smaple is used for brylliant cresin staining

A

1:4 na-citrate whole blood

49
Q

what sample is used for vital staining

A

1:4 fresh whole EDTA blood

50
Q

how do we count reticulocytes?

A

count 100-1000 rbc and take percentage of reticulocytes

51
Q

normal reticulocyte count

A

2-3%

52
Q

why should we double check the reticulocyte count or pvc? correction

A
  • 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
Q

corrected reticulocyte count

A
  • reticulocyte % x rbc count

- normal is less than 0,06 x terra per litre

54
Q

corrected reticulocyte percentage

A
  • (Ht patient / Ht average) x reticulocyte %
  • normal: less than 1-2 %
  • ( normal Ht dog 0,45, cat 0,37)
55
Q

causes of increased reticulocyte count

A
  • regenerative anemias: acute or chronic blood loss, haemolytic anemia, nutrient deficiencies
56
Q

what does osmotic resistance of rbc depend on?

A
  • ph of plasma
  • temperature
  • osmotic concentration of plasma and reagents
  • rbc membrane status
  • regenerative status
  • hbf content of rbc
57
Q

what does osmotic resistance analysis test?

A
  • membrane function
  • specific damage
  • physical damage
58
Q

what causes decreased rbc membrane resistance?

A
  • chronic haemolytic anemia: extravascular hemolysis,
  • chronic immunomediated hemolytic anemia
  • pyruvate kinase or glucose 6P dehydrogenase deficiency
    methemoglobin reductase deficiecy
59
Q

dilution line test

A

make nacl dilution line 0,3% to 2,5%
drip blood samples into different concentrations
centrifuge and check upper layer for hemolysis

60
Q

three test tube test

A
  • 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
Q

what do we expect to happen in tube 1

A

some hemolysis occur if there is an intravasal hemolytic crisis eg babesia

62
Q

what do we expect to happen in tube 2

A

severe hemolysis

63
Q

what do we expect to happen in tube 3

A

nothing should happen, this is control tube! if anything happens, you fucked up hehe

64
Q

what sample do you use for smears

A

fresh samples

65
Q

what gross signs do we check in a smear

A
  • rouleau formation - coin formation often in horse
  • rbc aggregates
  • large cells often in horse
  • thrombocyte aggregations
66
Q

explain intense staining of smear

A
  • polychromasia and hyperchromasia
  • more hgb in rbc
  • rna or nuclear remnants
  • regenerative
67
Q

explaine weak staining of smear

A
  • hypochromasia
  • low hgb content
  • iron and other nutrient deficiency
68
Q

name the different size/shapes of rbc

A
  • macrocytosis: large cells
  • microcytosis: small cells
  • anisocytosis: variable size, iron def, regenerative
  • poikylocytosis: variable shape and color
69
Q

name young nucleated rbcs

A
  • proerythroblast
  • basophil erythroblast: normocyte, normoblast
  • polychromatophil erythroblast: normocyte/blast
  • acidophil erythroblast: normo..,
70
Q

young but mature rbc

A

reticulocyte

71
Q

what does appearance of young rbc tell us?

A
  • regenerative anemia
  • spleen or bone marrow disease
  • leukemia
  • extramedullar erythrocyte prod
  • lead toxicosis
72
Q

name the various forms of adult rbcs

A
  • reticulocyte
  • spherocyte
  • stomatocyte
  • acanthocyte
  • schysocyte
  • anulocyte
  • codocyte
  • echynocyte
  • sickle cell
73
Q

reticulocyte

A
  • regenerative anemia
  • chronic iron def
  • hemolysis
  • acute or chronic blood loss
74
Q

spherocyte

A

sensitive rbc membrane

- immunomediated hemolysis

75
Q

stomatocyte

A
  • increased prod, regenerative
76
Q

acanthocyte

A
  • rbc membrane failiure
  • lipid metabolism disorder
  • hepatopathies
77
Q

schysocyte

A

traumatic or toxic damage

- uremia, parasites, dic

78
Q

anulocyte

A

iron deficiency anemia

79
Q

codocyte

A

regenerative process

80
Q

echynocyte

A

lab error

81
Q

sickle cell

A

rbc damage

hb globin chain malformation

82
Q

name the inclusion bodies

A
  • heinz body
  • howell-jolly body
  • basophilic punctuates
  • hb inclusions
83
Q

heinz body

A
  • o2 effect, oxidative damage to rbc

- cat, methemoglobinaemia

84
Q

howell-jolly body

A
  • b12 deficiency
  • increased production
  • splenectomy
85
Q

basophilic punctuates

A
  • regenerative process
  • young rbc of cat
  • physiological in ruminants
  • lead poisoning
86
Q

hb inclusions

A
  • hb damage
  • increased rbc prod
  • regenerative anemia
87
Q

name three rbc parasites

A
  • babesia spp
  • ehrlichia canis
  • dirofilaria immitis
88
Q

serum iron measurement what do we test, normal value

A
  • if we suspect iron deficiency, this test proves it

- normal sefe 18-20 mikromol/l

89
Q

iron metabolism

A
  • 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
Q

transferrin

A

only 30% saturated

acute phase protein produced in liver

91
Q

ferritin

A

store iron in spleen, liver and bone marrow

also in macrophage cells but less utilizable

92
Q

what sample do we need for serum iron measrement and why

A

serum sample, because fibrinogen content of plasma may disturb measurement

93
Q

causes of low serum iron conc

A
  • chronic blood loss
  • decreased intake
  • impaired gastric, duodenal, jejunal function
94
Q

causes of high iron content

A

iron toxicosis

95
Q

total iron binding capacity test

A
  • 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
Q

normal tibc

A

50-80 mikromol per litre

97
Q

causes of low tibc

A
  • chronic inflammation
  • chronic liver failiure
  • neoplastic disease
98
Q

causes of high tibc

A
  • iron deficiency anemia
  • not severe: normal iron level, high tibc
  • severe: low iron level, high tibc
99
Q

iron saturation equation and normal value

A
  • (sefe / tibc) x 100

- normal 20-55%

100
Q

lab findings in hemolysis

A

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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