Week 1 - Erythrocyte Morphology Flashcards
What blood values are used to detect anemias or erythrocytosis?
HCT or PCV
Anemia classification is based on what factors?
- MCV measures the VOLUME of RBC
* Normocytic
* microcytic (little RBCs)
* macrocytic (large RBC) - MCH & MCHC measures the Hgb in RBCs
* Normochromic
* Hypochromic (little Hbg)
* Hyperchromic (too much Hgb)
What are the main functions of erythrograms? Explain.
- counts mature RBC
* By counting RBC mass in whole blood: HCT, PCV*
* RBC count
* Hgb concentration - counts reticulocytes
* % and absRC to assess for a regeneration by the bone
marrow in response to the anemia; reticulocytes are immature RBC. When there are a large number of reticulocytes, machine calculates how many in sample to determine condition.
HCT and PCV: These have a Difference only ~3%. Should be ~3x Hgb concentration
Case 1
Macrocytic normochromic
AbsRC =
Case 2
elevated HCT = errythrociosis (more RBC than normally in blood).
errythrocytocis = dehydation, breed related (sighthound, HCT ~ mid-60s % is normal), greyhounds, whippet saluki
Case 2 Cont
Case 3
HYPERPROTEINEMIA
What values on bloodwork do we use to evaluate anemia?
How can you accurately determine RBC morphology?
A stained blood film made from blood collected
into an EDTA tube for a CBC is the only way to
accurately determine RBC morphology
* Hematology analyzer can NOT provide this info
What does analyzing RBC morphology allow you to do?
- Allows you to confirm that CBC data
generated by your analyzer is accurate - May help determine the cause of certain
diseases - Helps identify infectious organisms
Zones of a blood smear
image (unable to add at time)
Canine erythrocyte image
What species does this belong to? What type of cells do you see below?
Feline, erythrocyte
What are the differences between canine and feline erythrocytes?
clumping is called Rouleaux
What type of cell is pictured below? What species does it belong to?
Bovine erythrocyte image
What type of cell is pictured below? What species does it belong to?
Equine erythrocyte image
Rouleaux effect is more common in the horse. If you see no rouleaux, examine that horse!!
What are the differences between bovine and equine erythrocytes?
What type of cell is pictured below? What species does it belong to?
Camelid, reticulocyte
What type of cell is pictured below? What species does it belong to?
Avian, reptile, amphibians
large, nucleated, elliptical RBCs.
What process is occurring in the image below? Define this process.
Anisocytosis: Difference in cell size
What are macrocytes? Where/in what situations are they normally found? What value is affected when macrocytes are present?
Big RBCs
* In presence of polychromasia
* in animals with regenerative anemia
* increase MCV if SIGNIFICANT circulating macrocytes
In what situations can normochromic macrocytes be found? In what situations are they less commonly found?
- Horses regenerative anemia
- Less common in
- FeLV
- Less common in inherited disorders
* Mini & Toy Poodles, Poll Hereford cattle
- Less common in deficiencies: Vit B12
* Giant schnauzer
What type of cell is pictured below? What species does it belong to?
Macrocyte image
Camelid
- What are microcytes?
- What values are affected on CBC?
- What is this typically associated with?
- Where/in what situations are they normally found?
- Is this easily seen in blood smears?
- Small RBCs
- On CBC is significant #s of cells –> decreased MCV
- probably associated with Iron deficiency; Usually with concomitantly with low MCHC (hypochromasia), Vit B6 (Pyridoxine) deficiency, Portosystemic shunt
- Normal in healthy: Shiba Inus, Akitas
* ~Young animals sometimes have. Is normal up to x weeks. - Difficult to see in blood smears
Color differences in RBCs indicate what?
Color differences may indicate changes in RBCs Hgb content
- Define polychromasia.
- What does this reflect the presence of?
- In what situations does polychromasia occur?
- What CBC values are effected?
“many colors”
§ Reflects presence of both mature RBCs and reticulocytes
§ Regenerative anemia
§ On CBC, may see decreased MCHC and/or MCH
- Define hypochromasia.
- What is this usually indicative of?
- What values are affected on CBC?
- Less hemoglobin than normal
- Iron deficiency, Lead Toxicity (blocks Hgb Synthesis)
- On CBC: decreased MCHC and/or MCH
Hyperchromasia is _____ appreciated on a blood film. Occurs when there is an increased _____ and/or _____ this is ________.
not, MCHC, MCH, artifactual
What condition is pictured below?
polychromasia
What condition is pictured below? Explain the difference in color.
hypochromasia. No iron which is why they look pale.
Define poikilocytosis. What species normally exhibit this condition?
Differences in erythrocyte shape = poikilocytosis
* normal finding in healthy goats, young cattle, pigs any age
What are the causes of poikilocytosis?
Causes:
* A-Oxidative damage
* B-Fragmentary injury of RBCs
* Diseases, deficiencies
* Artifact, envenomation, arthropods bites
What are Heinz bodies?
Heinz bodies are denatured, precipitated
Hgb caused by oxidative changes.
How can you view heinz bodies in a blood sample?
Heinz bodies are readily visualized if the
blood is incubated for several minutes in
equal volume with New Methylene Blue.
What happens if cats have a low number of heinz bodies?
They can live a perfectly healthy life!
List some specific causes of oxidative damage that can cause erythrocyte shape changes?
Specific causes of oxidative damage:
* Acetaminophen (cats)
* Onion & garlic
* Brassica in ruminants
* Copper poisoning (sheep )
* Zinc
* Red maple leaf, Pistacia (horses)
What is pictured below?
Heinz body
What is pictured below?
Eccentrocytes
What is pictured below?
heinz body
What is pictured below?
Eccentrocytes
What is pictured below?
Heinz bodies
Keratocytes/pre-keratocytes image
caused by fragmentary injury
What is pictured below?
Schistocytes
What is pictured below?
Acanthocytes
List some specific causes of fragmentation injury that can cause erythrocyte shape changes?
- Disseminated intravascular coagulopathy (DIC)
- Hemangiosarcoma
- Cardiac disease
- Diseases that cause turbulent blood flow
What process is depicted below?
Schistocytes
Caused by fragmentary injury
What is pictured below?
Schistocytes
Schistocytes result from? Can be seen in?
- result from shearing by Intravascular Fibrin or
TURBULENT blood flow inside vasculature. - Seen in
- Disseminated intravascular coagulation (DIC)
- Hemangiosarcoma
- Glomerulonephritis
- Myelofibrosis, Vasculitis
What process is pictured below?
Acanthocytes image
caused by fragmentary injury
What is pictured below?
Acantocytes
Acanthocytes result from? Associated with?
- Spiculated RBC result from LIPID alteration of RBC’s
membrane - Associated with
- Hemangiosarcoma
- Glomerulonephritis
- Liver disease
- Lymphoma
What is pictured below?
Keratocytes
What are Keratocytes?
What happens if they rupture?
Seen in what situations?
- They are blister-like vesicles
- If they rupture –> leaving a “bite-shaped” defect in the cell outline or one or two horn-like projections on the same side of the cell.
- Seen in DIC together with Schistocytes
- What is an alternative name for Codocytes?
- Codocytes are seen in what clinical situations?
- Codocytes (“target cells” or Leptocytes)
- Liver disease, Portosystemic Shunt, Lipid disorders, Iron deficiency anemia
What is pictured below?
Codocyte image
What are Echinocytes/crenation?
- Most commonly an artifact [excess amount of EDTA
relative to amount of blood (“short sample”)] - Snake envenomation (rattlesnake, coral snake, vipers)
- form within 24 hours of the snakebite
- This is a useful hematologic marker of this poisoning
What process is seen below?
Echinocytes/crenation
What patterns do you commonly see in cases of DIC?
HSA?
Glomerulonephritis?
Liver Disease?
Describe the morphological structure of Mycoplasma spp.
- Very small (0.1-0.5 um in size)
- Circular, rod-shaped, or ring-shaped forms
- species specific pathogen (felis, canis, etc).
Mycoplasma felis
see some reituclocytes in this image.
Mycoplasma suis
Anaplasma marginale (Ruminant)
reticulocyte has a more bluish tint (left)
Babesia canis & B. gibsoni
infects RBCS
produces mild disease, EV hemolytic anemia
Parasite lyses RBC to complete life cycle
induces a concurrent IMHA
Babesia canis
Babesia gibsoni
Cytauxzoon felis
1-2 um
invased RBC and can be readily missed with low level of paracytemia (more likely in early infection).
Dirofilaria immitis