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Clinical Pathology Exam I
Covers material on exam I
254
Veterinary Medicine
Professional
09/30/2014

Additional Veterinary Medicine Flashcards

 


 

Cards

Term
Anemia
Definition
Decrease in circulating RBC mass
Term
Erythrocytosis
Definition
increase in circulating RBC mass
Term
Erythron
Definition
refers to all stages of developing RBCs in ALL parts of body
Term
Erythrogram
Definition
the portion of the CBC (hemogram) that pertains to red blood cell parameters
Term

RBCs

HgB

MCV

Hct

MCH

MCHC

RDW

Definition
  • concentration of red blood cells in x10^6/microL
  • concentration of hemoglobin molecules in grams/dL
  •  mean cell volume in femtoliters
  • red blood cells as a proportion of blood volume in %
  • mean cell hemoglobin (absolute amount of HgB) in picograms
  • mean cell hemoglobin concentration (average concentration of Hgb per RBC) in g/dL
  • red cell distribution width (index of vairability in RBC width) in %
Term
How do you correct a WBC count for nRBCs?
Definition
WBC(corrected) = WBC(automated)X [#RBC/(#RBC + #nRBC)]
Term
Why do we do a blood smear when we have the automated analyzer?
Definition
1. Detects things analyzer cannot see
2. Cross-check the data put out by analyzer
Term
RBC lifespan of: dog? cat? horses/cow?
Definition
100 days; 70 days; 150 days
Term
Most RBCs at the end of their life are disposed how?
Definition
EVH- they are phagocytosed by macrophages in the spleen
Term
4 reasons for normal RBC turnover:
Definition
1. decreased mechanical deformability
2. binding of Ig or complement
3. oxidative damage
4. exposure of phosphatiylserine on the outer membrane leaflet
Term
Talk through IVH:
Definition
RBCs are lysed in the bloodstream. Divides from a tetramer into two dimers. Dimers are bound to haptoglobin. Complex taken up by macrophages in the liver.
Term
How do hemoglobinemia and hemoglobinuria occur? In which type of hemolysis?
Definition
if free hemoglobin exceeds the binding capacity of haptoglobin it will be grossly detectable in blood. can also pass through glomerulus and be grossly present in urine
Term
Why can IVH cause hemoglobinemia but EVH cannot?
Definition
Red blood cells are broken down in the bloodstream, therefore hemoglobin is released in the bloodstream. EVH occurs in the spleen
Term
Plasma
Definition
fluid/acellular component of circulating blood- harvested after centrifugation in an anticoagulated sample-- HAS FIBRINOGEN
Term
Serum
Definition
fluid component of blood that has been harvested after centrifugation of coagulated sample- LACKS FIBRINOGEN
Term
Plasma is collected in these three tubes:
Definition
1. EDTA (PURPLE) for CBC & total plasma prot.
2. Heparin (GREEN) for chem profile
3. Citrate (BLUE) for coagulation tests
Term
Whole blood is also collected for CBC and total plasma protein in this kind of tube
Definition
EDTA- purple top
Term
Serum is collected in these two tubes:
Definition
1. Clot tube (RED) for chem profile, endocrine tests
2. Serum separator (TIGER) for chem profile, endocrine tests
Term
Chem profile can be done with either ______ or ______.
Definition
heparinized plasma or serum
Term
Colloidal particles are:
Definition
macromolecules (proteins) that are too small to settle out due to gravity, but too large to permeate cell membranes (capillary walls)
Term
COP/oncotic pressure is due mostly to what protein?
Definition
Albumin
Term
Principal force opposing the exit of fluid from vascular space:
Definition
colloidal osmotic pressure
Term
What are two sources of circulating proteins?
Definition
1. hepatocytes (albumin, alpha, beta globulins, coagulation factors)
2. lymphoid tissue (b lymphocytes and plasma cells produce immunoglobulins)
Term
In a plasma sample, Total Proteins = _____+_____+_____
Definition
albumin + globulins +fibrinogen
Term
In a serum sample, Total Proteins = ____+______
Definition
albumin + globulins
Term
Though there are many diverse proteins circulating, they are present in __________________ .
Definition
very small quantities.
Term
Globulins = _____+_____+_____
Definition
alpha glob + beta glob + gamma glob
Term
Three methods to measure total proteins:
Definition
1. Refractometer
2. Biuret method
3. dye-binding and precipitation methods
Term
Lipemic plasma will result in which artifact?
Definition
Falsely elevated TP
Term
Where is the line of demarcation on the refractometer?
Definition
Interface of light and dark
Term
What is the biuret method of measuring total protein?
Definition
colorimetric, spectrophotometric; detects peptide bonds; highly specific for protein measurement
Term
This is used to quantify very small protein amounts in urine and CSF
Definition
precipitation and dye-binding methods
Term
How is albumin measured in vet med? Human med?
Definition
Dye-binding method using bromcresol-green. In humans, bromcresol-purple/
Term
In which species does albumin not bind BCG well?
Definition
Non-mammalian
Term
What protein component can be calculated, measured by serum protein electrophoresis, or "stallside" kits
Definition
globulins
Term
What is the equation for globulin calculation?
Definition
Total proteins - albumin = globulins
Term
By which two methods can you measure fibrinogen?
Definition
1. Thrombin time
2. Heat precipitation method
Term
Which test is used to determine HYPERfibrinogenemia in large animals?
Definition
Heat precipitation
Term
Describe the steps in heat precipitation method of measuring fibrinogen:
Definition
1. fill two microcapillary tubes with blood
2. centrifuge both
3. measure TP of one tube using refractometer
4. incubate other tube in hot water bath for 3-9 minutes
5. recentrifuge this tube (fibrinogen, if present would be white precipitate in plasma layer)
6. measure this tube using refractometer
7. Fibrinogen = TP in tube 1 - TP in tube 2 x 1000 (mg/dL)
Term
Which test is the test of choice if you suspect HYPOfibrinoginemia?
Definition
Thrombin time (a timed coagulation test)
Term
Describe the process of protein electrophoresis.
Definition
1. Electric current applied to cellulose acetate strip
2. proteins separate according to electrical charge, weight, shape
3. separated proteins appear as bands on a tracing
Term
Which protein represents the darkest band/tallest peak on a normal protein electrophoresis?
Definition
albumin
Term
What is the most common cause of hyperproteinemia?
Definition
Dehydration (relative)
Term
What are possible causes of hyperglobulinemia?
Definition
Infection, inflammation (will also see increased fibrinogin), neoplasia
Term
Gammopathy:
Definition
non-specific term referring to an increase in globulin concentration
Term
What is the second most common cause of hyperproteinemia?
Definition
Inflammation (infectious or noninfectious)
Term
Absolute increase in albumin is ____ but can be due to: _______
Definition
RARE; glucocorticoids
Term
Positive acute phase reaction:
Definition
increased within hours of inflammatory stimulus and persists as long as stimulus is present
Term
4 examples of acute phase proteins:
Definition
1. alpha, beta -1 and -2 proteins,
2. fibrinogin
3. serum amyloid a
4. c-reactive protein (CRP)
Term
Negative acute phase proteins:
Definition
synthesis of these proteins are decreased in the face of a stimulus within days to weeks
Term
Name two negative acute phase proteins:
Definition
1. albumin
2. tansferrin
Term
Delayed response:
Definition
chronic antigenic stimulation causes production of these 1-3 weeks after inflammation onset
Term
Examples of delayed response proteins:
Definition
1. immunoglobulins
2. complement
Term
How is polyclonal gammopathy characterized?
Definition
Broad based peak in the gamma-globulin region
Term
What does polyclonal gammopathy imply diagnostically?
Definition
Chronic inflammation
Term
What does monoclonal gammopathy diagnostically imply?
Definition
cancer
Term
How is monoclonal gammopathy characterized?
Definition
Tall, narrow peak in the beta or gamma globulin area! because the globulin proteins are antigenically and electrophoretically identical
Term
Define oligoclonal gammopathy.
Definition
multiple IgG types migrate to the same space- also known as a restricted polyclonal gammpathy
Term
In what instances will you see oligoclonal gammopathy?
Definition
There are several infectious diseases that cause this:
1. FIP
2. canine erlichiosis
3. canine leishmaniasis
Term
What is an important indicator of acute inflammation in horses?
Definition
Hyperfibroginemia
Term
What do you expect to see in relative hypoproteinemia?
Definition
All plasma proteins diluted proportionately. Can occur with overhydration or CHF.
Term
Hypoalbuminemia: four means of increased loss from vascular space:
Definition
1. hemorrhage (glob & alb) 2. Protein losing nephropathy (only alb) 3. Protein losing enteropathy (alb & glob) 4. Severe exudate of skin (alb & glob)
Term
Hypoalbuminemia: means of loss by decreased liver synthesis:
Definition
1. hepatic insufficiency
2. cachexia
3. inflammation
4. neoplasia
Term

Which condition is characterized by these routine lab abnormalities?

 

↓ Na and Cl

↑ K

↑ urea, creatinine, P

↓ glucose

↑ Ca

Low USG

↑ Lymphocytes

↓ RBCs, Hct, Hgb

Definition
Hypoadrenocorticism (Addison's Disease)
Term

What condition is characterized by these routine lab abnormalities?

 

↑ Glucose

↑Cholesterol, triglycerides

Glucosuria

Low USG

Ketonuria

Definition
Diabetes mellitus
Term

What condition is characterized by these abnormal routine lab values?

 

↑ cholesterol, triclycerides


↓ RBCs, Hct, Hgb

Definition
Hypothyroidism
Term

What condition is characterized by these abnormal routine laboratory findings?

 

↑ cholesterol, triglycerides

↑ glucose

↑ ALP (in cats)

↑ ALT (in cats)

Low USG

 

Definition
Hyperthyroidism
Term

What condition is characterized by the following abnormal routine lab findings?

 

↑ ALP

↑ glucose

↑ cholesterol, triglycerides

Low USG

↓ lymphocytes

↑ neutrophils

↑ monocytes (esp. in dogs)

Definition
Hyperadrenocorticism (Cushing's disease)
Term

What condition is characterized by the following routine laboratory abnormalities?

 

↑ Ca

↓ P

Definition
Hyperparathyroidism
Term
Which three increased parameters on the CBC reflect erythrocytosis?
Definition
1. RBCs (erythrocyte concentration)
2. PCV/Hct
3. Hgb concentration
Term
What are two broad causes for relative erythrocytosis?
Definition
1. Hemoconcentration (dehydration, endotoxemia)
2. Redistribution of RBC (splenic contraction)
Term
What is the most common cause of erythrocytosis?
Definition
Dehydration!
Term
How does endotoxic shock cause relative hemoconcentration?
Definition
Shifting of the fluid from the IV space to the EV space
Term
What species experiences splenic contraction and thus eythrocytosis most frequently?
Definition
Horses
Term
Primary absolute erythrocytosis is _______
Definition
EPO independent.
Term
Secondary absolute erythroctyosis is _______
Definition
Epo dependent
Term
Secondary absolute erythrocytosis is further classified as ______ or ______
Definition
appropriate or inappropriate.
Term
When is secondary absolute erythroctyosis apropriate?
Definition
When the increased EPO production is a compensatory physiologic response.
Term
Secondary absolute erythrocytosis is inappropriate when ______
Definition
EPO production is autonomous
Term
HYPERVISCOSITY SYNDROME: Marked absolute erythrocytosis, either 1 or 2, causes these three changes:
Definition
1. increased blood viscosity
2. impairment of blood flow
3. distended microvasculature
Term
HYPERVISCOSITY SYNDROME: individuals with this are at increased risk of these three things:
Definition
1. thrombosis
2. hemorrhage
3. tissue hypoxia
Term
Clinical signs of hyperviscosity syndrome (5):
Definition
1. red mucous membranes
2. prolonged CRT
3. congested retinal and scleral blood vessels
4. thrombosis or bleeding
5. secondary signs related to sprecific affected organ systems
Term
Conditions causing primary erythrocytosis:
Definition
1. polycythemia vera (hemic neoplasia)
2. mutations to the Epo receptor
Term
Conditions causing secondary appropriate erythrocytosis:
Definition
1. R to L shunts (poorly oxygenated blood)
2. pulmonary disease
Term
Conditions causing secondary inappropriate erythrocytosis:
Definition
1. renal lesions secreting Epo
2. Extra-renal neoplasia secreting Epo
Term
Non-pathologic causes of erythrocytosis:
Definition
1. Breed variation
2. physiologic (altitude, exercise)
3. doping
Term
How is primary erythrocytosis normally diagnosed?
Definition
By exclusion of all other causes
Term
Signs of polycythemia vera:
Definition
marked increase in red cell mass
normal or decreased Epo plasma conc.
Term
Why do non-regenerative anemias develop slowly?
Definition
RBCs have long life-spans
Term
Most non-regenerative anemias are _______ and __________
Definition
normocytic and normochromic
Term
Most non-regenerative anemias are _______ and __________
Definition
normocytic and normochromic
Term
Most common form of non-regenerative anemia
Definition
anemia of inflammation
Term
What is anemia of inflammation associated with?
Definition
altered iron metabolism (sequestration in tissues, less serum iron)
Term
Key mediator of anemia of inflammation
Definition
hepcidin, an acute phase protein
Term
Classical iron deficiency anemia is ________ and_______
Definition
microcytic, hypochromic
Term
What is immunologic adaptation of anemia of inflammation?
Definition
It is meant to sequester iron so that it cannot be utilized by microbes
Term
How does increased hepcidin expression work?
Definition
It binds to the cell surface iron efflux protein (ferroportin) and induces its internalization and degradation
Term
What is hepcidin intended to do with iron?
Definition
1. inhibit GI absorption of iron
2. inhibit export of iron from hepatocytes and macrophages
Term
Inflammation has been shown to cause ________ RBC survival.
Definition
decreased
Term
Inflammatory cytokines are erythropoiesis inhibitors in these three ways:
Definition
1. direct toxic effect on RBC precursors
2. decreased expression of hematopoietic factors (Epo, stem-cell factor)
3. Decresed Epo receptor expression
Term
Iron deficiency occurs most commonly because of
Definition
chronic blood loss
Term
True iron deficiency can be either ____ or _____
Definition
rengenerative or non-regenerative
Term
Causes of decreased erythropoiesis (8):
Definition
1. Chronic renal failure (decreased Epo production)
2. Neoplasia
3. Endocrinopathies (hypothyroidism, hypoadrenocorticism)
4. Immune-mediated destruction of precursors
5. Infection of erythropoietic cells
6. Liver disease
7. Toxic insult to marrow
8. Nutritional deficiencies
Term
Three components of the minimum laboratory database
Definition
1. CBC
2. Chemistry and electrolytes
3. Urinalysis
Term
Reference intervals should be specific to what?
Definition
Method and species
Term
How are laboratory reference intervals established?
Definition
sampling a population of clinically normal animals, performing test of interest then analyzing the results
Term
What is the convention for reference thresholds?
Definition
Centel 95% of values, after exclusion of outliers
Term
Greater number of samples in reference group:
Definition
the more likely the samples accurately represent the larger population
Term
Appropriate protocols are followed to eliminate these three kinds of error:
Definition
1. pre-analytical
2. analytical
3. post-analytical
Term
Interpret the values of the test results.....
Definition
in context of all available information
Term
Sensitivity
Definition
how likely a test is to yield a positive result in an affected population
Term
Specificity
Definition
indicates how likely a test is to yield a negative result in an unaffected population
Term
Sensitivity and specificity are influenced by _______
Definition
cut points
Term
Sensitivity and specificity are NOT influenced by_____
Definition
the prevalence of the disease being tested
Term
PPV
Definition
probability that a positive test result is a true positive
Term
NPV
Definition
probability that a negative test result is a true negative
Term
Predictive value of a test IS influenced by _____ and _____
Definition
prevalence and test's diagnostic properties
Term
As prevalence increases, PPV ______
Definition
increases
Term
As prevalence increases, PPV ______
Definition
increases
Term
As prevalence decreases, NPV ______
Definition
increases
Term
Advantages of dividing whole blood into components
Definition
1. safer, more specific use
2. more efficient use
Term
Blood group
Definition
group of inherited antigens on the surface of RBCs
Term
Blood type
Definition
phenotypic expression of blood group
Term
Universal donor
Definition
minimally antigenic blood (blood could be given to any other individual of the spp with minimal risk)
Term
Universal recipient
Definition
has multiple blood group antigens (could receive any blood type
Term
Sensitization
Definition
occurs when a previously naive blood recipient is exposed to the antigens they do not possess and develop antibodies against it for next time
Term
Which canine blood group is clinically significant?
Definition
DEA 1.1 (and also maybe DEA 1.2 and DEA 7)
Term
T or F: dogs are often positive for more than one antigen
Definition
T
Term
Ideal canine donor:
Definition
DEA 1.1 negative
Term
What are the clinically significant feline blood groups?
Definition
A (most common), B, AB
Term
T or F: blood typing should be performed in all cat donors and recipients.
Definition
t
Term
Why can't AB cats recieve AB unwashed, packed RBCs?
Definition
Because the antibodies in the recipient cat will attack the antigen that it does not have UNLESS they are washed and packed
Term
What are the significant equine blood groups?
Definition
Aa, Qa, Ca, Ac
Term
Ideal equine donors are:
Definition
Aa, Qa negative
Term
How many equine blood groups and factors are there?
Definition
7 groups, 34 factors
Term
How many bovine blood groups?
Definition
11- very complex and transfusions not often done
Term
Neonatal isoerythrolysis:
Definition
hemolytic anemia occurring in neonate that acquired antibodies against its own RBCs from the dam via colostrum
Term
Clinical signs on NI:
Definition
sudden death, lethargy, weakness, tachypnea, tachycardia, jaundice
Term
Pathogenesis of NI:
Definition
antigen (-) dam bred to antigen (+) sire --> fetus has sire's antigen --> dam exposed to fetal blood during gestation --> dam makes antibodies to antigen --> neonate born --> ingests colostrum containing antibodies --> hemolytic anemia
Term
Know what combos of antigen NI can occur in
Definition
* A and AB kittens with a B queen
* Qa/Aa foals born to Qa/Aa negative mares
* puppies born to bitch transfused prior to whelping
* calves born to cows given RBC-membrane-containing vaccine
Term
Pre-transfusion history should include:
Definition
1. previously determined blood type
2. transfusion hx
3. pregnancy hx
Term
Goals of pre-transfusion testing:
Definition
1. confirm blood type
2. determine donor-recipient compatibility
Term
Blood typing performed using _________ blood
Definition
EDTA anticoagulated
Term
What is the endpoint of bloodtyping an crossmatching?
Definition
visible agglutination of RBCs
Term
Cross-matching used to:
Definition
1. confirm compatibility
2. investigate cause of adverse rxn
Term
Major cross matching
Definition
compatibility of plasma (for whole blood or packed cell trans.)
Term
Minor cross matching
Definition
compatibility of DONOR plasma to RECIPIENT RBCs (whole blood or plasma trans)
Term
What are the major classifications of hematopoietic neoplasia?
Definition

1. Neoplasia: a) myeloid or b) lymphoid

2. Chronic & acute leukemias

Term
Define lymphoma
Definition
malignant solid tissue lymphoid neoplasm arising in lymphoid tissues outside of the bone marrow
Term
How is diagnosis of lymphoma made?
Definition
aspiration cytology +/- biopsy and histo, then clinical staging and immunphentotyping
Term
Lymphoma common hematology findings?
Definition
non regenerative anemia
Term
Define leukemia
Definition
malignant neoplasm arising from hematopoietic cells in bone marrow or spleen with significant numbers of neoplastic cells in circulation
Term
Basic classification of leukemias:
Definition
chronic lymphoid leuk (CLL); chronic myeloid leuk (CML); acute lymphoid leuk (ALL); acute myeloid leuk (AML)
Term
"blast crisis"
Definition
chronic leukemia transforming into a more acute form, implying an additional mutation
Term
Chronic leukemias
Definition
cell of origin easy to identify, but not often easy to tell whether cells are neoplastic or just reactive; DX typically by exclusion
Term
Acute leukemias
Definition
high numbers of blasts in bone marrow(more then 20-30% of nucleated cells); specific lineage cannot normally be determined by routine micropscopy bc cells are poorly differenitated; ID done by immunophenotype
Term
Myelodysplastic syndrome
Definition
clonal myeloid proliferation characterized by ineffective hematopoiesis
Term
How is MDS classically diagnosed?
Definition
1. less than 20-30% blasts in bone marrow
2. cytopenia of more than one cell line
3. abnormal blood cell morphology
Term
Plasma cell tumors (two kinds)
Definition
Plasmacytomas, multiple myelomas
Term
Plasmacytomas
Definition
solid tumors that involve skin or mucous membranes- usually benign and excision is usually curative
Term
Multiple myelomas
Definition
arise in bone marrow and secrete large amounts of immunoglobin, so HYPERGLOBULINEMIA
Term
You diagnose multiple myelomas based on TWO of which abnormalities:
Definition
1. markedly increased plasma cells in BM
2. Monoclonal gammopathy
3. Radiographic evidence of osteolysis (so HYPERCALCEMIA)
4. Light chain proteinuria
Term
Define immunophenotyping
Definition
use of antibodies to recognize specific molecules expressed on different cell types to determine the identity of a cell population of interest
Term
Clonality assays
Definition
indentifies clonal lymphoid proliferations based on homogeneity of antigen receptor genes
Term
Neoplastic cells are ____clonal and reactive cells are ______clonal
Definition
mono; poly
Term
Hct:
Definition
calculated value based on the concentration and size of RBCs
Term
PCV:
Definition
measured value based on centriguation
Term
Anemia causes these signs:
Definition
MM pallor
lethargy
weakness
blood viscosity --> murmurs (due to changes in laminar blood flow)
Term
Renerative or nonregenerative anemia is classified based on an increase in circulating what?
Definition
reticulocytes
Term
Causes of regenerative anemia are the 2 H's or 2 L's, which stand for what?
Definition
hemorrhage and hemolysis
loss and lysis
Term
How do reticulocytes appear on blood smear exam?
Definition
larger polychromatophilic RBcs
Term
Which species does not ever release appreciable #'s of retics?
Definition
Horses
Term
In cats, which more mature form of RBC is not counted as a reticulocyte?
Definition
Punctat retics
Term
In ruminants, what accompanies reticulosytosis in the face of regenerative anemia?
Definition
basophilic stipplin
Term
How long after a stimulus does it normally take to see reticulocytosis on CBC?
Definition
several days and several more days until the regenerative response PEAKS
Term
How can you confirm regenerative response in "preregen" cases?
Definition
evidence of erythroid hyperplasia in BM, or emergence of reticulocytosis on subsequent CBCs
Term
Strong regenerative response can cause what anemia pattern?
Definition
macrocytic, hypochromic
Term
Most regenerative anemias follow what pattern?
Definition
Normocytic, normochromic
Term
What can cause artifactual hypochromia and macrocytosis?
Definition
Prolonged storage of blood in routine EDTA tubes
Term
EVH often results in this condition of the spleen:
Definition
splenomegaly
Term
Three laboratory findings common in BOTH IVH and EVH:
Definition
1. regenerative anemia
2. hyperbilirubinemia
3. bilirubinuria
Term
This laboratory finding is strongly associated with EVH only:
Definition
spherocytosis
Term
These findings are strongly associated with IVH only:
Definition
hemoglobinemia
hemoglobinuria
Term
IMHA
Definition
patient's own antibodies react against it's eryhtrocytes- predominant mechanism is EVH (severe and strongly regenerative anemia)
Term
Common laboratory abnormalities in INHA pts
Definition
* spherocytosis
* autoagglutination (bc of cross linking antibodies bound to RBC)
* Inflammatory leukogram (immune complex formation is inflammatory)
Term
Two tests available for IMHA
Definition
1. Coombs test
2. Flow cytometry
Term
Causes of secondary IMHA:
Definition
1. infection
2. neoplasia
3. drug administration
4. vaccination
Term
Infectious Hemolytic Anemia: agents:
Definition
1. Mycoplasma
2. Anaplasma marginale
3. Piroplasmosis (Babesia, Cytauxzoon, Theileria)
4. Equine infectious anemia
Term
Oxidative Hemolytic Anemia
Definition
normal oxidative pathways that generate reducing agents are compromised/overwhelmed (may result IVH, EVH or both)
Term
Heinz bodies
Definition
foci of denatured hemoglobin due to oxidative damage (round, blue inclusions)
Term
Two toxins that can result in Heinz body formation
Definition
1. Maple leaf tox
2. Garlic/onion tox
Term
Which healthy species will have low numbers of Heinz bodies?`
Definition
Cat
Term
How does Heinz body formation cause anemia (2):
Definition
1. increased clearance of RBCs by the spleen/ immune mediated mechanisms
2. increaed fragility --> IVH
Term
Eccentrocytes
Definition
RBCs that have one side of the cell with increased pallor- represent oxidative damage
Term
Methemoglobin
Definition
conversion of iron from the Fe 2+ to the Fe3+ state, which cannot bind to oxygen --> also result of oxidative damage
Term
What can you grossly detect with methemoglobin?
Definition
chocolate color to blood
Term
Which three conditions will cause a positive "blood protein" reading?
Definition
1. hematuria
2. hemoglobinuria
3. myoglobinuria
Term
What can artifactually increase the total protein measurement and/or hemoglobin measurement?
Definition
lipemia
Term
Leukogram
Definition
quantification and characterization of all leukocytes in circulation at one time
Term
Granulocytic hyper/hypoplasia
Definition
increase/decrease in number of granulocytic precursors in BM
Term
WBC count
Definition
# of leukocytes per microliter of blood
Term
automated WBC count:
Definition
# nucleated cells/microliter blood
Term
WBC differential:
Definition
percentages of different leukocyte types present that add up to 100%
Term
ALWAYS USE THE (absolute/relative) COUNT TO INTERPRET.
Definition
absolute
Term
What are the five basic components of leukogram?
Definition
1. neutrophils
2. monocytes
3. lymphocytes
4. eosinophils
5. basophils
Term
Neutrophil concentration in the blood reflect what three processes?
Definition
1. bone marrow production and release
2. distribution in vessels
3. tissue demand for neutros
Term
Which immature cells comprise the proliferation pools (neutro):
Definition
myeloblasts
progranulocytes
myelocytes
Term
Neutro maturation pool?
Definition
metamyelocytes
bands
segs
Term
Neutro storage pool?
Definition
segs
Term
Which species generally has the largest storage pool?
Definition
Dogs
Term
Circulating storage pool:
Definition
cells moving freely in blood stream
Term
Marginating pool:
Definition
adhered to adhesion molecules on the endothelial surface of vessels
Term
Once neutrophils are in tissue they can return to the blood (t/f)
Definition
false
Term
Toxic change- definition and examples:
Definition
visible cytoplasmic changes in neutrophils that result from inflammatory stimulus
1. Dohle bodies
2. increased cytoplasmic basophilia
3. cytoplasmic vacuolations
4. toxic granulation
Term
Dohle bodies:
Definition
irregular, blue-grey focal cytoplasmic inclusions (normal in low numbers in cats)
Term
What are the four patterns of neutrophilia?
Definition
1. Physiologic (epinephrine mediated)
2. Stress (glucocorticoid mediated)
3. Chronic myelogenous leukemia
4. Acute/chronic inflammation
Term
What kind of neutrophilia will you see in physiologic?
Definition
MATURE
Term
What sort of neitrolphilia will you see in a Stress neutorphilia?
Definition
mature (less than 2X the reference interval)
Term
What are common concurrent Stress Leukogram findings?
Definition
SMILED

Segs, monos increased; lymphs eos decreased
Term
Chronic myelogenous leukemia:
Definition
rare, but can see a degenerative left shift
Term
Which pattern of neutrophilia represents an issue of supply and demand?
Definition
Inflammatory
Term
Mature neutrophilia
Definition
increased numbers of only segs- means bone marrow is fully meeting tissue demand
Term
Left shift
Definition
presence of increased numbers of immature neutrophils incirculation (bands mostly)

LEFT SHIFT ALWAYS INFLAMMATION
Term
Regenerative left shift
Definition
increased immature neuts,but mature still outnumber the immature
Term
Degenerative left shift
Definition
immature neutros outnumber the mature ones (segs)

PROGNOSTICALLY WORRISOME
Term
Neutropenia
Definition
decreased numbers of segmented neutros (also often left shift)

ALSO PROGNOSTICALLY WORRISOME
Term
Why do cattle often have neutropenia with left shift in initial inflammation?
Definition
SMALL storage pools!
Term
Extreme neutrophilia "leukemoid response"
Definition
>50,000 in dog/cat; >30,000 in horse or bovine; indicated chronic stimulation of granulopoiesis with granulocytic hyperplasia
Term
Two most common causes of leukemoid response:
Definition
1. non-draining pyogenic infections (bag of pus_
2. hemolytic disease (esp IMHA)
Term
Inflammation DOES NOT EQUAL....
Definition
infection!
Term
Indications for bone marrow sampling:
Definition
1. hemic abnormalities
2. Cancer staging
3. Reasonable suspicion of infection/neoplasia affectin marrow (fishing)
Term
Changes is bone marrow can be relative or absolute. Define these.
Definition
Relative: BM responding to disease somewhere else in body
Absolute: primary disease of BM
Term
List mechanisms of altered BM cellularity:
Definition
1. hypoplasia
2. aplasia
3. hyperplasia
4. dysplasia
5. neoplasia
6. myelphthisis
7. necrosis
8. inlammation
Term
Myelopthisis
Definition
bone marrow failure secondary to replacement/displacement of hematopoietic tissue by abnormal tissue
Term
Myelopthisis
Definition
bone marrow failure secondary to replacement/displacement of hematopoietic tissue by abnormal tissue
Term
Common areas to take BM sample:
Definition
iliac crest, proximal humerus, sternum
Term
What is the main contraindication to BM sampling?
Definition
It is not needed diagnostically
Term
Complications of BM sampling:
Definition
* hemorrhage
* infection
* damage to adjacent soft tissue
* needle breakage
*bone fracture
Term
Ideally, biopsy and aspirate should be taken together, but if you can do only one, which one?
Definition
cytology
Term
If you perform both, which should you take first?
Definition
aspirate
Term
What is the "full monty" as described by Flatland?
Definition
1. CBC
2. Core biopsy
3. Cytology smear
Term
How to help the pathologist (with respect to BM sampling)
Definition
1. indicate reason for BM sample
2. concurrent CBC data
3. good quality cyto smears
4. keep smears away from formalin
Term
At a minimum what CBC data does pathologist need?
Definition
PCV total WBC count platelet count
Term
How many spicules should a good quality smear contain?
Definition
2-4
Term
How many good quality BM smears should you have?
Definition
3-5
Term
Marrow Cellularity must be interpreted in light of which two things?
Definition
pt age
sample quality
Term
M:E ratio normals in canines
Definition
1:1 or 2:1
Term
Dysplasia
Definition
atypical morhphology
Term
"Orderly maturation"
Definition
refers to the fact that marrow contains more late-stage precursors than early-stage precursors
Term
Maturation arrest
Definition
cessation of cell maturation at a particular stage of development
Term
Ineffective hematopoiesis
Definition
death or destruction of hematopoietic cells within the BM so that such cells are not seen in circulation
Term
Hypercellular marrow with concurrent cytopenia-
Definition
ineffective hematopoiesis
Term
Dyshematopoiesis
Definition
defect in hemic cell production AND presence of cellular atypia
Term
Myelodysplastic syndrome
Definition
due to a clonal disorder of BM stem cellsand resulting in ineffective hematopoiesis, dyshematipoiesis, and and susceptibility to acute myeloid leukemia
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