Exam One Review

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What is the cause of Fe def. in neonates?

reduced intake

What is the cause of Fe def. in adults?

chronic blood loss

How is Fe def. treated?

Neonates: injectable iron
Adults: locate source of blood loss

In what species is Fe. anemia most life threatening?

baby pigs - no access to iron containing soil

5 x causes of Heinz body anemia in cat

APAP, propylene glycol, Lymphoma, Hyperthroidism, Diabetes

What are some inherited neutrophil abnormalities?

Pelger-Huet Anomaly
Birman Cat neutrophil granulation: Neuts have red granules
mucopolysaccharidoses: Neuts and lymphs have purple granules, lysosomal storage disease along with GM2 Ganliosidosis - progress neurological dz and cytoplastic granulation/vaculation
Chediak-Higashi syndrome

Pelger-Huet Anomaly

Mature hyposegmented neutrophils/eosinophils with coarse chromatin pattern
No segmented neutrophils are present in this animals and they are healthy
also affects eosinophils

Chediak-Higashi Syndrome

pink stained fused lysosomes
typically affect Persians - slight tendency to bleed otherwise healthy

Acquired neutrophil abnormalities

Toxic change, hypersegmentation, degeneration, leukocyte agglutination, cytoplasmic vacuolation, presence of Dohle bodies

What is Sensitivity?

measure of frequency with which the test result is positive or abnormal with animals that have the disease
TP/((TP)(FN)) x 100

What is Specificity?

measure of frequency in which test shows negative or normal for those without disease
TN/((TN))(FP)) x 100

What are the lab abnormalities assoc. with IMHA?

decreased PCV, RBC's, hemoglobin concentration
excess hemoglobin in blood and urine
excess bilirubin in blood and urine
Spherocytosis most important

How do you tell blood loss from destruction?

If total protein is high: blood destruction
If total protein is low: blood destruction
however, body will reabsorb blood lost to body cavity

What are the causes of increased MCV?

Regenerative anemia - immature erythrocytes that are polychromatophilic, FeLV, myelodysplasia, Poodles, Alaskan Malamutes, Mini schauners, and Dutch partridge dogs, blood that has been sitting out too long

What is the most common cause of increased MCV?

Regenerative anemia

What would cause an increased MCV in a cat with non regenerative anemia?

FeLV

Hematologic abnormalities with Anemia of Inflammatory disease?

Microcytosis, decrease: serum Fe and total binding capacity
Increase: ferritin, hemosiderin, and storage in BM
inflammatory leukogram and normal to microcytic MCV's

What hematological abnormalities would you see with a dog with renal disease?

Anemia: moderate to severe, nonregenerative, normocytic

What causes toxic neutrophils?

inflammatory responses, regenerative anemia
immature neutrophils with organelles/ribosomes and Dohle bodies (fragments of endoplasmic reticulum)
basophilic cytoplasm

What causes neonatal isoerythrolysis?

form of immune mediated hemolytic anemia
mom's Ab's against the neonate's blood group antigen
most common in horses (non thoroughbred ones)

What lab findings for lead poisoning?

Basophilic stippling: aggregation of ribosomes,
Typically associated with intensely regenerative anemia

What species is basophilic stippling seen with regenerative anemia?

Cows
Dogs/Cats with intensely regenerative anemia

What are some causes of falsely increased hemoglobin concentration?

Hemolysis, Lipemia, and very large number of Heinz bodies in cats

How would falsely increased hemoglobin concentration affect the MCHC?

(HGB/PCV)(100) = MCHC

What tests require lysis of erthyrocytes?

Hemoglobin, Unopette, Saline - for IMHA, and iron

RBC abnormalities in APAP tox?

Heinz body formation

RBC abnormalities in IMHA?

Spherocytes, Agglutination, and ghost cells

RBC abnormalities in Lead poisoning?

Basophilic stippling, Howell Jolly bodies, and Nucleated RBC's

RBC abnormalities in Hemagiosarcoma?

Acanthocytosis, Schistocytes, Mesothelial cells in abdomen, polychromasia

RBC abnormalities in Fe deficiency anemia?

microcytosis, schistocytes, hypochromatic keratocytes, and blister cells

RBC abnormalities in Rattlesnake envenomation?

echinocytes, type III, spheroechinocytes

What species would a degenerative left shift be less omnimous?

Ruminants

Why is degenerative left shift omnious in other species?

suggestive of an aggressive inflammatory lesion

What are the causes of lymphocytosis?

Lymphoma, lymphocytic leukemia, multiple myeloma, excitement (particularly in cats) and ERLICHOSIS
Lymphocytes are relatively normal in ruminants

What is the progression of Neutrophil maturation?

Proliferative: Myeloblast, Progranulocyte, Myelocyte, Maturation/storage: Metamyelocyte, Band Neutrophil, Neutrophil

At what concentration of lymphocytes/mL would you diagnose lymphoid leukemia?

35,000/mL

What are causes of neutrophilia?

Stress, excitement, inflammation, granulocytic leukemia

What concentrations of Neutrophils/mL would you diagnose granulocytic leukemia?

neutrophils > 100,000 mL

What, other than magnitude, would you consider granulocytic leukemia?

marked neutrophilia, disorderly left shift, and anemia, blast crises: increased concentration of myeloblasts

Describe an excitement leukogram

neutrophilia with normal to higher end lymphocytes due to increased epi - marginated to circulating pool
NO LEFT SHIFT
lymphocytosis is hallmark of feline excitement response

Describe a stress leukogram

neutrophilia with lymphopenia (typical of sick animals) /eosinopenia
NO LEFT SHIFT
pain, illness, metabolic issues
tx with steroids or steroid producing tumors

Describe an inflammatory leukogram

neutrophilia with increase bands and monocytosis - when greatly increased (neut/mono's) - think myelomonocytic leukemia

What are two criteria that are indicative of an inflammatory leukogram?

2 x increase of neutrophils about normal limit and increased left shift

What is the most common cause of lymphopenia?

Stress - increase of cortisol, acute viral infections such as distemper and parvo

What lab. abnormalities are assoc. with anemia of inflammatory disease?

inflammatory leukogram
increased: neutrophils/bands and ferritin, and stainable Fe stores
decreased: serum iron and total binding capacity

What are 2 x causes of thrombocytopenia when assoc. with IMHA?

agglutination and DIC

Describe the different causes of polycythemia?

increase of concentration of RBC's
dehydration, decreased plasma volume, splenic contraction in poodles, greyhounds, and dachshunds, hypoxia - increase of erythropoietin, methemoglobinemia

What laboratory tests could you use?

arterial blood gas analysis - PaO2 < 60 mmHg, then hypoxia
kidney functioning - tumor of the kidney thus increasing erythropoietin

How do you calculate absolute # of various leukocytes?

TNCC x % of particular leukocyte = absolute #

How do you calculate the absolute # of reticulocytes?

RBC x %reticulolycte = absolute #

What type of blood tube is used for a CBC?

purple with EDTA
too much EDTA would result in Leptocytes/Codocytes

What type of blood tube is used for a Biochemical profile?

Sure Sep, red top, or Heparin (lead concentration)

What type of blood tube is used for coagulation tests?

Blue top with Citrate

What happens to lab results if one doesn't put enough blood in a purple tube?

erythrocytes shrink so you get an erroneous decrease in PCV and MCV, leptocytes and codocytes

What is the progession of red blood cell maturation?

Rubiblast, Prorubricyte, Metarubricyte, and mature erythrocyte
Dog: 24-48, Cat: Aggregates become punctates in 12 hours and punctates persist for 12 days - not counted

Ehrlichia

Anemia (non-regenerative) thrombopenia - will spontaneously bleed if < 10, 000, decreased WBC, lymphocytosis, large granular lymphocytes

Which species has the largest RBC?

Dog

Which species has the smallest RBC

Goat

What is the buffy coat?

white blood cells, platelets and NRBC's

What will artificially increase plasma protein?

Glucose, Lipemia, Urea, Cholesterol

Increased albumin is always due to?

Dehydration

How do you calculate a hematocrit?

(MCV)(RBC)/10 = HCT (PCV)

What causes an increase in MCHC?

Nothing - increases are ALWAYS artifactual
things erroneously can like lipemia, hemolysis, and heinz bodies but it can never truly happen

Round cell tumors

Mast cell tumors, Cutaneous lymphoma, histocytoma, and plasmacytoma

Erythremic myelosis

Red cell leukemia, Rubriblasts in peripheral blood

Acquired lymphocyte vacuolation

plants containing swainsonine - locoweed - which results in inhibition of lysosomal enzymes resulting in dz similar to alpha-mannosidosis

Causes of neutropenia?

consumption with inflammatory
Immune mediated destruction
Bone marrow problems either reversible or irreversible
reversible: canine parvo, feline panleukopenia, chemotheraputic drugs
irreversible: FeLV

What are inherited lymphocyte abnormalities?

MPS/GM2 gangliosidosis may result in cytoplasmic granulation/vacuolation
Fucosidosis, alpha mannosidosis, acid lipase deficiency, and Nieman Pick: vacuolation without granulation
MPS/acid lipase def do not cause severe progressive neuro

Aquired lymphocyte vacuolation

ingestion of plants containing swainsonine - locoweed - which results in inhibition of lysosomal enzymes resulting in what looks like alpha mannosidosis

What are eccentrocytes?

Shifting of hemoglobin to one side of cell
often seen with heinz bodies

Mycoplasma haemofelis

dark blue rods or rings on surface of RBC
severe hemolytic anemia
regnerative unless with FeLV

Mycoplasma canis

Rare, "y" shaped, opportunistic: splenctomized or nonfunctional spleen
Spherocytes and Agglutination

Protozoal parasites

Cytauxzoon felis: basophilic ring with nucleus, hemolytic and non regenerative anemia, leukopenia/thrombocytopenia
Babesia canis and gibsoni: intra/extravascular hemolysis

Mycoplasma weyonii

opportunists like canis: splenctomized or immune compromised
iatrogenic: one needle many cows
dependent edema/lymphadenopathy

Rouleaux formation

normal in horses, suggests increased globulin in small animals
To difference agglutination from rouleaux: add saline - if rouleaux will disperse and agglutination will persist

List ddx for spherocytosis

IMHA, mismatched blood transfusion, rattlesnake envenomation, heinz body anemia in horses (band 3 clustering (B3C)), zinc toxicosis (B3C), and bee stings (B3C)

Anaplasmosis

Ruminants: marginale and centrale
tick borne rickettsial, fatal hemolytic anemia, immune mediated hemolytic destruction
Blood film: parasites and basophilic stippling in polychrom ery.

Theileriosis

Protozoals cx: hemolytic anemia
affect deer
RBC's in merozoite

Feline cytauzoonosis

Protozoan, RBC's - piroplasms, Macrophages - schizonts
trans by ticks, almost always fatal

What bacteria cause hemolytic anemia?

Clostridium perfringens A: "Yellow Lamb disease"
Clostridium haemolyticum: "Red Water Disease" in cattle
fluke creates a nice environment for bacterium

Pyruvate Kinase deficiency

Dogs: basenji, beagle, West Highland, and Cairn
decreased glucose utilization/ATP formation results in RBC destruction

Phosphofructokinase deficiency

English springer spaniels
dec. syn of 2,3-diphos., PCV normal, crisis when alkalemic

What causes "pink tooth" in cattle?

def. of uroporphyrinogen III co-synthase resulting in unability to syn. hemoglobin, accumulation of uroporyphrin/coproporphyrin in bones/teeth - photosensitivity

Aplastic anemia

General Bone marrow suppression
FeLV, Ehrlichia, and Estrogen in dogs/ferrets, EIA

Different types of Erythroid hypoplasias

Renal: low erythropoietin
Inflammatory: inavailability of Fe?
Endocrine: Hypothyroidism, hypoadrenocorticism - Addison's

Polycythemia

Relative: dehydration, fluid shift, excercise, excitement - splenic contractions
Absolute: increase EPO due to: chronic hypoxia and renal tumors
Primary (polycythemia vera): myeloproliferative disorder

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