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213 terms

Ch 16

Clinical text for vet techs
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CBC
PCV, Hematocrit, WBC count, RBC count, hemoglobin determination, RBC indices, platelet count or estimate, total plasma protein, evaluation for morphology wbc differential
what type of blood needed for hematologic procedures?
anticoagulated whole blood
excess anticoagulant does what to hematology sample?
decrease the PCV and increase the total protein values
PCV?
Packed Cell Volume. the % of whole blood that is made up of RBCs
hemoglobin
iron-containing protein in red blood cells that transports oxygen from the lungs to the tissues of the body
RBC stage:chromatin is condensed, no nucleolous, 2 stages of division
rubricyte
RBC indices
Mean Corpuscular Volume (MCV), Mean Cell Hemoglobin (MCH), and the Mean Cell Hemoglobin Concentration (MCHC) and red cell distribution width(RDW)
Leukocytosis
increase in the number of white blood cells
buffy coat
a thin light colored layer of white blood cells and platelets than lie between a top layer of plasma and red blood cells
microfilaria
the larva stage of heartworms
which species has platelets that tend to clump?
Feline
# of Leukocytes per 10x field in normal K9 blood?
20
Platelets in mammals look like?
cytoplasmic fragments, no nuclei
platelet equivilant in avain
thrombocytes, have nucleus
Order of RBC in species, large to small
dog, cat, horse, cow, sheep, goat, llama
anisocytosis
presence of red blood cells of unequal size (an = not, without; iso = equal)
Poikilocytosis
the presence of large, irregularly shaped red blood cells (poikil/o = irregular)
Leptocytes
RBC's with increased membrane surface area or decreased volume (Target cells, cells with a traverse fold))
Schistocytes
RBC fragments, resulting from the shearing of the red cells by intravascular truama, seen during DIC disseminated intravascular coagulation (death is coming)
Spherocytes
Smaller than normal and lack central pallor
More likely seen in dogs
Reduced membrane - macrophage destruction
Immune mediated diseases, hemolytic anemia, transfusion w/ rejection
polychromasia
variation in RBC color, in animals with anemia suggests anemia is regenerative
2 types of cat reticulocytes
Puncate (too old to count)
Aggregate (hyperchromophilic, counted)
reticulocyte
an immature red blood cell with a network of precipitated basophilic material in the cytoplasm
what species does not exhibit polychromasia and reticulocytosis in peripheral blood?
horses
most common cause of hypochromasia?
Iron deficiency
hypochromasia
Lack or decrease in staining intensity because of a decrease in cellular hemoglobin
Term for a low MCHC value
What does rouleaux mean in dogs?
inflammatory or neoplastic diseases
Marked rouleaux is normal in what species?
horses
Howell-Jolly bodies
In RBC's: small, singular, deeply basophillic nuclear remnants.noted in splenictomized animals & regenerative animia
characteristic of lead poisoning
increased #'s NRBC's with mild to no anemia occassionally basophillic stipping
Heinz bodies
denatured hemoglobin that has fused to an RBC membrane, distinct darkly stained inclusions protruding from the cell surface.
IMHA
immune mediated hemolytic anemia, Coombs test will confirm, animals own antibodies attach to and destroy its own RBC's
Little to no polychromasia in an anemic animal suggests?
Anemia is nonregenerative
What color are eosinophil granules?
reddish-orange
Color basophil granules?
bluish-purple
Color of Neutrophil granules?
clear
Lymphocyte is predominant leukocyte in which animals?
Cattle, sheep and goats
Left shift
increased numbers of immature neutrophils in the blood, indicative of a disease process
degenerate left shift
left shift is present in the absence of increased segmenters
What are some toxic changes in neutrophils?
Dohle bodies, cytoplasmic vacuolation, cytoplasmic basophilia, rarely retention of fine, reddish granules called toxic granulation
Dohle's bodies
small, pale, blueish gray, irregular cytoplasmic inclusions of RNA containing rough endoplasmic reticulum, likely assoc. w systematic inflammatory disease.
Generalized cytoplasmic basophilia is representative of increased___?
RNA
Which animals may have Dohles in small #'s in health?
cats
Nuclear hypersegmentation
normal neutrophils 3-5 lobes
hypersegmented lobes= >5, normal aging process
Barr Body
small drumstick appearing nuclear appendage. Inactive x chromosome in some females
What do eosinophils do?
help control allergic or anaphylactic hypersensitivity reactions, attracted to sites of these reactions
What do eosinphils look like?
segmented nucleus, colorless to pale blue cytoplasm, distinct eosinophlic -reddish orange granules
Which leukocyte's granules can be used to identify species?
eosinophil
Lymphocytes look like?
small to med mononuclear cells, dominated by nucleus, high nuclear to cytoplasmic ratio N/C
Monocytes definition
derived from the bone marrow, circulate briefly before entering tissues where they become macrophages
gray blue cytoplasm, frequently has a fine subtle lightly eosinophilic granulation may contain few clear vacuoles and variable-shaped nucleus; may be confused with toxic band metamyelocyte
monocyte
abnormal circulating cell types
mast cells, lymphoblasts, myeloblasts, erythroblasts; may indicate leukemia or systematic mastocytosis
Which #'s significant for interpreting differential count?
absolute #'s
flow cytometry
counting of particles as they flow past a detection device
How determine plasma protein
capillary tube used to measure PCV broken just above buffy coat, plasma runs through unbroken endonto a refractmeter, values only accurate if plasma is clear
What will excess anticoalgulant do to a plasma protein value?
artifactually increase it
What is useful in detecting inflammatory process, particularly in cattle and horses?
semiquantitative determination of plasma fibrinogen levels
hemostasis
The stoppage of bleeding; blood clotting. depends on vascular integrity, adequate #'s and normal functioning of platelets, complete compliment of coagulation factors
initail plug to stem the immediate flow of blood
mechanical phase or primary hemostasis
biochemical reactions that lead to the formation of a fibrin mesh, envelopes the plug of platelets and stabilizes
chemical phase orsecondary hemostasis
what does hemostasis rely upon?
wide range of proteins called clotting factors & co factors such as calcium & vit K
Basic coagulation testing includes?
Platelet count, evaluation of the 2 major pathways(intrinsic and extrinsic) that lead to the conversion of prothrombin to thrombin
what tube should be used for a platelet count?
EDTA
What tube for coagulation assays?
citrate(turquoise or blue top)
2 tests that eval kidney function?
BUN (blood urea nitrogen) & creatinine; distinguish simple dehydration from renal failure
increased protein values are seen with?
dehydration, inflammation, autoimmune disease
Albumin
most abundant plasma protein, 60% of the total protein, made by the liver, plays an important role in osmotic balance, contributes to the viscosity of blood, transportation of lipids/hormones/calcium..., and helps to maintain pH
decreased albumin seen?
liver failure, gastrointestinal disorders, renal glomular disease
electrolytes
ions that disassociate in water& have capacity to conduct electricity
collectively called electrolytes
levels of serum sodium, potassium, chloride, calcium and phosphorus
what would electrolytes reflect changes in?
fluid balance, gasto disorders, acid based disturbances, renal dysfunction, metabolic or endocrine disorders
2 types of chemistry analyzers
liquid reagent(require more expertise and time) and dry chemistry(simple consistent)
what principle do liquid reagent based instraments use?
photometry: measurement of light transmittance by a solution
Beers Law
the concentration of a substance in a liquid indirectly proportional to the amount of light that passes throught the liquid; high the concentration of a sustance, less light passes through
spectrometer
A device that analyzes light emitted or absorbed by a substance
three levels of quality control
preanalytic, analytic, analytic quality monitoring;
preparing patient, method used, quality control
standard solution
contain analyte of interest at validated true concentration; gold standard
control solutions
quality control product thatmay report a given expected concentration of analyte of interest; normal, high abnormal, low abnormal
lyophilized
rapidly frozen and dehydrated
2 most common problems that interfere with sample analysis
hemolysis:excess pressure during veni
lipemia: sample after eating
2 tubes used for chem profiles
clot (red), heparin (green)
Can EDTA be used for chem tests?
No, EDTA binds calcium to prevent clot formation thus interferes with many assays
why must serum be seperated from the clot quickly?
prolonged exposure of serum to the cells will decrease glucose, increase phosphorus, may increase potassium
what is the horizontal head microscope aka?
what is the swinging arm microscope aka?
disadvantages of horizontal head?
air friction and remixing at the end are disadvantages
which edges of a microhematocit do you count?
Top and left are counted
3 types of hematology analyzers
Impedance, Laser-based, quantitative buffy coat system
Beers Law
a direct linear relationship exists between the concentration of an analyte and light absorption
RBC stage: nucleus is round, no nucleolous
prorubricyte
Hemostasis
ability to maintain the integrity of the blood and blood vessels
cell membrane
cell structures acts as a flexible, elastic barrier between the inner cytoplasm and the outside environment
poikilocytosis
the presence of large, irregularly shaped red blood cells
Cilia and flagella extend from the_______ into the _______?
___ & ____extend from the cell membrane into extracellular space.
RBC indices
MCV, MCH, MCHC
basophillic stippling
small blue staining granules (retained RNA) within the the erythrocyte, may be lead poisoning/toxicity
Band neutrophils seen w/ regenerative or non regenerative anemia?
Regenerative anemia results in the release of immature red blood cells from the bone marrow
The refractometer aka
total solids meter aka
MCH
mean corpuscular hemoglobin
MCHC
mean corpuscular hemoglobin concentration
RDW
red cell distribution width
If buffy coat is thicker?
infection and neoplasia may be suspected
leukopenia
decrease of white blood cells
Why platelet count important?
they play an important role in clot formation, several diseases cause a decrease in them
Leptocytes
RBC's with increased membrane or decreased volume. They are larger and their membranes are thin, may easily fold
2 common leptocytes
target cells(codocytes), cells w/ traverse fold
DIC
disseminated intravascular coagulation
IMHA
Immune Mediated Hemolytic Anemia
spherocytes
appear smaller than rbc's, no central pallor, but have comparable MCV bcincreased volume to surface area
schistocytes
fragmented RBCs assos. w/ DIC
nRBC aka & info
metarubricyte; in increased #'S may be regenerative anemia or bone marrow pathology as seen with toxins & neoplasia
order of size of RBC's in species
dog, cat, horse, cow, sheep, goat, llama
Morphological features of the mature RBC of most mammals does not include
nucleus is not a part of which RBC
Which of the following cell structures provides the most energy to the cell?
mitochondria
What are the functions of the cell's cytoskeleton?
Gives support and shape to the cell, Enables cell to move, Provides direction for metabolic activity
Cytoplasm is composed of....
Proteins, Electrolytes, Metabolites, cytoskeleton, organelles
Medullary site
Bone marrow
Extramedullary site
Spleen, Liver, Lymph nodes
Has potential to become different types of blood cells
Pluripotent stem cell
White blood cell production
Granulopoesis
Maintains hereditary information of the species and controls cellular activities
nucleus
extracellular fluid specifically found in tissues
Interstitial fluid
Important cite in cell for protein synthesis
Ribosomes
formed by macrophages partially removing antibody-coated membranes
Spherocytes
an unorganized, three-dimensional clustering of RBCs
Agglutination
remnants of membranes of RBCs that have undergone intravascular lysis
Ghost cells
has crescent-shaped clear areas eccentrically placed
Eccentrocyte
RBC stage: loses blue color becoming red
mature RBC
Burr cells
have multiple projections and are oval to elongate in body
increased central pallor; decreased hemoglobin
Hypochromasia
This is seen in horses treated with heparin
Agglutination
This type of clumping of the RBC is related to the charge on the cell
Rouleaux
Basophilic stippling is sometimes mistaken for
Pappenheimer bodies
characteristics of a toxic neutrophil?
cytoplasmic basophilia, cytoplasmic granules stained red, generalized foamy appearance to the cytoplasm
Basophils are most commonly seen in..
Horses
mechanical phase of coagulation
phase begins when blood vessel is ripped or torn
chemical phase of coagulation
phase referred to as the coagulation cascade whichends in a formed clot
stuctures found in mammalian cell
cell membrane, cytoplasm, nucleus
The entire contents of the cell, exclusive of the nucleus and genetic material and bounded by the plasma membrane.
cytoplasm
2 types of centrifuges
horizontal centrifuge head, angled centrifuge head
functions of cell membrane?
governs movement of atoms in & out of cell; acts as flexible elastic barrier
cell membrane consists of?
primarily protein & phospholipids; lipid soluable
functions of cytoskeleton
gives support, shape, enables movement, provides direction for metabolic activity, anchors organelles
flagella cilia
Mircrotubules that helps cells to swim through liquids
produces most of cells energy
mitochondria; enclosed by 2 membranes, outer smooth inner contains folds called cristae
main point of chemistry analyzers
show how patients organ are functioning
ribosomes
2 subunits that contain protein & RNA; important site for protein synthesis
rough ER
has ribosomes on its surface & involve in production of protein
smooth ER
involved in synthesis and storage of lipids
inclusions
metabolic substances the cell has engulfed, may single or no membrane
RNA
ribonucleic acid; a nucleic acid that plays an important role in the production of proteins
nuclear envelope
2 lipid bilayers, outer continous w/ ER studded w/ ribosomes
chromatin
fibers in nucleoplasm, made of DNA & histones
RBC stage: round cells no nucleus, bluish cytoplasm
reticulocyte aka polychromatophil
nucleolus
structure inside the nucleus, where ribosomal subunits are made
RBC stage: large round cell w/ large round nucleus, coarse granular chromatin prominant nucleolous
Rubriblast
temporary or permanent inibition of genes that may be active in others cells
cell differentiation
production and release of new cells occurs in?
bone marrow
RBC stage: very condensed chromatin, from this stage on no more division
metarubricyte
order of RBC development
rubriblast, prorubricyte, rubricyte, metarubricyte, reticulocyte aka polychromatophil
pluripotent stem cel can become what 2 cells
Lymphoid stem cell or myeloid stem cell
a myeloid stem cell can become what 4 cells
Megakaryoblast, monoblast, myeloblast, rubriblast
Stages of megakaryoblast
promegakaryocyte, megakaryocyte, platelets
Stages of monoblast
promonocyte, monocyte
stages of myeloblast
promyelocyte-after that either eosinophil, neutrphil, basophil- myelocyte, metamyelocyte, band then devoloped
3 types of granulocytes
neutrophillic, eosinophillic, basophillic
formed from the cytoplasm of Megakaryocyte
proplatelets
formed from the fragments of proplatelets
platelets
2 main types of lymphocytes
B T
where do plasma cells come from
end stage of B lymphocytes
common morphological features of mature RBC's of most mammals
lack nuclei, stain reddish to reddish orange, biconcave discoid shape
what species has most prominant central pallor
dog
which 3 species have least prominant central pallor
cat, horse ruminant
5 catagories of variation of RBC's
regenerative response, immune-mediated damage, oxidative injury, membane/ metabolic disorder, mechanical fragmentation
best stain to see reticulocytes
new methylene-blue
why nRBC's released?
bone marrow stromal damage, increased demand, extramedullary hematopoisis
basophillic stippling
small blue staining granules (RNA) within the the erythrocyte, may be lead poisoning/toxicity in dogs &cats
formed by macrophages partially removing antibody coated membranes
spherocytes
Inclusions: erythrocytes that retain small round nuclear fragments. dark staining inter cellular bodies. removed by the spleen
Cause: noted in splenic disorders, regenerative animia
howell-jolly bodies
seen in horses treated with heparin
agglutination
cells with multiple, small, delicate, regularly spines distributed evenly around the RBC
Echinocyte; metabolic & renal disorder
cells with multiple irregularly shaped, blunt finger-like projections
acanthocytes; liver disease
Canine-granules are few in number and stain purple to blue-black, Feline-granules are round & stain light lavender, Equine and bovine granules are usually more numerous and may completely pack the cytoplasm
basophil
what RBC inclusion is normal in animals who've had splenectomies
Howell-jolly bodies
cause of echinocyte formation
crenation
RBCs fragmented during intravascular trauma
schistocytes
what are howell-jolly bodies often mistaken for?
Anaplasma organisms
not for plasma samples; good for hematologic studies
EDTA
WBC: cytoplasm stains pink, fine diffuse granules, 3-5 lobes
neutrophils
can be used for tests requiring plasma samples, not for differentials
heparin
increased # of cells in the blood
philia or cytosis
decreased # of cells in the blood
penia
neoplastic cells in the blood or bone marrow
leukemia
most common WBC found in blood of common domestic species other than ruminants
segmented neutrophils
avian equivalent to neutrophil
heterophil
WBC: horseshoe shaped nucleus w/ large round ends
band neutrophil
second most common cell type in the peripheral blood of most of the domestic species, and most common cell type in ruminants
lymphocyte
Kurloff cells (guinea pigs)
natural killer cells
difference between metamyelocyte and band
meta preceedes band and is thicker than banded
order of development for eosinophils, neutrophils and basophil
Myeloblast, Promyelocyte, Myelocyte, Metamyelocyte
Band, Seg
Large cells with variably shaped nuclei, May be kidney bean shaped,eolongated or lobulated
Nulcear chromatin is diffuse and cytoplasm is blue-gray,Cytoplasmic vacuoles & small, fine, pink granules may also be present
monocyte
Canine-granules are variable sizes(small/large)
Feline-granules are small, rod-shaped, numerous, Equine-granules are large and round to oval, staining intense orange-red
eosinophils
toxic neutrophils
cytoplasmic basophillia, foamy appearance for cytoplasm, intensely stained primary granules
Azurophilic granules in the cytoplasm of lymphocytes, Associated with chronic antigenic stimulation
Reactive lymphocytes
Sometimes called basket cells
Degenerative cells that have ruptured
smudge cells
buffy coat
a thin light colored layer of white blood cells and platelets than lie between a top layer of plasma and red blood cells
what does lipemic plasma do do a protein concentration
usually falsely increases
Aids in classification of certain anemias
RBC indices
MCH
The mean weight of hemoglobin (Hb) contained in the average RBC
Evaluates every clinically significant clotting factor except factor VII-Requires Vacutainer tube containing diatomaceous earth (finely ground fossils/fresh water diatoms)
ACT activated clotting time
Detects abnormalities in platelet function
Anesthetized patient in lateral recumbancy
Strip of gauze - tie upper lip back to expose the mucosal surface
BMBT Buccal Mucosal Bleeding Time
Most common bleeding disorder seen in small animal veterinary practice; Decreased # of platelets
Thrombocytopenia
RBC's have increased Hgb in relation to its size, Usually no central pallor
hyperchromasia
yellow discoloration of the skin, sclera (white of the eye), and other tissues caused by excessive bilirubin in the blood, as seen in liver disease
icterus