Term
| What is EDTA's mechanism of action? |
|
Definition
Chelates calcium so that it is not available for participation in the clotting cascade
*also preserves cell detail |
|
|
Term
| What is the anticoagulant of choice for birds and reptiles? |
|
Definition
Heparin (potentiates the action of endogenous anticoagulatn antithrombin III)
*EDTA causes cell lysis in birds/reptiles |
|
|
Term
| acidic components of cells stain what color under romanowski stains (ex. diff-quik, wright, giemsa)? |
|
Definition
|
|
Term
| basic components of cells stain what color under romanowski stains (ex. diff-quik, wright, giemsa)? |
|
Definition
| eosinophilic (ex. hemoglobin, protein) |
|
|
Term
| What stain is most useful for evaluation of reticulocytes, heinz bodies, mast cell granules, and fungal elements? |
|
Definition
New Methylene Blue
*this stain is aqueous (vs. alcohol-based) and does not fix cells, used in wet mounts |
|
|
Term
| What three parameters of the erythrogram simultaneously decreased with anemia and increase with erythrocytosis? |
|
Definition
| total RBC count, PCV, hemoglobin concentration |
|
|
Term
| What is the most accurate measurement of RBC mass? |
|
Definition
|
|
Term
| What does elevated MCHC (ie. hyperchromic) mean? |
|
Definition
| artifact (ex. hemoglobinemia, in vitro hemolysis, lipemia, icterus, heinz bodies) <-- anything that increased sample turbidity because MCHC is measured by light absorbance |
|
|
Term
| The presence of what cell type is the index of erythroid bone marrow regeneration? |
|
Definition
reticulocytes (new methylene blue)
aka
Polychromatophils (wright/diff-quick) |
|
|
Term
| What cell features give reticulocytes their unique staining characteristics? |
|
Definition
| Residual RNA and mitochondria give them increased basophillia in comparison to mature RBC |
|
|
Term
| What species are most prone to platelet clumping? How does this affect total platelet counts? |
|
Definition
Cats, cows, pigs, mice
artifactually decreases platelet counts |
|
|
Term
| What anticoagulant can be used instead of EDTA to reduce the incidence of platelet clumping in equine patients? |
|
Definition
|
|
Term
| What does plasma contain? |
|
Definition
| fluid component of blood containing abundant proteins, electrolytes, CLOTTING FACTORS, glucose etc. |
|
|
Term
| What type of analysis is more greatly impacted by laboratory methadology, hematology or chemistry? |
|
Definition
|
|
Term
| What percentage of normal patients will be outside of reference ranges? |
|
Definition
|
|
Term
| What are some hematopoietic cytokines that regulate the production of RBC within the bone marrow? |
|
Definition
| poietins, colony stimulating factors, interleukins |
|
|
Term
| What stimulates increased erythropoietin production and where does it occur? |
|
Definition
| renal hypoxia stimulates cells in the renal cortex to increase production of erythropoietin |
|
|
Term
| What are the three functions of hemoglobin? |
|
Definition
| Transport oxygen from lungs to tissues, transport carbon dioxide from tissues to lungs, buffer H+ |
|
|
Term
| What state must the iron in hemoglobin be in to bind oxygen? |
|
Definition
|
|
Term
| Iron in methemoglobin is _____ |
|
Definition
|
|
Term
| How is iron transported in the plasma? |
|
Definition
| bound to the protein transferrin |
|
|
Term
| how is iron stored in body tissues? |
|
Definition
| as hemosiderin, or bound to the protein ferritin (also stored in plasma bound to ferritin) |
|
|
Term
| What measurement is the best indicator of total body iron content? |
|
Definition
| serum ferritin (i.e. serum iron is NOT specific to iron deficiency, for example tissue iron stores could be increased coinciding with low serum iron levels) |
|
|
Term
| What is the erythrocyte lifespan in a dog? In a cat? |
|
Definition
canine- 120 days
feline - 60 days |
|
|
Term
| Aged erythrocytes are phagocytized by macrophages which break down hemoglobin into ____ and _____ |
|
Definition
| heme (---->iron and bilirubin) and globin (---> amino acids) |
|
|
Term
| What species has the larges MCV, which has the smallest? |
|
Definition
| dog has largest, goat has smallest |
|
|
Term
| what breeds of dogs normally have macrocytic RBC? |
|
Definition
|
|
Term
| What does anisocytosis describe? |
|
Definition
| variation in RBC size (i.e. increased numbers of small RBC, large RBC, or both) |
|
|
Term
| What is MCHC dependent upon? |
|
Definition
| MCHC is a measurement of erythrocyte color and is dependent upon the hemoglobin concentration within the cells |
|
|
Term
| what species has RBC characterized by well defined regions of central pallor? |
|
Definition
|
|
Term
|
Definition
abnormally shaped RBC
(may be present in healthy goats, pigs, and young cattle) |
|
|
Term
| What are the morphological characteristics of spherocytes? |
|
Definition
| decreased diameter, decreased central pallor, increased staining intensity |
|
|
Term
| In what species are spherocytes typically noted, and what pathological process is implicated by their presence? |
|
Definition
canine
indicative of immune mediated damage to RBC, spherocytes form following partial phagocytosis of RBC membrane |
|
|
Term
| What morphological feature characterizes schistocytes and what pathologic processes are they associated with? |
|
Definition
| irregular RBC fragment indicating physical damage to RBC as a result of abnormal hemostasis/vasculature (ex. DIC, vasculitis, hemangiosarcoma) |
|
|
Term
| What morphological feature characterizes keratocytes and what pathologic processes are they associated with? |
|
Definition
| blister or horn-like projections, form as a result of intravascular trauma (ex. DIC, hemagiosarcoma, vasculitis) |
|
|
Term
| What morphological feature characterizes eccentrocytes and what pathologic processes are they associated with? |
|
Definition
| oxidative damage causes cell membrane fusion resulting in a clear region with all of the hemoglobin shifted to the opposite side of the cell, may also be seen in association with heinz bodies |
|
|
Term
| What morphological feature characterizes ghost cells and what pathologic processes are they associated with? |
|
Definition
| empty RBC membranes that form as a result of cell lysis. Can be artifactual as a result of poor sample preparation, or in association with intravascular hemolysis (ex. IMHA) |
|
|
Term
| What morphological feature characterizes acanthocytes and what pathologic processes are they associated with? |
|
Definition
| irregular surface projections that form as a result of altered lipid/cholesterol content in cell membranes. Acanthocytes are seen in association with splenic hemangiosarcoma, hepatic lipidosis and renal disease etc. |
|
|
Term
| What morphological feature characterizes echinocytes and what pathologic processes are they associated with? |
|
Definition
short, evenly spaced, uniform surgace projections
usually articatual as a result of slow blood film drying
can be associated with electrolyte depletion, renal disease, neoplasia, rattlesnake envenomation, and chemotherapy |
|
|
Term
| What morphological feature characterizes codocyte and what pathologic processes are they associated with? |
|
Definition
aka. target cell, central area of hemoglobin surrounded by a clear ring and an outer rim of hemoglobin
LIMITED DIAGNOSTIC SIGNIFICANCE |
|
|
Term
| What are the three basic elements of fluid analysis? |
|
Definition
| Measurement of total protein, total nucleated cell count, and preparation of cytologic specimen |
|
|
Term
| What is the typical nucleated cell count and total protein for normal feline and canine thoracic and abdominal fluid? What type of exudate is this? |
|
Definition
less than 1000 cells/um (large animals normally have higher cell counts <5000), less than 2.5 g/dl
transudate |
|
|
Term
| What is the lowest accurate reading that can generally be obtained with a hand-held refractometer? |
|
Definition
|
|
Term
| What is the major cell type generally found in transudates? |
|
Definition
| Mononuclear cells (mostly macrophages, smaller numbers of mesothelial cells, mature lymphocytes, and non-degenerate neutrophils) |
|
|
Term
| Transudates develop secondary to _____ process. |
|
Definition
| passive (ie. altered fluid dynamics, most frequently secondary to hypoproteinemia and/or hypertension) |
|
|
Term
| What cytologic feature is characteristic of reactive mesothelial cells? |
|
Definition
an eosinophilic fringe/brush border
may also be multinucleated with prominent multiple nucleoli (ie. challenging to differentiate from malignant neoplastic cells) |
|
|
Term
| Modified transudates are associated with what pathologic process? |
|
Definition
| increased vascular permiability of non-inflamed vessels (ie. increased hydrostatic pressure or lymphatic obstruction) |
|
|
Term
| What is the total protein and total nucleated cell count that characterizes a modified transudate? |
|
Definition
2.5-5.0 g/dl
1000-8000 cells/um (large animals normally have higher cell counts (>5000) |
|
|
Term
| What conditions favor the development of a non-septic exudate? |
|
Definition
| chronic transudate/modified transudate can act as an inflammatory instigator resulting in chemotaxis of neutrophils(non-degenerate) in the absence of bacterial organisms. |
|
|
Term
| What type of process is associated with exudates? What are the observed total protein and total nucleated cell counts? |
|
Definition
inflammatory
>3g/dl
>5000 (>10,000 for large animals) cells/um |
|
|
Term
| What is the predominant cell type observed in an exudate? |
|
Definition
neutrophils
(also macrophages, lymphocytes, eosinophils and mesothelial cells) |
|
|
Term
| What pathologic process results in chylous effusions? What cell type predominates? |
|
Definition
leakage of lymphatics, small lymphocytes predominate
(fluid parameters are comparable to modified transudate, milky opacity is a result of high triglyceride content (>100mg/dl) |
|
|
Term
| What are the morphologic features of degenerate neutrophils and what pathologic process does their presence implicate? |
|
Definition
poor cellular detail, swollen pale nuclei
degenerate neutrophils are highly suggestive of a septic process (CULTURE this fluid even if organisms cannot be cytologically evaluated) |
|
|
Term
| How can hemorrhage effusion be distinguished from iatrogenic blood contamination? |
|
Definition
erythrophagocytosis and the presence of hemosiderin (blue/black amorphous material) and/or hematoidin(golden rhomboid crystals) within macrophages
*if the hemorrhage is very recent it is near impossible to distinguish from contamination, use entire clinical picture to guide decision making |
|
|
Term
| In mature adults hematopoiesis occurs primarily in what bones/regions? |
|
Definition
flat bones (ex. sternum)
and epiphyses of long bones |
|
|
Term
| True or false, bone marrow is highly vascularized and richly innervated |
|
Definition
|
|
Term
| Where do leukocyte precursors concentrate within the bone marrow? |
|
Definition
|
|
Term
| Where do megakaryocytes and erythrocyte precursors concentrate within the bone marrow? |
|
Definition
|
|
Term
| Within the bone marrow more mature cells exist in _____ numbers than immature cells |
|
Definition
| more mature cells are present in the LARGEST numbers, while the least mature forms are present in small numbers (ie. pyramid of development) |
|
|
Term
| True or false, mature lymphocytes and plasma cells are not seen in the bone marrow |
|
Definition
| FALSE, although bone marrow is not the primary organ for lymphoid cell production small numbers of lymphocytes and plasma cells are regularly appreciated in bone marrow biopsy |
|
|
Term
| What are the five indications for bone marrow aspirate/core biopsy? |
|
Definition
1. unexplained non-regenerative anemia, neutropenia and/or thrombocytopenia
2. Presence of unusual/abnormal cells in the peripheral blood
3. suspected hematologic malignancy (on the basis of LN/spleen aspirates, and to aid in staging)
4. Evaluation of unexplained hypercalcemia (r/o lymphoma or multiple myeloma) or hyperglobulinemia (r/o lymphoid neoplasia mets to marrow)
5. Screening for infectious agents (ex. histoplasmosis or leishmania) |
|
|
Term
| What are the strengths of bone marrow aspiration as compared to core biopsy? |
|
Definition
| better evaluation of fine morphologic details and patterns of maturation |
|
|
Term
| What are the strengths of bone marrow core biopsy as compared to aspiration? |
|
Definition
| Better assessment of overall cellularity and tissue architecture |
|
|
Term
| When assessing the quality of a bone marrow aspirate what two features should be present in a good quality sample? |
|
Definition
| small particles of bone and fat |
|
|
Term
| What is the normal distribution of cells:fat in healthy adult animal bone marrow? |
|
Definition
|
|
Term
| In the bone marrow of younger animals what percentage of the aspirate sample should be cells? In geriatric animals? |
|
Definition
|
|
Term
| The ratio of Myeloid:Erythroid cell precursors in the bone marrow of a healthy animal should be ____ |
|
Definition
|
|
Term
| What is a more common bone marrow pathology, hyperplasia or hypoplasia? |
|
Definition
| hyperplasia (often attributed to immune or inflammatory disease, drug effects, infectious agents, or iron deficiency) |
|
|
Term
| Marrow hyperplasia with normal cellular maturation is indicative of what process? |
|
Definition
| Increased peripheral demand (ex. IMHA, heinz body anemia, bacterial infection) |
|
|
Term
| What drugs have been shown to cause marrow suppression? |
|
Definition
| Cytotoxic chemotherapy (target rapidly dividing cells), estrogen, fenbendazol/albendazole, tapazol/methimazole, phenobarbitol |
|
|
Term
| What type of diagnostic test is most useful to confirm bone marrow necrosis? |
|
Definition
|
|
Term
|
Definition
| primary tumors of the blood and bone marrow |
|
|
Term
| What type of cells predominate, and what is the expected clinical course in acute leukemias? |
|
Definition
immature blastic cells predominate
rapidly progressive disease |
|
|
Term
| What type of cells predominate, and what is the expected clinical course in chronic leukemias? |
|
Definition
mature cells predominate
protracted course of disease |
|
|
Term
|
Definition
| the accumulation of additional cytogenetic abnormalities in a population of chronic leukemic cells resulting in the evolution to acute leukemia |
|
|
Term
| Patients with leukemia usually have circulating levels of neoplastic cells greater than ______ |
|
Definition
| 50,000 cells/um and often up to 100,000-300,000 cells/um |
|
|
Term
|
Definition
| very low numbers of circulating neoplastic cells |
|
|
Term
| What characteristics of patient signalment are associated with acute lymphoblastic leukemia (ALL)? |
|
Definition
young-middle aged, systemically ill on presentation, pale mucus membranes, hepatomegaly and splenomegally, mild-moderate lymphadenopathy
cats are often FeLV positive |
|
|
Term
| What CBC findings are supportive of acute lymphoblastic leukemia (ALL)? |
|
Definition
persistent marked immature lymphocytosis, non-regenerative anemia, neutropenia, throbocytopenia
further DX: Assess core biopsy to avoid hemodilution |
|
|
Term
| What characteristics of patient signalment are associated with chronic lymphocytic leukemia (CLL)? |
|
Definition
| middle aged-older, more common in dogs, minimal clinical signs |
|
|
Term
| What CBC findings are supportive of chronic lymphocytic leukemia (CLL)? |
|
Definition
persistant well differentiated lymphocytosis (often large granular lymphocytes: azurophilic cytoplasmic granules, less condensed chromatin, increased quantity of pale cytoplasm)
mild non-regenerative anemia may be present
further DX: Assess core biopsy to avoid hemodilution |
|
|
Term
| What characteristics of patient signalment are associated with acute myeloid leukemia (AML)? |
|
Definition
| variable age, acute onset of clinical signs related to peripheral cytopenias (ie. pallor, shifting lameness, bleeding), mild to moderate lymphadenopathy, splenomegally, cats tend to be FeLV positive |
|
|
Term
| What CBC findings are supportive of acute myeloid leukemia (AML)? |
|
Definition
| elevated numbers of immature neoplastic cells, moderate-marked non-regenerative anemia, neutropenia, thrombocytopenia |
|
|
Term
| What bone marrow aspirate findings are consistent with acute myeloid leukemia (AML)? |
|
Definition
| blast cells representing 20-30% of all nucleated cells |
|
|
Term
| What CBC results are consistent with chronic granulocytic leukemia? |
|
Definition
marked neutrophilia with disorderly left shift, mild non-regenerative anemia
further DX: BM aspirate (<30% blasts) |
|
|
Term
| What CBC results are consistent with chronic myelomonocytic leukemia? |
|
Definition
marked neutrophilia and monocytosis, mild non-regenerative anemia
further DX: BM aspirate (<30% blasts) |
|
|
Term
| What CBC results are consistent with chronic eosinophilic leukemia? |
|
Definition
marked eosinophilia, mild non-regenerative anemia
further DX: BM aspirate (<30% blasts) |
|
|
Term
| True or False, most mast cell tumors originate in the bone marrow |
|
Definition
| FALSE, mast cells do originate in the bone marrow and true mast cell leukemia has been reported, but the majority of mast cell tumors metastasize to the bone marrow from peripheral tissues |
|
|
Term
| Bernese Mountain Dogs, Rottweilers, Gold Retrievers, and Flat Coated Retrievers are predisposed to develop what type of round cell tumor? |
|
Definition
| histiocytic sarcoma complex |
|
|
Term
| What cytologic features are commonly noted in dogs with hemophagocytic histiocytic sarcoma? |
|
Definition
| significant numbers of large pleomorphic mononuclear cells, with multiple nuclei and bizarre mitotic figures |
|
|
Term
| What are two differential diagnoses for histiocytic sarcoma? |
|
Definition
| Large T-Cell lymphoma, and aplastic mast cell tumors |
|
|
Term
| multiple myeloma originates from what cell population? |
|
Definition
| well differentiated B lymphocytes |
|
|
Term
| What gammopathies are most common in dogs with multiple myeloma? |
|
Definition
|
|
Term
| What gammopathies are most common in cats with multiple myeloma? |
|
Definition
|
|
Term
| What are heinz bodies? In what species can heinz bodies be appreciated in healthy individuals |
|
Definition
clumps of denatured hemoglobin that form secondary to oxidative damage to RBC.
Healthy cats can have heinz bodies in up to 10% of their RBC |
|
|
Term
| Basophilic stippling of RBC can be appreciated best in what species? What process results in this morphologic feature? |
|
Definition
Best appreciated in ruminant immature RBC associated with regenerative anemia.
can also be seen in animals with lead toxicity |
|
|
Term
| The presence of nucleated RBC in peripheral blood is indicative of what pathologic process? |
|
Definition
toxic, hypoxic, or physical damage to the bone marrow endothelium
may also be seen in association with regenerative anemias |
|
|
Term
| In what species is rouleaux formation normal? |
|
Definition
| horses, slight amounts may also be seen in normal cats |
|
|
Term
| what hematologic abnormality is seen is conjunction with rouleaux? |
|
Definition
| hyperprotinemia, the proteins mask the negative charges on the RBC surface membrane allowing the cells to associate with each other in linear stacks |
|
|
Term
| What pathologic process is responsible for RBC agglutination? |
|
Definition
| antibody bridging between RBC results in irrgular grape-like clusters of cells. Often seen in conjunction with IMHA |
|
|
Term
| Blood loss or RBC destruction results in ______ anemia. |
|
Definition
|
|
Term
| What species does not release reticulocytes into peripheral circulation with regenerative anemias? |
|
Definition
| horses, evaluate bone marrow respose with serial PCV, CBC, or bone marrow biopsy |
|
|
Term
| What three basic processes can result in the clinical presentation of anemia? |
|
Definition
1. Loss of RBC (ex. hemmorhage)
2. Destruction of RBC (ex. IMHA)
3. Failure of production (ex. decreased erythropoitin) |
|
|
Term
| acute blood loss anemia is characterized by (cell size, color, marrow response): |
|
Definition
| macrocytic, hyopchromic, regenerative anemia |
|
|
Term
| Iron deficiency anemia is characterized by (cell size, color, marrow response): |
|
Definition
| microcytic, hypochromic, non-regenerative anemia |
|
|
Term
| Immune mediated hemolytic anemia is characterized by (cell size, color, marrow response): |
|
Definition
macrocytic, hypochromic, regenerative anemia
also spherocytes, agglutination, hemoglobinemai/hemoglobinuria |
|
|
Term
| acetaminophen, onion/garlic, zinc toxicity, propofol, methylene blue, and propylene glycol, red maple leaf (equine), copper toxicity (sheep), selenium deficiency (ruminants) can all cause _____ anemia. |
|
Definition
|
|
Term
| Fragmentation anemia is characterized by what RBC morphological abnormalities? |
|
Definition
| schistocytes and keratocytes (ie. direct physical trauma to RBC) |
|
|
Term
| Anemia of inflammation/chronic disease is characterized by (cell size, color, marrow response): |
|
Definition
mild-moderate normocytic, normochromic, non-regenerative anemia
(due to altered iron kinetics, reduced production and response to erythropoitin, and decreased RBC lifespan) |
|
|
Term
| Anemia of chronic renal failure is characterized by (cell size, color, marrow response): |
|
Definition
| moderate to severe normochromic, normocytic, non-regenerative anemia |
|
|
Term
| Pure red cell aplasia is characterized by (cell size, color, marrow response): |
|
Definition
SEVERE normocytic, normochromic, non-regenerative anemia with normal leukocyte and platelet numbers
(due to immune mediated destruction of erythroid precursors in the bone marrow) |
|
|
Term
| Aplastic pancytopenia is characterized by (cell size, color, marrow response): |
|
Definition
peripheral bicytopenia/pancytopenia, normocytic, normochromic, non-regenerative anemia
(bone marrow space is replaced by fat, reversible or irreversible damage to hematopoietic precursors (ex. estrogen, toxins/drugs, infectious agents like parvo FeLV and ehrlichia)) |
|
|
Term
| Relative polycythemia occurs following what two processes? |
|
Definition
1. dehydration (elevated TP is supportive)
2. splenic contraction (esp. in excited/stressed horses and cats, concurrent epinephrine leukogram is supportive) |
|
|
Term
| True or False, primary absolute polycythemia is rare |
|
Definition
| TRUE, polycythemia vera is a rare neoplastic proliferation of mature RBC (ie. myeloproliferative disorder) |
|
|
Term
| Secondary appropriate polycythemia occurs with what pathologic process? |
|
Definition
systemic hypoxemia (ie. decreased PaO2)
-->elevated erythropoietin |
|
|
Term
| Secondary inappropriate polycythemia occurs secondary to what two pathologic processes? |
|
Definition
1. Renal ischemia
2. Erythropoietin-producing tumor
---> increased erythropoietin, normal systemic PaO2 |
|
|
Term
| What species has the largest neutrophil resevoir pool? The smallest? |
|
Definition
Dogs have the largest
Ruminants have the smallest |
|
|
Term
| What CBC abnormalities characterize a left shift? What underlying process results in a left shift? |
|
Definition
| elevated numbers of band neutrophils are present on the CBC as a result of depletion of mature segmented neutrophils in the bone marrow storage pool. |
|
|
Term
| What CBC abnormality is considered the hallmark of acute inflammation? |
|
Definition
|
|
Term
| What is a degenerative left shift, and what effect does its presence have on prognosis in small animals? in large animals? |
|
Definition
degenerative left shift occurs when band neutrophils outnumber mature segmented neutrophils.
degenerative left shift is a poor prognostic indicator in small animals given their relatively generous marrow storage pools
degenerative left shift is not a poor prognostic indicator in large animals, esp. ruminants which have a much smaller bone marrow reserve pool |
|
|
Term
| What mechanisms are responsible for inflammatory neutrophilia? |
|
Definition
| increased release of neutrophils from marrow storage pools and increased production of neutrophils by hematopoietic precursors in the bone marrow |
|
|
Term
| What mechanisms are responsible for steroid neutrophilia? |
|
Definition
| Shift from marginated to circulating pool (glucocorticoids down regulate surface adhesion proteins) and increased release from bone marrow reserve pools. |
|
|
Term
| What mechanisms are responsible for epinephrine neutrophilia? |
|
Definition
| Shift from marginated to circulating pool, transient neutrophilia is most commonly appreciated in cats and horses |
|
|
Term
| What three general mechanisms are associated with neutropenia? |
|
Definition
1.shift from circulating to marginated pool
2. decreased production in the bone marrow
3. overwhelming tissue demand |
|
|
Term
| What are the mechanisms associated with inflammatory neutropenia? |
|
Definition
overwhelming tissue demand
most commonly seen in ruminants (small bone marrow reserve pools) and often in conjunction with left shift |
|
|
Term
| What are the mechanisms associated with endotoxemia neutropenia? |
|
Definition
| shift from circulating to marginated pool (due to LPS present in the cell wall of gram negative organisms) |
|
|
Term
| What processes can cause decreased production of neutrophils in the bone marrow? |
|
Definition
| viruses, tick borne diseases, drugs, neoplasia, myelofibrosis etc. can damage either the granulocytic precursors or the bone marrow microenvironment in such a way that production of neutrophils is suppressed (usually see bicytopenia or pancytopenias) |
|
|
Term
| True or False, immune mediated neutropenia is rare |
|
Definition
|
|
Term
| Where do toxic changes develop? |
|
Definition
| toxic changes occur in developing neutrophils within the bone marrow during times of increased production |
|
|
Term
| What are the three most common morphological features of neutrophil toxic change? |
|
Definition
1. Cytoplasmic vacuolization
2. Increased cytoplasmic basophilia
3. Dohle bodies (focal basophilic inclusions, aggregates of rough endoplasmic reticulum) |
|
|
Term
| What leukocyte abnormality is seen in animals that have pelger-huet anomaly? How does this affect the function of these cells? |
|
Definition
ALL granulocytes (neutrophils, eosinophils, and basophils) have hyposegmented nuclei
Cells have normal function and should not be mistaken for degenerative left shift |
|
|
Term
| What species typically have more variation in lymphocyte size in healthy animals? |
|
Definition
|
|
Term
| What morphologic features are characteristic of reactive lymphocytes? |
|
Definition
| increased cytoplasmic basophilia and amount, perinuclear clear zone, increased size, nuclear atypia |
|
|
Term
| What are the effects of epinephrine, chronic inflammation and/or hypoadrenocorticism on circulating lymphocyte levels? |
|
Definition
|
|
Term
| What is the mechanism of steroid lymphopenia? |
|
Definition
sequestration of lymphocytes within lymphoid tissues and decreased production.
*lymphopenia is the most consistent feature of a steroid leukogram |
|
|
Term
| What are the three main functions of monocytes? |
|
Definition
| phagocytosis, antigen presentation (to lymphoid cells), secretion of cytokines (to modulate immune response) |
|
|
Term
| What three processes can cause a monocytosis? |
|
Definition
| inflammation, steroids, neoplasia |
|
|
Term
| What are the two main functions of eosinophils? |
|
Definition
| antiparasitic (esp. major basic protein), and modulation of allergic reactions |
|
|
Term
| True or False, mast cells are commonly seen in circulation |
|
Definition
|
|
Term
| Mature neutrophilia with normal morphology and lymphocytosis is characteristic of what leukogram pattern? |
|
Definition
steroid leukogram
more commonly seen in cats and horses, transient (resolves in minutes to hours) |
|
|
Term
| Mature neutrophilia with normal morphology, lymphopenia +/- monocytosis and eosinopenia is characteristic of what leukogram pattern? |
|
Definition
steroid leukogram
*lymphopenia is the most consistent feature of a steroid leukogram |
|
|
Term
| neutrophilia +/- left shift and toxic change +/- monocytosis is indicative of what leukogram pattern? |
|
Definition
|
|
Term
| Neutropenia +/- toxic change and left shift is indicative of what leukogram pattern? |
|
Definition
inflammatory with overwhelming tissue demand
or
endotoxin leukogram (LPS causes a rapid shift of neutrophils from circulating to marginated pool, given time increased production in the bone marrow will result in neutrophilia and a classic inflammatory leukogram) |
|
|
Term
| neutropenia +/- anemia and thrombocytopenia is indicative of what process? |
|
Definition
|
|
Term
| In adult cattle are neutrophils or lymphocytes more numerous in the peripheral blood? |
|
Definition
|
|
Term
| In what species are neutrophils the predominant circulating leukocyte? |
|
Definition
| dogs, cats, horses (N:L is approximately 1-2) |
|
|
Term
| What are clinical signs associated with primary hemostatic disorders? |
|
Definition
| petechia, ecchymoses, bleeding from mucosal surfaces, prolonged bleeding from injection sites |
|
|
Term
| Activation of platelets and the formation of a platelet plug are processes involved in ______ hemostasis. |
|
Definition
|
|
Term
| What clinical signs are associated with secondary hemostatic defects? |
|
Definition
| hematomas, bleeding into joints, body cavities, and muscle |
|
|
Term
| The coagulation cascade and formation of a stable fibrin clot are associated with _____ hemostasis. |
|
Definition
|
|
Term
| Platelets are produced by what cell type in the bone marrow? |
|
Definition
|
|
Term
| What is the primary stimulus for platelet production and in what organ is it mainly produced? |
|
Definition
| thrombopoietin, produced mainly in the liver |
|
|
Term
| characterize the relationship between platelet mass and circulating levels of thrombopoietin. |
|
Definition
| inverse relationship (thrombopietin is continually being cleared from circulation via receptor mediated uptake by platelets and megakaryocytes so as the numbers of platelets in circulation rise, the amount of free thrombopoietin falls.) |
|
|
Term
| What is the life span of a neutrophil in peripheral blood? |
|
Definition
|
|
Term
| what is the lifespan of a platelet in peripheral blood? |
|
Definition
|
|
Term
| platelet cell membranes contain receptors for what molecules? |
|
Definition
| fibrinogen, von Willebrand factor, collagen, and ADP among others |
|
|
Term
| What substances are contained in platelet alpha granules? |
|
Definition
| coagulation and growth factors |
|
|
Term
| what substances are contained in platelet dense granules? |
|
Definition
| ADP, calcium ions and serotonin |
|
|
Term
| subendothelial collagen, thrombin, inflammatory mediators all have what effect on platelets? |
|
Definition
|
|
Term
| Aside from their role in hemostasis, what other functions to platelets engage in? |
|
Definition
| mediate inflammatory processes, maintenance of vascular integrity, and tissue repair |
|
|
Term
| What concentration of platelets in peripheral blood is consistent with hemorrhage in the absence of abnormalities other than thrombocytopenia? |
|
Definition
| <25,000 platelets/um (most likely due to a breakdown in endothelial cell tight junctions, as platelets play a vital role in maintaining vascular integrity) |
|
|
Term
| If hemorrhage occurs concurrent with peripheral platelet levels >50,000/um what other pathologic processes should be considered? |
|
Definition
| platelet function defect (ie. thrombopathy) or DIC |
|
|
Term
| What does the presence of macroplatelets indicate? |
|
Definition
| macroplatelets indicate regenerative marrow response to thrombocytopenia, additionally macroplatelets appear to be hyperfunctional |
|
|
Term
| What hemostatic abnormalities will prolong buccal mucosal bleeding time? |
|
Definition
moderate to marked thrombocytopenia and platelet function defects
ie. NOT coagulation factor abnormalities |
|
|
Term
| What is the most common cause of marked thrombocytopenia in dogs? |
|
Definition
| Immune mediated thrombocytopenia |
|
|
Term
| Disseminated intravascular coagulation can present with what degree of thrombocytopenia? |
|
Definition
|
|
Term
| What infectious agents are associated with thrombocytopenia? What mechanisms are responsible? |
|
Definition
| ehrlichia and anaplasma, increased platelet destruction/consumption and suppressed platelet production |
|
|
Term
| What dog breed has a heritable idiopathic thrombocytopenia? What is the clinical presentation? |
|
Definition
| Cavalier King Charles Spaniels, these animals are normal and do not have bleeding problems because their platelets are hyperfunctional (ie. macrothrombocytosis) |
|
|
Term
| What effect does exercise and epinephrine have on circulating platelet levels? |
|
Definition
| mild transient thrombocytosis |
|
|
Term
| What is the most common hereditary bleeding disorder in dogs? |
|
Definition
|
|
Term
| How does von Willebrand factor influence hemostasis? |
|
Definition
| vWF bridges platelets to subendothelial collagen as well as forming stabilizing complexes with coagulation factor 8. |
|
|
Term
| What diagnostic findings are supportive of von Willebrand disease? |
|
Definition
| normal platelet numbers and coagulation assays, prolonged buccal mucosal bleeding time |
|
|
Term
| Which inflammatory cytokine in particular stimulates thrombopoeitin? |
|
Definition
|
|
Term
| What is the end result of the coagulation cascade? |
|
Definition
| formation of thrombin and a stable cross-linked fibrin plug |
|
|
Term
| What organ is responsible for the production of most of the coagulation factors? |
|
Definition
|
|
Term
| What coagulation factors are vitamin K dependent? |
|
Definition
| factors 2(thrombin),7,9,10 |
|
|
Term
| In-vivo coagulation is generally initiated by activation of what coagulation factor in which pathway? |
|
Definition
| factor 3 (tissue factor) in the extrinsic pathway |
|
|
Term
| What coagulation factors are involved in the intrinsic pathway? |
|
Definition
|
|
Term
| What is the most commonly reported coagulation factor deficiency in cats? |
|
Definition
| factor 12, markedly prolonged coagulation tests but no clinical bleeding disorder (factor 7 can activate the intrinsic system) |
|
|
Term
| Individuals with hemophilia have deficiencies in which coagulation factors? |
|
Definition
|
|
Term
| What coagulation factors are involved in the extrinsic pathway? |
|
Definition
| tissue factor (3), and factor 7 |
|
|
Term
| What coagulation factor has the shortest half life? |
|
Definition
| factor 7 (this is the first factor to be depleted in cases of rodenticide toxicity) |
|
|
Term
| What coagulation factors are involved in the common pathway? |
|
Definition
| factor ten, five, 2 (prothrombin) and 13 |
|
|
Term
| How does thrombin amplify the hemostatic response? |
|
Definition
| thrombin activates factor 5 and 13 of the common pathway, and factors 8 and 11 of the intrinsic pathway, induces platelet aggregation, activated endothelial cells and activated inflammatory mononuclear cells |
|
|
Term
| What is the function of factor 13 of the common pathway? |
|
Definition
| cross-links fibrin (D-dimer) to form a stable secondary hemostatic plug |
|
|
Term
| What is the major inhibitor of coagulation? What organ produces it? |
|
Definition
| Antithrombin III, produced by the liver |
|
|
Term
| What five coagulation tests abnormalities are consistent with DIC? |
|
Definition
low fibrinogen (consumption in clots)
elevated PTT/PT
elevated fibrinogen degredation products
erythrocyte morphology indicative of physical trauma to RBC (shistocytes and keratocytes)
low antithrombin (this value is rarely measured) |
|
|
Term
| Which coagulation test is the least sensitive to abnormalities in coagulation factors? |
|
Definition
Activated clotting time (ACT) (is decreased when a given factor has only 5% function remaining)
additionally may be prolonged in cases of marked thrombocytopenia due to a reduction in phospholipid surfaces necessary for coagulation) |
|
|
Term
| PTT (partial thromboplastin time) is a screening test for which of the coagulation pathways? |
|
Definition
|
|
Term
| PT (prothrombin time) is a screening test for which of the the coagulation pathways? |
|
Definition
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