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101 Cards in this Set
- Front
- Back
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Analytical specificity (define)
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Ability of an assay to measure an analyte in the presence of potentially interfering substances
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Analytical sensitivity (define)
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How much change in an analyte is needed for a particular assay to detect that change
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Analytical accuracy (define)
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Comparison between the measurement of an analyte in question and a true value or gold standard
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Analytical precision (define)
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Reproducibility of a test
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Correlation study (define)
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Used to compare measurements of an analyate between different instruments or methodologies
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9 general attributes that affect a reference interval
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- Age
- Sex - Species - Breed - Diet - Exercise - Excitement - Medications - Collection and processing of sample |
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How is a reference interval established?
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Testing at least 120 individuals from different populations
- May have to use less, around 60 though, for vet med. |
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What is an ideal reference interval?
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Values obtained in the past from same patient
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What amount of 'normal' animals might have values outside the reference interval?
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2.5%
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Three things being evaluated during Quality Control
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- Instrument
- Assay method - Operator |
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Reagent (define)
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Used to measure amount, concentration, or activity of a particular substance
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Control (define)
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Solutions designed to determine precision and accuracy of an instrument
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Calibrator (define)
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Solutions designed to adjust or establish instrument settings for a particular assay
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Diagnostic sensitivity (define)
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Ability of a test to correctly identify individuals with a disease
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Diagnostic specificity (define)
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Ability of a test to correctly identify individuals without a disease
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Prevalence (define)
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Total numbers of cases of a disease in existence at a certain time in a designated population
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Relationship of prevalence to PPV and NPV
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As prevalence increases, PPV increases
- Vice versa for NPV |
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Formula for diagnostic sensitivity
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[TP / (TP + FN)] x 100
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Formula for diagnostic specificity
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[TN / (TN + FP)] x 100
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Positive predictive value (define)
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Probability that an animal that tested positive for a disease, actually has the disease
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Negative predictive value (define)
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Probability that a animal that tested negative for a disease does not have that disease
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Incidence (define)
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Number of new cases of a specific disease occurring within a certain period
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Positive predictive value (formula)
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[TP / (TP + FP)] x 100
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Negative predictive value (formula)
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[TN / (TN + FN)] x 100
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Hematopoiesis (define)
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Formation and development of blood cells
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3 granulocytes
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- Neutrophils
- Basophils - Eosinophils |
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4 locations of fetal hematopoiesis
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- Yolk sac (first location of blood production)
- Liver - Spleen - Bone marrow |
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3 sites of post-natal hematopoiesis
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- Bone marrow
- Spleen (extramedullary) - Liver (extramedullary) |
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When does extramedullary hematopoiesis occur?
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When demand outpaces the ability of bone marrow to produce
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Two primary compartments of bone marrow
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- Vascular compartment
- Hematopoietic compartment |
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3 primary hematopoietic cell lineages
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- Stem cells
- Burst forming units (BFUs) - Colony forming units (CFUs) |
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2 cells that BFUs create
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- Erythrocytes
- Megakaryocytes |
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5 cells that CFUs create
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- Erythrocytes
- Megakaryocytes - Moncytes - Eosinophils - Basophils |
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2 differences between multipotential and pluripotential stem cells
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Multipotential can renew indefinitely; gives rise to pluripotential precursor cells
- Pluripotential can also renew, but not to the same extent Multipotential is CD34+ Pluripotential is CD34+, CD38+ |
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What are committed precursor cells?
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Precursor cells that lack capacity of unlimited self-renewal and are restricted in their differentiation potential
- Includes BFUs and CFUs |
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What is the platelet series? (6)
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CFU - GEMM
V BFU - Meg V CFU-Meg V Megakaryoblast V Megakaryocyte V Platelets |
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Erythroid series (erythropoiesis)
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CFU - GEMM --> BFU - E --> CFU - E --> Rubriblast --> Prorubricyte --> Rubricyte --> Metarubricyte --> Reticulocyte --> Erythrocyte
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Granulocyte series (granulopoiesis)
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CFU - GM --> CFU - G --> Myeloblast --> Promyelocyte --> Myelocyte --> Metamyelocyte --> Band cell --> Segmented cell
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Monocyte series (monocytopoiesis)
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CFU - GM --> CFU - G --> Monoblast --> Promonocyte --> monocyte -->-->--> Macrophage (in tissue)
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How long does thrombopoesis take from megakaryoblast to mature platelets?
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4 - 5 days
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How long does erythropoiesis take from the rubriblast to the reticulocyte stage?
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4 - 5 days
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What is the last stage of erythropoiesis that's capable of cell division?
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Rubricyte
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How much of the erythropoietic series should be rubricytes and metarubricytes?
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80 - 90%
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What indicates a left shift in erythropoietis?
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Increase in rubriblasts and prorubricytes
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How long does granulocytopoiesis take from the myeloblast to mature segmented cell stage?
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4 - 6 days
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Two 'compartments' involved with granulocytopoiesis
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- Proliferation-mitotic compartment (mitotic pool)
- Storage-maturation compartment (storage pool) |
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4 stages that occur in the proliferation-mitotic compartment in granulocytopoeisis
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CFU --> myeloblast --> promyelocyte --> myelocyte
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3 stages that occur in the storage-maturation compartment in granulocytopoeisis
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Metamyelocyte --> band cell --> segmented cell
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Which stages of granulocytopoiesis are capable of division?
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CFU --> myeloblast --> promyelocyte --> myelocyte
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6 reasons for bone marrow evaluation
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- Low numbers of cells
- High numbers of cells - Abnormal cells - Suspicion of neoplasia or metastasis - Suspicion of systemic infection - Assessment of iron stores |
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What species does not store iron in their bone marrow?
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Cats
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What must be run concurrently with a bone marrow evaluation?
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CBC
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What's the major growth factor that regulates erythropoiesis?
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Erythropoietin
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How does erythropoietin work?
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Acts on CFU-E stage to prevent apoptosis of progenitor cells
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Three important growth factors in granulocytopoiesis
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- IL-3
- Granulocyte-macrophage Colony Stimulating Factor (GM-CSF) - Granulocyte Colony Stimulating Factor (G-CSF) |
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What does Granulocyte Colony Stimulating Factor (G-CSF) do?
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Stimulates neutrophil production and function
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What does IL-3 do?
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Expands progenitor or precursor pools in bone marrow to increase leukocyte function
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What 3 cell lines does IL-3 affect?
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- Megakaryocyte
- Erythroid - Myeloid |
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What does Granulocyte-macrophage Colony Stimulating Factor (GM-CSF) do?
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Stimulates production and function of granulocytes and macrophages
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4 growth factors being used therapeutically
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- Thrombopoietin
- Erythropoietin - IL-11 - G-CSF |
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2 types of bone marrow biopsies
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- Aspiration biopsy
- Core biopsy |
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What is an aspiration biopsy used for?
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Cytological evaluation
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What is a core biopsy used for?
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Histopathological evaluation
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What bone marrow biopsy technique would you use to determine cellular morphology?
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Aspiration
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What bone marrow biopsy technique would you use to determine overall cellularity?
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Core biopsies
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3 locations for bone marrow collection in dogs
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- Iliac crest
- Proximal femur - Proximal humerus |
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4 locations for bone marrow collection in horses
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- Iliac crest
- Tuber coxae - Sternum - Ribs |
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4 locations for bone marrow collection in ruminants
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- Iliac crest
- Tuber coxae - Sternum - Rib |
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2 locations for bone marrow collection in cats
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- Proximal femur
- Proximal humerus |
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Hyperplasia (define)
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Orderly increase in production of normal cells due to increased demand
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Leukemia (define)
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Uncontrolled, disorderly production of cells independent of demand
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Myelodysplasia (define)
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Marrow disorder characterized by maturation defects, abnormal morphology in several cell lines, and ineffective hematopoiesis.
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Myelofibrosis (define)
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Replacement of bone marrow by fibrous tissue
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When should myelofibrosis be suspected? (2)
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- When repeated aspiration attempts fail
- When low cellularity and spindle-shaped cells are present in aspirates |
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How is a definitive Dx of myelofibrosis obtained?
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Histologic evaluation of a core biopsy of marrow
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What should the M:E ratio be in most species?
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1:1 to 3:1
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What are the two components of the M:E ratio?
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M: leukocyte precursors (except lymphocytes)
E: nucleated erythroid precursors |
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What should the M:E ratio be interpreted in the context of?
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A CBC
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Three causes of a increased M:E ratio
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- Increased myeloids
- Decreased erythroids - Both |
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What stain is used to confirm hemosiderin?
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Prussian Blue
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Prognosis of myelofibrosis
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Poor
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7 types of 'other cells' found in bone marrow
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- Lymphoid cells
- Plasma cells - Stem Cells - Stromal cells - Mast cells - Osteoclasts - Mitotic figures |
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5 abnormal cellular findings in bone marrow
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- Increase in blast cells
- Increase in lymphoid cells - Increase in plasma cells - Increase in mast cells - Metastatic neoplastic cell populations |
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What color is active bone marrow?
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Red
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Two causes of active bone marrow
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- Increased demand
- Increased peripheral loss |
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Be sure to look over all the 'Typical Causes' of hyperplasias and hypoplasias on pages 33 - 34
"Just have an idea, don't need to memorize" |
Be sure to look over all the 'Typical Causes' of hyperplasias and hypoplasias on pages 33 - 34
"Just have an idea, don't need to memorize" |
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What's the difference between an effective and ineffective hyperplasia?
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Effective hyperplasia is an expected response to a stimulus
Ineffective hyperplasia is an unexpected response (be it lack of peripheral cellularity or what have you) |
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What causes an effective erythroid hyperplasia?
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Erythropoietin stimulation
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How does an ineffective erythroid hyperplasia present?
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Increased cellularity in bone marrow, but may not have corresponding peripheral increase
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What is an effective granulocytic hyperplasia generally seen with?
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Ongoing stimulation with G-CSF or GM-CSF
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What is an ineffective granulocytic hyperplasia characterized by?
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Neutropenia in peripheral circulation with a concurrent granulocytic hyperplasia in marrow
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What is an erythroid hypoplasia characterized by?
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Selective decrease in erythroid percursors resulting in nonregenerative anemia
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What is a myeloid or granulocytic hypoplasia characterized by?
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Decreased numbers of myeloid precursors
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What is an megakaryocytic hypoplasia characterized by?
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Decreased number of immature and mature megakaryocytes and megakaryoblasts
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Myelophthisis (define)
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Replacement of normal hematopoietic tissue by a proliferation of abnormal cells
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Myelitis (define)
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Inflammation of bone marrow
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Bone marrow necrosis (define)
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Refers to bone marrow in which necrosis is the primary or predominant abnormality
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2 general causes of myelofibrosis
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- Sequelae to a generalized bone marrow damage (ex radiation, toxin, ischemia)
- Sequelae to neoplasia |
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3 general causes of myelophthisis
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- Leukemia
- Myelofibrosis - Inflammatory osteomyelitis |
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General cause of myelitis
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Infection
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4 general causes of bone marrow necrosis
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- Toxicants
- Hypoxia - Feline panleukopenia - Disseminated intravascular coagulation (DIC) |
