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104 Cards in this Set
- Front
- Back
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What are some differentials or reasons necessitating bone marrow evaluation?
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Non-regenerative anemia; persistent, unexplained neutropenia; persistent thrombocytopenia; unexplained pancytopenia; monoclonal gammopathy; neoplasia
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What data must always be available concurrently with a bone marrow sample?
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CBC data
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What are sites of bone marrow sampling?
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Head of humerus/femur; wing of ileum
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T or F: bone marrow aspirates should always be stained immediately!
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False! Don't stain the ones that you're gonna send in!
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What cell lines should be evaluated on a bone marrow sample?
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megakaryocytes, erythroid cells, and myeloid cells
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What is the target myeloid:erythroid ratio?
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2:1 (Bildfell) or ~1:1 (Tornquist)
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Homogeneity in a bone marrow aspirate can be indicative of what finding?
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Neoplasia
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Macrophages containing a golden-brown pigment in bone marrow is indicative of what?
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Hemosiderin is indicative of RBC breakdown; can explain Fe deficiency
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What are the two types of hematopoietic leukemia?
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Lymphoproliferative and myeloproliferative
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What species is most likely to get leukemia of erythrocytes? What is the cause?
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Cats due to FeLV
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T or F: The blood is the most common tissue to identify lymphoproliferative disease.
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False!
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In which tissues are lymphoproliferative diseases commonly identified?
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Lymph nodes; spleen; gut
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T or F: True leukemias arise in the bone marrow.
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True!
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Increased lymphoblasts in the blood and bone marrow describes…
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…acute lymphocytic leukemia
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How can lymphocytic leukemia be diagnosed?
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Blood smear/bone marrow exam; immunophenotyping; PCR
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Choose acute or chronic lymphocytic leukemia… …increased lymphocytes in the blood and bone marrow.
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Chronic
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Choose acute or chronic lymphocytic leukemia… …often an incidental finding.
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Chronic
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Choose acute or chronic lymphocytic leukemia… …Usually involves T lymphocytes.
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Chronic
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Choose acute or chronic lymphocytic leukemia… …increased lymphoblasts in bone marrow and blood.
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Acute
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Which form of plasma cell neoplasia involves proliferation at multiple sites in the bone marrow?
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Multiple myeloma
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Where does multiple myeloma commonly present?
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Limb
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T or F: A common hallmark of large granular lymphoma/leukemia is hyperproteinemia due to excessive immunoglobulin produciton.
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False! This describes multiple myeloma!
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What are some laboratory features of multiple myeloma?
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anemia, pancytopenia, hyperproteinemia, proteinuria
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What are some radiographic lesions associated with multiple myeloma?
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Osteolytic bone lesions
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T or F: Multiple myeloma often involves a monoclonal gammopathy.
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Tru dat!
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What are the diagnostic criteria for multiple myeloma?
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Monoclonal gammopathy; Bence-Jones proteinuria; radiographic evidence of osteolysis;
>15-20% plasma cells in marrow |
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Immunoglobin light chains detected in the urine describes…
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…Bence-Jones proteinuria (a criterion for multiple myeloma)
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What form of multiple myeloma involves hyperviscosity syndrome? What molecule is responsible for this?
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Waldenstriom's Macroglobulinemia; caused by IgM
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Which species (canine, feline, equine, bovine) is associated with the following lymphoma characteristic?...
...BLV -related |
Bovine
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Which species (canine, feline, equine, bovine) is associated with the following lymphoma characteristic? Usually alimentary or mediastinal.
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Feline
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Which species (canine, feline, equine, bovine) is associated with the following lymphoma characteristic? Occasionally associated with hypercalcemia.
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Canine (PTH-like hormone)
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Which species (canine, feline, equine, bovine) is associated with the following lymphoma characteristic? Uncommon!
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Equine
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Which species (canine, feline, equine, bovine) is associated with the following lymphoma characteristic? Usually presents with lymphopenia.
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Canine
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Which species (canine, feline, equine, bovine) is associated with the following lymphoma characteristic? Persistent lymphocytosis is more common than lymphoma.
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Bovine
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In which species is myelodysplastic syndrome most common?
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Cats
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Abnormal proliferation of macrophages and/or dendritic cells describes…
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…histiocytic neoplasia
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What is the difference between malignant histiocytic sarcoma and malignanant histiocytosis?
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MHS arises in a single site and disseminates rapidly; MH arises at multiple sites
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What is a histologic characteristic of histiocytic neoplasia?
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Neoplastic cells often phagocytose RBCs leading to anemia
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What factors are involved in hemostasis?
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Platelets, vessels, coagulation factors, fibrinolytic factors, & inhibitors
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What are the two types of hemostasis?
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primary and secondary
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What are the components involved in primary hemostasis?
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vWF and platelets
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What are the major categories involved in secondary hemostasis?
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Intrinsic, extrinsic, and common pathway
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Which factors are involved in the intrinsic pathway?
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12, 11, 9, 8
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Which enzyme is necessary to break the clot down? What does the clot get broken into?
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Plasmin breaks fibrin clots into FDPs then to D-dimers
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What substance do blood vessels produce to begin the coagulation cascade?
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Tissue factor
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What is the anlogue to a platelet found in birds, reptiles, fish, and amphibians?
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Thrombocyte
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What is the main activator of plasmin? What does plasmin do (generally)?
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Tissue Plasminogen activator activates plasminogen to plasmin; plasmin breaks-down clots
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What are some natural inhibitors or control mechanisms to hemostasis?
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Antithrombin III; heparin; thrombin; Proteins C and S
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T or F: Heparin inactivates thrombin to prevent clotting.
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False! Heparin enhances Antithrombin III's inactivation of thrombin
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What effect can a protein losing pathology have on hemostasis?
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ATIII can be lost, causing thrombi
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What is the activity of ATIII?
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ATIII = antithrombin; inactivates thrombin, preventing clotting
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What is the action of thrombin?
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Cleaves fibrinogen to form fibrin
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What is the first line of defense against thrombus formation?
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Rapid blood flow
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Which of the natural anticoagulants are vitamin K dependent?
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Proteins C and S
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T or F: platelet disorders of hemostasis are more common than vessel disorders of hemostasis.
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True!
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What rickettsial disease can cause thrombocytopenia?
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Erlichiosis
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At what level can spontaneous bleeding occur with thrombocytopenia?
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<20000 platelets/uL
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What are the 4 basic mechanisms of thrombocytopenia?
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Decrease in production; increase in destruction; increase in utilization; sequestration
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What are some causes for decreased platelet production?
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pharmacologic; infectious agents; toxins & chemicals; radiation; myelophthisis
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What are some causes for increased platelet destruction?
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Immune mediated; drug-induced; infectious
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What are signs of immune-mediated thrombocytopenia? In which species is this common?
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Hematuria, epistaxis, & petechiae (common in cocker spaniels and poodles)
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How can immune-mediated thrombocytopenia be diagnosed?
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Active megakaryocytes in marrow; IgG detection by flow cytometry
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Immune-mediated thrombocytopenia associated with immune-mediated anemia is known as…
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…Evan's syndrome
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What are examples of drug-induced thrombocytopenia?
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Heparin-induced (horses); TMS (dawgz)
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What are some examples of increase in platelet utilization causing thrombocytopenia?
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DIC; snakebite; some infections
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Which is more common, primary or secondary thrombocytosis?
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Secondary
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What is the main cause of essential thrombocytopenia?
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Neoplastic megakaryocytes
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What are some primary conditions that can result in thrombocytopenia?
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Burns, pregnancy, infections, Fe deficiency, non-hematopoetic anemia, blood loss, splenectomy
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T or F: A secondary thrombocytopenia resolves when the underlying condition is resolved.
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True!
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What are the two main types of thrombopathies?
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Acquired and heriditary
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What are some heriditary thrombopathies?
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Chediak-Higashi syndrome; vonWillebrand's dz; otterhounds and bassethounds
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What are the types of vonWillebrand's disease? Which is the most common in vet med? Which is the most severe?
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Types 1, 2, and 3. Type 1 is most common and type 2 rare; type 3 is most severe!
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How can one perform surgery on a vonWIllebrand's diseased dog?
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Give dog cryoprecipitated vWF
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What are some causes of acquired thrombopathies?
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Drugs (aspirin); uremia; liver disease
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How does aspirin inhibit coagulation?
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Blocks thrombaxane A2
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What is impacted in Hemophilia A? In Hemophilia B?
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A - deficiency of factor VIII; B - deficiency of factor IX
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What are major causes of acquired coagulopathies?
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Hypovitaminosis K; Heteropathy; Glomerulopathies; DIC
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What can cause hypovotaminosis K?
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Warfarin; coumarin; broudifacoum; sweet clover
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Vitamin K is necessary for which factors?
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II, VII, IX, X
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Glomerulopathies and hepatopathies both impact what substance resulting in coagulopathies?
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Antithrombin III
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What tube is used for most coagulation assays?
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Teal top (citrate)
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What tube is commonly used for platelet counts?
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Purple top (EDTA)
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What is the normal platelet range for most animals?
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200K to 500K platelets/uL
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What are the two tests that evaluate platelet function?
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Buccal mucosal bleeding time; Platelet IgG test (for immune mediated thrombocytopenia)
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What are the two main tests that evaluate coagulation? Which system does each assay?
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PTT (partial thromboplastin time - intrinsic); PT (Prothrombin time - Extrinsic)
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What is a quick and dirty test for coagulation? What equipment is necessary?
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ACT (activated coagulation time); need gray top tube and an armpit
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What is tested to evaluate fibrinolysis?
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FDP (fibrin degredation products); D-dimers
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How many blood groups are there in dogs?
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8
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Which blood group in dogs is the most immunogenic?
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DEA 1.1
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Naturally occurring antibodies against a specific blood type describes…
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…an ALLOANTIBODY
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What condition is also known as hemolytic disease of the newborn?
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Neonatal isoerythrolysis
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What are the feline blood groups? Which is most common?
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A (most common), AB, and B
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T or F: Type B cats are in danger of a reaction following their first transfusion with type A blood.
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TRUE
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T or F: Type DEA 1.1 negative dogs are in danger of a reaction following their first transfusion of DEA 1.1 blood.
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False! They will, however, become sensitized!
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T or F: There are no existing alloantibodies likely to cause a reaction in dogs.
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True!
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T or F: Type A cats are in danger of an immediate reaction following their first transfusion with type B blood.
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False! RBC lifespan is decreased though.
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In feline neonatal isoerythrolysis, what is the blood type of the queen? Of the kittens?
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Queen = B; Kittens = A or AB
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How many blood groups in horses? Which are most immunogenic?
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7 blood groups; Aa and Qa are most immunogenic.
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What is the universal donor for horses?
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NONE!
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What is the pathogenesis for neonatal isoerythrolysis?
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Dam develops Ab to foal blood type; with next pregnancy, subsequent foals ingest antibodies and succumb to disease.
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How is neonatal isoerythrolysis treated in horses?
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Wash mare's RBCs then transfuse!
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Choose blood typing or cross matching…
…determines the blood group antigens present by reaction with reagent antibodies. |
blood typing
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Choose blood typing or cross matching…
…tests for reaction between donor RBC and recipient serum |
cross matching (major)
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Choose blood typing or cross matching…
…tests for reaction between donor serum and recipient RBCs. |
cross matching (minor)
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