Bryan - Clin Path - Test 1 - Winter 2Nd Year

Front 1

What are the 5 progenitor cells that a stem cell can differentiate into during hematopoiesis?

Back 1

Proerythroblast
Monoblast
Myeloblast
Lymphoblast
Megakaryoblast

Front 2

What is the first identifiable stage in RBC erythropoiesis?

Back 2

Rubriblast

Front 3

What are the stages of development from rubriblast to erythrocyte (hint...there are 6)?

Back 3

Rubriblast
Prorubricyte
Rubricyte
Metarubricyte
Polychromatophilic RBC (or Reticulocyte)
Erythrocyte

Front 4

Which developmental stages in erythropoiesis are normally anuclear?

Back 4

Erythrocyte
Polychromatophilic RBC (reticulocyte)

Front 5

What is the difference between a Polychromatophilic RBC and a Reticulocyte?

Back 5

Reticulocyte is stained with new methylene blue stain; Polychromatophilic RBC is stained with a Wright's stain

Front 6

A retained nuclear fragment in a normally anuclear erythrocyte is a __________________.

Back 6

Howell-Jolly Body

Front 7

In which stage of erythropoiesis does hemoglobin development begin?

Back 7

Rubricyte

Front 8

What is the trigger for erythropoietin production? What organ produces this?

Back 8

Hypoxia is detected by the JGA in the kidney to release erythropoietin

Front 9

What are 5 conditions where nucleated RBCs may be seen?

Back 9

Regenerative anemia
Splenic dysfunction
Splenic neoplasia
Hematopoietic neoplasia
Pb poisoning

Front 10

What factors influence RBC deformability?

Back 10

surface:volume ratio
Membrane properties
Hgb viscosity

Front 11

T or F:
RBCs use glucose as their sole source of energy.

Back 11

Tru dat!

Front 12

What metabolic pathway protects Hgb from oxidative stress? What molecule provides this protection?

Back 12

Pentose Phosphate Pathway produces NADPH which protects from oxidative stress

Front 13

Disorders of which metabolic pathway can be responsible for unexplained anemias? What enzymatic deficiencies can be manifest?

Back 13

Embden Myerhof Pathway disorders can be due to pyruvate phosphatase or phosphofructokinase deficiencies.

Front 14

Which pathway prevents overaccumulation of methemeglobin?

Back 14

Hemeglobin reductase pathway

Front 15

Choose left shift or right shift...
...due to increased Hgb affinity for oxygen.

Back 15

left shift

Front 16

Choose left shift or right shift...
...results in increased availability of oxygen to the tissues.

Back 16

right shift

Front 17

Choose left shift or right shift...
...due to decreased Hgb affinity for oxygen.

Back 17

right shift

Front 18

Choose left shift or right shift...
...results in reduced oxygen availability to the tissues.

Back 18

left shift

Front 19

Choose left shift or right shift...
...increased pH

Back 19

left shift

Front 20

Choose left shift or right shift...
...decreased pH

Back 20

right shift

Front 21

Choose left shift or right shift...
...increased temperature

Back 21

right shift

Front 22

Choose left shift or right shift...
...decreased temperature

Back 22

left shift

Front 23

Choose left shift or right shift...
...decreased DPG (diphosphoglycerate).

Back 23

left shift

Front 24

Choose left shift or right shift...
...increased DPG (diphosphoglycerate)

Back 24

right shift

Front 25

Choose left shift or right shift...
...decreased CO2.

Back 25

left shift

Front 26

Choose left shift or right shift...
...increased CO2.

Back 26

right shift

Front 27

Which organ is chiefly responsible for Fe storage?

Back 27

Liver

Front 28

Body Fe regulated by rate of ________; not ________.

Back 28

Body Fe regulated by rate of absorption; not excretion

Front 29

What regulates the rate of Fe absorption?

Back 29

Fe stores and erythropoiesis rate

Front 30

What are the four methods of evaluating Fe levels?

Back 30

Serum Fe
Serum transferrin
% saturation of transferrin
Serum ferritin

Front 31

transferrin + iron =

Back 31

serum iron

Front 32

total iron binding capacity is the same as...

Back 32

...serum transferrin

Front 33

how much transferrin is bound to iron is also known as...

Back 33

...% saturation of transferrin

Front 34

the circulating storage pool of Fe is...

Back 34

...serum ferritin

Front 35

What is the most common cause of hypoferremia?

Back 35

chronic low-level blood loss

Front 36

Which of the following would be expected clinical data in cases of hypoferremia due to chronic blood loss?

Low serum Fe
Low TIBC
Low serum ferritin

Back 36

Low serum Fe
Low serum ferritin
(should see HIGH OR NORMAL TIBC)

Front 37

Which of the following would be expected clinical data in cases of hypoferremia due to inflammation?

Low serum Fe
Low TIBC
Low serum ferritin

Back 37

Low serum Fe
Low TIBC
(should see HIGH serum ferritin)

Front 38

What is a clinical measurement of transferrin?

Back 38

TIBC (total iron binding capacity)

Front 39

What triggers erythrocyte breakdown?

Back 39

Changes in cell membrane (less deformable)
Cell enzymes

Front 40

What cells remove most RBCs from circulation? Where are these cells located?

Back 40

Macrophages in spleen

Front 41

What is the relative proportion of intra vs. extravascular hemolysis in a non-pathogenic system?

Back 41

10% intravascular
90% extravascular

Front 42

What are two good clinical indicators of increased intravascular hemolysis?

Back 42

Hemeglobinuria
Hemeglobinemia

Front 43

Name a ton of tests that can be used for erythron evaluation!

Back 43

RBC count
PCV
Hgb measurement
Morphology
Retic count
Coomb's test
Indices (MCH, MCHC, & etc)

Front 44

T or F:
PCV = Hematocrit

Back 44

False! The values are usually the same or similar but they are arrived in a different manner (PCV via capillary tube and Hematocrit via instrumental counting)

Front 45

What is a good rule of thumb in estimating target hemoglobin concentration?

Back 45

Hgb in g/dl should be ~1/3 the hematocrit % in mammals.

Front 46

Name two findings that will impact the accuracy of the hemoglobin concentration.

Back 46

Lipemia
Heinz bodies

Front 47

What are the 2 methods for conducting a RBC count?

Back 47

Flow cytometry (light scatter)
Impedence cytometry

Front 48

Which two RBC indices provide indications of RBC population cell size?

Back 48

MCV (mean corpuscular volume)
RDW (red cell distribution width)

Front 49

Which two RBC indices provide indications of RBC population hemoglobin? How do these differ?

Back 49

MCH (mean corpuscular hemoglobin) - uses Hgb and RBC count
MCHC (mean corpuscular hemoglobin concentration) - uses Hgb and PCV

Front 50

What RBC morphology is indicated by the arrows? What condition(s) are associated with these cells?

Back 50

Spherocytes;
Indicative of immune-mediated hemolytic anemia

Front 51

What kind of RBC is indicated by the arrow? What condition(s) are associated with this?

Back 51

Schistocytes;
DIC, Vasculitis, and Hemangiosarcoma

Front 52

What kind of RBC is indicated by the arrows? What condition(s) are associated with this?

Back 52

Echinocytes;
Usually artifactual but can be from electrolyte imbalances

Front 53

What kind of RBC is indicated by the arrow? What condition(s) are associated with this?

Back 53

Acanthocyte;
Associated w/splenic and hepatic disorders and metabolic disorders affecting cell membrane

Front 54

What kind of RBC is indicated by the arrows? What condition(s) are associated with this?

Back 54

Keratocytes (blister and helmet cells);
Caused by RBC trauma (similar to schistocytes)

Front 55

What kind of RBC is indicated by the arrow? What condition(s) are associated with this?

Back 55

Codocytes (target cells);
Excess membrane due to young cells or metabolic disorder

Front 56

What kind of RBC is indicated by the arrow? What condition(s) are associated with this?

Back 56

Dacryocyte;
Artifact or myelopathy

Front 57

What kind of RBC is indicated by the arrow? What condition(s) are associated with this?

Back 57

Stomatocyte;
Hereditary disorder seen in Malamutes

Front 58

What are the two types of Reticulocytes? Which one is unique to cats?

Back 58

Punctate (cats)
Aggregate

Front 59

What index takes into account reticulocyte production/maturation time? What value is considered regenerative?

Back 59

RPI (reticulocyte production index); RPI>2 = regenerative

Front 60

T or F:
More reticulocytes should be found in cases of hemolytic anemia than in blood loss anemia.

Back 60

True!
Hemolytic recycles raw materials.

Front 61

How long does it take to make a reticulocyte? When are peak values usually found?

Back 61

48-72h production time;
7d peak

Front 62

T or F:
Dogs generally have more reticulocytes than cats.

Back 62

True!
<1% dogs; <0.4% cats

Front 63

T or F:
Absence of reticulocytes always indicates a non-regenerative anemia.

Back 63

False!
It can also indicate inadequate response time (haven't made any yet).

Front 64

Which test is used to test for immune-mediated hemolytic anemia?

Back 64

Coomb's test

Front 65

T or F:
Macrocytic hypochromic anemia is a common finding in iron-deficiency anemia.

Back 65

False!
This is typical of regenerative anemia!

Front 66

In terms of laboratory data, how can anemia from internal hemorrhage be discerned from anemia due to external hemorrhage?

Back 66

External hemorrhage would also be hypoproteinemic

Front 67

In a case of hemolytic anemia, predict the values of the following indices:

PCV
Reticulocytes
Protein
RBC Morphology

Back 67

PCV - low
Reticulocytes - high
Protein - normal

Front 68

List some possible causes of hemolytic anemia.

Back 68

Immune-mediated
Drugs
Toxins
Parasites
DIC
Inherited defects
Oxidative injury
Hypophosphatemia

Front 69

What are some examples of parasite-induced hemolytic anemia?

Back 69

Mycoplasma haemofelis
M. haemolamae
M. haemominitum
Babesia canis
Anaplasma marginale

Front 70

What are some examples of hemolytic anemia due to oxidative damage?

Back 70

Garlic/onion toxicity
Red maple toxicity
Cu toxicosis
Acetaminophen toxicity

Front 71

Which of the following is lacking with ineffective or reduced erythropoiesis?


a) stem, progenitor, and precursor cells
b) stimulating/growth factors
c) nutrients (eg: Fe)
d) microenvironment

Back 71

One or more are lacking.

Front 72

What are some differentials for normocytic, normochromic anemia with normal neutrophils and platelets?

Back 72

Renal failure (no erythropoietin)
Anemia of chronic disease/inflammation
FeLV-associated anemia
Immune-mediated

Front 73

What are some differentials for normocytic, normochromic anemia with decreased neutrophils and platelets (pancytopenia)?

Back 73

Infectious anemia
Radiation
Toxins/drugs
idiopathic
Myelophthsis anemia

Front 74

What are the two major lines of leukocytes?

Back 74

Lymphoid and Myeloid

Front 75

What cytokines stimulate neutrophil production?

Back 75

GM-CSF, G-CSF, and IL-3

Front 76

What are the stages of neutrophil development?

Back 76

Myeloblast, promyelocyte, myelocyte, metamyelocyte, band nutrophil, segmented neutrophil

Front 77

What are the two pools of neutrophil population?

Back 77

Marginated and circulation

Front 78

How long do neutrophils spend in circulation?

Back 78

~10h

Front 79

What are neutrophils called in fish, birds, and reptiles?

Back 79

heterophil

Front 80

Macrophages in circulation are called…

Back 80

monocytes

Front 81

How long does it take for monocytes to mature? How long do they circulate?

Back 81

24-36h; 24h circulation

Front 82

Which leukocyte can have stormy blue cytoplasm, vacuoles, and/or pseudopods?

Back 82

monocytes

Front 83

What cytokine stimulates eosinophil produciton?

Back 83

IL-5

Front 84

Identify these cells (note, they are all various stages of the same type of cell).

Back 84

A - Promyelocyte; B - Myelocyte; C - Seg. Neutrophil

Front 85

What type of cell is depicted here? ID the species of A-D. ID the specific subtype of E and F.

Back 85

A - Canine Lymphocyte; B - Feline Lymphocyte; C - Equine Lymphocyte; D - Bovine Lymphocyte; E - Reactive Lymphocyte; F - Granular (NK cell) lymphocyte

Front 86

What is the production time for eosinophils? How long do they remain in circulation?

Back 86

2-6d production; 1hr circulation

Front 87

What is unique about horse eosinophils?

Back 87

large granules (raspberry eosinophil)

Front 88

What is unique about cat eosinophils?

Back 88

rod-shaped granules

Front 89

Which species can have vacuolated eosinophils?

Back 89

Dogs (greyhounds)

Front 90

What is the production time for basophils? How long do they last in circulation? How long in the tissue?

Back 90

2.5d production; 6h in circulation; 2wks in tissues

Front 91

T or F: Eosinophils and basophils are stimulated by the same chemokines.

Back 91

False! Eosinophils are stimulated by IL-5; Basophils by IL-3

Front 92

Which species has indistinct basophil granules?

Back 92

Canine

Front 93

Which species has lavender/gray basophil granules?

Back 93

Feline

Front 94

What are the smallest leukocytes?

Back 94

Lymphocytes

Front 95

Describe a reactive lymphocyte.

Back 95

Larger and bluer than normal lymphocyte

Front 96

What structure indicates that a lymphocyte is antibody producing? What type of lymphocyte is this?

Back 96

White golgi body indicates Ab production of PLASMA CELL

Front 97

What are lymphocytes with magenta granules?

Back 97

NK cells

Front 98

Which leukocyte is mostly nucleus?

Back 98

Lymphocytes

Front 99

What can distort a leukogram?

Back 99

Nucleated RBCs

Front 100

Which type of neutrophil has a kidney shaped nucleus?

Back 100

Metamyelocyte

Front 101

What is the difference between a left shift and a degenerative left shift?

Back 101

Both have significant #s of immature neutrophils; in degenerative L shift, immatures outnumber matures

Front 102

What is the prognosis for animals exhibiting a degenerative left shift?

Back 102

Piss poor

Front 103

Why is a degenerative left shift not bad in ruminants?

Back 103

They have small marrow pool so initial response appears degenerative.

Front 104

Marked neutrophilia coupled with a left shift describes…

Back 104

Leukemoid reaction

Front 105

What are causes of neutrophilia?

Back 105

Physiologic,
corticosteroids,
inflammatory,
hemolysis or hemorrhage,
Myeloproliferative dz

Front 106

Release of epinephrine causes what type of neutrophilia? In which species is this common?

Back 106

Epi releases marginated neutrophils (physiologic neutrophilia); common in foals and cats; also releases lymphocytes

Front 107

What are the hallmarks of a stress leukogram?

Back 107

Neutrophilia, lymphopenia, eosionpenia, monocytosis

Front 108

What can cause neutropenia due to increased margination?

Back 108

Endotoxemia (gram neg bacteria)

Front 109

What are causes of neutropenia?

Back 109

increased margination; increased demand; decreased production; immune mediated; myelophthisis

Front 110

What are causes of monocytosis?

Back 110

Stress leukogram; chronic/acute inflammation

Front 111

What are causes of eosinophilia?

Back 111

Parasitic infection; hypersensitivity; idiopathic; tumor; hypoadrenocorticism

Front 112

What are causes of eosinopenia?

Back 112

Stress leukogram!

Front 113

What are causes of basophilia?

Back 113

similar to eosinophilia!

Front 114

What is the difference between a basophil and a mast cell?

Back 114

Basophil has a lobed nuc; mast cell has a round nuc.

Front 115

What are causes of lymphocytosis?

Back 115

Physiologic; antigenic stimulation; Bovine Leukemia Virus

Front 116

What infectious agents can result in lymphocytosis?

Back 116

Rickettsial disease (erlichia); Bovine Leukemia Virus

Front 117

What are causes of lymphopenia?

Back 117

Stress leukogram; immunosuppression; immunodeficiency; lymph loss (uncommon)

Front 118

What causes the presence of toxic neutrophils?

Back 118

inflammatory mediators affecting bone marrow

Front 119

What are some hallmarks of toxic neutrophils?

Back 119

Increased basophilia to cytoplasm; toxic granules; Dohle bodies

Front 120

What are Dohle bodies?

Back 120

Bluish aggregates of RER found in toxic neutrophils

Front 121

What are examples of vacuolation defects in neutrophils?

Back 121

Chediak-Higashi Syndrome; neutrophil anamoly of Birman cats; storage diseases

Front 122

What neutrophil abnormality can be mistaken for a left shift?

Back 122

Pelger-Huet Anamoly

Front 123

What are causes of neutrophil hypersegmentation?

Back 123

Old blood; corticosteroids; poodle bone marrow dyscrasia

Front 124

Which leukocytes can contain intracytoplasmic organisms?

Back 124

Monocytes and neutrophils

Front 125

What are some examples of intracytoplasmic organisms that can be found within leukocytes?

Back 125

Erlichia; Hepatozoon; Bacteria; viral inclusions; Histoplasma; Leishmania