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197 Cards in this Set
- Front
- Back
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Erythron
-definition |
-all erythroid cells in an animal
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Anemia
-methods of classification |
-marrow responsiveness
-morphological classification -pathophysiologic classification |
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Anemia
-classification by marrow responsiveness |
-regenerative
-nonregenerative |
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Regenerative anemia
-definition |
-anemia + reticulocytosis
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Reticulocyte in Wright Stain
|
-polychromatic erythrocyte
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Reticulocytosis
-species not commonly found in |
-horses (rarely release polychromatic erythrocytes from marrow)
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Reticulocytosis
-timeline |
-expected 3-4 days after onset of anemia
-peak at 7-10 days after onset of anemia |
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Reticulocytosis
-concurrent findings |
-macrocytosis
-hypochromia -anisocytosis -howell-jolly bodies -rubricytosis -codocytosis -basophilic stippling |
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Regenerative anemia
-causes |
-blood loss
-hemolysis |
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Nonregenerative anemia
-causes |
reduced/defective erythropoiesis
-anemia of inflammatory disease -anemia of renal failure -erythroid hypoplasia -myelopthesis |
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Morphologic classification of anemia
-based on |
-MCV
-MCHC |
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MCV
-definition |
-Mean Cell Volume (average erythrocyte volume)
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MCHC
-definition |
-Mean Cell Hemoglobin Concentration (average erythrocyte hemoglobin conc.)
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Pathophysiologic Classification of anemia
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-Blood loss anemia (External/Internal)
-Hemolytic anemia (Extravascular/Intravascular) -Anemia due to decreased erythrocyte production (inflammation, renal disease, marrow hypoplasia, erythroid hypoplasia) |
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Discocyte
|
-mature erythrocyte
-normocyte |
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Rouleau
-usually seen with |
-hyperglobulinemia
-hyperfibrinogenemia |
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Rouleau
-due to |
-inflammation
-dehydration |
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Rouleau
-common in what species |
-horses
-cats |
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Agglutination
-due to |
-antibody forming bridges between cells
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Agglutination in horse
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-heparin induced
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Agglutination
-effect on cell counting |
seen as large RBCs
-dec. [RBC] -inc. MCV |
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How to differentiate agglutination from rouleau
|
-saline dispersion test
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How does the saline dispersion test work?
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-when saline is added to the blood, the saline will cause the rouleau formation to disperse
-agglutination will stay together because it is due to antibody |
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Rubricytosis
-defintion |
-increased concentration of nRBCs in blood
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Types of Rubricytosis
|
-appropriate rubricytosis
-inappropriate rubricytosis |
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Appropriate rubricytosis
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-rubricytosis with a regenerative anemia
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Inappropriate rubricytosis
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-rubricytosis with nonregenerative anemia
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Inappropriate rubricytosis
-due to |
-marrow damage
-lead poisoning (dogs) |
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Hypochromic erythrocytes
-formation |
-incomplete hemoglobin synthesis
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Polychromatophilic erythrocyte
-formation |
-increased hemoglobin content
-cytoplasmic RNA |
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Polychromatophilic anemia
-sign of |
-accelerated erythropoiesis
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Reticulocytes
-sign of |
-accelerated erythropoiesis
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Reticulocyte is the same cell as
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-polychromatophilic erythrocyte
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Erythrocyte parasites
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-Anaplasma marginale
-Cytauxzoon felis -Babesia sp. -Theleria sp. -Mycoplasma haemocanis -Mycoplasma haemofelis |
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Anaplasma marginale
-morphology |
-marginal bodies that are uniformly dark
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Cytauxzoon felis
-morphology |
-piroplasms (signet rings) in erythrocytes
-shizonts in macrophages |
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Babesia sp. found in dogs
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-B. canis
-B. gibsoni -B. conradae -Theleria annae |
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Babesia sp.
-largest piroplasms |
-Babesia canis
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Theileria sp.
-in cattle and horses |
-Cattle: T. buffeli
-Horse: T. equi |
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Mycoplasma haemocanis
-morphology |
-chains of cocci that grow on erythrocytes
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Mycoplasma haemofelis
-morphology |
-cocci and the rings on the surface of erythrocytes
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Basophilic Stippling
-formation |
-persistence of ribosomal RNA
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Basophilic stippling
-significance |
-regenerative anemia in cattle
-canine lead poisoning |
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Heinz bodies
-formation |
-oxidation of hemoglobin
-defective RBC metabolism |
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Heinz Bodies
-significance |
-heinz body anemia
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Heinz bodies
-normally ocurring species |
-cats
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Heinz body
-defective RBC removal |
-intravascular hemolysis
-macrophages |
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Howell-Jolly Bodies
-formation |
-nuclear remnant of nRBC after mitosis
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Howell-Jolly Bodies
-significance |
-inc. erythropoiesis
-dec. splenic function |
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Anisocytosis
-definition |
-variation in erythrocyte volume
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Macrocyte
-formation |
-incomplete maturation
-skipped cell division |
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Macrocyte
-significance |
-inc. erythropoiesis
-abnormal erythropoiesis |
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Microcyte
-formation |
-inc. in cell divisions during development
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Microcyte
-significance |
-Fe deficiency (blood loss)
-Hepatic insufficiency (portosystemic shunt) |
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Poikilocyte
-definition |
-abnormal erythrocyte
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Acanthocyte
-morphology |
-irregularly spaced blunt membrane projections
-spheroid |
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Acanthocyte
-formation |
-RBC trauma
-excess membrane lipid |
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Acanthocytosis
-significance |
-canine hemangiosarcoma
-hepatic and renal disorders -abnormal lipid content -spherocytes from budding fragmentation |
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Acanthocytes
-common in |
-dogs
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Codocyte
-formation |
-excess membrane relative to the amount of hemoglobin
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Codocyte
-significance |
-usually regenerative anemia
-if nonregenerative: Fe deficiency, lipid disorder |
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Eccentrocyte
-formation |
-oxidative damage to the RBC membrane and hemoglobin
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Eccentrocyte
-significance |
-overwhelming exposure to antioxidants
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Echinocyte
-formation |
-membrane changes due to an alkaline pH (slide changes
-regularly spaced, pointed projections |
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Echinocytes
-due to |
-slow drying
-rattlesnake venom -hyponatremic dehydration |
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Elliptocyte
-significance |
Aquired
-meulofibrosis -FE-deficiency -Hepatic lipidosis in cats Hereditary -Erythrocyte membrane defects |
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Elliptoctes
-normally found in |
camelids
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Keratocyte
-formation |
-intravascular RBC trauma
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Keratocyte
-significance |
-microangiopathy
-intravascular coagulation -vasculitis |
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Pyknocyte
-formation |
-oxidative damage to membrane and hemoglobin
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Pyknocyte
-significance |
-overwhelming exposure to oxidants
-seen with eccentrocytes |
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Schizocyte
-formation |
-intravascular RBC trauma
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Schizocyte
-significance |
-microangiopathy
-intravascular coagulation -vasculitis |
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Spherocyte
-formation |
-removal of membrane/defective membrane
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Spherocyte
-significance |
-immune-mediated
-fragmentation |
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Spherocytes
-only animal noticed in |
-dogs
-consistent central pallor |
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Impedence Cell Counter
-how to use for counting erythrocytes |
-dilute blood with isotonic fluid
-cells impede electron flow -differentiate RBCs and platelets by volume -[RBC] |
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Optical Cell Cytometer
-how to use for counting erythrocytes |
-dilute blood with isotonic fluid
-cells scatter light -differentiate RBCs and platelets -[RBC] |
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Why don't WBCs interfere with electronic methods of counting RBCs?
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-there aren't enough of the WBCs in comparison to the RBCs
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Centrifugation analysis of RBC
-measures what |
-percent of blood volume occupied by cells
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3 assessments of RBC mass in blood
-what is measured |
-Centrifuge to separate cells from plasma (Hct)
-Lyse all RBCs (Hgb) -Enumerate number of RBCs in a defined volume ([RBC]) |
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Plasma pigment colors
|
-Colorless to pale yellow (typical)
-Yellow/orange (herbivores, icterus) -Pink to Red (hemoglobin -White to Hazy (lipids) |
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Buffy Coat
-composition |
-platelets
-WBCs |
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Hematocrit
-measured how |
-centrifugation in microhematocrit tubes
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Hemoglobin
-measured how |
Spectrophotometry
-lyse RBCs and add reagent that binds to hemoglobin |
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[RBC]
-measured how |
-dilute blood
-electronic methods -calculate |
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Exceptions to Hct, Hgb, and [RBC] all changing the same
|
-different size RBCs
-Hypochromic RBCs with less hemoglobin -In vitro hemolysis |
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Wintrobe RBC indices
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-MCV
-MCHC -MCH |
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MCHC
-how to calculate |
=([Hgb]x100)/Hct
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Difference between Hgb and MCHC
|
-Hgb - amt. of Hgb in amount of blood
-MCHC - amt. of Hgb in amount of RBCs |
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MCH
-how to calculate |
=([Hgb]x10)/[RBC]
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CBC
-calculated values |
-Hct
-MCHC -MCH |
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Hct
-how to measure |
=(MCVx[RBC])/10
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Reticulocyte
-defintion |
-non-nucleated, immature erythrocyte
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Stain use for counting Reticulocyte Percentage
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-New Methylene Blue (NMB)
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Reticulocyte
-maturation time to RBC in blood |
-1 day
-younger retics released due to anemia take longer than 1 day |
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CRP
-how to calculate |
=RPx(patient's Hct/avg. Hct for spp.)
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CRP
-shows what |
-what the Reticulocyte percentage would be if the animal were not anemic
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Best semi-quantitative evidence of increased erythropoiesis
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-Reticulocytosis
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What is a reason why reticulocytosis would not occur with an increase in RBC production?
|
-Erythroid hyperplasia resulting in more effective erythropoiesis
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How does anemia cause inc. reticulocyte production?
|
-hypoxia
-inc. Epo -erythropoiesis stimulated -reticulocyte production |
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Classifications of reticulocytes in cats
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-Aggregate reticulocytes
-Punctate reticulocytes |
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Aggregate reticulocytes
-properties |
- >6 punctate RNA granules
-1 day life span -become erythrocytes or punctate reticulocytes |
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Punctate reticulocytes
--properties |
- <6 punctate RNA granules
-3 day life span -become erythrocytes |
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Appropriate release of nRBCs due to
|
-inc. Epo opening marrow pores
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Inappropriate release of nRBCs due to
|
-damaged marrow
-others |
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RBC life span
-dog |
-100 days
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Disorders causing nonregenerative anemia
|
-Inflammatory disease
-Renal disease -Marrow hypoplasia/aplasia -Erythroid hypoplasia/ineffective erythropoiesis |
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How long will it take anemia to develop if caused by decreased erythropoiesis?
|
several weeks to months
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Anemia of inflammation
-takes how long to occur |
-weeks to months
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Anemia of inflammation
-due to |
-Shortened RBC life span (oxidants/immunoglobins)
-Cytokines making erythroid cells less responsive to Epo -Cytokines causing a shift of Fe to storage so that it can't be use for Hgb synthesis |
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Most common cause of anemia in domestic animals
-why |
-Anemia of inflammation
-inflammation is a common component of illness |
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Anemia of Renal Disease
-due to |
-dec. Epo production by kidney
-dec. clearing of metabolic waste by kidneys shortening RBC lifespan -possibly Anemia of inflammatory disease -possibly GI hemorrhage |
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Why is anemia of renal disease not seen with acute renal failure?
|
-the animal either dies or gets better; the disease is not present long enough for anemia to develop
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Erythroid hypoplasia
-can be caused by |
-damage to erythroid precursors
-damage to marrow -persistent dec. in Epo -persistent inhibition of erythropoiesis by cytokines |
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Anemia of Ineffective Erythropoiesis
-sign |
-see a lot of young cells and little to no mature erythrocytes
-causes a maturation arrest |
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Blood Loss anemia
-causes |
-hemorrhage
-parasitism -blood removal for transfusion |
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Blood loss anemia
-classifications |
-Acute (external, internal) hrs
-Chronic (external) wks-months |
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Acute Blood loss
-mechanism of anemia |
-decrease in blood volume
-hypovolemia -movement of ECF from extravascular to intravascular -dilution of erythrocytes -anemia |
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Animals with good blood storage spleens
|
-horses
-dogs |
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Chronic Blood Loss
-mechanism of anemia |
-continual loss of small quantities of blood over weeks to months (compensatory erythropoiesis replaces erythrocytes)
-Fe deficiency -dec. in erythropoiesis (erythroid precursors aren't as responsive to Epo) -dec. in erythrocyte lifespan -dec. hemoglobin synthesis in erythroid precursoirs -microcytosis and hypochromasia |
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Chronic Blood loss
-due to |
Parasites
-hooks, whips, fleas, ticks GI Neoplasm |
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Hemolysis
-types |
-extravascular - intracellular (macrophages)
-intravascular - within the vascular system |
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Hemolysis type with a poorer prognosis
|
-intravascular
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Extravascular hemolysis
-mechanism of anemia |
Event causing damage to RBC
-macrophage recognizes damage -engulf and lyse RBCs -degrade Hgb to bilirubin -icterus & bilirubinuria |
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Intravascular hemolysis
-mechanism of anemia |
Event causing damage to RBC
-RBCs lyse in blood -hemoglobinemia -hemoglobinuria |
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Why does icterus occur with extravascular hemolysis?
|
-bilirubin is being formed faster than it can be taken up and excreted
-hyperbilirubinemia (incomplete removal of Bu/Alb from plasma, Bc regurgitation into plasma) -bilirubinuria (Bc is excreted) |
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Reason for hemoglobinemia and hemoglobinuria during intravascular hemolysis
|
Fe conservation systems become saturated
-rate of hemolysis exceed hgb-binding proteins ability to conserve Fe -hemoglobinemia (Hgb dimers in plasma) -dimers excreted in urine (hemoglobinuria) |
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Intravascular hemolysis
-site of hemolysis |
-blood vessels
-heart |
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Extravascular hemolysis
-site of hemolysis |
-macrophages near spleen, liver, marrow
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Hemolytic disorders and conditions
|
-Immune hemolytic disorder (idiopathic, penicillin, parasitic, neonatal)
-Bacterial/Viral infection (Mycoplasma, anaplasma) -Erythrocyte metabolic defects (heinz bodies, eccentrocytic, hypophosphatemic, sorbose intox) -Erthrocyte fragmentation (keratocytes and acanthocytes -unknown causes |
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Immune hemolytic disorders
-caused by |
-idiopathic
-parasitic -penicillin-induced -neonatal |
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Antibodies that bind directly to erythrocytes are:
|
-idiopathic
-hapten-induced -surface parasites -colostral antibody (horse) |
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Immune hemolysis
-pathogenesis |
-extravascular hemolysis in macrophages
-intravascualar hemolysis through the binding of complement and the initiation of the membrane attack complex -spherocytosis from the removal of membrane by macrophages (intravascular or extravascular hemolysis) |
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Immune hemolytic disorder
-secondary inflammatory reaction |
-inc. neutrophils
-left shift -inc. monocytes |
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Bacterial/Viral infections leading to hemolysis
-cats -dogs -pigs -cattle -llama |
-Cats: Mycoplasma haemofelis, Mycoplasma haemominutum
-Dogs: Mycoplasma haemocanis, Mycoplasma haemataparvum -Pigs: Mycoplasma haemosuis, Mycoplasma parvum -Cattle: Mycoplasma weyonii, Anaplasma marginale -Llama: Candidatus haemolamae |
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Major functions of RBC biochemical pathways
|
-produce NADPH & GSH
-produce ATP |
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NADPH function
|
-reduce Hgb-Fe
|
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HMP Shunt
-function |
-produce reducing compounds (NADPH, GSH)
|
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How do heinz bodies form?
|
-HMP shunt is overwhelmed by oxidant
-proteins get oxidized -Hgb is denatured -Heinz bodies form |
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How do eccentrocytes form?
|
-HMP shunt is overwhelmed by oxidant
-proteins get oxidized -RBC membranes become damaged -Eccentrocytes form |
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Major oxidants
-dogs |
-acetaminophen
-onions -sulfa compounds -zinc |
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Major oxidants
-cats |
-acetaminophen
-onions -benzocaine -propylene glycol |
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Major oxidants
-horses |
-onions
-red maple leaves |
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Major oxidants
-cattle |
-onions
-kale -rape -copper |
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How does hypophosphatemia cause hemolysis?
|
-Glycolysis needs phosphate to produce ATP
-dec. phosphate causes dec. ATP -dec. membrane repair -hemolysis |
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hypophosphatemia disorder
-cattle |
-postparturient hemoglobinemia
|
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hypophosphatemia disorder
-dogs |
-hyperinsulinemia
-phosphate enters cells -intravascular hemolysis |
|
|
hypophosphatemia disorder
-cats and dogs |
-hyperalimentation following anorexia
|
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How does L-sorbose cause hemolysis?
|
-sugarless gum contains L-sorbose
-blocks hexokinase in glycolysis -decreased ATP -hemolysis |
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Dog breed not affected by L-sorbose intoxication?
|
High-Potassium RBCs
-Japanese akita -Japanese shiba -Korean jindo |
|
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How does erythrocyte fragmentation lead to hemolysis?
|
-fibrin strands of microthrombi impale RBCs
-damage causes formation of schizocytes, keratocytes, acanthocytes -cells are removed by macrophage -extravascular hemolysis (usually w/o icterus) |
|
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Protozoal causes of hemolysis
-dogs -horses -cattle |
-dogs: Babesia gibsoni, Babesia canis
-horses: Babesia caballi, Theleria equi -Cattle: Theleria buffeli |
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Pathogenesis of protozoal hemolysis
|
Either:
-protease from organism -immune reaction -oxidative damage |
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How does heparin produce anemia in horses?
|
-erythrocytes agglutinate after 6-8 hrs
-RBCs get trapped in the spleen and die causing hyperbilirubinemia -Cell counter miscounts large RBCs giving a falsely low Hct |
|
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Parasitism by A. marginale and Cat/Dog hemic mycoplasma anemia
-pathogenesis |
-Antibody binds to infected RBCs
-extravascular hemolysis by macrophages -anemia |
|
|
Parasitism by Cytauxzoon felis anemia
-pathogenesis |
organism multiplies in the macrophages of the spleen, liver, and marrow
-marrow becomes damaged leading to decreased erythrocyte production -Chronic macrophagic inflammatory reaction causing anemia of inflammation mechanisms leading to dec. production and life span |
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Hemoconcentration
-defintion |
-increase in blood components due to a decrease in plasma volume
|
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Hemoconcentration
-most common cause |
-dehydration
|
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Polycythemia vera
-definition |
-clonal myeloproliferative disorder caused by neoplastic proliferation of all marrow cell precursors, leading to erythrocytosis, leukocytosis, thrombocytosis
|
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Relative polycythemia
-definition |
-erythrocytosis due to hemoconcentration or splenic contraction
|
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Absolute polycythemia
-definition |
-erythrocytosis due to increased erythrocyte mass
-polycythemia vera |
|
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Causes for water loss
|
-vomiting
-diarrhea -polyuria |
|
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Effect of water loss on total protein
|
-increase [TP]
|
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Effect of plasma loss on total protein
|
-no change in [TP]
|
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Reasons for splenic contraction
|
Catecholamines
-excitement -fright -exercise |
|
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Erythrocytosis from splenic contraction
-species more common in |
-dogs
-horses |
|
|
Secondary erythrocytosis
-due to |
-inc. Epo
|
|
|
Secondary appropriate erythrocytosis
-causes |
-persistent cardiovascular disease or chronic respiratory disease leading to hypoxia
|
|
|
Secondary inappropriate erythrocytosis
-causes |
-liver or kidney neoplasm leading to inc. Epo
|
|
|
Increased Epo causes what to occur
|
-erythroid hyperplasia
|
|
|
Primary erythrocytosis
-causes |
Neoplastic transformation
-primary erythrocytosis (RBCs) -Polycythemia vera |
|
|
99% of erythrocytoses are due to:
|
-hemoconcentration (dehydration or plasma loss)
-splenic contration |
|
|
Describe the absorption of Iron in healthy animals
|
-iron comes from the diet of animals and is absorbed by the intestine based on need
-Transported to plasma and becomes transferrin (bound to apotransferrin) -transported to either the marrow, liver, or spleen -marrow: either becomes hemosiderin (storage) or ferritin (used for hemoglobin) |
|
|
Hypoferremia
-definition |
-dec. [iron] in serum
|
|
|
Hypoferritinemia
-defintion |
-dec. [ferritin] in serum
|
|
|
How to measure serum Fe
|
-add acid to serum to liberate Fe from transferrin
-dye Fe for a photometric assay |
|
|
TIBC
-definition |
-total iron binding capacity
-total amount of iron that van be bound to transferrin |
|
|
How to measure TIBC
|
-add excess Fe to serum
-separate the bound Fe from the free Fe -measure the amount of bound Fe |
|
|
UIBC
-defintion |
-unbound iron binding capacity
-additional amount of Fe that could bind in serum |
|
|
How to measure the amount of stored Fe
|
-add prussian blue stain to hemosiderin
|
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Species that does not have stainable Fe
|
-cats
|
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Reasons for hypoferremia
|
-Fe deficiency
-Inflammation |
|
|
How to differentiate reasons for hypoferemia
|
-Inflammation results in an increase in stainable Fe in marrow and an increase in serum [ferritin]
|
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How to differentiate reasons for increased Fe storage
|
-serum Fe is WRI for pathologic hemolysis and dec. for inflammation
|
|
|
Hypoferremia
-pathogenesis |
Persistent low grade blood loss
-lose RBCs with Fe in hemoglobin -use stored Fe to replace last RBCs -depleted total body Fe -decreased stainable Fe or Persistent inflammatory disease -cytokines cause hepcidin synthesis -binds to ferroportin in macrophages -Fe stays in marcophages -inc. stainable Fe |
|
|
Methods to detect erythrocyte surface antibody
|
-Coombs test
-Flow cytometric detection |
|
|
Coombs test
-aka |
-direct antiglobulin test
|
|
|
Coombs test
-purpose |
-detect Erythrocyte Surface Associated Immunoglobullin (ESAIg)
|
|
|
How to perform a Coomb's test
|
-wash erythrocytes in saline
-incubate the erythrocytes with anti-immunogobulin -if immunoglobulin is present on the surface of the erythrocytes, there will be agglutination |
|
|
Reasons for a Coomb's Positive test
|
-autoimmune (IMHA)
-parasite -drug -neonatal isoerythrolysis |
|
|
Neonatal isoerythrolysis
|
-mothers antibodies against the blood type of the newborn
|
|
|
Unexpected Coombs Test results
|
-negative result in immune hemolytic anemia (prozone, wrong antiglobulin)
-positive result without significant hemolysis (inflammation) |
|
|
Flow cytometry for ESAIg
-method |
-take EDTA blood and wash with saline
-add fluorescin-labeled antibody against IgG/IgM -run through flow cytometer -RBCs with antibody will fluoresce |
|
|
How does the Optical cytometer from advia work
|
-makes all erythrocytes into spheres and then counts them based on the angle that a sphere causes light to scatter
|
|
|
Prozone
-defintion |
-no agglutination because [Ab] >>>>>[Ag]
|
|
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Postzone
-definition |
-no agglutination because [Ag] >>>>>> [Ab]
|
