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357 Cards in this Set
- Front
- Back
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Define Hematopoiesis |
Production of blood cells |
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Define Granulopoiesis |
Production of granulocytes |
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Define Erythropoiesis |
Production of RBCs |
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Define Thrombopoiesis |
Production of platelets |
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What is Erythropoietin |
A hormone produced by the kidney, stimulates the production of RBCs. can be used as a palliative treatment for animals with kidney disease |
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What is Thrombopoietin |
A hormone which stimulates the production of Platelets |
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Erythropoiesis is stimulated by __________ |
Erythropoetin |
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Thrombopoiesis is stimulated by _________ |
Thrombopoetin |
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Hematopoiesis can occur in what other tissues other than the Bone Marrow |
Liver, Spleen, and rarely in the Lymph nodes, thymus |
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What is a stem cell? |
A cell that has the capacity to differentiate into specialized cell types |
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There is not a common stem cell for Neutrophils and monocytes. true or false? |
False, there is a common stem cell for neutrophils and monocytes |
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How is the Maturation time of granulocytes affected by inflammation?- what is the normal production time for them? what do the cells that are created during shortened maturation time look like? |
The time is shortened. as there is an increased demand for neutrophils,- 6 days toxic changes- color, shape, size |
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In Rbcs, as the cell looses basophilia it gains ____________ |
Eosinophilia |
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When neutrophil concentration in peripheral blood increases, what other cell also commonly increases in concentration. |
Monocytes |
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what is "Toxic change" |
If the bone marrow needs to it can increase production, however instead of coming out normally they have Toxic changes which can cause them to be more basophilic, more vaculated, or have other cellular abnormalities. |
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What does the Nucleus of the Myeloblast look like? |
- Very Fine/granular chromatin - Nucleoli |
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What does the Cytoplasm of the myeloblast look like? |
- Deeply basophilic - No granules |
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What does the Nucleus of the Promyelocyte look like? |
-Fine chromatin - +/- Nucleoli |
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What does the cytoplasm of the promyelocyte look like? |
- Basophilic -Azurophilic granules |
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What doe the Nucleus of the Myelocyte look like? |
-coarse, clumped chromatin -no nucleoli |
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What does the Cytoplasm of the myelocyte look like? |
- similar to neutrophil, slightly more basophilic - secondary granules - no primary granules |
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What does the Nucleus of the Metamyelocyte look like? |
-Coarse, clumped chromatin -shallow indent (bean, or fat hourglass) |
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what does the cytoplasm of the metamyelocyte look like? |
-similar to mature cell, may be slightly basophlic |
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What does the nucleus of a Band look like? |
- Coarse, clumped, condensed chromatin - sausage shaped - "Parallel" sides - Thicker than the nucleus of a neutrophil |
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What does the cytoplasm of the band look like? |
-similar to mature cell, slightly basophilic. |
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In what order does the precurser WBCs develop? |
1. Myeloblast 2. promyelocyte 3. myelocyte 4. metamyelocyte 5. band 6. Neutrophil |
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Where does erythropoiesis occur? |
Primarily in the bone marrow |
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Erythropoiesis takes how long? and what things does it need to be preformed? |
4-6 days, cannot be sped up. Protein, iron, copper, cobalt and vitamins |
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With RBCs we don't get a change in granulation, whereas what changes dramatically? |
Chromatin and colour changes dramatically in RBC maturation. |
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What is a Pluripotent stem cell? |
Produces RBCs, WBCs and platelets |
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Compared to granulocytic precursors, erythroid precursors are... |
- Smaller - more basophilic when young - have very round nucleus |
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what does the Nucleus of the Rubriblast look like? |
- large round nucleus - delicate, stippled chromatin -nucleoli |
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what does the cytoplasm of the Rubriblast look like? |
- thin rim - royal blue - perinuclear clear zone |
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what does the nucleus of the prorubricyte look like? |
- Nucleoli usually disappear - chromatin is slightly more coarse than a rubriblast |
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What does the cytoplasm of the prorubricyte look like? |
- Royal blue -prominent perinuclear clear zone |
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What does the nucleus of a Rubricyte look like? |
- Relatively large, "juicy nucleus" - alternating light and dark clumps of chromatin |
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What does the cytoplasm of a Rubricyte look like? |
- usually varies from intensely basophilic to polychromatic (grey-blue) |
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true or false, a basophilic rubricyte is usually smaller than a polychromatic rubricyte |
FALSE the basophilic rubricyte is usually larger. and has a more condensed nucleus |
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What does the Nucleus of a Metarubricyte look like? |
- Small -pyknotic (dark and shrivelled) |
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What does the cytoplasm of a metarubricyte look like? |
- relatively more cytoplasm than a rubricyte - polychromatic or eosinophilic. |
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what species never has polychromatic RBCS in circulation? Polychromatic's are called what when stained with NMB? |
Horses Reticulocytes |
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when a cell is between two stages what should you call it? |
call it the more mature |
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How are WBCs/precurses reported during a differantial cell count? |
WBCs are named specifically & counted as part of the differentiall cell count, i.e. part of the 100% |
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How are nRBCs reported during a differential cell count? |
nRBCs are named specifically and are reported as # per 100 WBCs |
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when Rbcs are destroyed they are metabolized into what? |
- iron - protein - bilirubin |
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what is the bilirubin cycle |
1. rbcs are broken down into heme. 2. the heme turns into unconjugated bilirubin 3. the conjugated bilirubin goes to the liver to become conjugated 4. the conjugated bilirubin comes out in the urine, or gets stored in the gallbladder, until it is needed. 5. it is then moved into the bile duct and becomes stercobilinogin in the feces, or urobilinogin which is recirculated by the body. |
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What does IMHA mean? |
Immune Mediated Hemolytic Anemia |
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What is IMHA? |
It is the destruction f RBCs by the immune system, resulting in anemia. the animals immune system attacks its own cells |
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due to the excessive RBC destruction during IMHA, what will there be an increased production of? |
There will be an increased production of both Unconjugated and Conjugated bilirubin. |
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What Causes IMHA? |
- when the RBCs are coated with immunoglobulins or compliment (secondary to many causes including neoplasia, antibiotic therapy, vaccines etc) - the body recognizes RBCs as "Foreign" and destroys them. |
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What is Intravascular Hemolysis |
i.e. ghost cells - membrane only -hemoglobin has been lost |
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What is Extravascular Hemolysis |
i.e. Spherocytes - smaller, darker, with no central pallor |
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What is a leptocyte? why are they formed? |
Leptocyte- an rbc with a misshapen area of pallor they are formed when cells are large and less flexible than normal. |
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What increased number of Howell-Jolly bodies indicate? |
It indicates decreased Splenic function |
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What are the clinical signs of IMHA? |
- often vague - poor appetite - listless - weak - pale Mucous Membranes |
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true or false: the presence of spherocytes is highly suggestive of IMHA |
TRUE |
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Agglutination is diagnostic for IMHA, if agglutination if not present what test should be preformed? |
a Coomb's test |
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why is it important to recognize normal RBCs? |
so that abnormalities can be detected. |
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In dogs, what size, size variation, and central pallor is normal? |
- about 7um - large central pallor - no anisocytosis |
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In Cats, what size, size variation, and central pallor is normal?
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- about 5.8um - small central pallor - some anisocytosis |
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What is the function of RBCs? |
- use hemoglobin to transport oxygen and carbon dioxide - removal of wastes from plasma |
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what are the clinical signs of Anemia |
- lethargy, fatigue, weakness -tachypnea & tachycardia - possibly a systolic heart murmur |
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what is the lifespan of RBCS? |
- varies between species - approx. 10-22 weeks -100 days in dogs |
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which of the byproducts of RBC metabolism are recycled |
-Iron - Globin |
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How is RBC number presented |
__ x 10^12/L |
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What are the 2 units Microhematocrit (PCV) is presented? |
Traditional: __% SI: __ L/L |
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true or false: Hematocrit is presnted in the same units as microhematocrit (Traditional and SI units) |
TRUE |
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What are the units for Hemoglobin, what is it? |
__g/L Hemoglobin is the TOTAL amount of hemoglibin in a volume of blood |
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What Does anemia mean (Hint: theres more than one answer) |
Anemia: Decreased RBC numbers ORhematocrit/PCV OR hemoglobin concentration in the blood |
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Define Polycythemia |
Increased concentration of RBCs inthe blood. RBC numbers and/or hematocrit/PCV and/or hemoglobinconcentration are increased.
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what is responsible for the pink color of RBCs |
The Hemoglobin |
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"Hb" on an erythrogram refers to what? |
The total hemoglobin in the blood, NOT the amount of hemoglobin in a cell |
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what is Methemoglobin? |
it is when cells cannot hold oxygen |
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What happens when Methemoglobin occurs? |
- Mucous membranes appear cyanotic - blood appears brown |
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when referring to colour we are referring to what saturation in the cells? |
hemoglobin saturation. |
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what does MCH mean? and what does it refer to? |
Mean corpuscular hemoglobin - it refers to the weight of the hemoglobin in an average RBC |
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What does MCHC mean? and what does it refer to? |
Mean corpuscular hemoglobin concentration. - it refers to the concentration of Hemoglobin in an average RBC (g/L) |
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A patient has a PCV of 0.20 L/L, hemoglobin of 72 g/L and a RBC count of 3.2 x 10^12/L what is MCH? (MCH= Hemoglobin (g/L) / RBC #/L ) |
MCH = 72g/L / 3.2x10^12/L = 22pg ( 72/3.2 = 22 ) - so MCH is calculated by dividing hemoglobin by RBC count number |
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A Patient has a PCV of 0.20 L/L,hemoglobin of 72 g/L and a RBC count of 3.2 x 10^12/L
What is the MCHC? (MCHC= Hemoglobin (g/L) / PCV(L/L) ) |
MCHC = 72g/L / 0.20L/L = 360g/L (72/0.20 = 360) -so MCHC is calculated by dviding hemoglobin by PCV |
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When hemoglobin concentration is Decreased, normal, increased is is referred to as |
Decreased: Hypochromic Normal: Normochromic Increased: Hyperchromic. (cannot actually be hyperchromoic but can appear to be) |
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what is a femtoliter (fL) |
- it is a unit expressed as "10^-15/L" used for MCV |
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true or false: an MCV is an average, an animal with small and large RBCs might not have a normal MCV |
FALSE- their MCV may be normal, the average of a small RBC and a Large RBC = a regular RBC |
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What is meant by Mild Anisocytosis? |
- the diameter of the smallest cell, plus 1/3 the diameter of a normal cell makes the largest cells |
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What is meant by Moderate Anisocytosis? |
- the diameter of the smallest cell plus 2/3 the diameter of a normal cell makes the largest cells |
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what is meant by Marked Anisocytosis? |
- the diameter of the smallest cell plus the diameter of a normal cell makes the largest cells. |
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What is a microcyte? what is a Macrocyte? |
Microcyte- Small RBC Macrocyte- Large RBC |
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How can Anemia be classified? |
1. According to size, and hemoglobin saturation of RBCs 2. According to response - responsive/ regenerative -non-responsive/ non-regenerative 3. According to cause |
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RBC count determins what on an erythrogram? |
- It determines if there is anemia. if the numbers are within reference values the animal is normal, if they are below reference values the animal is anemic. |
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MCV determines what on an erythrogram? |
- It determines the size of the cell. whether it is normocytic, microcytic or macrocytic. |
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MCHC determines what on an erythrogram? |
- it determines the chromasia of the cell. whether it is the hypochromic, normochromic, or hyperchrmoic. |
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- Sphereocytes appear what on a smear? |
Hyperchromic |
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How would you describe a cell that has increased MCV and Normal MCHC |
- Macrocytic -normochromic |
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How would you describe a cell that has normal MCV and Decreased MCHC |
-Normocytic - hypochromic |
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How would you describe a cell that is decreased MCV and decreased MCHC |
-Microcytic -hypochrmic |
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What is expected to be found in a responsive anemia? |
- the bone marrow releasing immature cells to replace the "missing" ones (the bone marrow is responding to the anemia, therefore it is responsive) - increased concentration of polychrmoatic RBCs - increased anisocytosis |
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if the anemia is regenerative MCV will be ______ and MCHC will be ______ since young RBCs are _________ and not fully hemoglobinized |
If the anemia is regenerative, MCV will be __increased__ and MCHC will be __decreased__ since young RBCs are __larger__ and are not fully hemoglobinized. |
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True or false: the presence of Nucleated RBCs in the absence of increased polychrmoatic RBCs does indicate a response |
False- it DOES NOT indicate a response. |
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What is a reticulocyte? |
A reticulocyte is a polychromatic RBC that has been stained basophilic with a supravital stain |
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What are the two different kinds of reticulocytes in cats? |
-aggregate (clumps or clusters of organelles) -punctate (scattered individual organelles) |
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True or False: reticulocytes are a better indicator of bone marrow response the anemia than polychromasia |
True. reticulocytes will give a definitive answer |
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True or False when reporting RBC precursors, they are included in the differential cell count |
False, they are NOT included in the differential cell count |
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An animal with increased MCH but decreased MCHC is decreased presumably, what do the cells look like in regards to color |
The cells would appear Hypochromic |
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On a Erythrogram, how can you tell if an anemia is responsive or non-responsive? |
If there is a more than normal # of polychromatic RBCs / reticulocytes than the anemia could be regenerative |
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What is the equation for corrected reticulocyte count? |
Corrected reticulocyte % = origional count x patients PCV/"Normal" PCV -Make sure to use the middle (or average) of the reference interval for the "Normaml |
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what does a RBC look like when it undergoes crenation? |
even projections, and around edges only, they are often an artifact |
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Describe an Echinocyte: |
Even projections, on all surfaces, a more severe form of crenation. |
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How does an Acanthocyte differ from and Echinocyte |
an Acanthocyte has irregular spaced- blunt and a various lengthed projections, they are caused by liver disease and hemangiosarcoma. Echinocytes have even projections, and are a form of crenations. |
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An RBC that has projections on only one edge is a: |
crenated RBC |
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An RBC that has even projections on all surfaces and is a form of crenation is a: |
Echinocyte. |
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Describe an Ovaloechinocyte: |
They have short projections and are oval in shape. |
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What is the #1 cause of crenated RBCs? |
someone didn't dry the smear quick enough
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Are Acanthocytes normally seen in normal blood, T/F? |
False |
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Snake bites cause which of the following in RBCs? a) Crenation b) Echinocytosis c) Acanthocytes to be present d) Ovaloechinocytosis |
Echinocytosis |
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Anemia |
A decrease in the PCV, RBC count or hemoglobin value s below normal values |
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Anisocytosis |
variation in the size of cells
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Aplasia |
Cessation of blood cell formation |
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Basket cell |
A free ruptured nucleus which has swollen so that separated chromatin can be seen |
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basophilia |
1. increased numbers of basophils in circulation 2. The blue staining of a structure with a Romanowsky |
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Buffy coat |
The layer of WBCs, platelets and nucleated RBCs if present, that collects above the RBC's in sedimented or centrifuged blood |
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Chromatin |
DNA which makes up the nucleus of a cell |
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Degenerative left shift |
the number of immature, non-segmented neutrophils exceeds the number of mature, segmented neutrophils in circulation, |
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Doehle Body |
Small, irregular, blue-grey body in the cytoplasm of neutrophils residual RNA |
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Eosinophilia |
increased concentration of eosinophils in circulation |
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Eosinopenia |
Decreased concentration of eosinophils in circulation |
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Erythropoiesis |
the production of RBC's |
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Fibrin |
the end product of coagulation. |
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Hemacytometer |
A precision instrument for manually counting cells |
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Hemoglobin |
A protein found in erythrocytes; composed of heme and globin |
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Hemoglobinemia |
a condition in which free hemoglobin is present in the plasma |
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hemolysis |
Destruction of RBCs |
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hypersegmented |
a neutrophil with six or more nuclear lobes |
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hypochromic/hypochromatic |
an adjective used to describe a RBC that shows a decrease in the density of hemoglobin present in the cell, resulting in increased central pallor |
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Hyperproteinemia |
increased protein concentration in the blood |
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Hypoproteinemia |
increased protein concentration in the blood |
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Idiopathic |
of unknown cause |
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karyorrhexis |
pyknosis and fragmentation of the nucleus |
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Leukemia |
neoplastic disease of the bone marrow and blood |
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Idiopathic |
of unknown cause |
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Karyorrhexis |
pyknosis and fragmentation of the nucleus |
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Leukemia |
neoplastic disease of the bone marrow and blood |
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Extramedullary |
Blood being formed outside of the bone marrow, in the spleen, liver and lymph |
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Leukemoid |
Resembles leukemia by having a marked leukocytosis or by having a lot of immature cell in the blood not due to neoplastic changes in the hematopoietic tissue |
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Left shift |
Presence on an increased concentration of immature (non-segmented) neutrophil in the circulation |
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leukocytosis |
increased concentration of white blood cells in circulation |
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leukopenia |
decreased concentration of white blood cells in circulation. |
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lymphocytosis |
increased concentration of lymphocytes in circulation |
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lymphopenia/lymphocytopenia |
decreased concentration of lymphocytes in circulation |
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marcocyte |
an rbc that has a volume that is larger than normal |
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macrocytic |
a cell that is larger than normal (adjective) |
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Macrocytosis |
an increased number of large RBCs |
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Macroplatelet |
A large platelet; at least as large as a normal RBC |
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Mast cell |
A tissue cell which has granules that contain histamine & heparin |
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MCHC |
Mean corpuscular hemoglobin concentration |
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MCV |
Mean corpuscular volume |
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microcyte |
An rbc with a volume which is smaller than normal |
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microcytic |
A cell that is smaller than normal(adjective) |
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Microcytosis |
An increased number of small RBC's |
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Monocytosis |
Increased concentration of monocytes in circulation |
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Neutropenia |
decreased concentration of neutrophils in circulation |
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neutrophilia |
increased concentration of neutrophils in circulation |
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Normochormic or normochromic |
a RBC with normal hemoglobin saturation (MCHC) |
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normocytic |
an adjective used to describe an RBC of normal size (volume) |
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Pancytopenia |
A decrease in all blood cell (RBC, WBC and platelet) Lines |
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Plasma |
The fluid component of the blood |
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Polychromasia |
increased concentration of polychromatic RBCs in circulation |
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Polycythemia |
increased RBC Mass (PCV; RBC count) in the body |
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pyknosis |
nuclear condensation and death |
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Reticulocytosis |
an increased concentration of reticulocytes in circulation |
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Right shift |
Presence of an increased number of hypersegmented neutrophils in circulations. |
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Sedimentation rate |
The rate at which "RBCs settle in their own plasma in a given amount or time" |
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Serum |
The fluid component of the blood produced after the blood has been allowed to clot
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Shift red blood cell |
A RBC which is twice the size of a normal RBC and polychromatic |
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Smudge cell |
A nucleated cell that was ruptured during smearing, due to mechanical damage or increased fragility of cell, chromatin has not spread out in distant strand (see "basket cell") |
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Supravital staining |
use of stain that is taken up by a live cell so that "vital and functional processes" can be studied, eg. New Methylene Blue or brilliant cresyl blue |
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Thrombocytopenia |
Decreased concentration of platelets (thrombocyte) in circulation |
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Thrombocytosis |
increased concentration of platelets (thrombocytes) in circulation |
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Toxic neutrophil |
A neutrophil showing certain morphologic changes such as vacuolation, toxic granule, increased basophilia and/or nuclear changes. |
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Does a patient have to be anemic to see Acanthocytes |
NO |
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When will a cell spiculate? |
if a smear is to thick or if a smear is not dried quickly or if the sample is aging |
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Leptocyte |
general term for RBC with an area of pallor that is oddly shaped and large and and less flexable |
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Target Cell |
also called a codocyte "bulls eye" |
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Stomatocyte |
a RBC with a central slit |
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Bar Cell |
central bar of hemoglobin visible |
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Describe apple stem cell |
it has one stalk or projection |
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Descibe keratocyte |
has two horns or projections |
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HOW much is this worth? |
10% |
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Eccentrocyte |
has membrane stuck together on one side fused |
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Pyknocyte |
the eccentrocyte but without the membrane |
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Spherocyte |
Cell is spherical, rather than biconcave, smaller & darker than a normal RBC no central pallor- only identified in species with a large zone of central pallor |
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Eccentrocytes are not always abnormal t/f |
false |
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What is the difference between elliptocytes and ovalocytes? |
elliptocytes are cigar- shaped ovalocytes are egg- shaped |
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Elliptocytes and ovalocytes are normal in what species? |
Camelids- camels, alpacas, llamas, birds, reptiles |
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What are fragmented RBC's usually caused by? |
Shearing damage by fibrin or movement through tortuous vessels - hemangiosarcoma or inflammation, RBCs hitting the fibrin. |
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Schistocytosis in patients with thrombocytopenia is highly suggestive of |
DIC disseminated intravascular coagulation, medical emergency. but can also be seen with iron deficiency. |
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poikilocyte |
Any odd- shaped RBC, Use only when shape change cannot be specifically identified |
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Schistocyte |
a RBC fragment usually up to 1/3 RBC in size torn off of an RBC |
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Fragmented RBCs |
Torn RBCs are obviouslt torn but are the cell portion |
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Ghost Cell |
Has lost its hemoglobin membrane only |
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Smudged RBCs |
Blurred edges frequent with lipemia |
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Hemoglobin Crystal |
one or more rectangular pink crystals |
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Dacryoctes |
Teardrop-shaped makesure these are not just stretched |
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describe Basophilic stippling |
variable size, lighter than howell-jolly bodies |
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What is Basophilic stippling indicative of? |
Regenerative anemia (ruminants and cats) as well heavy metal poisoning |
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what causes howell- jolly bodys and what is the normal value of them in cats and horses. and what are they a remnant of |
round nuclear remnant normal in cats and horses (up to 1%) lack of splenic function |
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describe heinz bodies and how to identify and also what they are caused by and also what color they stain |
only stain blue with NMD or brilliant Cresyl blue; pink with routine stains caused by oxidative damage |
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lead poisoning will cause a) basophilic stippling b) heinz bodies |
a) basophilic stippling |
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describe Heinz bodies |
often have a clear area at the base may be on top of the cell and will appear as round pale areas colourless and retractile in unstained wet preparations, basophilic with NMB or brilliant cresyl blue. |
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what is Rouleaux? |
Stacking of RBCs |
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True or false marked rouleaux is normal in cats |
false moderate marked is horses and mild is dogs |
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t/f rouleaux is increased with hyperproteinemia |
t |
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Agglutination is when |
RBCs stick together in clumps |
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what does agglutination indicate? |
an immune mediated hemolytic process |
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immune- mediated hemolytic process is confirmed with : |
a saline agglutination test blood mixed with normal saline 1:4 check a wet prep for the presence of agglutination |
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what is it meant when the term Lipemic artifact is used |
when RBCs appear smudged and misshapen poikilocytosis can not be reliably identified on these smears |
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what number do you use to assess WBC s
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Absolute numbers |
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what is the only exception to the rule that the number of decimal places of the absolute numbers should match the number of decimal places of the WBC count |
if the number is very small and would otherwise round to zero, please leave an extra decimal place |
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Blood is only collected from the a) marginated pool b) circulating pool c) swimming pool d) blood vessel |
circulating pool |
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cells move freely between ---------- and ------------- pools. |
Circulation and marginating pool |
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Cells marginate after moving into tissues t/f |
false before |
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leukocytosis can be due to: |
increase is any type of WBC or a combination of different types of WBCs most frequently due to neutrophilia +-monocytosis, and occ lymphocytosis |
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what is neutrophilia caused by? |
inflammation- fast acting stress- neutrophil demarginate exercise/ epinephrine leukemia/neoplasia |
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inflammation = infection? t/f |
false |
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What change may be seen initially in the circulating neutrophil concentration? |
Neutrophils are first released frommarrow granulocyte reserve pool• Granulopoiesisis stimulated• As supply of mature neutrophils isdepleted, less mature neutrophils are released, i.e. a LEFT SHIFT is seen in circulating blood
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define left shift |
an increased concentration of immature, non segmented neutrophil in circulation |
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an inflammatory leukogram has to have a left shift. t/f. |
False does not |
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accelerated granulopoiesis may result in------------ changes. |
Toxic |
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in established (chronic) inflammation, what change in production of blood cells happens? |
the bone marrows capacity for granulopoiesis is increased, bone marrow can "keep up" with increased demand neutrophilia, but no left shift often a monocytosis is seem. |
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what change in cell numbers are seen in stress/ corticosteroid cases? |
Lymphopenia isthe most common changeEosinopeniaoften not seen due to low “normal” reference valuesChangesoccur within 6 hours
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what change in cell number are seen in exercise/ epinephrine cases? |
Lymphocytosis is most frequently seen in cats & young animalsChanges are almost IMMEDIATE, but disappear within a few hours once the patient is calm/rested
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What is Leukemia? |
The presence of neoplastic (cancerous)cells in circulation or the bone marrow
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what are the two types of leukemia? |
Myelogenous leukemia Lymphocytic leukemia |
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General causes of Neutropenia? |
1.Decreased productionLack of hematopoietic space InfectionsDrugs (not being made)
2.Overwhelming tissuedemand/Decreased survival (leaving) 3.Sequestration (hidden) |
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Neutropenia due to decrease production is because of: |
lack of hematopoietic space: tumors affects all cell lines infections: parvovirus feline distemper feline leukemia FTLV Drugs: |
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Neutropenia due to increased tissue demand/ decreased survival can be due to: |
severe bacterial infections toxic changes seen often with degenerative left shift |
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if a neutropenia is seen to check for bacterial infections do a buffy coat to check for bacteria |
true |
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Buffy coat: how do you preform it? |
Spin microhematocrit,as usual- Score the tube (to weaken it) justabove the buffy coatBreak the tube where it is scoredInsert a paper clip into thesealant at the bottom of the tubePush until the buffy coat comes outthe topDab buffy coat on a slideSmear and stain as usual
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Degenerative left shift is: |
The number of immature, non-segmented neutrophil (bands and younger) outnumber the number of mature neutrophils, bone marrow just cant keep up man! |
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Sequestration is when neutrophils are: |
hidden in the margination pool- allergic reaction. or due to anaphylaxis or endotoxemia (from bacterial infection) |
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Lymphocytosis is caused by? |
1.Physiologic– excitement/epinephrine
2.Chronic immune stimulusRemember what lymphocytes do 3.NeoplasiaLymphocyticleukemia 1.Animalexcited, young, active, they also get a neutrophilia that goes along with it,will go away within a few hours, 2.Something that stimulates body tomount an immune response, - lymphocytes make anitbodies- if there is an infection and there isan ongoing intruder –it is common to see lyphocytosis 3.Lymphoblastic leukemia also named |
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if the patient was upset there may be an alteration in lymphocytosis. t/f |
true |
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immunoglobins are antibodies to something, if seen is high numbers this case can be an immune respond. t/f? |
true |
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Lymphopenia is cause by: |
1.Stress/corticosteroids- ear meds, cushings, biological strss
2.Renal disease 3.Viral damage to lymphoid tissue 4.Loss/sequestration/blockage of lymphRemember lymphocytes re-circulate |
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Eosinophilia is caused by: |
parasites allergies Specific eosinophilicdiseases Inflammation of tissues with lotsof mast cells- similar granules to basophils Remember mast cells containhistamine & eosinophils havean anti-histamine action |
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basophilia is caused by: |
heartworm disease- commonly mast cell neoplasia |
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please fill in the chart for the WBCs for the causes of changes in leukocyte concentrations |
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Myogobinurea is caused by: |
Muscle breakdown, and muscles release the myoglobin, to the blood steam, tying up |
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Morphologic changes can occur in the absence of changes in cell -----------. i.e |
Numbers toxic changes neoplastic changes diagnostic for a specific disease, eg. distemper inclusions inclusions- phagocytosed material, organisms, cellular debris etcetera |
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Machines cannot detect morphologic changes t/f |
true |
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All routine morphology should be assessed in the |
Optimal viewing area |
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normal PCV: for cats and dogs |
cats: 37-55 dogs: 27-45 Middle range 36, 46 |
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The feathered edge is checked for ----------- & ----------- cells. |
Large & unusual |
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What did a bilobed neutrophil start out as? |
a myelocyte |
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Giant Neutrophils |
Diameter is >16 um - Compare with RBCs |
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Do giant neutrophils mature without the cell dividing normally? |
yes |
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Giant neutrophils are common in which species |
cats |
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What is increased Cytoplasmic Basophilia due to: |
RNA short maturation time or an interference with maturation |
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describe Cytoplasmic Basophilia: |
often streaky or blotchy in appearance |
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where do you look for vacuolation on the cells: |
the edges |
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If increased cytoplasmic basophilia is present than there are often vacuoles present, t/f? |
true |
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What do indistinct "holes" or cytoplasmic vacuolation look like? |
Motheaten or foaminess |
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what are large punctate vacuoles usually due to? |
and artifact of (EDTA) |
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Doehle bodies are remnants of what? |
RNA |
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What do Doehle Bodies look like? |
small, irregular, blue grey bodies |
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Doehle bodies are common in which species? |
cats |
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Doehle bodies can form in blood if it is stored prior to smearing t/f? |
True 15MINUTES!##@#@#%@%@#%@#% |
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describe hypersegmentation: |
6 or more nuclear lobes |
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what is hypersegmentation due to? |
corticosteroids |
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when does hypersegmentation occur? |
when A cell has stayed in circulation for longer than usual. |
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Hypersegmentation is a toxic change t/f? |
false |
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What is a Right shift? |
Presence of Hypersegmented cells |
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Pelger- Huet Anomaly is a Left shift t/f? |
False DO NOT CONFUSE THIS WITH A LEFT SHIFT |
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What does the Pelger-huet anomaly look like? |
condensed chromatin but not constricted. |
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Not all neutrophils are effected with a patient with pelger-huet anomaly t/f? |
false ALL neutrophils are affected. |
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neutrophils are the only cell affected by pelger huet anomaly t/f? |
no others are too- check the eosinophils |
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Toxic Granulation is : |
retained primary granules |
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what is the difference between toxic granules and normal neutrophil granules? |
toxic granules are more dark than normal neutrophil granules |
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Toxic Granulation is most common in dogs t/f? |
true |
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Name 4 nuclear changes to the shape or lobulation of the neutrophils: |
Hypersegmentation hyposegmentation Pyknosis/ karyorrhexis donut nuclei |
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nuclear change: hyposegmentation is also known as left shift? t/f? |
false |
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What are some changes seen in the chromatin of nuclear changes |
mitotic figures nuclear/ cytoplasmic asynchrony or nuclear immaturity. |
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Barr body look like: |
a small drumstick- like nuclear appendage |
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Barr bodys are often seen in male animals? t/f? |
false females ore hermaphrodites |
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doughnut or ring nucleuses are often seen in cats t/f? |
true |
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doughnut or ring nucleus are only seen in neutrophils? t/f |
false, both neutrophils and bands can see this change. |
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Describe Pyknosis and Karyorrhexis |
nucleus shrunken and condensed |
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how do pyknosis and karyorrhexis differ? |
the number of "balls" p- nuclei form one "ball" k- nuclei form two "balls" |
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Pyknosis and karyorrhexis are seen in samples that are not processed immediately t/f? |
True |
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what is nuclear/ cytoplasmic asynchrony or immature chromatin? |
the maturity of the nucleus/ chromatin does not "fit" with the maturity of the cytoplasm or nuclear shape |
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Bilobed Neutrophils is NEVER normal. |
false- normal in Elephants |
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What WBC changes are considered toxic? |
Doehle bodies cytoplasmic basophilia and vacuolation donut nuclei giant neutrophils toxic granulation |
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Toxic neutrophils are caused by what? |
Accelerated granulopoiesis... inflammation |
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sepsis causes toxic neutrophils t/f |
false, but they are often seen in septic patients |
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how do you report the morphologic change of doehle bodies, cytoplasmic basophilia, foamy cytoplasm? |
few- 5-10% moderate- 11-30% many- > 30 % |
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how do you report the morphologic change of giant neutrophils, doughnut nucleus, bilobed neutrophils, hypersegmented neutrophils, barr bodies, pyknosis/karyorrhexis, reactive lymphocytes, atypical lymphocytes |
check box if present. |
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describe granular lymphocytes |
they have a collection of large azurophilic granules, |
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granular lymphocytes are not frequently seen in low numbers in sheep? t/f |
false they are seen frequently |
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granular lymphocytes often indicate what? |
inflammation, but can be seen in neoplastic cells |
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Describe a reactive lymphocyte. |
large royal blue cytoplasm perinuclear clear zone nucleus may be indicated may have vacuoles |
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describe a lymphoblast |
they have one or more nucleoli usually large chromatin is finer and more dispersed often have moderately to deeply basophilic cytoplasm |
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describe an atypical Lymphocyte |
Nucleus has deep clefts or multiple infoldings May have dark blue or abundant cytoplasm doesn't look right, if a lymphocyte looks "ODD" but you can't classify it call it "atypical" |
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describe small lymphocytes |
smaller than a neutrophil nucleus ~ 1 RBC |
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Describe Plasma cells |
deeply basophilic cytoplasm prominent perinuclear clear zone eccentric nucleus |
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Describe Lymphoblasts |
Stippled chromatin prominent nucleolus moderate to deeply basophilic cytoplasm |
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what are some breakdown products of RBC's |
Hemosiderin and hematoidin, |
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what are some Phagocytosed material |
infectious organisms cells hemosiderin and hematoidin cellular debris |
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what is Chédiak-Higashi Syndrome ?
what does it look like?...... "dont memorize" |
inherited syndorme mostly in cattle and persian cats partial oculo-cutaneous albinism large, pink- purple granules |
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Describe mast cells, where they are found on smear, and why they are caused and example |
Round to oval with an oval nucleusand abundant deep purple granules Most commonly seen in the featherededgeCan also check a buffy coat smear May be due to inflammatory diseaseor may be systemic mastocytosis example hit by car trauma |
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where do cell tumors form? |
spleen |
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what is leukoagglutination? |
Clumping of WBCs in peripheral blood
Usually an artifact due to prolonged storage Can be due to EDTA Try a different anticoagulantCan affect automated counts |
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what does leukoagglutination effect? what can you try to fix it? |
effects count and differential, try anticoagulation. |
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what is distemper viral inclusions, what are they used to diagnose. |
Round, pale basophilic to magenta, intracytoplasmicinclusionsCan also be seen in RBCs Diagnosticfor CANINE DISTEMPER
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What are some organisms that affect WBCs |
Ehrlichiaspp.
Hemogregarines- Hepatazoonspp. Leukocytozoon spp. See Blood-borne Organisms lecture |
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What are the normal #'s of polychromatic RBCs seen in dogs, and cats, |
dogs ( up to 1%) and cats ( up to 0.3%) |
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When are polychromatic RBCs released in Cattle, Sheep, and Goats. |
Only if they are needed. |
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Describe the destruction of RBC's |
they are picked up by the reticuloendothelial cells, especially in the spleen, then they are metabolized to iron, protein, & bilirubin, iron is stored for reuse and, proteins are broken down stored in the amino acid pool, bilirubin comes from heme, as unconjugated bilirubin, then goes to the liver and it changes it to conjugated bilirubin- stored in the gull bladder, and then goes to the bile duct and to the intestine which changes it to stercobilinogon and urobilinogen, |
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What are the clinical signs of IMHA |
Often vague Poor appetite Listless Weak Pale mucous membranes |
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in what order should you asses all the features of the WBCs |
- Maturation/precursors - Size - Cytoplasm - Nucleus |
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What Changes are occurring to this WBC? |
Toxic changes - Cytoplasmic Basophilia - Cytoplasmic Vaculation - Doehle Bodies |
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What Changes are occurring to this WBC?
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Toxic changes
- Cytoplasmic Basophilia - Cytoplasmic Vaculation - Doehle Bodies |
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What Changes are occurring to this WBC?
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Toxic Changes: - Toxic granulation |
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What Changes are occurring to this WBC?
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Toxic Changes: - Cytoplasmic Basophilia - cytoplasmic vaculation Doehle bodies - Giant Neutrophil (16 micrometers or larger) |
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What Changes are occurring to this WBC?
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Not toxic: - Hypersegmentation (6 or more nuclear lobes present) |
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What Changes are occurring to this WBC?
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Not Toxic: - Pyknosis |
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What Changes are occurring to this WBC?
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Not Toxic: - Karyorrhexis |
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What Changes are occurring to this WBC?
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Toxic: - Cytoplasmic Basophilia - Cytoplasmic Vaculation - Doehle Bodies |
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What Changes are occurring to this WBC?
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Toxic: Donut Band |
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What Changes are occurring to this WBC?
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Not Toxic: - Smudge |
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What Changes are occurring to this WBC?
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Not Toxic: - Basket |
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What is occurring in this Picture? |
Erythrophagocytosis |
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With Giant Neutrophils the Nucleus _______ without the cell __________ normally |
With Giant Neutrophils the Nucleus matures without the cell dividing normally |
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What is increased Cytoplasmic Basophilia caused by? |
It is due to retained RNA, and a to short maturation time or something interfering with maturation. |
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What do Doehle Bodies look like and how could they be formed? |
They are small, irregular, blue-grey bodies. can form if the blood is stored prior to smearing or if left in EDTA |
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What is Toxic granulation |
It is retained primary granules, they are more prominent and darker than normal neutrophil granules. it is very uncommon. |
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Hypersegmentation- a cell that has _________ in circulation for _______ than usual. |
Hypersegmentation- a cell that has stayed in circulation for Longer than usual.
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What is The presence of Hypersegmented cells known as? |
A Right Shift |
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What is the Pelger-Huet Anomaly? |
It is when chromatin is condensed, but not constricted, Neuclei do not segment normally and will affect all Neutrophils. |
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What is a Barr Body and where are they seen? |
They are small drumstick-like appendages coming off the nucleus, it is seen only in females (or hermaphrodites) as it is due to a second "X" Chromosome. |
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Can a Donut Cell be seen in a Band or a Neutrophil? or both? |
It can be seen in both, differentiation depends on the width of the nucleus. NOTE: do not misidentify as just a normal cell with overlapping ends. |
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Identify and comment on the Nucleated cells |
Left: Toxic Neutrophil - Cytoplasmis Basophilia Right: Toxic neutrophil. - Giant, Donut, Cytoplasmic Basophilia |
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With Pyknosis the Nucleus is _______ and _______ (Dead) |
With Pyknosis the Nucleus is Shrunken and Condensed (Dead)
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What is this?
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A Mitotic Figure (Mitotic cell) |
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Is the Presence of a Bilobed Neutrophil a toxic change? |
No |
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What changes in WBCs are considered toxic? |
Doehle Bodies, Cytoplasmic Basoplilia and Vaculation, Donut nuclei, giant neutrophils, toxic granulation. |
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What are toxic neutrophils caused by? |
caused by accelerated granulopoesis, such as that in Inflammation. |
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What kind of cell is this? |
Small Lymphocyte (the size of one RBC) |
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What kind of cell is this?
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Medium Lymphocyte (The size of 2 RBCs) |
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What kind of cell is this?
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Large Lymphocyte (the size of 3 or more RBCs) |
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What kind of cell is this? |
Reactive Lymphocyte (may have vaculation, indented nucleus, perinuclearclear zone) |
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What kind of cell is this?
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Granular Lymphocyte |
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What kind of cell is this?
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Lymphoblast (one or more Nucleoli) |
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What kind of cell is this?
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Atypical Lymphocyte |
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What kind of cell is this?
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Plasma Cell (a cell that is producing antibodies, a B Lymphocyte) |
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Can granular lymphocytes be seen in low numbers in normal animals? |
yes |
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Describe a Lymphoblast (Necleus, size, chromatin, cytoplasm) |
-one or more Nucleoli -usually large -Chromatin is finer + more dispersed -moderatly to deeply basophilic cytoplasm |
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what is the fuzzy round inclusions on the nucleated cell |
Distemper viral Inclusion |
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What is this image showing? |
Leukoagglutination |
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What is the syndrome being presented in this image? |
The Chediak-Higashi Syndrome. |
