VLT Q2: RBC, coagulation, quality control, transfusion
Terms
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- Classifications of Anemia
-
Bone marrow response
RBC size
Hb concentration - Classification of bone marrow response
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Regenerative: increased reticulocytes
Nonregenerative: bone marrow dysfunction - Classification of RBC size
-
Normocytic - chronic disorders
Macrocytic - rare, suggests regeneration
Microcytic - iron deficiency - Hypochromic vs Normochoromic anemia
-
Hypochromic: reduced Hb concentration
Reticulocytes are hypochromic
Normochromic: normal Hb concentration - Coombs Test
- agglutination test
- Hematopoesis
- generation of blood in bone marrow
- Reticulocytes are absent in...
- horses
- Spherocytes
-
RBC with no central pallor
only K9
Suggest immune-mediated hemolytic anemia (IMHA) - Name 2 groups of feline reticulocytes
- aggregate & punctate
- Aggregate reticulocytes
- contains large clumps of reticulum
- Punctate reticulocytes
-
contains 2-8 small, singular basophilic granules
not counted - Rouleax formation
-
grouping of RBCs in stacks
increased fibrinogen in plasma
inflammation
normal in horses - Agglutination
-
clumping of RBC
immune-meddiated - Anisocytosis
- variation in RBC size
- Poikilocytosis
- variation in shape
- Spiculated cells
- RBCs with surface spicules
- Crenation
- blood smear artifact
- Basophilic stippling
-
dark blue bodies in immature RBC
common in ruminants
K9s - lead poisoning - Howell-Jolly Body
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basophilic nuclear particle
normal near spleen
Increased with spleen disorder - Heinz Body
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Blue bodies on peripheral wall of cell
Denaturation of Hb - drugs, chemicals. - Blood parasites
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Hemobartonella Felis/Canis
Babesia sp.
Ehrlichia sp. - Coagulation factors
-
plasma proteins (albumin, fibrinogen)
synthesized in liver - Intrinsic pathway of coagulation
-
essential
occurs intravascularly - Extrinsic pathway of coagulation
-
tissue pathway
enhances coagulation - Preffered anticoagulant for coagulation tests
-
sodium citrate
light blue top - Whole blood clotting time (Lee-White method)
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3 tubes with blood are held in hand. Each tube is tilted every 30 sec until clotting occurs.
Clotting time: time between blood in syringe to clot in 3rd tube - Activated Clotting Time (ACT)
- Commercially available ACT tubes are used.
- Bleeding time
- make puncture & remove blood every 30sec
- Outlab clotting tests
-
Use citrated plasma
Activated Partial Thromboplastic Time (APTT)- intrinsic
One-Stage Prothrombin Time (OSPT) - extrinsic - Coagulation disorders are caused by...
- liver disorder, bone marrow intoxication (rat poison)
- Thrombocytopenia
- decreased platelets
- RBC precursors
-
rubriblast
prorubricyte
rubricyte
metarubricyte
polychromatophilic erythrocyte - Granulocyte precursors
-
myeloblast
progranulocyte
myelocytes
metamyelocytes
band - Thrombocyte precursors
-
megakaryoblast
promegakaryocyte
megakaryocyte
thrombocyte - Other cells observed in bone marrow films
-
lymphocyte
plasma cells
monocyte & macrophage
osteoblasts & osteoclasts - Dog blood typing
-
8 blood types
no clinical signs w/ 1st transfusion b/c no natural antibodies to blood - Feline blood typing
-
A, B, AB
A - majority
B - purebred
AB - rare
Mixing blood types = transfusion reaction, death - Cattle blood typing
-
11 blood groups
Only Anti-J antibodies - Horse blood typing
- no natural occuring antibodies, only from vax
- Crossmatching procedure
-
mix blood
no match if agglutination & hemolysis - Control serum
- consists of pooled, freeze-dried serum from many patients
- Assayed control serum
- serum is analyzed repeatedly for serum constituents & acceptable values are statistically established
- Standard deviation
- extent of random variation in group of observation
- Standard
- solution with exact known amount of constituent
- Quality control of refractometer
- check daily with distilled water
- When should controls be done
-
lot number of reagent
shift change in personell
after instrument maintenance - Trend
- gradual increase/decrease over 6 consecutive days
- Shift
- sudden but consistent change increase/decrease from mean value