An 13
Terms
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- CBC tests should include:
-
1.PCV
2.TPP
3.TWBC
4.differential WBC count
5. erythrocyte morphology
6.PLT
7. Reticulocytes count if anemic
8. Hgb oncentratin
9, MCV
10. WBC differential - Methods for performing CBC
-
1. Electronic cell counters
2. quantitative buffy coat analysis - How does the electronic cell counter work
- Cells are passed btwn 2 elerodes which interrupts the flow of electricity. Each interruption counts the cell as well assize & volume due to the interruption
- Define MCV
- mean corpuscular volume, determines the erythrocyte volume distribution
- Why are WBC samples diluted with a lytic agent
- It destroys the cell membrane leaving only the nuclei for counting
- Define blood
- cells embedded into a fluid matrix
- What is the purpose of blood
-
1. Transport system for supplies (glucose, O2, H2O electrolytes, hormones)
2. Carry waste (Co2 & nitrogenous protein waste - What can a blood exam help to determine
-
1. Disease
2. View of overall health
3, Adjunct to evaluation & dz dx
4. assess ability to fight infection
5, evaluate trends - deviation from normal
6. ck for effects of tx
7. View in light of PE, Hx - Common veins for blood draws
- Large veins like jugular, femoral, saphenous
- Why use anticoagulants
- Blood may clot too quickly for test to be completed
- What anticoagulant is in a Purple Top
- EDTA
- Why is the ratio of anticoagulant to blood so important
- The shape of the blood cells can be altered if the ratio isn't correct
- What anticoagulant is in a green top
-
Heparin
Used for certain specie like reptiles ck for RBC - How is the proper ratio of blood added to the anticoagulant in the tubes
- The tubeis a vaccuum so will suck out enough blood in the correct proportions
- What is the best gauge needle to withdraw blood & why
- Nothing less than 20 gauge b/c will damage cells and give a miss reading
- What measures should you take to preserve cell shape if you use a vacutainer or syringe smaller than 20 gauge
- After blood draw, remove the needle & let sample dribble down the side of the tube so that the blood is not forced 2x thru the narrow opening of the needle
- Who has fragile blood
- birds
- What is quantitative data
-
Cell counts
Cell measurements - ex. volume of RBC - What does the volume of RBC help to determine
- The volume of hte RBC helps to determine its capacity to carry O2. The hemoglobin in the RBC is the O2 carrier
- Why collect qualitative data
-
1. morphology
2. Cell shape evaluation
3. Cytoplasm of WBC gets weird when fighting infection
4. Parasites change cells - What values do CBC determine
-
1. PCV
2. TPP
3.TWBC
4. Blood film
5. Reticulocyte count - What is PCv & how is it obtained
-
Packed Cell Volume
1. fill a hermatocrit tube 3/4 full using capillary action
2. may or may not have anticoagulant depending on test you want to run
3. Mix gently
4. Stab the end in clay
5. Centrifuge
6. Read against the hermatocrit reader - What does PCV help to determine
- RBC mass. If you know the volume of the cylinder, you can compute the # of RBC
- What 3 components are separated during centrifugation
-
1. RBC on the bottom (Hgb is heavy with iron)
2. Buffy coat holding the WBC & platelets & parasites
3. Top coat - serum (if blood is allowed to coagulate)
or plasma if blood is not allowed to coagulate - How do you determine the PCV
- You know the total volume of the blood and reading the fine line at the top of the RBC layer
- What test can be done with the buffy coat/
- Plasma Protien concentration using a refractometer
- What does specific gravity determine
- extrapolate to determine the amount of protein in the blood. Thehigher the specific gravity, the higher the protein in the blood
- What can be measured with the refractometer
-
1. Specific gravity (g/dl)
2. Urine specific gravity - What is the major protein in blood
- albumin
- Which tube top has no anticoagulate
- Blue top
- Why make a blood smear & what are important components
- Trying to get a singel layer of cells to examine & to count & to enumerate RBC, WBC & stuff
- What does Dif quik do
- Differential stain that stains different parts of the cell differently
- What are the 3 components of Dif Quik
-
1. Fix with alcohol
2. Eosin which stains the cytoplasm (red stuff)
3. methylene - stains the nuclei purple - How do you measure a WBC Count using the unopette
-
Unopette hematocytometer designed for TWBC
Dilute blood sample 1:100.Microhermatocrite designed to draw in specific volume of blood
Mix gently & wait 10 minutes
Fill hermatocytometer,
Cover with special slide
Look on 4x for grid
Count each of he sections on 10x
RBC lysed so easier to count - Formula for determining WBC
- (Total cells counted +10% of those counted)x dilution factor (100) = #/ul
- How do you calculate HCT
- MCV x RBC count
- How big is a RBC
- 7 microns
- What is the function of RBC
-
1. Produce, protect & carry Hgb & O2
2. Produced in teh bone marrow - How long does a RBC last
- 90-120 days
- Where do dead RBC go
-
Spleen gets rid of them. Onoly the young RBC can fold up & pass through the capillaries
Spleen recycles Hgb, iron and other parts & send to Bonne Marrow - What does pink urine indicate
- You ate beets or you are losing RBC faster than the spleen can clean them up
- Why is the nucleus of the RBC kicked out
-
Allows more room for Hgb
2. cell is more flexible to fold in splenic cappilaries - What are signs of anemia
-
Decreased circulation of RBC
2. Decreased PCV
3. Decreased Hgb
Decrease in bodies ability to oxygenate teh blood - Why do a Blood Film
-
1. Differential WBC count
2. Estimate platelet #
3. Evaluate morphology - What is the most clinically relevant classification of anemia
- Bone Marrow Respones
- What is regenerative anemia
- Bone Marrow increases erythrocyte production & releases immature RBC (nRBC) or polychromatophilic RBC = reticulocytes.
- What does the presence of reticulocytes indicate
- regenerative anemia
- What are the usual causes of regenerative anemia
-
1. blood loss - hemorrhage
2. blood destruction - hemolysis - What is non-regenerative anemia
- Bone marrow malfunction requiring bone marrow biopsy
- What are signs of non-generative anemia
-
Absence of reticulocytes in blood
Less erythropoesis - What are causes of non-generative anemia
-
1. endocrine
2. metabolic
3. bone marrow mal function - What does the blood look like in regenerative anemia
-
1. reticulocytes
2. polychromasia
3. anisocytosis
4. Purple nucleus when stained
5. nRBC have bluish cast to ribosomes & RBC & are a little bigger - Define normocytes
- RBC of normal size 7micron
- Define microcyte & possible cause
-
small cells
Iron Deficiency - macrocyte & possible cause
-
larger than normal size which are larger & stain blue
reticulocytosis
Vit B12 deficiency in humans - Hypochromic RBC may indicate -----
- reticulocytes b/c full concentration of Hgb is not attained
- What die macrocytic hypochromic RBC suggest
- regenerative anemia
- What are indications of ypochromic anemia
-
1. iron deficiency
2. microcytosis - Why is iron important in RBC formation
-
Iron helps make Hgb,
Cell division stops when full concentration of Hgb is met. If there is no signal to tell cell to stop dividing, this results in smaller cells -
What does macrocyticm hypochromia anemia look like
& which kind is it -
Big pale RBC
regenerative - What does micromyctic, hypochromic RBC indicate
- iron deficiency
- Macrocytic, normochromic RBC indicates ?
- non-regenerative anemia
- Normocytic, normochromic RBC
- non-regenerative anema - cat in chronic renal failure
- How is MCV measured
- femtoliters
- What is formulat to determine MCV
- PVC (%) x 10/RBC ( millions/ul)
- What is MCH
-
Mean corpusculat corpuscular hemoglobin is the mean weight of Hb
MCH (in picograms)= Hb (g.dl) x RBC (millions/ul) - MCHC
-
Mean CorpuscularHb concentration
Animals pack in as much Hb as they can
MCHC (g/dl) = Hb (g/dl) x 100/PVC (%) - What is normal MCHC range for mammels
- 30- 36 g/dl (wt/volume)
- Why care about erothrocyte indices
- Helps to classify type of anemia
- Stain reticulocytes with----
- New Metholine Blue
- What are poikilocytes
- abnormally shaped RBC
- What is a reticulocyte
- Immature RBC with organells (ribosomes) that look blue gray when Wright's stained
- What does a reticulocyte look like
- Clumps of blue in cytoplasm of cells
- What forms of reticulocytes do cats have
-
1. Aggregate form -normal one of bluish chains
2. Punctate form - 2-8 small singlular granulosesbasophilic cells that dosn't stain - Why count reticulocytes
- Indicates if animla is anemic and if BMis working (regenerative) or not
- How do you count reticulocytes
-
equal amounts of whole blood & new methylen blue
2. wait 10 min
3. smear
4. count RBC and # of teticluocytes to determine % - What is a corrected Reticulocyte %
- Observed reticulocyte % x PCV/normal mean PCV
- What aspects of cell morphology are improtant
-
1. species
2. cell arrangement
3. Cell size
4. cell color
5. cell shape - What is a rouleaux
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Stacke sof RBC
Common in horses - What causes rouleaux
-
Increases w' increased fibrinogen (serum protein of blood coaggulation whic increases coagulation)
Add saline & cells come apart - Define agglutination
-
Clumps of cells
Caused by immune mediated dissease
RBC coated w/ antibioties
If add saline cells do not come apart - What is the big test to determine rouleaux or agglutination RBC
-
add saline
1. Agglutination - cells stick together
2. Rouleaux - cells separate -
define anisocytosis
& what do they indicate? -
unequal cell size
Macrocytes -Large cells. MCV = reticulocytosis
Microcytes - small cells/MCV - iron deficiency - How is polychromasia determined
- Bluish stain of organelles in cytoplasm indicating young RBC
- How is hypochromia determined
- Decreased staining intensity caused by insufficent Hb usually the result of iron deficiency in RBC
- What are spiculated cells
- spiky TBCcells
- What do schistocytes indicate
-
RBC fragments indicating intravascular trauma where RBC get sheared by fibrin strands
DIC, neoplasia, iron deficiency -
Spur cells are ---
& are caused by -
acanthocytes
Change in membrane chlestrol
altered Lipid metabolism from hepatic lipidosis in a cat or liver dz in a dog (hemangiosarcoma -
What are burr cells
& cause -
echinocytes
artifact of slow drying -pH & fluids leak out which changes membrane shape
renal dz - dogs
lymphosarcoma - dogs
after excercise in horses
rattlesnake envenomization in dogs
in vitro artifact know as crenation - What do spherocytes look like
-
Dark staining RBC with little central pallor
Best detected in dogs
Or blood mismatch - What is a sign of lead poisoning
-
Basophilic stippling
small dark-blue dots in - When is it most likely to see Howell-Jolly bodies
-
after spelectomy b/c the spleen usually removes remnants in RBC
They look like a purple concentrated nuclear remnantdot - What are Heinz bodies
-
Denatured Hb caused by drug reaction, poisonings that harm the Hb
denatured Hb becomes detached & sticks to the cell wall - Increase in Heinz bodies may indicate what
-
1. lymphosarcoma
2. hyperthyroidism
3. diabetes mellitis in cats - How do you differentiate btwn an artifact & a parasite in teh blood
-
Artifact is refractile & form rings
Parasites will probably see more than 1 - Define Hemobartonella
-
Common feline RBC parasite
Coccoid, rod shaped or ring-like structures that stain purple - In hemobartonella felis what doest hte blood lok like
-
Anisocytosis
polychromasia
nRBC with almost black nuclei
Black oval on the edge of the cytoplasm - Hemobartonella canis is distinguished by
- chain of cocci across RBC
- Who gets eperythrozoa
-
it is hemobartonella in large animals - ring form is most common.
Organismas are free all over theRBC - What 2 RBC dz cells look alike
-
1. Howell-Jolly bodies
2. anaplasma marginale in cattle with peripheral dark spot on cells - Descripe babesia
-
tear chaped protozoan in RBC
paired in dogs at the feathered edge. Look like 2 eyeballs in teh RBC - What does rhinicephalus canis cause
-
Ehrlichia - intercellular parasite of monocytes & neutrophils
Morulae or small clusters in cytoplasm - What is a rare cause of hemolytic anemia in cats
-
Cytauxzoon Felis
small irregular rings in erythrocytes, lymphocytes, & macrophages - What is the cause of feline infectious anemia
- hemobartonella
- What are the 5 types of leukocytes in teh blood
-
1. Neutrophils - infection fighters
2. Lymphocytes - nuerous in cows than neutrophils
3. Monocytes
4. Eosinophils - lots if parasite infestatin
5. Basophils - rare in mammals but common in reptiles - Define -penia
- decreased # of cells in the blood
- Define -philia or - cytosis
- increased # of cells in th blood
- Define left shift
-
Increased # of immature neutrophils in the blood
INDICATES SEVERE INFECTION - Define leukemia
- neoplastic cells in blood or BM
- Define leukemoid response
-
indicated by marked leukocytosis & usually the result of inflammatory dx
Often confuese tiwh leukemia
NOT CANCER - Define lymphoproliferative disorders
- conditions in which lymphocytes and plasma cells proliferate abnormally
- Myeloproliferative disorders
-
BM disorders usually neoplastic characterized by proliferation of 1, several or all BM cell lines
REALLY BAD CANCER - What is a differential WBC count
- to determine dz & help with dx
- What is the criteria for counting WBC
-
1. nice monolayer
2. near the feathered edge
3. perform each section consistently
4. coutn 100WBC
5. View under oil immersion
6. count with 5 clickers to enumerate each type
7. Report as % of each type
8. Determine absolute values
9. Consider TWBC to get relavent absolute value - Formulate for correcting WBC
- Observed WBC x 100/100 + % of nucleated RBC
- % of nRBC is determined by---
-
count in differential & just subtract from the total count
TWBC - |nRBC| = corrected amount - How do you differentiate a horse neutrophil from that of a D&C
- Heavy clumped coarse chromatin with ligth blue to pink cytoplasm
- Which cells get Dohle bodies
- Toxic neutrophils
- What are distinguishing characteristics of neurtrophils
-
1.granulated cytoplasm that doesn't take up a stain
2. obvious nucleus b/c granules don't stain
3.If pinched nucleus - mature - What distinguishes lymphocytes
-
1.Beautiful light blue stain with big dark nucleus
2. may have a slight dent
3. rim of bright blue cytoplasm with large nucleus - Describe a band neutrophil
-
Horseshoe shaped with rounded ends
No vacuoles in Cytotoplasm
Young neutrophil possibly indicating massive infection b/c didn't get a chance to mature before put to work - Describe a Seg
- 1.Segmented neutrophil looks like a clogged colon
- describe a monocyte
-
1. diffuse muclear chromatin
2. lobulated nucleus
3. cytoplasm is blue-gray & vacuoles - lots of vacuoles
4. Absence of Left shift(aka increased immature neutrophils in the blood - Describe lymphocyte
-
1.small lymphocytes have slightly indented nucleus
2. coarsely clumped chromatin
3. Cytoplasm may contain pink-purple granules
4. similar in size to RBC - Describe eosinophils
-
1. Obvious granules b/c stain
2. Horses - grape like big granules
3. Roudn & oval red granules - How do you avoid smudge cells
- Don't destroy the monolayer with too much turbulence
- Dog esoinophils are distinguished by
-
Granules stain closer in color to Hg, horses stain intense red-orange
cats - granules are rod shaped - Basophil
-
1.Rarely seen,
2.stain dark purple to blue-black that over crowd the nucleus
3.Larger in size
4. Look like monocytes but very rare
5. poorly defined round lite purple granules -
Define hyposegmentation
& cause -
1.WBC with too few lobes
2. indicates early release of band neutrophils
1. normal inflammatory response
2.Drug reaction
3. Pelger-Huet anomaly - rare inherited - Define hypersegmentation
-
1. 5 or more lobes
2. aging neutrophil
3. Seen in poodles macrocytosis
4. prolonged blood storage before making films
5. in vivo - glucocorticoids - What doe toxic change cells look like
-
1. inflammation
2. infection
3. drug toxicity
Presence ot basophilia, Dohle bodu=ies, vacuoles or foamyness - What causes toxic change
- decreased time of neutrophil maturation w/in the BM
- What is another name for platelets
- thrombocytes
- Describe platelets
-
non-nucleated cells expelled by the cytoplasm of megakeryocytes in the BM.
Clotting agents - What is indicated if platelet count drops below 20-50K/ul
-
Increased bleeding
Normal is 2-5 platelets per oil immersion field - Where do you find platelets in a slide
- in the feathered edge where they clump
- What does the refractometer measure
-
3 major plasma proteins:
1. albumin - wworkhorse
2. Globulin - response to infection
3. Fibrinogen - soluble circulating plasma protein - Which plasma protein in important in determining inflammation in cows
- Fibrinogen inceases with increases in inflammation
- How is PP measured
- mg/dl
- What is normal fibrinogen measurement in a cow
- 200-800mg/dl
- Why heat centrifuged blood
-
fibrinogen is sensitive to heat & will precipitate out.
1. get 2 samples
1.Centrifuge a 2nd time
2.Compare to other centrifuged sample
3. read both in refractometer
4.Difference in 2 values = amt of fibrinogen - Define hemostasis
- Blood clotting or coagulation
- Where are clotting factors made
- Protein made by liver
- What are the 2 methods of fibronogen production
-
1. intrinsic - intravascular
2. extrinsic - extravascular (tissue) - Why is Calcium important
- Involved in activating proteins to vreat fibrinogen
- How does blood clot
- Fibrinogen form mesh which traps the RBC to clot the blood & stop bleeding
- What are the components of clot
-
1. fibrinogen
2. platelets or thrombocytes
3. blood - What does Whole Blood Clotting Time test
- intrinsic clotting mechanism
-
What is the normal Whole Blood clotting time for a dog
Horse
Cows -
dog- 2 to 10 min
horse - 4 -15 min
cows- 10 - 15 min - What is the normal clotting time using a simple syringe tilt test
- 2-10 minutes
- What activates clotting time
- Diatomacious earth
- What is the normal clotting time in an Activated Clotting time
- 60-90 seconds
- What is importatnt to remember when performing Activated Clotting time
-
1. do not use an anti-coagulant
2. Keep warm for 60 seonds
3. Compare with normal donor blood for - Why is the activated clotting test good to use
-
1. Fast
2. Helps to determine if it is okay to proceed with a surgery - What dz indicate a bleeding disorder with inadequate platelets
-
1. petecchiae
2. epistaxis
3. hematuria - Why compute bleeding time
-
Increased bleeding time indicates
1.platelet defects
2. Increased capillary fragility
3. von Willebrands disease - What are the tests for intrinsic clotting mechanism
-
1.whole blood clotting time
2. activated clotting time (
ACT)
3. bleeding time
4. activated partial thromboplastin time (APTT) - What are tests for extrinsic clotting mechanisms
-
1. One stage Prothrombin Time (OSPT)
Citrated plasma is added to thrombo-calcium mix
Time to form fibrin - What does prolonged OSPT indicate
-
1.Severe liver dz
2. DIC (disseminated intravascular coagulation)
3. warfarin toxicity
4. Vit K deficiency
5. hereditary or acquired defeciencies - What is normal in a OSPT
- 7-10 seconds for dogs
- If TPP is elevated, why it imporant to determine which factor is elevated
-
1. Albumin increase = dehydration
2. globulin increase= active infection - In the fibrinogen test what temperature do you use & for how long
- 1. 56C for 5 min
- Why do a BM biopsy
- to determine if there is BM failure or neoplasia when unable to dtermine through peripheral blood
- What cells have granulocytes
-
WBC
1. Neutrophil
2. eosinophils
3.basophils - What are platelet precusors
-
1. Megakaryoblast -
2. Promegakaryocytes
3. Mwegakaryocyte
4. Platelets - What do megakaryoblast look like
-
1. large
2. 2 reddish nuclei
3. basophilic
4. scanty cytoplasm - What do promegakaryocytes look
-
1. Partially divided nuclei in 4,8,16,32 numbers
2. nuclear lobes remain connected
3. cytoplasm does NOT divide
4. cytoplasm rim around nuclear mass - Describe megakaryocytes
-
1. abundant cytoplasm
2. Pale blue cytoplasm with azurophilic granules
3. Really large - Where do platelets come from
-
Cytoplasmic structures of megakaryocytes
2. vary in size
3. azurophilic granules in pale blue background
4. Giant cigar shape - esp in cats