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Hematology--Whitney

Clin Path Exam 1

QuestionAnswer
What is the erythron? produced mainly in the bone marrow of healthy adult animals and are specialized and well adapted to carry oxygen via its binding to hemoglobin molecules. Precursors and RBCs
What form must iron be in to bind oxygen? REduced state--> 2+, ferrous
What is hepcidin? Doesn't allow iron to be absorbed. Levels drop when iron is needed. Inflammation increases hepcidin levels.
What is iron bound to in plasma? Transferrin. Measured indirectly as TIBC. decreases in inflammation.
What is iron stored as? Ferritin and hemosiderin. The serum ferritin level is proportional to the amount of stored iron. Ferritin is more soluble. Levels increase in infection.
What is the Embden-Meyerhoff pathway? For energy production to maintain membrane pumps: glycolysis. Can have pyruvate kinase deficiency and phosphofructose kinase deficiency.
What two pathways provide protection to RBCs from oxidant stress? Hexose monophosphate shunt and Methemoglobin reductase pathway.
What is the Hexose monophosphate shunt? Generates NADPH (cofactor for glutathione reductase--gets oxidized instead of RBC).
What is hte Luebering-Rapoport pathway? Aids oxygen delivery to the tissues when anemia is present. Affects the affinity of iron molecule for binding oxygen. When increased, oxygen leaves iron faster. Hope bone marrow can compensate before it becomes a problem.
What are the developmental stages for the RBC? Stem cell--> rubriblast--> prorubricyte--> rubricyte--> metarubricyte--> reticulocyte--> mature erythrocyte
About how long does it take for a blast to mature to a circulating RBC? about 5-6 days
What is the major route of removal of RBCs? Phagocytosis in the spleen! Somewhat in liver and other tissues.
What is haptoglobin? Binds free hemoglobin for recycling. Excessive hemolysis leads to saturation of haptoglobin. Hemoglobinuria then ensues.
What is the corrected reticulocyte count? PCV/average PCV times reticulocyte percentage.
What is the absolute RC? RBC x retic count.
What is the MCV? PCV/RBC x 10
What is the MCHC? Hb/PCV. Less prone to error.
What could cause a true increase in MCV? Reticulocytosis, nuclear maturation arrest (neoplasia, B12 def, folate def). cell will not divide as often as it should.
What can decrease MCV? Iron deficiency. Cytoplasmic maturation defect. MCHC also decreases.
What causes a false increase in the measured MCV and decrease in RBC count? RBC agglutination
What causes false increases in MCHC? If free hemoglobin is present in the plasma or if measured hemoglobin concentration is falsely elevated. Lipemia, oxyglobin, Heinz bodies.
What are regenerative anemias due to? Hemolysis or blood loss
What causes non-regenerative anemias? Maturation abnormalities (ineffective erythropoiesis)or to erythroid hypoplasia/aplasia.
What is increased/decreased in chronic blood loss? Decreased--> Serum iron, serum ferritin, marrow iron Increased--> UIBC, TIBC
What is increased/decreased in hemolysis? Decreased--> UIBC Increased--> serum iron, serum ferritin, marrow iron Normal TIBC
What is increased/decreased in anemia of inflammatory disease? Decreased--> serum iron, UIBC, TIBC Increased--> serum ferritin, marrow iron
What causes nuclear maturation arrest anemia? Macrocytic. Folate deficiency, B12 deficiency. Neoplasia, FeLV.
What causes cytoplasmic maturation arrest anemia? Interferes with hemoglobin. Microcytic. Decreased MCV and MCHC. Iron deficiency. Copper deficiency. Chronic blood loss.
What causes erythroid hyperplasia/aplasia? Chronic kidney disease. Hypothyroidism. Anemia of chronic inflammation. Normocytic normochromic. Myelophthosis.
What causes relative erythrocytosis? splenic contraction, dehydration
What causes absolute secondary erythrocytosis? natural or artificial increases in production of erythropoietin. Appropriate--> physiologic--altitude, genetic Inappropriate--> neoplasms, endocrine abnormalities
What causes absolute primary erythrocytosis? myeloproliferative disease. abnormality of bone marrow
Where are most of the granulocytes and lymphocytes produced? Granulocytes--> bone marrow Lymphocytes--> lymphoid tissues Monocytes--> marrow
What type of lymphocytes are the ones in the blood? T lymphocytes
About how long does normal WBC maturation take? 5-6 days
What makes up the proliferative pool? Myeloblasts, promyelocytes, myelocytes
What makes up the maturation and storage pool? Metamyelocytes, Band cells, segmenter cells
At what stage can you tell what kind of cell it will become? Myelocyte
What are the storage pools like in animals? Dogs and cats--> good pool Horses--> not as much, but still some Ruminants--> very small
What are colony stimulating factors? humoral substances derived from T cells, monocyte/macrophage cells, and other cells, and appear to be responsible for the induction and growth of monocyte and granulocyte precursors in the bone marrow.
What pools are in the bone marrow? Proliferation and maturation/storage pools
What pools are in the peripheral blood? Marginated pool and circulating pool
What is the marginated pool? Neutrophils attached to the wall of a vessel. Eventually will migrate through and go into the tissue.
What is physiologic leukocytosis (epinephrine effect)? Fear. Increase BF and increased BP. Neutrophils will transiently be demarginated. Neutrophilia. No left shift. Cats will get a lymphocytosis as well.
What is corticosteroid induced leukocytosis (stress leukogram)? Decreases stickiness of neutrophils. Less migration into tissues. Lymphopenia, neutrophilia, monocytosis. Decreases recirculation of T lymphocytes.
What is the neutrophilia of inflammation? Left shift depends on severity of inflammation. Acute, subacute, chronic purulent inflammation. Inflammation with superimposed stress.
When do you use fibrinogen counts to measure inflammation? In ruminants mostly because don't have as much of a storage pool. Fibrinogen is an acute phase protein--increases in inflammation.
What are the toxic changes in neutrophils? Indicate severe inflammation. Cytoplasmic basophilia, vacuolation, Dohle bodies (retained RER), retention of granules.
What is neoplastic neutrophilia? Granulocytic or myelogenous leukemia. Uncontrolled proliferation of neutrophils. Paraneoplastic neutrophilia--> tumor secretes a substance that stimulates production (carcinomas, indolent lymphoma)
What are some miscellaneous causes of neutrophilia? Leukocyte adhesion deficiency, estrogen toxicity, G-CSF administration, immune-mediated hemolytic, hepatozoonosis.
What causes eosinophilia and basophilia? Allergic and many parasitic diseases. Tissue inflammation that involves mast cell degranulation. Mast cell neoplasia. Idiopathic conditions. Rarely paraneoplastic syndrome or leukemia.
What causes monocytosis? Increased need for phagocytes. Component of chronic inflammation. Stress leukogram. Anything causing hypoxia/necrosis.
What causes lymphocytosis? Physiologic leukocytosis. Chronic inflammation. Lymphoid neoplasia. Hypoadrenocorticism. Persistent lymphocytosis of cattle.
What do the leukemias look like? Acute--> immature cells Chronic--> more mature cells Aleukemic--> only in bone marrow
What are the causes of lymphocytopenia? Acute viral infections. Acute inflammation (increases margination). Steroid effects. Immunosuppressive drugs or irradiation. Hereditary or acquired T cell deficiency. Loss of lymph.
What causes neutropenia? Due to decreased neutrophil survival (severe acute inflammation, immune-mediated destruction), decreased production/release (bone marrow damage, infectious agents on bone marrow, myelophthisic syndromes, hereditary, idiopathic)
What do you find in neutropenia? decreased absolute numbers of neutrophils, left shift, toxic changes in remaining ones, other cytopenias
What does the presence of toxic changes in neutrophils indicate? systemic toxemia. myeloproliferative disease. drug toxicity.
What are Dohle bodies? small pale blue cytoplasmic inclusions. low numbers in healthy cats.
What are foamy cytoplasmic basophilia? indicates more severe toxicity.
What is toxic granulation? prominent purplish cytoplasmic granules.
What is megalocytosis? larger than normal neutrophils.
What are ring form nuclei? look like donuts.
What is lymphocytic reactivity? Increased amount of cytoplasm, increased basophilia of cytoplasm, and increased aggregation of chromatin. Perinuclear Golgi zone.
What are activated or reactive monocytes? contain numerous vacuoles. begin to look like macrophages.
What are hypersegmented neutrophils? greater than 5 lobes. Normal aging change. Neutrophils that have been in circulation too long.
What is the Pelger-Huet anomaly? hereditary failure of granulocytes to segment properly. chromatin condenses as in normal mature neutrophils. no apparent health effects.
When do you evaluate the bone marrow? persistent leukopenia, unexplained thrombocytopenia or non-regenerative anemia, pancytopenia, inappropriate nRBC response, hematopoietic neoplasia, osteomyelitis, fever of unknown origin, neoplasms, monitoring chemo.
When do you not evaluate the bone marrow? When there is a bleeding disorder
What is leukemia? hematopoietic neoplasia. presence of neoplastic hematopoietic cells in the blood and/or marrow
What is myeloproliferative disease? neoplastic proliferation of any of the hematopoietic cells except those of lymphoid origin. FeLV cats.
What is myelodysplastic syndrome? clonal hematopoietic disorder that evolves into over leukemia. peripheral cytopenias coupled with a highly cellular marrow that has abnormal cells.
What is lymphoproliferative disease? neoplastic proliferation of cells of lymphoid origin
What is lymphoma? Neoplasm of lymphoid origin arising as solid tissue masses in organs other than bone marrow. may spread to bone marrow
What is lymphoid leukemia? presence of neoplastic lymphoid cells in the blood and/or bone marrow.
What is acute lymphoid leukemia? originates in the bone marrow. neoplastic cells are medium to large and immature. other cytopenias. clinical course is rapid.
What is chronic lymphoid leukemia? neoplastic cells are normal or nearly normal mature. may start in spleen with marrow and other tissue involvement later. blast crisis that looks like ALL later.
What is large granular cell lymphoma/leukemia? arises in small intestine and involves abdominal lymph nodes and liver. neoplastic cells are variable in size and contain chunky pink to magenta granules.
What kind of BLV-associated but non-neoplastic condition to cattle get? Persistent lymphocytosis
What are some types of myeloproliferative disease? Acute myeloid leukemia, chronic granulocytic leukemia, chronic monocytic leukemia, chronic myelomonocytic leukemia, primary erythrocytosis, essential thrombocythemia
What is acute myeloid leukemia? leukemic cells are immature in appearance. there are more than 30% of blasts in marrow.
What is chronic granulocytic leukemia? circulating neoplastic cells have normal to near normal morphology. anemia and/or thrombocytopenia.
What is thrombopoiesis? occurs in bone marrow and lungs in adult animals and is regulated by thrombopoeitin. TPO is important for overall hematopoiesis. Megakaryoblasts and promegakaryocytes are found in bone marrow. Platelets are fragments of megakaryocytes
What is the lifespan of platelets in circulation? 5-9 days
How much platelets does spleen contain? 30-40% of circulating platelet mass
Which species have the largest platelets? dogs and cats. Cavalier king charles spaniels commonly have enlarged platelets in health.
What causes thrombocytopenia? not being produced in adequate numbers, being destroyed or used up, or being sequestered
What can cause thrombocytosis? physiologic, iron deficiency, spleen contraction, neoplasia, reactive marrow
What is physiologic thrombocytosis? splenic contraction. excitement or acute external hemorrhage. exercise. transient
What is reactive or secondary thrombocytosis? secondary to a disease process or medication. not associated with thrombosis or hemorrhage. due to increased plasma thrombopoietin levels. iron def, inflammation, hepatic cirrhosis, from severe hemorrhage,cancer drugs,hemolytic anemias, trauma,surgery
What are some myeloproliferative disorders? autonomous platelet production. associated with thrombosis, hemorrhage, or functional platelet defects. megakaryocytic leukemia, thrombocythemia (dogs).
Created by: bazkb4