Clinical Pathology

CBC, PCV, total solids, chem, urinalysis

5 standard database/baseline tests for clinical pathology

coag, bone marrow biopsy, cytology, fluid analysis, immunology, culture, serology, fecal, surgery, PCR

10 confirmatory tests for clinical pathology

point of care

lab testing performed outside a conventional reference lab and in close proximity to patients

fast results, better patient monitoring and care, small samples, less invasive

4 potential advantages for point of care testing

quality control, operator error

2 potential disadvantages for point of care testing

time

main disadvantage of external/reference laboratory testing

pre-analytical, analytical, post-analytical

quality of laboratory results is influenced by what 3 factors

pre-analytical

lab result factor that is the most common source of errors

pre-analytical

lab result factor that includes patient preparation, collection method, appropriate tubes filled and mixed appropriate, handling, storage, labeling, delayed processing

whole blood, plasma, CBC

purple top blood sample tube contains what 2 things, and does what test

serum, chemistry

red top blood sample tube contains what, and does what test

lithium heparin, plasma chemistry, ammonia, blood gas

green top blood sample tube contains what, and does what 3 tests

citrate, coag

blue top blood sample tube contains what, and does what test

glucose, potassium

2 consequences of aged serum samples are a false decrease in what and an increase in what

bilirubin

light exposure degrades what in serum and urine of icteric animals

electrolytes

evaporation or freezing of a blood sample leads to a false increase in what

analytical

lab result factor that includes methodology, instrument quality/calibration, reagent quality, and interfering substances

post-analytical

lab result factor that includes transcribing results, appropriate reference intervals

cell count, cell size, cell density/complexity

in an automated hematology analyzer, forward scatter of cells does what, and low angle scatter of cells does what, and high angle scatter of cells does what

no

can automated hematology analyzers distinguish between nucleated red blood cells from leukocytes

leukergy

term for leukocyte aggregation

leukocyte, platelet

what aggregation and what clumping especially in cats leads to inaccurate analyzer counts unless identified by blood film review

lipemia, hemolysis, icterus, paraproteins

4 artifacts/interfering substances that lead to spurious results of analytical factors

greyhound, dachshund, scottish terrier

what 3 dog breeds have high PCV

reference intervals

what are used to define a “normal” test result, based on 95% of the healthy population

erythrocyte, leukocyte, platelet

3 blood component cells

bone marrow

primary hematopoietic organ

spleen, liver, lungs

3 secondary hematopoietic organs

endothelial cells, adventitial reticular cells, macrophages, adipocytes

4 stromal elements in bond marrow

erythroid, myeloid/granulocytic, megakaryocytic

3 hematopoietic precursors

cytopenia

major indication for bone marrow evaluation, term for low count of blood cells

proximal lateral humerus, iliac crest/wing, femur

3 bone marrow collection sites in dogs and cats

sternebrae

bone marrow collection site in horses

proximal ribs

bone marrow collection site in cow

CBC

bone marrow should be interpreted in the context of what current test

erythrocyte, platelet

common myeloid progenitor gives rise to what 2 blood cells

lymphocytes, NK cells

common lymphoid progenitor gives rise to what 2 blood cells

bone marrow, tissues

mast cells are produced where and mature where

growth factors, production, apoptosis

in health, there is a steady state/equilibrium of positive and negative what that affect what 2 processes of red blood cells

3-5 days

erythrocyte marrow transit time

polychromatophil/reticulocyte

term for immature erythrocyte

rubriblast

term for leas mature erythrocyte

glycoproteins

hematopoietic growth factor that promotes hematopoietic cell proliferation, maturation, and survival (broad)

receptor

hematopoietic cells must have what to respond to a specific growth factor

erythropoietin, colony stimulating factor, interleukins

3 main hematopoietic growth factors/cytokines

erythropoietin

glycoprotein growth factor that aids in proliferation, differentiation, and survival of mature stem and progenitor cells of erythrocytes

apoptosis

main mechanism of erythropoietin is inhibition of what

marrow transit time, reticulocytes

increased amounts of erythropoietin decreases what of erythrocytes and promotes early release of what cells

renal interstitial cells

site of erythropoietin synthesis

chronic kidney disease

what disease often leads to anemia because of decreased erythropoietin production

liver, macrophage, erythroid cells

extrarenal production of erythropoietin include what organ and what 2 cell types in bone marrow

amino acids, fatty acids

2 major nutrients required for erythropoiesis

iron

nutrient for heme synthesis

copper

nutrient for hephaestin and ceruloplasmin

cobalt

nutrient that is a component of vitamin B12

B6

vitamin required for heme synthesis

B12

vitamin required for folate metabolism

tetrahydrofolic acid

vitamin required for DNA and RNA synthesis, amino acid metabolism

oxygen

blood loss and anemia causes what to decrease in the tissues, which signals kidneys to increase production of erythropoietin

IL1, TNF alpha, IL6

3 inflammatory cytokines that can inhibit erythropoiesis at high concentrations

anemia of inflammatory disease

most common anemia

chemotherapy

what drug class ca target bone marrow because it contains rapidly dividing cells

2-10 days

platelet marrow transit time

megakaryocyte

thrombopoiesis progenitor cell

thrombopoietin

what molecule promotes differentiation of progenitor cells into megakaryocytes, stimulates increased endomitosis, and promotes platelet formation from megakaryocytes and delivery to circulation

endomitosis

term for increase in “ploidy” and size of a cell where nuclei divide without cell division, occurs in megakaryocytes

hepatic endothelial cells

major site of thrombopoietin production

renal tubular epithelium, bone marrow stromal cells

2 extrahepatic sites of thrombopoietin production

constant

is thrombopoietin production constant or variable

IL6

what cytokine stimulates hepatic thrombopoietin synthesis during inflammation

liver

failure of what organ can lead to thrombocytopenia

1000-3000

___-___ platelets can be produced per megakaryocyte

vascular sinus

megakaryocyte niches are located just outside what

5-7 days

platelet circulating lifespan

spun microhematocrit tube, automated parameters, manual blood film

3 components of a CBC

green

what color blood tube do you use for exotic CBC

erythrogram

CBC component that characterizes erythroid lineage

leukogram

CBC component that characterizes leukocyte population

thrombogram

CBC component that characterizes platelets

cell number, cell volume

in automated CBC impedance counter, number of pulses measures what, and amplitude of each pulse measures what

no

can automated CBC impedance counter distinguish cell size ovelaps

feathered edge, monolayer, body

3 main parts of a blood film

feathered edge

what part of a blood film contains clumped platelets, large/atypical cells, microfilaria/infectious agents, and leukocyte inclusions

methanol, acidic/eosin, basic/azure

3 blood film stains (broad)

air

should you use heat or air to dry blood film

water

what blood film artifact can lead to RBC center/portion has a shiny/refractile or punched out appearance, usually out of the main plan of focus

body

what part of a blood film is the thickest part of the smear, usually not utilized except for severe thrombocytopenia or leukopenia cases, or searching for atypical (neoplastic) cells

monolayer

what part of a blood film is used for platelet number estimation, leukocyte number estimation and differential count, and morphological evaluation of all cells

100

what magnification should platelets be looked at on a blood film

(total platelets in 10 100x fields / 10) x 15000-20000

platelet slide estimate formula

cats

do cats or dogs typically have larger platelets

Cavalier King Charles Spaniel, terrier

2 dog breeds with large platelets

PLT, MPV

low what and high what on a machine readout could be do to large platelets

erythrocyte

most numerous formed element in blood

oxygen, carbon dioxide

erythrocyte function is to carry what to tissues and transport what away from tissues

hydrogen

erythrocytes act as a buffer via what ion

glycolipids, glycoproteins

2 components of outer erythrocyte membrane

cholesterol, phospholipid

2 components of middle erythrocyte membrane

cytoskeleton

1 component of inner erythrocyte membrane

receptors, transport, antigens

3 integral erythrocyte membrane proteins