⭐️Alt. CP Exam #1 Review - LECTURES 6-10🟢

Rouleaux ("stacked coin")

What is this called?

Increased inflammation & fibrinogen

Rouleaux is normal in horses & cats. What would cause this in dogs?

Agglutination

What is happening here?

IgG or IgM

Generally, what causes agglutination?

Rouleaux is dispersed using saline solution. Cells don't adhere with rouleaux, but continue to adhere in saline with agglutination.

How can you differentiate between rouleaux from agglutination?

Anisocytosis

Describe the morphology:

Hypochromasia

Describe the morphology:

Polychromasia & Anisocytosis

Describe the morphology:

Normochromic

Describe the appearance:

Hypochromic

Describe the appearance:

Iron deficiency anemia

At this level of hypochromia, what is the only condition this could be?

Abnormally shaped erythrocytes

What does poikilocytosis mean?

Goats & young healthy cattle

What species is it normal to find poikilocytosis?

Spiney cells

What does echinocytes mean?

Echinocyte

Describe the appearance:

True

True/False: Echinocytes have a reversible shape change.

Pigs

In what species is echinocytes an artifact? (underlined)

Snake bites

Where are echinocytes not reversible? (underlined)

Acanthocytes

Describe the appearance:

Acanthocytes

Describe the appearance:

Excess cholesterol vs phospholipids

What happens to RBCs to make acanthocytes?

Liver disease (blue text)

Hemangiosarcoma (underlined), glomerulonephritis, DIC in dogs

What are the causes of acanthocytes?

Stomatocytes

Describe the appearance:

Artifacts

In thick blood films, what should you consider most stomatocytes to be? (underlined)

Swollen erythrocytes having increased MCV & decreased MCHC

What would you see in dogs with hereditary stomatocytosis? (underlined)

Smaller diameter

Do spherocytes have a smaller or larger diameter compared to discocytes (bi-concave shape)?

Immune-mediated hemolytic anemia (IMHA)

Commonly, what condition leads to spherocyte presence? (mentioned multiple times in lecture!!)

Only a portion of the membrane is bound & removed (erythrocytes can reseal themselves). Loss of membrane no longer allows for the formation of discocytes.

How are spherocytes formed? (Both underlined & blue text to answer this question)

Not remarkedly lower

How do spherocytes volumes compare to discocytes?

Band 3 deficiency

What can cause spherocytes in cattle?

Fragmentation

How do you describe schistocytes?

Schistocytes

Describe the appearance:

Disseminated intravascular coagulation (DIC), caval syndrome due to heartworms, glomerulonephritis, cardiac valvular stenosis

What would cause mechanical injury that would lead to erythrocyte fragmentation?

Hemangiosarcoma (dogs), Vasculitis, splenic or hepatic disease

What would cause endothelial injury that would lead to erythrocyte fragmentation?

Heat stroke, severe burns

What would cause thermal injury that would lead to erythrocyte fragmentation?

Membrane oxidant damage

How do erythrocytes become eccentrocytes? (blue text)

Acetaminophen

What is the considered the #1 cause of eccentrocytes?

Eccentrocytes

Describe the appearance:

Regenerative anemias, lead toxicity, heat stroke

What are the common causes of nucleated erythrocytes?

Lead toxicity

Based on this slide, what is your top differential? ("NEED TO KNOW")

Howell-Jolly body

What is this?

Regenerative anemias, splenectomy, glucocorticoids, vincristine therapy

What conditions lead to Howell-Jolly bodies?

Reticulocyte stain

What stain allows for better appreciation of Heinz bodies?

5%

What % of heinz bodies are found in normal cats? (blue text)

Diabetes, lymphoma, hyperthydroidism

What would increase the % of Heinz bodies in cats? (blue text)

Splenectomy

What would cause heinz bodies to present in dogs?

Acetaminophin

What is the major cause of Heinz body production in small animal medicine? (emphasized & underlined)

Basophilic stippling

What is described as aggregates of ribosomes & polyribosomes?

Regenerative anemia (underlined) & lead toxicity (blue text)

In ruminants, what condition would have basophilic stippling?

Protozoa

What is described as a single celled organism with nucleus & cytoplasm?

Reviewed

Reviewed

Theileria spp

Severe hemolytic anemia

What can T. equi cause in horses?

Reviewed

Anaplasma spp

What organism is this?

Hemotropic mycoplasmas

What is described as small bacterial organisms attached to the outside of erythrocytes?

Reviewed

M. haemofelis

What mycoplasma is most important in cats because it can lead to fatal hemolytic anemia?

Distemper virus inclusions

What virus is this?

Regenerative anemia, especially hemolytic anemia

What type of anemia would you see a high MCV/macrocytosis? (underlined)

Nonregenerative anemia

What type of anemia is commonly found in FeLV-positive cats? (underlined)

Poodles

What breed of dogs could have high MCV/macrocytosis but is not anemic? (underlined)

Folate deficiency

Why would cats on a plant-based "vegan" diet have high MCV/macrocytosis?

Autoagglutination, prolonged blood storage, persistent hypernatremia (high osmolality)

When would you see erroneous macrocytosis (High MCV)?

Chronic iron deficiency anemia

What is your top differential with microcytosis (low MCV)?

(Blue Text & emphasized)

Portosystemic shunts

What condition in dogs causes microcytosis (low MCV) and a variable mild anemia? (underlined)

Oriental breeds- Akita, Shiba Inu, Jindo, Tosa, Chow Chow, Shar-Pei

What dog breeds normally show microcytosis (low MCV) without anemia? (underlined)

Platelets counted as erythrocytes in severely anemic patients

Persistent hyponatremia (lower osmolality)

What would cause spurious microcytosis in animals?

Regenerative anemias

What do you get when you have low MCHC and high numbers of reticulocytes are present (also macrocytic)?

Chronic iron deficiency anemia

What do you get when you have low MCHC and are also microcytic?

Marked reticulocytosis

What is happening in the right cell?

Chronic iron deficiency anemia

What is happening in the right cell?

Intravascular hemolysis, in vitro hemolysis, heinz bodies, lipemia, erythrocyte agglutination in electronic cell counters

What would cause high MCHC values (artifacts)?

RDW

What is the coefficient of variation of erythrocyte volumes & an electronic measure of anisocytosis?

Anemia with increased large reticulocytes

Iron deficiency anemia with increased microcytes

RBC fragmentation

Post- blood transfusion

What are some causes of increased RDW?

Coombs test

What is the direct antiglobulin test called?

Erythrocyte transfusions

When would you choose to do a major cross match? (underlined)

Neonatal isoerythrolysis test or plasma transfusions

When would you choose to do a minor cross match?

Tests RBC of donor against serum of recipient

Tests for RBC antibodies in serum of recipient

How does the major cross match work?

Tests serum of donor against RBC of recipient

Tests for RBC antibodies in serum of donor

How does the minor cross match work?

Serious transfusion reactions

What would happen if there are incompatibilities in the major cross match?

Hemolytic reactions after colostrum absorption or plasma transfusion

What could happen if there are incompatibilities in the minor cross match?

0.1%

What is the % of iron in plasma?

30%

What is the % of iron in tissues?

65%

What is the % of iron in RBCs/hemoglobin?

Total body iron content is low, erythropoiesis is increased

When would you see an increased in iron absorption?

Total body iron is high, inflammation is present

When would you see a decrease in iron absorption?

Hemosiderin

What is this?

Peptide hepcidin

What provides systemic control of iron metabolism?

Hepatocytes

What secretes hepcidin?

Enterocytes, macrophages, & hepatocytes

Hepcidin inhibits iron release from what? (underlined)

When iron is needed (total body iron content low, erythropoiesis increased)

When is hepcidin concentration decreased?

When iron is not needed (total body iron is high, inflammation present- limits iron for bacterial growth)

When is hepcidin concentration increased?

Bound to transferrin

Where do you find most plasma iron?

Hemolytic anemia & dyserythropoiesis

Hypoplastic or aplastic anemia

Iron overload

Glucocorticoids in dogs & horses

When would you see an increase in serum iron concentrations?

Iron deficiency

Anemia of inflammatory disease (increase hepcidin production)

Portosystemic shunt

Marked erythropoiesis with inadequate iron mobilization

Glucocorticoids in cattle & goats

Intense exercise in dogs & horses

When would you see a decrease in serum iron concentrations?

Serum ferritin concentration

What measurement correlates with total body iron stores?

Iron deficiency

When do you see a decrease in serum ferritin concentration?

Iron overload, hemolytic anemia, inflammation, malignant histiocytosis, transiently in exercising horses & dogs

When do you see an increase in serum ferritin concentration?

Hypoxemia with low pO2 in arterial blood

Methemoglobinemia with normal pO2 in arterial blood

What are the main 2 causes of cyanotic-appearing skin?