Clinical Pathology Chapter 5

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Gia_bella
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144700
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Clinical Pathology Chapter 5
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2012-04-24 16:20:47
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Animal Clinical Pathology
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Chapter 5
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  1. If reticulocytes are high u have regenerative anemia (rbc are larger)
    If reciulocytes are lower than normal u have non regenerative anemia
    If u have chronic renal failure, why r they anemic erthrpoietin. Kidneys aren't producing it.
    • chromic - color
    • normal normachromic
    • high is hyperchromic
    • normal mcv is normacidic
    • high mcv is macrocidic

    microcidic anemia - lower than normal color MCV
  2. Polycythemia
    • An increase in either RBC count, the total hemoglobin, and or hematocrit.
    • Bad because blood should have a certain balance. RBC's go into body parts. like molasses.
  3. Polycythemica Results in
    • sludging- increased blood viscosity and inhibits proper blood flow.
    • Maybe absolute or relative
  4. Symptoms for Polycythemia Vera ( a cancer)
    • Hematemesis (vomiting of blood) and hematachezia (Blood in stool)
    • (RBC are being squeezed into brain bladder)
  5. Diagnosis for Polycythemia
    • High PCV and RBC parameters
    • Bone marrow is overproducing RBC
  6. Treatment for polycythemia
    • Phlebotomy
    • Chemotherapy (hydroxyurea) chemo drug
  7. Absolute Polycythemia
    # RBC are actually increased
  8. Absolute Primary Polycythemia
    also known as
    • Polycythemia Rubra Vera
    • A neoplastic condition where the bone marrow increases the production of all cell lines, but mostly RBC's
    • Decreased erythropioten (hormones secreted by the kidneys) levels
    • Rare condition in dogs, cats and cattle
  9. Secondary Polycythemia (absolute) develops in response to what
    • Develops in response to hypoxemia (reduction of oxygen) and an increase in erythropoietin (Hormones secreted by kidneys) stimulation
    • Seen when animals move to higher elevations
    • Any condition which decreases blood flow to the kidneys
    • Decreased blood flow to the kidney is interpreted as hypoxemia and stimulates the release of erythropoietin
    • Conditions such as heart failure and renal arterial thrombosis (blood clotting)
  10. Red Cell Storage Pools
    What percentage is not circulating
    where are they stored
    rbc production takes how many days
    • 30-40% of rbc are not circulating: they are held in reserve in the bone marrow and spleen
    • These reserves helo the body respond quickly to acute needs sonce RBc production in the bone marrow takes 3-6 days.
    • Premature release of RBC from these storage pools can result in an absolute polycythemia
  11. what is the cause of Relative Polycythemia
    Most common cause is dehydration
  12. what happens to the RBC in Relative Polycythemia
    the actual total body mass of RBCs remains the same, but there is a decrease in the plasma level. TP is normal.
  13. Define hemoconcentration
    • Decrease in the fluid part of the blood
    • Common in any condition where there is loss of body fluids, dehydration, or shift in fluid distribution.
    • (Dehydration) Vomiting, diarrhea, polyuria, excessive sweating
    • (HGE) Stress
    • in Shock, there is vascular pooling and fluid shifts out of the vasculature, resulting i hemoconcentration.
  14. where are WBC storage pools
    What percentage is not in circulation
    • in the bone marrow and along the wall throughout the bloodstream.
    • Between 50- 75% of neutrophils are not circulating :rather they are adhered along the blood vessel walls.
  15. Define margination or pavementing
    • Neutrophils are not circulating. They are adhered along the blood vessel wall.
    • Marginated Neutrophils constitute the "Marginal Pool"
    • Movement of WBC from the bone marrow reserves, and back and forth between the bloodstream and the marginated pool can result in rapid changes to WBC differential and total WBC readings.
  16. (CNP) Circulating Neutrophil pool
    CNP Neutrophils last 6-7 hours in circulation and 4 days in tissue.
  17. Define Neutrophilia
    Form of Leukocytosis, an increase in circulating neutrophils.
  18. When the neutrophilia includes and increased number of band cells (immature Neutrophils) it is called
    Left Shift
  19. What causes neutrophilia
    Epinephrine- induced neutrophilia (physiological neutrophilia) Stress and anxiety
  20. Corticosteroid -induced neutrophilia (stress neutrophilia) or medication as prednisone (used to treat inflammatory conditions)
    Neutrophilia induced by tissue demand for phagocytic function (inflammatory disease) pain, surgery, trauma
  21. Corticosteroid induced neutrophilia occurs _ or __
    • It occurs naturally (stress) or due to steroid injection
    • Mobilization of marginal and maturation pools
    • Steroids also inhibit Neutrophils from leaving the blood stream
    • No Left Shift (no increase in band cells)
    • Causes include stress secondary to pain, anesthesia, surgical manipulation, trauma, neoplasia and hyperadrenocorticism(Cushings Disease- too much glucocorticoid is produced)
    • Results in the characteristic "stress Hemogram"
  22. Mechanisms of Neutrophilia
    • Epinephrine- induced neutrophilia (physiological neutrophilia)
    • Fear, exercise, excitement, strange surroundings, causes release of epinephrine from adrenal medulla (fright or flight)
    • Mobilization of cells from marginal pool only (no left Shift)
    • Transient 20- 30 min
    • Only in healthy animals
  23. Proliferation
    the reproduction or multiplication of similar forms, especially of cells
  24. Neutrophilia induced by tissue demand for phagocytic function
    • (inflammatory disease-infection)
    • The magnitude of inflammatory neutrophilia is determined by the balance between the rates of bone marrow release and tissue emigration. If the rate of bone marrow release exceeds the rate of emigration excee3ds the bone marrow release rate neutrophila occurs.
    • Generally results in a left shift.
  25. Regenerative left shift
    • if mature cells continue to outnumber immature cells.
    • Mature neutophils outnumber bands , and are elevated or normal.
  26. Degenerative left shift
    • If immature cells start to outnumber mature cells, there is a left shift without a neutrophilia.
    • Excessive neutrophil consumption → bands and/or less mature forms outnumber mature neutrophils.
  27. Neutropenia is the decrease in
    circulating neutrophils
  28. Causes for neutropenia
    • caused by overwhelming tissue demand for phagocytes (infection)
    • Neutropenia is casued by granulopoietic hypoplasia (reduced production neutropenia)
    • Sequestration neutropenia (shock)
  29. Mechanisms of neutropenia
    • Neutropenia caused by overwhemlming tissue damand for phagocytes.
    • Neutropenia is a marked decrease in the number of neutrophils.
    • Transit time in the bloodstream markedly reduced
    • Large number of immature neutrophils
    • Seen in peracute pyogenic bacterial infections (peritonitis, bovine mastitis, aspiration pnemonia) and in some viral diseases (cancer Distemper and Infectious Hepatitis)
  30. Neutropenia caused by granulopoietic hypoplasia (reduced production neutropenia)
    • Diminished bone marrow and release
    • Occurrence of immature neutrophils in the blood stream is variable.
    • Seen in infections (FIP, Toxoplasmosis, Canine Erhlichiosis) Seen in intoxication (cancer Chemotherapy)
    • May be genetic (grey collie neutropenia)
  31. cause of Sequestration Neutropenia
    • Shock
    • Neutropenia suddenly and transiently occurs because the neutrophils marginate
    • Causes include anaphylactic shick and endotoxemia
  32. What is Lymphocytosis
    an increase in circulating lymphocytes
  33. Mechanisms of Lymphocytosis
    • Physiologic (epinephrine-induced) lymphocytosis
    • Chronic infections
    • Lymphosarcoma and or leukemia virus infection
    • Enlargement of lymph nodes do not necessarily cause a corresponding change in blood lymphocyte count
  34. Define Lymphopenia
    a decrease in circulating lymphocytes
  35. Lymphopenia
    S
    Loss of
    C
    I
    • Stress and steroid related
    • Loss of lymphatic fluid (chylothorax- loss into the thoracic cavity)
    • Cancer Chemotherapy
    • Irradiation
    • Congenital T-cell Immunodeficiency
  36. Define Monocytosis
    Increase in circulating Monocytes
  37. Monocytosis
    • Stress and steroid related
    • Chronic Inflammation
    • Granulomatous diseases
  38. Define Monocytopenia
    A decrease in circulating monocytes
  39. Monocytopenia
    • seen in pancytopenic conditions
    • Not generally clinical significant in standard leukograms
    • ( a tabulation of the leukocytes present in a blood sample)
  40. Define Eosinophilia
    An increase in circulating Eosinophils
  41. Eosinophilia- Allergin reaction or parasite
    • Parasitism in which sensitization has occured, or where host tissue -parasite contact is lond and intimate.
    • Seen in specific eosinophilic Granuloma Complex in cats (excessive Eosinophils)
    • Eosinophilic enterocolitis
    • Immediate hypersensitivity disorders
  42. Define Eosinopenia
    Decrease in circulating eosinophils
  43. Eosinopenia
    • Stress and steroid related
    • All pancytopenic conditions
  44. The Stress Leukogram
    • Increased total WBC (15,000-35,000)
    • Neutrophilia No left Shift
    • Eosinophenia
    • Lymphopenia
    • monocytosis
  45. The Inflammatory Leukogram
    • Increased Total WBC (20,000- 35,000)
    • Neutrophilia with significant left shift and toxic neutrophils.
    • Eosinophenia (may be diseased-stress related)
    • Generally a monocyte (depending on type of disease)
  46. What is ACT?
    • Activated coagulation time (ACT) of whole blood in normal dogs
    • Clotting time
    • Average time is 77.5 seconds
    • PROTOCOL Dispense 2ml of freshly drawn whole blood into each of three siliceous earth vacutainers (Becton Dickinson) and commence timing immediately. Jugular venupuncture is recommended to minimise the delay between sampling and commencing timing. Gently invert each tube five times. Tilt each tube gently at 10 second intervals and observe the blood as it spreads along the length of the tube. The ACT is the mean time taken to the appearance of the first unmistakable clot in each of the three tubes (this precedes the formation of a solid clot involving the whole sample).
  47. Prothrombin time (PT)
    is a blood test that measures how long it takes blood to clot

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