Hemology

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Author:
XQWCat
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238962
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Hemology
Updated:
2013-10-06 00:01:50
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Clin Lab
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Hemology in Lab
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  1. Specimens should be labeled with (4-7)
    • date sample was taken, species, ID, initials
    • optionally, age, history and symptoms of specimen
  2. Preferred way of drawing blood sample
    vaccutainer bolder with needle attachment or as large a needle as possible, gently put into tube
  3. Hemolysis
    • breaking apart or destruction of RBCs caused by trauma.  Pink or red serum.  
    • Can effect chemistry and hemology results.
    • can be caused by alcohol
  4. Hemolysis-affected results.
    • diluted sample leads to falsely lower concentrations (PVC, RBC count, WBC count)
    • higher levels of certain constituents (K+, ALP, enzymes, LDH, Ca, Mg, LD, AST, ALT, GGT, folate, iron.  
    • interferes with lipase and bilirubin determinations
  5. Blood for CBC
    anticoagulated.  Lavender top, EDTA tube.
  6. CBC consists of (9)
    • RBC count
    • WBC count
    • platelet count
    • PVC or hematocrit
    • hemoglobin
    • blood smear (differential, automated, give counts, morphology, platelet estimate, inclusion bodies and blood parasites)
    • Total plasma protein
    • erythrocyte indices (MVC, MCH, MCHC)
  7. erythrocyte indices
    MCV, MCH, MCHC
  8. reticulocyte count
    • performed to check for degree/type of anemia
    • COunt of reticulocytes (must be anticoagulated blood)
  9. EDTA tube
    • purple top, used for CBCs. Anticoagulant.  
    • Spun, plasma only used for cTnI (cardiac troponin I)
  10. Heparin tube
    Green top.  Can be used for CBC, not great for WBC.  Used in exotics, plasma can be used for chemistries, so good when only a small amount of blood available.
  11. Sodium citrate tube
    • blue top.  Not used for CBCs.  
    • Clotting factor tests.
  12. Sodium floride tube
    grey top.  Rare in vet.  Used in glucose tolerance tests
  13. Red stopper tube
    nothing inside.  Coated with silicone to prevent sticking.  Yields serum after spinning.
  14. Red/tan striped stopper tube
    (tiger top).  Serum separator.  Contains wax plug between serum and clot.  Yields serum, you can pour serum out without a pipette.
  15. supernatant
    removable liquid part of a sample after centrifugation.
  16. Plasma
    liquid part (supernatant) of anticoagulated blood
  17. serum
    liquid part (supernatant) of clotted blood.
  18. PCV
    packed cell volume.  Made up of RBC, buffy coat and plasma.
  19. Total protein
    told with plasma on a refractometer (scales for proteins and specific gravity)
  20. Estimated platelet count
    • Count platelets in 10 oil immersion fields on stained blood smear, multiply by 15,000.  Platelets per microliter.  
    • Look at feather edge for clots.
  21. Why do corrected WBC count?
    Automated counter counts nRBCs as WBCs, have to subtract for accuracy.
  22. Hypersegmented neutrophils
    five lobes or more.  Can be from EDTA or old neutrophils, or disease/inherited condition
  23. band cell
    immature neutrophil.
  24. metamyelocyte
    VERY early neutrophil, marked left shift, usually seen with many band cells.  Cytoplasm darker.
  25. Myelocyte
    Extremely immature neutrophil, younger than metamyelocyte, very rarely seen.
  26. Lymphocyte
    • Can be small or large.  Small has less cytoplasm and is smaller.  Cytoplasm is pale blue.
    • a-typical, abnormal, reactive (granulation)
  27. Toxic changes in neutrophils
    • signifies rapid reproduction, can be too much EDTA or old blood too.  
    • Least to most severe is dohle bodies, cytoplasmic basophilia, vacuoles or foaminess, intensely stained primary granules (toxic granulation), change in nuclear size and shape (or change in nuclear cytoplasmic ratio).
  28. Red blood cell changes
    basophilic staining (common in mature ruminants, sometimes in cats with anemia, lead poisoning in dogs)
  29. Heinz bodies
    • oxidative injury to RBCs.  5-10% normal in cats.  
    • Nipple-like projection of denatured hemoglobin
  30. Howell-Jolly bodies
    nuclear remnants, stain blue.  More significant in dogs than cats (more common in cats)
  31. Precursors to platelets
    megakaryocytes
  32. Where we look on a blood slide
    everywhere, then monolayer
  33. crenation
    pointed projections around cell, caused by smear not being dry before fixing.
  34. rouleaux
    stacking (coins), normal in horse.
  35. Agglutination
    clumping of cells, immune mediated.  Can try saline agglutination test
  36. polychromasia
    blue tint to cell (usually macrocytic, reticulocytes)
  37. hypochromia
    decreased staining in cell due to decreased hemoglobin.
  38. stomatocytes
    rod shaped pallor across cell.  no significance unless there are lots, then inherited.
  39. anisocytosis
    variation in size of cell.  Microcytosis or macrocytosis.
  40. poikilocytosis
    change in shape, general term (must be qualified with specifics)
  41. acanthocytes
    spur cells.  uneven blunt projections.  Hepatic lipidosis, hermangiosarcoma, dogs with liver diease
  42. echinocyte
    burr cells.  Spiculated cells with evenly spaced and sized projections.  Not blunt.
  43. Spherocytes
    round, smaller than normal, darkened cells with no/little central pallor.  IMHA
  44. Leptocytes
    thin, folded or distorted cells.  Target cells.  Too much EDTA or precursers to acanthocytes
  45. schistocytes
    fragmented cells.
  46. keratocyte
    incompletely fragmented cells
  47. eccentrocytes
    displacement of hemoglobin because opposing sides of the RBC membranes have fused due to oxidative injury.
  48. anulocytes
    bowl shaped erythrocytes, too much membrane flexibility
  49. Dacrocytes
    teardrop shaped erythrocytes seen in myelofibrosis.  Artifact if all tails point same directions
  50. pencil cells
    oval elliptical cells or elongated.
  51. ghost cells
    intervascular trauma
  52. Babesia
    large teardrop shaped intracellular organisms, seen at feather edge.  Looks like a vacuole.  Tick-bourne.
  53. Hemobartonella felis
    short dark purple rods on periphery of cell.  Also mycoplasma haemofelis.
  54. Ehrlichia canis
    intracellular parasite in monocytes and neutrophils.  Looks like small clusters called morulae.
  55. Refractile droplets within RBCs.  Which stain is messed up?
    Fixative has water in it.
  56. Plasma fibrinogen
    spin 2 microhematocrit tubes.  Read plasma protein on one, put the other in 56 degree C water for 5 minutes, then read again.  Fibrinogen has precipitated.
  57. Coagulation tests
    usually blue top.  Whole blood clotting time, activated clotting time, bleeding time
  58. Ways to get RBC and WBC in birds and reptiles
    Natt and Herrick's solution or eosinophil method (indirect)
  59. How to count on a slide (manual)
    backward "S"
  60. What do you need to calculate an absolute count?
    Differential and absolute count (percentage vs. absolute number)
  61. Four things in a SNAP test
    lyme, heartworm, ehrlichia, anaplasmosis
  62. Mice and rats
    • granulocyte nuclei are doughnut shaped.  
    • Basophils may be confused with mast cells (appear with cardiocentesis)
    • Hamsters, gerbils and chinchillas have same hematological features
  63. Guinea pig hemology
    larger RBC than other rodents.  Kurloff bodies.
  64. Rabbit hemology
    • neutrophils have eosiniphilic granules and are called heterophils (used to be called pseudo-eosinophils).  Same function.  
    • Eosinophils have larger granules.
  65. Ferret hemology
    Inhalant anesthetics decrease RBC and hematocrit, as much as 33%.
  66. Llama hemology
    thin, elliptical erythrocytes.  Gives higher oxygen carrying capacity due to high altitude
  67. Colors of plasma
    • red: hemolysis (slight v. marked)
    • yellow: icteric (normal in horse)
    • white and cloudy: lipemic
  68. Blood stains
    • 1. Fixative
    • 2. eosin stain for RBC, eosinophils and some parts of parasites
    • 3. Wrights-Giemsa or hematoxylin stain for nuclei of WBC, inclusion bodies and parts of parasites
  69. Order of most frequently found WBC in cats and dogs
    • No Lazy Monkeys Eat Bananas
    • neutrophils, leukocytes, monocytes, eosinophils, basophils
  70. nRBC
    metarubrocyte.  immature RBC (before reticulocyte)
  71. barr body
    female sex indicator, little nodule off neutrophil nucleus
  72. dohle bodies
    toxic change on a neutrophil, small light grey staining area in cytoplasm of neutrophil
  73. How much of an atypical cell do you report?
    write down all, but 5% significant
  74. lymphoblast
    HUGE lymphocyte
  75. Plasma cell
    looks like a lymph with more cytoplasm, peripheral nucleus, vacuoles called russell bodies
  76. dog monocytes
    tri-lobed
  77. mast cell
    HUGE basophil
  78. distemper inclusion body
    large greyish (bluish?) body in lymphocyte.
  79. Largest RBC in rodents is in
    guinea pigs
  80. kurloff bodies
    HUGE inclusion, pushing nucleus of lymph to side.  Sometimes in guinea pigs
  81. Dif between basophilic rubricyte and thrombocyte in bird
    Basophilic rubrocyte is bigger, has dark cytoplasm.  Throbocyte has very pale cytoplasm.
  82. Small lymphocyte vs thrombocyte in bird
    Small lymph is bigger
  83. Blood parasite plasmodium common name
    malaria.  Avian plasmodium.
  84. leukocytozoan
    extracellular, big leaf-shape.  Exotic
  85. hemoproteus
    big darker vacuole inside of cell.  Exotic
  86. Azurophil
    in reptiles, like monocyte.  Same function.
  87. If you cannot positively identify an inclusion you classify it as....
    an inclusion.  Don't classify unless you can tell.

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