Blood Smear Examination Quiz
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Questions and Answers

What does macrocytosis with polychromasia indicate?

  • RBC regeneration (correct)
  • Iron deficiency
  • Autoimmune disease
  • Increased platelet count

    • Which part of the blood smear examination involves reviewing RBC morphology?

  • Base or head
  • Lateral edge
  • Feathered edge
  • Monolayer (correct)

    • What condition is often indicated by the presence of nucleated red blood cells (nRBC) without RBC regeneration?

  • Chronic anemia
  • Bacterial infection
  • Cirrhosis of the liver
  • Lead poisoning (correct)

    • In which species are nucleated RBCs expected to be present normally?

    <p>Birds and reptiles (D)</p> Signup and view all the answers

    What does hypochromasia indicate about red blood cells?

    <p>Insufficient hemoglobin levels (D)</p> Signup and view all the answers

    Which term describes variability in cell size?

    <p>Anisocytosis (D)</p> Signup and view all the answers

    What effect does polychromasia have on the appearance of RBCs?

    <p>Increased color variability (C)</p> Signup and view all the answers

    Which of the following is NOT typically assessed through the examination of the buffy coat?

    <p>RBC morphology (B)</p> Signup and view all the answers

    What are schistocytes evidence of?

    <p>Shear injury (A)</p> Signup and view all the answers

    What condition is NOT typically associated with Acanthocytes?

    <p>Iron deficiency anaemia (D)</p> Signup and view all the answers

    Which of the following is a common artifact associated with echinocytes?

    <p>Crenated RBC (B)</p> Signup and view all the answers

    What are Heinz bodies indicative of?

    <p>Oxidative injury (D)</p> Signup and view all the answers

    Which red blood cell anomaly is characterized by a reduced surface area with no central pallor?

    <p>Spherocytes (D)</p> Signup and view all the answers

    Which of the following conditions is least likely to cause the formation of ghost cells?

    <p>Vascular neoplasia (C)</p> Signup and view all the answers

    Which of the following can lead to oxidative injury in red blood cells?

    <p>Methaemoglobinaemia (C)</p> Signup and view all the answers

    Which red blood cell abnormality is common with regenerative anemia?

    <p>Target cells (A)</p> Signup and view all the answers

    What is the primary goal of the online Blackboard task for clinical haematology?

    <p>To analyse and interpret clinical cases and haematology results (B)</p> Signup and view all the answers

    During the quizzes, how many attempts can a student make?

    <p>Unlimited attempts are allowed for each quiz (A)</p> Signup and view all the answers

    Which of the following strategies is NOT suggested for the online task?

    <p>Collaborate with classmates to complete the quizzes (D)</p> Signup and view all the answers

    What will students receive upon completing each quiz?

    <p>Summaries of their answers and feedback (B)</p> Signup and view all the answers

    What is true about the case studies presented in the quizzes?

    <p>Each case study features only a single disease process (B)</p> Signup and view all the answers

    Which of the following is the expected outcome of the live task review session?

    <p>Wrapping up the cases and an opportunity for questions (A)</p> Signup and view all the answers

    How should students approach the quizzes for optimal understanding?

    <p>Take their time to fully analyze and interpret results (A)</p> Signup and view all the answers

    What type of feedback can students expect regarding their quiz responses?

    <p>Specific comments on their interpretation of results (C)</p> Signup and view all the answers

    Where does erythropoiesis most commonly occur?

    <p>Bone marrow (B)</p> Signup and view all the answers

    Which of the following is NOT a primary site for erythropoiesis?

    <p>Spleen (A)</p> Signup and view all the answers

    In which situation might extramedullary erythropoiesis occur?

    <p>When the bone marrow is failing (A)</p> Signup and view all the answers

    Which of the following bones is least likely to be involved in erythropoiesis?

    <p>Phalanges (D)</p> Signup and view all the answers

    What is the clinical significance of understanding normal erythropoiesis?

    <p>It is essential to identify and diagnose red blood cell abnormalities. (B)</p> Signup and view all the answers

    Which of these is NOT a reason why red blood cells are biconcave?

    <p>Improved ability to resist compression (B)</p> Signup and view all the answers

    Which of the following statements about red blood cell lifespan is TRUE?

    <p>Red blood cells lack a nucleus and therefore cannot repair themselves. (D)</p> Signup and view all the answers

    What is the main stimulus for red blood cell production?

    <p>Erythropoietin (A)</p> Signup and view all the answers

    Which of the following is a limitation of automated haematology analysers?

    <p>Susceptibility to interference from artefacts (B)</p> Signup and view all the answers

    Which of these is a potential artefact that can interfere with accurate red blood cell analysis?

    <p>Abnormal red blood cell morphology (B)</p> Signup and view all the answers

    What is the best tube to collect blood samples for haematology analysis?

    <p>EDTA tube (C)</p> Signup and view all the answers

    What is the difference between a PCV and a haematocrit?

    <p>PCV is a measure of the percentage of red cells in a volume of blood, while haematocrit is a measure of the volume of red cells in a whole blood sample (D)</p> Signup and view all the answers

    Which of the following red blood cell parameters is NOT directly measured by an analyser?

    <p>Mean cell haemoglobin concentration (MCHC) (B)</p> Signup and view all the answers

    Flashcards

    Erythrocyte

    A red blood cell responsible for oxygen transport in the body.

    Erythropoiesis

    The process of producing red blood cells, primarily in the bone marrow.

    Bone marrow

    The primary site for the production of erythrocytes in adults.

    RBC abnormalities

    Irregularities in red blood cells that can indicate health issues.

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    Auxiliary diagnostic tests

    Additional tests used to evaluate red blood cell health beyond simple counts.

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    Erythropoietin (EPO)

    A hormone that stimulates red blood cell production.

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    Biconcave disk

    Shape of red blood cells that enhances oxygen diffusion.

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    Anucleate

    Describes red blood cells that lack a nucleus.

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    RBC lifespan

    The average lifespan of red blood cells in circulation.

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    Packed Cell Volume (PCV)

    Percentage of red blood cells in a volume of blood.

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    RBC indices

    Metrics that help evaluate red blood cell characteristics.

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    Hemolysis

    Breakdown of red blood cells, can be artifact-related.

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    Sample collection tube for hematology

    Specific types of tubes used to collect blood samples for analysis.

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    Buffy coat

    A layer of white blood cells and platelets found in centrifuged blood.

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    Plasma color evaluation

    Assessing plasma for signs of hemolysis, jaundice, or lipaemia.

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    Anisocytosis

    Variability in red blood cell sizes indicating possible health issues.

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    Macrocytes and microcytes

    Large and small red blood cells respectively, indicating various conditions.

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    Polychromasia

    Variability in red blood cell color, often due to immature cells.

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    Nucleated red blood cells (nRBC)

    Red blood cells with retained nuclei, often seen in regeneration.

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    Hypochromasia

    Condition where red blood cells have less hemoglobin than normal.

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    Blood smear examination

    A method to assess blood cells through staining and microscopy.

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    Poikilocytosis

    Abnormal shapes of red blood cells (RBCs) often associated with disease.

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    Schistocytes

    Fragments of red blood cells indicating shear injury.

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    Acanthocytes

    RBCs with large, blunt-ended projections linked to liver disease.

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    Echinocytes

    Crenated RBCs, typically an artifact but can indicate injury.

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    Spherocytes

    RBCs with a smaller surface area and no central pallor seen in certain anemias.

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    Heinz bodies

    Inclusions in RBCs from oxidized hemoglobin, associated with certain toxins.

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    Codocytes (target cells)

    Target-shaped RBCs often seen in regenerative anemia.

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    Inclusion bodies

    Structures within cells indicating an infectious agent or health issue.

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    Clinical Haematology

    The study and diagnosis of blood disorders through lab tests.

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    Predicting Findings

    Using haematological principles to anticipate results from tests.

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    Aetiology in Haematology

    The cause or origin of blood-related diseases indicated by test results.

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    Differential Diagnosis

    List of possible conditions based on clinical findings and tests.

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    Quizzes on Blackboard

    Online assessments to interpret clinical haematology cases.

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    Comorbidities

    The presence of one or more additional conditions with a primary condition.

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    Unlimited Attempts

    The ability to retake quizzes as needed for understanding.

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    Feedback Importance

    Constructive criticism to improve understanding and performance.

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    Study Notes

    Clinical Haematology 1 & Introduction to Task

    • The session is part of a course called "AGEP 2; Animal Systems and Professional Life 2"
    • The lecturer is Emi Barker, a veterinary specialist in small animal internal medicine
    • She holds degrees in BSc (Hons), BVSc (Hons), PhD, PGCertTLHE, and DipECVIM-CA, and is a Fellow of the Royal College of Veterinary Surgeons (FRCVS)
    • She is a recognised expert and European Veterinary Specialist
    • The course material is available on the University of Bristol website
    • Use the Turning Point mobile application to participate (session ID: EmiB)
    • The website eClinPath (https://eclinpath.co.m) is an online textbook for veterinary clinical pathology.

    Intended Learning Outcomes

    • Understand the laboratory assessment of erythrocytes
    • Recognize common red blood cell (RBC) abnormalities, including terminology and clinical significance.
    • Be aware of auxiliary diagnostic tests used in assessing RBC abnormalities, such as those related to evaluating platelets and white blood cells.

    Haematology

    • Haematology is the scientific study of blood and the tissues that produce or form blood.
    • The series of lectures/notes will focus primarily on canine and feline species, but other species will be noted where appropriate.

    Red Blood Cell Production

    • Erythropoiesis (RBC production) is typically within the bone marrow, particularly in the medullary cavity of larger bones.
    • Erythropoietin (EPO) stimulates RBC production.
    • The stages of production include pluripotent hematopoietic stem cells, proerythroblast, erythroblast, reticulocyte, and erythrocyte. This process takes 5-7 days.
    • Mature erythrocytes circulate for 1-2 days, or 70 days, or 110 days, or 145 days depending on the species.

    RBC Structure

    • RBCs are biconcave disks; this increases surface area for oxygen diffusion.
    • They are flexible for passing through small vessels.
    • They contain haemoglobin, a metalloprotein that carries oxygen.
    • Mammals have anucleate (no nucleus) RBCs.
    • Senescent (aging) RBCs are removed by the spleen.

    Sample Collection for Haematology

    • EDTA tubes are commonly used for blood sample collection related to haematology.
    • Other options include: citrate, Heparin, Oxalate fluoride, or Serum / clot.

    Red Blood Cell Parameters

    • Haemoglobin, haematocrit, red blood cells (RBCs), mean cell volume (MCV), mean cell haemoglobin (MCH), mean cell haemoglobin concentration (MCHC), platelets, and white blood cell (WBC) parameters provide measurements and ranges.

    Artefacts

    • Clots, platelet clumps, macroplatelets, cell agglutination (RBC and leukocytes), nucleated RBCs, Heinz bodies, and lipemia can influence and skew results.

    Evaluating RBC

    • Packed cell volume (PCV) is the percentage of red cells in a blood sample.
    • Manual technique, by centrifugation, is a method to determine PCV.
    • Additional parameters that can be evaluated from a blood sample include haematocrit, RBC mass, and indices (RBC indices to provide further analyses).

    Evaluating Platelets

    • Platelet counts have a typical range for different species/animals.
    • Macrothrombocytes may skew results and falsely appear low.

    Evaluating White Blood Cells (WBCs)

    • Various white blood cell types (band neutrophils, neutrophils, lymphocytes, monocytes, eosinophils, and basophils) are measured and have specific ranges.
    • Macrothrombocytes (large platelets) may cause a falsely low platelet count during analyses.

    Blood Smear Examination

    • Stain the slide with a dye like modified Wright's then use oil immersion microscope.
    • Begin examining from the feathered edge of the slide, and then move to the monolayer/battlements, and later to the lateral edge of the smear.
    • Examination looks for platelet clumps, atypical cells, RBC morphology and for platelets estimation. Also, WBC count, morphology and 100-cell differential.

    Normal RBC Parameters

    • Normocytes and normochromic cells are considered normal cells.

    Anisocytosis and Polychromasia

    • Anisocytosis describes variation in cell size (macrocytosis/microcytosis).
    • Polychromasia, the variability in cell color, is linked to immature RBC presence and indicates regeneration. This is seen in larger and bluer cells (polychromatophils).

    Macrocytes and Microcytes

    • Macrocytes and microcytes are abnormal RBC sizes, sometimes associated with regeneration or other conditions, like FeLV, familial macrocytosis, etc.

    Nucleated Red Blood Cells (nRBCs) and Howell-Jolly Bodies

    • nRBCs are red blood cells with nuclei, often associated with regeneration, lead poisoning, splenic disease, or bone marrow disease.
    • Howell-Jolly bodies are nuclear remnants within RBCs and can also indicate regeneration.

    Species Differences in Nucleated RBC

    • Birds and reptiles, and horses, and donkeys and lagomorphs/rodents are normal species with nucleated RBCs.
    • Sheep and cattle do not typically have nucleated RBCs.

    Hypochromasia

    • Hypochromasia indicates a lower than usual level of haemoglobin in RBCs.
    • It commonly occurs in iron-deficiency anaemia, and some farm animals and copper deficiency is also a potential cause.
    • It's often associated with poikilocytosis (abnormal RBC shapes) and microcytosis (small RBCs).

    Schistocytes

    • Schistocytes are fragmented RBCs, indicative of shear injury.
    • Potential causes include vascular neoplasia, disseminated intravascular coagulopathy, and iron-deficiency anaemia.

    Acanthocytes, Keratocytes, and Blister Cells

    • Acanthocytes have irregular projections; they might be present in liver disease, lipid disorders, and shear injury.
    • Keratocytes are abnormalities in RBC shape, and are linked to shear injury.
    • Blister cells also indicate shear injury to RBCs.

    Echinocytes

    • Echinocytes (crenated RBCs) are common artefacts, but if present alongside other shear-related changes, they might indicate a true condition.

    Spherocytes and Ghost Cells

    • Spherocytes are small, round RBCs and often occur with certain anemias, such as immune hemolytic anemia.
    • Ghost cells are empty RBCs.

    Red Blood Cell Oxidative Injury

    • Heinz bodies are inclusions in RBCs from oxidized hemoglobin and are present in some animal species, especially cats, horses and dogs.
    • Oxidative injuries are sometimes caused by toxicity or disease.

    Codocytes

    • Codocytes (target cells) are a frequent, but non-specific, finding in blood smears.
    • They are related to regenerative anemia or hypochromia (low hemoglobin).

    Inclusion Bodies

    • Inclusion bodies are small, abnormal structures within cells.

    Infectious Agents

    • Possible infectious agents: Anaplasma spp, Babesia spp., Dirofilaria spp., Ehrlichia spp. and Leishmania spp.

    Task - Intended Learning Outcomes

    • These intended learning outcomes focus on applying established knowledge, recognizing normal and abnormal haematology results, interpreting haematology data to understand likely causes, suggesting extra tests and applying basic principles to predict relevant findings.

    Must Do Tasks

    • Online Blackboard tasks
    • Case studies, clinical haematology, will be examined and presented on Blackboard.
    • Specific due dates and times to complete each section are included in these instructions.

    Additional Information

    • The course will have review sessions and other available support for further learning.
    • Students can ask questions and provide feedback on padlet; specific queries can be sent to the instructor, by email.

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    Related Documents

    AGEP 2 Clinical Haematology 1 24-25 PDF

    Description

    Test your knowledge on blood smear examinations and the implications of various findings. This quiz covers key concepts related to red blood cell morphology and associated conditions. Perfect for students and professionals in hematology.

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