Podcast
Questions and Answers
Which species has the highest mean corpuscular volume (MCV) values indicating the largest red blood cells (RBCs)?
Which species has the highest mean corpuscular volume (MCV) values indicating the largest red blood cells (RBCs)?
- Sheep
- Goats
- Dogs (correct)
- Llamas
What do hypochromic red blood cells indicate in terms of hemoglobin concentration?
What do hypochromic red blood cells indicate in terms of hemoglobin concentration?
- Increased cholesterol levels
- Normal hemoglobin levels
- Decreased hemoglobin concentration (correct)
- High iron concentration
Heinz bodies are associated with which type of damage to red blood cells?
Heinz bodies are associated with which type of damage to red blood cells?
- Physical trauma to the RBCs
- Viral infections
- Nutritional deficiencies
- Oxidant damage (correct)
Acanthocytes are commonly observed in which specific conditions?
Acanthocytes are commonly observed in which specific conditions?
What is the cause of basophilic stippling in red blood cells?
What is the cause of basophilic stippling in red blood cells?
Which of the following is true regarding the classification of anemia?
Which of the following is true regarding the classification of anemia?
What condition typically results in pale red blood cells with a decreased concentration of hemoglobin?
What condition typically results in pale red blood cells with a decreased concentration of hemoglobin?
What appearance do Heinz bodies take when stained with methylene blue?
What appearance do Heinz bodies take when stained with methylene blue?
What is the primary concern when interpreting plasma protein concentration in the presence of hyperlipemia?
What is the primary concern when interpreting plasma protein concentration in the presence of hyperlipemia?
Which method can be used to determine total leukocyte concentration?
Which method can be used to determine total leukocyte concentration?
Which of the following is true regarding reticulocyte regeneration in dogs?
Which of the following is true regarding reticulocyte regeneration in dogs?
How does hemoglobin concentration relate to packed cell volume (PCV) in most species?
How does hemoglobin concentration relate to packed cell volume (PCV) in most species?
What does an increased mean cell volume (MCV) indicate about RBCs?
What does an increased mean cell volume (MCV) indicate about RBCs?
Which term describes the variation in red blood cell size?
Which term describes the variation in red blood cell size?
Which type of red blood cell abnormality is caused by intravascular trauma?
Which type of red blood cell abnormality is caused by intravascular trauma?
Which characterization best describes the red blood cells of Akita and Shiba Inu dogs?
Which characterization best describes the red blood cells of Akita and Shiba Inu dogs?
What are codocytes primarily associated with in animals?
What are codocytes primarily associated with in animals?
What characteristic feature distinguishes stomatocytes from other red blood cells?
What characteristic feature distinguishes stomatocytes from other red blood cells?
What does polychromasia indicate in a blood sample?
What does polychromasia indicate in a blood sample?
Which type of anemia is characterized by red blood cells of normal volume?
Which type of anemia is characterized by red blood cells of normal volume?
Why might band cells be present in peripheral blood, albeit in small numbers?
Why might band cells be present in peripheral blood, albeit in small numbers?
What is a key identifying feature of metamyelocytes?
What is a key identifying feature of metamyelocytes?
What would suggest an increased mean corpuscular volume (MCV) in red blood cells?
What would suggest an increased mean corpuscular volume (MCV) in red blood cells?
What does the presence of rouleaux formation in blood indicate?
What does the presence of rouleaux formation in blood indicate?
Which statement accurately describes metarubricytes?
Which statement accurately describes metarubricytes?
What characterizes polychromatophilic erythrocytes?
What characterizes polychromatophilic erythrocytes?
Which of the following best describes acute inflammatory changes in neutrophils?
Which of the following best describes acute inflammatory changes in neutrophils?
What is true about granulocyte (myeloid) cells?
What is true about granulocyte (myeloid) cells?
Which of the following is accurate regarding the maturation sequence of megakaryocytes?
Which of the following is accurate regarding the maturation sequence of megakaryocytes?
What defines toxic neutrophil changes in the context of acute inflammation?
What defines toxic neutrophil changes in the context of acute inflammation?
How do rubricytes differ from their precursor cells?
How do rubricytes differ from their precursor cells?
Which anatomical site is considered optimal for bone marrow aspiration in small dogs and cats?
Which anatomical site is considered optimal for bone marrow aspiration in small dogs and cats?
What is the approximate myeloid-erythroid (M:E) ratio in normal conditions?
What is the approximate myeloid-erythroid (M:E) ratio in normal conditions?
Which cell type should be present at least 5 to 10 per slide for a proper hematological evaluation?
Which cell type should be present at least 5 to 10 per slide for a proper hematological evaluation?
What is a potential reason for the increased number of macrophages in a sample?
What is a potential reason for the increased number of macrophages in a sample?
In which phase is the myeloblastic series most abundant?
In which phase is the myeloblastic series most abundant?
What percentage of the total erythroid cells does the prorubricyte stage typically represent?
What percentage of the total erythroid cells does the prorubricyte stage typically represent?
What type of leukemia may complicate the identification of the hemodiluted samples?
What type of leukemia may complicate the identification of the hemodiluted samples?
Which of the following does NOT typically increase the complexity of sample evaluation for hemodilution?
Which of the following does NOT typically increase the complexity of sample evaluation for hemodilution?
What is the composition of the segmented neutrophils in the myeloid series?
What is the composition of the segmented neutrophils in the myeloid series?
What characteristic is true for metamyelocytes compared to myelocytes?
What characteristic is true for metamyelocytes compared to myelocytes?
How do band neutrophils differ from segmented neutrophils?
How do band neutrophils differ from segmented neutrophils?
What is a distinguishing feature of osteoblasts compared to osteoclasts?
What is a distinguishing feature of osteoblasts compared to osteoclasts?
Which cell type is primarily recognized for lysis of bone?
Which cell type is primarily recognized for lysis of bone?
What best describes the appearance of monocytes in peripheral blood compared to bone marrow?
What best describes the appearance of monocytes in peripheral blood compared to bone marrow?
What does a decreased myeloid to erythroid (M:E) ratio indicate?
What does a decreased myeloid to erythroid (M:E) ratio indicate?
Which condition is suggested by disorderly maturation of cells?
Which condition is suggested by disorderly maturation of cells?
An increased M:E ratio primarily suggests which of the following?
An increased M:E ratio primarily suggests which of the following?
What percentage of mature cells, such as metamyelocytes and bands, should ideally be observed in a normal sample?
What percentage of mature cells, such as metamyelocytes and bands, should ideally be observed in a normal sample?
Which of the following is NOT a typical indication of increased myeloid cell production?
Which of the following is NOT a typical indication of increased myeloid cell production?
What does the presence of spherocytes in a blood sample predominantly suggest?
What does the presence of spherocytes in a blood sample predominantly suggest?
Eccentrocytes in a blood sample are associated with which mechanism of RBC damage?
Eccentrocytes in a blood sample are associated with which mechanism of RBC damage?
Which of the following statements about rouleaux formation is accurate?
Which of the following statements about rouleaux formation is accurate?
Leptocytes are characterized by what distinct feature?
Leptocytes are characterized by what distinct feature?
What is the primary consequence of agglutination of red blood cells?
What is the primary consequence of agglutination of red blood cells?
What characterizes the staining of neutrophils in different species?
What characterizes the staining of neutrophils in different species?
In which situation do eccentrocytes often appear?
In which situation do eccentrocytes often appear?
Which of the following best describes the feature of polychromatophilic erythrocytes?
Which of the following best describes the feature of polychromatophilic erythrocytes?
What should be suspected if a steroid response is absent in a sick dog?
What should be suspected if a steroid response is absent in a sick dog?
In the evaluation of neutrophilia, what should be examined if there is no left shift present?
In the evaluation of neutrophilia, what should be examined if there is no left shift present?
Which abnormality indicates the presence of lymphocytic leukemia?
Which abnormality indicates the presence of lymphocytic leukemia?
What is the primary feature of rubriblasts in the erythroid cell maturation sequence?
What is the primary feature of rubriblasts in the erythroid cell maturation sequence?
What condition can lead to lymphopenia necessitating consideration of a steroid response?
What condition can lead to lymphopenia necessitating consideration of a steroid response?
In horses, why is bone marrow evaluation particularly important?
In horses, why is bone marrow evaluation particularly important?
What is characteristic of erythroid cells as they mature?
What is characteristic of erythroid cells as they mature?
What is the expected quality of lymphocytes during an excitement response?
What is the expected quality of lymphocytes during an excitement response?
Which statement about lymphocytes is true?
Which statement about lymphocytes is true?
What distinguishes regenerative anemia from nonregenerative anemia?
What distinguishes regenerative anemia from nonregenerative anemia?
What does a high concentration of reticulocytes indicate?
What does a high concentration of reticulocytes indicate?
Which of the following correctly describes the features of monocytes?
Which of the following correctly describes the features of monocytes?
What is the significance of MCHC levels in hemolytic conditions?
What is the significance of MCHC levels in hemolytic conditions?
What does the presence of granular lymphocytes indicate?
What does the presence of granular lymphocytes indicate?
Which assertion about hyperchromic anemias is correct?
Which assertion about hyperchromic anemias is correct?
What characteristic is commonly seen in reactive lymphocytes?
What characteristic is commonly seen in reactive lymphocytes?
Which specific characteristic distinguishes microcytic anemia?
Which specific characteristic distinguishes microcytic anemia?
Heinz bodies are indicative of which condition in red blood cells?
Heinz bodies are indicative of which condition in red blood cells?
The presence of which pathogens is linked to dark blue inclusions in red blood cells?
The presence of which pathogens is linked to dark blue inclusions in red blood cells?
What type of inclusion characterizes Cytauxzoon felis in infected red blood cells?
What type of inclusion characterizes Cytauxzoon felis in infected red blood cells?
What classification of anemia is primarily linked to disorders in bone marrow?
What classification of anemia is primarily linked to disorders in bone marrow?
Which condition is described by the presence of paired or single RBC inclusions?
Which condition is described by the presence of paired or single RBC inclusions?
What appearance is indicative of Heinz bodies when viewed under a microscope without staining?
What appearance is indicative of Heinz bodies when viewed under a microscope without staining?
Which of the following best describes the appearance of anemic red blood cells due to iron deficiency?
Which of the following best describes the appearance of anemic red blood cells due to iron deficiency?
What does the presence of echinocytes indicate regarding the condition of red blood cells?
What does the presence of echinocytes indicate regarding the condition of red blood cells?
Howell-Jolly bodies in red blood cells are indicative of which condition?
Howell-Jolly bodies in red blood cells are indicative of which condition?
Siderotic granules in red blood cells typically indicate what underlying issue?
Siderotic granules in red blood cells typically indicate what underlying issue?
What abnormality is characterized by the presence of spiculated projections on red blood cells?
What abnormality is characterized by the presence of spiculated projections on red blood cells?
In which scenario would nucleated red blood cells most likely be found in peripheral circulation?
In which scenario would nucleated red blood cells most likely be found in peripheral circulation?
What is the primary association of basophilic stippling in red blood cells?
What is the primary association of basophilic stippling in red blood cells?
Which of these conditions can contribute to the formation of siderocytes in red blood cells?
Which of these conditions can contribute to the formation of siderocytes in red blood cells?
What might be suggested if nucleated red blood cells are observed during a blood examination?
What might be suggested if nucleated red blood cells are observed during a blood examination?
What condition can lead to a falsely low white blood cell (WBC) concentration?
What condition can lead to a falsely low white blood cell (WBC) concentration?
Which factor is typically associated with neutrophilia in inflammation?
Which factor is typically associated with neutrophilia in inflammation?
What is a characteristic change associated with neutropenia due to severe inflammation?
What is a characteristic change associated with neutropenia due to severe inflammation?
Which option describes a typical scenario accompanying inflammatory conditions?
Which option describes a typical scenario accompanying inflammatory conditions?
What condition can contribute to irreversible neutropenia?
What condition can contribute to irreversible neutropenia?
What factor may contribute to the variations in bone marrow response to inflammation across species?
What factor may contribute to the variations in bone marrow response to inflammation across species?
What causes neutropenia with a left shift when inflammation is present?
What causes neutropenia with a left shift when inflammation is present?
What might be a cause of mild increases in packed cell volume (PCV)?
What might be a cause of mild increases in packed cell volume (PCV)?
What is the primary difference between Type I and Type II myeloblasts?
What is the primary difference between Type I and Type II myeloblasts?
Identify the true statement regarding promyelocytes based on their cytoplasmic characteristics.
Identify the true statement regarding promyelocytes based on their cytoplasmic characteristics.
Which of the following statements best describes the cytoplasmic characteristics of myelocytes?
Which of the following statements best describes the cytoplasmic characteristics of myelocytes?
What is a distinguishing feature of granulocytes compared to other white blood cells?
What is a distinguishing feature of granulocytes compared to other white blood cells?
Which of the following best describes the characteristics of macrophages?
Which of the following best describes the characteristics of macrophages?
What is considered a primary characteristic of megakaryocytes?
What is considered a primary characteristic of megakaryocytes?
Which feature is typical for the maturation sequence of myeloid cells?
Which feature is typical for the maturation sequence of myeloid cells?
Identifying which type of cell may suggest a lymphoproliferative disorder is associated with which cells?
Identifying which type of cell may suggest a lymphoproliferative disorder is associated with which cells?
What is a defining characteristic of metarubricytes in terms of their size and cellular content?
What is a defining characteristic of metarubricytes in terms of their size and cellular content?
Which feature is unique to polychromatophilic erythrocytes when stained with methylene blue?
Which feature is unique to polychromatophilic erythrocytes when stained with methylene blue?
Which statement correctly describes granulocyte (myeloid) cells?
Which statement correctly describes granulocyte (myeloid) cells?
What distinguishes megakaryocytes from other hematopoietic cells in terms of size?
What distinguishes megakaryocytes from other hematopoietic cells in terms of size?
In the context of acute inflammatory changes, what does a left shift refer to?
In the context of acute inflammatory changes, what does a left shift refer to?
What type of transition occurs in the maturation of normoblasts to reticulocytes?
What type of transition occurs in the maturation of normoblasts to reticulocytes?
Which of the following statements is true regarding acute inflammatory consumption?
Which of the following statements is true regarding acute inflammatory consumption?
What is the typical appearance of erythroblasts transitioning into more mature stages of erythropoiesis?
What is the typical appearance of erythroblasts transitioning into more mature stages of erythropoiesis?
Which feature is characteristic of metamyelocytes compared to myelocytes?
Which feature is characteristic of metamyelocytes compared to myelocytes?
What is the distinguishing cytological feature of band neutrophils?
What is the distinguishing cytological feature of band neutrophils?
What indicates that osteoclasts are specialized macrophages?
What indicates that osteoclasts are specialized macrophages?
How do macrophages typically appear when they accumulate hemosiderin?
How do macrophages typically appear when they accumulate hemosiderin?
What is true about the maturity sequence of monocytes in the bone marrow?
What is true about the maturity sequence of monocytes in the bone marrow?
Which cell type is characterized by having irregularly sized spicules on the surface and is commonly seen in cholestatic liver disease?
Which cell type is characterized by having irregularly sized spicules on the surface and is commonly seen in cholestatic liver disease?
What do Howell-Jolly bodies signify in a blood smear?
What do Howell-Jolly bodies signify in a blood smear?
Which of the following is NOT associated with the formation of echinocytes?
Which of the following is NOT associated with the formation of echinocytes?
What condition is associated with the presence of basophilic stippling in red blood cells?
What condition is associated with the presence of basophilic stippling in red blood cells?
What do siderotic granules in red blood cells indicate?
What do siderotic granules in red blood cells indicate?
Which type of cell abnormality is typically a sign of regenerative anemia?
Which type of cell abnormality is typically a sign of regenerative anemia?
What are siderocytes commonly associated with?
What are siderocytes commonly associated with?
Which of the following cell types remains in circulation with a retained nucleus, often indicating regenerative states?
Which of the following cell types remains in circulation with a retained nucleus, often indicating regenerative states?
What does an increased M:E ratio suggest in a hematological evaluation?
What does an increased M:E ratio suggest in a hematological evaluation?
Which condition is indicated by disorderly maturation of hematopoietic cells?
Which condition is indicated by disorderly maturation of hematopoietic cells?
What is the typical range for the percentage of mature cells, such as metamyelocytes and bands, in a normal sample?
What is the typical range for the percentage of mature cells, such as metamyelocytes and bands, in a normal sample?
What does a decreased M:E ratio imply regarding hematopoietic activity?
What does a decreased M:E ratio imply regarding hematopoietic activity?
Which of the following conditions is NOT typically associated with an increased M:E ratio?
Which of the following conditions is NOT typically associated with an increased M:E ratio?
What cellular characteristic is commonly seen with hemangiosarcoma?
What cellular characteristic is commonly seen with hemangiosarcoma?
Which condition is associated with reticulocytosis and polychromasia?
Which condition is associated with reticulocytosis and polychromasia?
What is a common finding in chronic blood loss?
What is a common finding in chronic blood loss?
Eosinophils participate in which type of responses?
Eosinophils participate in which type of responses?
What is the primary feature of basophils?
What is the primary feature of basophils?
What morphological feature distinguishes cat eosinophils from other species?
What morphological feature distinguishes cat eosinophils from other species?
Which type of anemia is characterized by the presence of spherocytes?
Which type of anemia is characterized by the presence of spherocytes?
What is a characteristic feature of erythrocyte parasites like Mycoplasma species?
What is a characteristic feature of erythrocyte parasites like Mycoplasma species?
What is the first step to assess neutrophilia in a sick dog?
What is the first step to assess neutrophilia in a sick dog?
In horses, what is a key factor in determining if anemia is regenerative?
In horses, what is a key factor in determining if anemia is regenerative?
What does lymphopenia in a sick dog typically suggest?
What does lymphopenia in a sick dog typically suggest?
Which characteristic best distinguishes rubriblasts in the erythroid series?
Which characteristic best distinguishes rubriblasts in the erythroid series?
What abnormality is indicated by the presence of lymphocytosis in patients?
What abnormality is indicated by the presence of lymphocytosis in patients?
What does a lack of a left shift in neutrophils suggest during the evaluation of a sick dog?
What does a lack of a left shift in neutrophils suggest during the evaluation of a sick dog?
What morphological feature defines a metarubricyte within erythroid cells?
What morphological feature defines a metarubricyte within erythroid cells?
In the context of neutrophilia, what does the presence of large-diameter lymphocytes indicate?
In the context of neutrophilia, what does the presence of large-diameter lymphocytes indicate?
Flashcards
Plasma Protein Concentration
Plasma Protein Concentration
Concentration of proteins in plasma, measured by refractometry; can be falsely elevated by hyperlipemia.
Leukocyte Concentration
Leukocyte Concentration
Total number of white blood cells; measured using special dilutions or automated cell counters.
Hemoglobin Concentration
Hemoglobin Concentration
Amount of hemoglobin in a volume of blood, reflected by RBC mass; similar to PCV in most species.
MCV
MCV
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Macrocytic RBCs
Macrocytic RBCs
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Microcytic RBCs
Microcytic RBCs
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Normocytic RBCs
Normocytic RBCs
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MCH
MCH
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MCHC
MCHC
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Anisocytosis
Anisocytosis
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Poikilocytosis
Poikilocytosis
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Schistocytes
Schistocytes
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Keratocytes
Keratocytes
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Acanthocytes
Acanthocytes
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Polychromasia
Polychromasia
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Hypochromic RBCs
Hypochromic RBCs
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Heinz Bodies
Heinz Bodies
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Basophilic Stippling
Basophilic Stippling
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Codocytes
Codocytes
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Stomatocytes
Stomatocytes
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Study Notes
Plasma Protein Concentration
- Determined by refractometry
- Hyperlipemia can falsely increase concentration by 2 g/dL
Total Leukocyte Concentration
- Measured using Unopette dilutions or instruments designed for particle counting
- Detects all nuclei in solution, including nucleated RBCs
Hemoglobin Concentration
- An index of RBC mass per unit volume of blood
- Provides information similar to PCV
- In most species (except camels), hemoglobin concentration is about a third of the PCV
Mean Cell Volume (MCV)
- Reflects RBC size
- Macrocytic: Suggests increased red cell turnover
- Some toy poodles, miniature poodles, and greyhounds may have macrocytic RBCs
- Microcytic: Suggests defective red cell growth
- Akita and Shiba Inu dogs may have microcytic RBCs
- Normocytic: Red cell size is unchanged
- Dogs have the highest MCV values (largest RBCs)
- Sheep, llamas, and goats have the lowest MCV values (smallest RBCs)
Mean Corpuscular Hemoglobin (MCH) and Mean Corpuscular Hemoglobin Concentration (MCHC)
- Used to classify anemia
RBC Morphology
- Changes in Size:
- Anisocytosis: Variation in RBC size
- Microcytic RBCs: Smaller than normal, with decreased MCV
- Macrocytic RBCs: Larger than normal, with increased MCV
- Changes in Shape (Poikilocytosis):
- Poikilocytes: Abnormally shaped RBCs
- Schistocytes: RBC fragments, usually caused by intravascular trauma
- Keratocytes: RBCs with two or more spicules
- Acanthocytes (Spur Cells): Irregular, spiculated RBCs with unevenly distributed surface projections
- May result from changes in cholesterol or phospholipid concentrations in the RBC membrane
- Commonly seen in cats with hepatic lipidosis and dogs with hemangiosarcoma
- Changes in Color:
- Polychromasia: Presence of young erythrocytes (larger and slightly bluer) - Degree of polychromasia correlates with reticulocyte response
- Hypochromic RBCs: Pale, with decreased hemoglobin concentration (usually from iron deficiency)
- Structures in or on RBCs:
- Heinz bodies: Caused by oxidant damage, denaturation of hemoglobin, appear as small, pale structures near the margin of RBCs (may protrude)
- Basophilic Stippling: Aggregation of ribosomes into small granules, caused by membrane folding - target cell formation (codocytes)
- Codocytes: Thin and bowl-shaped with a dense central area of hemoglobin (target appearance) - May be seen in animals with increased serum cholesterol concentrations
- Stomatocytes: RBCs with a mouthlike clear area in the center - Found in dogs with hereditary stomatocytosis
Reticulocytes
- Corrected percentage for a reticulocyte value greater than 1% indicates RBC regeneration
- Count greater than 60,000 cells/L indicates RBC regeneration
- Takes at least 3 days for reticulocytes to appear in the circulation
- Horses do not release reticulocytes
Rouleau and Agglutination
- Rouleau: Stacking of RBCs resembling a roll of coins, can occur in normal conditions but may change in response to inflammation
- Agglutination: Clumping of RBCs, indicates autoimmune hemolytic anemia
Anemia Types
- Regenerative: Increased reticulocyte count
- Nonregenerative: Normal or decreased reticulocyte count
- Normochromic: Normal MCHC
- Hypochromic: Decreased MCHC
- Normocytic: Normal MCV
- Microcytic: Decreased MCV
- Macrocytic: Increased MCV
Bone Marrow Collection
- Common sites:
- Large Dogs: Dorsal approach to the iliac crest
- Small Dogs and Cats:
- Lateral approach to the wing of the ilium for core biopsies
- Trochanter fossa of proximal femur for aspiration biopsies
- Proximal humerus for both aspiration and core biopsies
Bone Marrow Cells
- Myeloid Cells:
- Myeloblasts: 5% of ancestral myeloid cells (AMC)
- Progranulocytes, Myelocytes: 15% of AMC
- Metamyelocytes, Bands: 80-85% of AMC
- Erythroid Cells:
- Rubriblasts: 5% of ancestral erythroid cells (AEC)
- Prorubricytes, Rubricytes: 65-75% of AEC
- Metarubricytes: 20-30% of AEC
- Megakaryocyte Cells:
- Maturation sequence: Megakaryoblasts, promegakaryocytes, megakaryocytes
- Megakaryoblasts are larger than any other types of precursors
- Other Cells:
- Macrophages: Usually present in small numbers, increased numbers may indicate immune-mediated disorders
- Myeloid:Erythroid (M:E) Ratio:
- Approximately 0.5:1 to 3:1
- Hemodiluted samples are difficult to evaluate
Cytochemistry and Immunophenotyping
- Provide additional information for bone marrow analysis
Red Blood Cell Morphology
- Spherocytes: Dark-staining RBCs without central pallor. Most easily identified in dogs. Suggest immune-mediated hemolytic anemia
- Eccentrocytes: Hemoglobin shifted to one side, clear eccentric zone. Indicate oxidative damage and may occur with Heinz bodies.
- Leptocytes: Excess membrane relative to internal contents, may occur in vitro with excess EDTA.
- Rouleaux Formation: Stacking of RBCs, normal in horses, enhanced with increased plasma protein concentration
- Agglutination: Clumps of RBCs, associated with immune-mediated hemolytic anemia
Leukocytes
- Neutrophils: Contain small granules in cytoplasm that stain differently in different species
- Lymphocytes: Responsible for immune responses, have a round to oval nucleus with minimal clear cytoplasm
- Monocytes: Participate in inflammation, migrate into tissues and develop
Anemia
- Hypochromic Anemia: RBCs contain less hemoglobin than normal (decreased MCHC)
- Normochromic Anemia: RBCs contain a normal amount of hemoglobin (normal MCHC)
- Hyperchromic Anemia: Does not occur, MCHC can be falsely elevated with intravascular hemolysis
Anemia Responsiveness
- Regenerative Anemia: Increased number of immature RBCs circulating, indicating increased RBC production. Reticulocyte count greater than 60,000 cells/L
- Nonregenerative Anemia: No increase in immature RBCs, indicates lack of bone marrow response
Bone Marrow Evaluation
- Indications: Nonregenerative anemia, neutropenia, thrombocytopenia, gammopathies, possible neoplastic marrow disease.
- Horses: Useful for determining if anemia is regenerative because horses don't release reticulocytes
- Sites: Ilium, ribs, sternum in horses, cattle, camelids.
- Erythroid Cells: Round nuclei, moderate to deep blue cytoplasm, pinker as hemoglobin is produced
- Erythroid Cell Maturation: Rubriblast -> prorubricyte -> rubricyte -> metarubricyte -> polychromatophilic erythrocyte -> mature erythrocyte
- Other Cell Types: Macrophages, osteoblasts, osteoclasts, mast cells
- Interpretation:
- 50% cells and 50% fat is normal
- Decreased M:E ratio suggests increased RBC production, decreased neutrophils, or both
- Increased M:E ratio suggests increased myeloid cell production, decreased RBC production, or both
Neutrophilia
- Left Shift: Presence of immature neutrophils (bands, metamyelocytes, myelocytes) indicates inflammation
- No Left Shift: Consider lymphopenia, indicating a steroid response, possibly combined with inflammation
- Normal or Increased Lymphocytes: Consider excitement response
Lymphocytosis
- Excitement Response: Lymphocytes appear normal
- Lymphocytic Leukemia: Abnormal morphology, including large diameter and light staining nucleus, visible nucleoli, increased cytoplasm
- Chronic Canine Ehrlichiosis: Secondary granules present, eosinophilic precursors have pink granules, basophilic precursors have purple granules
Monocyte Cells
- Difficult to Distinguish: From Myeloid Series, monocyte cells have irregular nuclear outlines
- Maturation Sequence: Monoblasts -> promonocytes -> monocytes
- Bone Marrow Appearance: Same as peripheral blood. Precursors are difficult to identify.
Acanthocytes
- Blood smear from a dog with cholestatic liver disease
- Irregularly sized spicules
Erythrocyte Inclusions
- Associated with immature RBCs in ruminants
- Lead poisoning often causes basophilic stippling
- Nucleated RBCs are an indication of regenerative anemia, a nonfunctioning spleen, or steroids (endogenous or exogenous)
- Howell-Jolly bodies are nuclear remnants in RBCs
- Siderotic granules are visible iron granules in RBCs (siderocytes)
Anemia
- Microcytic Anemia
- RBCs are small (decreased MCV)
- Usually because of iron deficiency
- Can be caused by portocaval shunts
- Macrocytic Anemia
- RBCs are large (increased MCV)
- Usually due to vitamin B12 or folate deficiency
- Can be caused by liver disease
Polycythemia
- Secondary Polycythemia
- Generalized hypoxia
- Increased erythropoietin production
- Primary Polycythemia
- Bone marrow disorder
- Cells appear normal, and maturation process is normal
Leukocyte Responses
- Falsely Low White Blood Cell (WBC) Concentration
- May cause a mild increase in PCV (not greater than 60%)
- Causes a mild increase in PCV (not greater than 60%)
- Lymphocyte Vacuolation
- May occur after ingestion of swainsonine (locoweed ingestion in horses or cattle)
- It also occurs in lysosomal storage diseases
Response to Inflammation
- Increased demand for leukocytes as a result of consumption
- Bone marrow should respond by releasing more leukocytes and increasing production
- Most inflammation is associated with some degree of neutrophilia
- Severity of inflammation can be predicted by the degree of left shift and the toxic changes present
- Neutropenia with left shift may occur when the consumption of neutrophils by the inflammatory process exceeds the bone marrow's capacity to produce neutrophils
- Species variation in the amount of bone marrow reserve to respond to inflammation
Neutropenia
- Reversible Neutropenia
- Typically accompanied by nonregenerative anemia and thrombocytopenia
- Causes include chemotherapeutic agents, other drugs such as estrogen or phenylbutazone in dogs, and ehrlichiosis
- Irreversible Neutropenia
- Causes include feline leukemia virus (FeLV), hypoproliferative disorders, myelodysplasias, and myeloproliferative disorders
Bone Marrow Cells
- Erythrocyte Precursors
- Prorubricytes - Largest of the erythrocyte precursors - Nucleus is round to oval with a fine chromatin pattern and nucleoli that are visible - Cytoplasm is blue-gray
- Rubricytes - Can still undergo mitosis - Smaller than prorubricytes - Very coarse chromatin - Polychromatophilic cytoplasm
- Metarubricytes - Still contain a nucleus - Smaller than rubricytes - Polychromatophilic cytoplasm
- Polychromatophilic erythrocytes - Do not contain a nucleus - Blue-pink - May contain nuclear remnants (Howell-Jolly bodies) - When stained with methylene blue and reticulum is visible, they are termed reticulocytes
- Granulocyte (Myeloid) Cells
- Granulocytes - Irregularly shaped nuclei with fine chromatin patterns and lavender cytoplasm
- Maturation Sequence - Myeloblast, promyelocyte, myelocyte, metamyelocyte, band neutrophil, segmented neutrophil
- Type I myeloblasts - Most immature - Round to oval nucleus - Nucleoli - Small amount of blue-staining cytoplasm - No azurophilic granules - Cytoplasm has a ground glass appearance and may contain small vacuoles
- Type II myeloblasts - Contain a few azurophilic granules (primary granules) in the cytoplasm - Otherwise appear similar to type I myeloblasts
- Promyelocytes - Many azurophilic granules in the cytoplasm - Nucleus is central to eccentric - Nucleoli are present
- Myelocytes - Can still undergo mitosis - Smaller than promyelocytes - Light blue cytoplasm - No primary granules - Nuclei are round to oval
- Megakaryocyte Cells
- Derived from stem cells
- Maturation Sequence - Megakaryoblasts, promegakaryocytes, megakaryocytes
- Megakaryoblasts - Larger than any other types of precursors
- Promegakaryocytes - Two to four nuclei with a deep blue cytoplasm
- Megakaryocytes - Very large - Numerous nuclei that are connected - Cytoplasm becomes granular and is sometimes light pink
- Other Cells
- Lymphocytes - Appear as they do in the peripheral circulation
- Plasma Cells - Differentiated lymphocytes that produce immunoglobulin - Look similar to rubricytes, but the cytoplasm is more abundant in plasma cells and they have a clear perinuclear Golgi zone
- Lymphoblasts - Rare - May indicate a lymphoproliferative disorder
- Macrophages - Derived from monocytes - In low numbers in bone marrow - Cytoplasm is usually vacuolated, is gray-blue, and may contain small pink granules
Bone Marrow Collection Sites
- Dogs
- Dorsal approach to the iliac crest
- Lateral approach to the wing of the ilium
- Trochanter fossa of proximal femur
- Proximal humerus
- Cats
- Lateral approach to the wing of the ilium
- Trochanter fossa of proximal femur
- Proximal humerus
Erythrocyte Morphology
- Acanthocytes have irregularly sized spicules, are commonly seen in cholostatic liver disease, and are also seen with hemangiosarcoma
- Echinocytes (burr cells) have evenly distributed blunt to sharp surface projections
- May be an artifact from slow drying of a blood smear
- Seen in renal disease, lymphoma, rattlesnake envenomation, and when RBCs are engulfed by macrophages
- Commonly Misidentified Cells
- Spherocytes are characterized by a lack of central pallor
- Schistocytes are fragmented RBCs
- Basophilic Stippling is associated with immature RBCs in ruminants and lead poisoning
- Nucleated RBCs are RBCs in the circulation that have retained their nucleus
- Indicate regenerative anemia, a nonfunctioning spleen, or steroid use (endogenous or exogenous)
- Howell-Jolly Bodies are nuclear remnants in RBCs that appear as dark staining, round inclusions, and are associated with regenerative anemia or suppressed splenic function
- Siderotic Granules are visible iron granules in RBCs (siderocytes), associated with chloramphenicol, myelodysplasia, and impaired heme synthesis
Anemia
- Acute Blood Loss
- Acanthocytes, schistocytes, reticulocytosis, polychromasia, and thrombocytopenia are commonly present
- Chronic Blood Loss
- Iron deficiency anemia
- Decreased MCV (microcytosis), increased RDW, MCHC usually normal
- Keratocytes and schistocytes are common
- Blood Destruction
- Immune-mediated hemolytic anemia
- Neonatal isoerythrolysis
- Erythrocyte parasites
- Mycoplasma: haemofelis (cats), haemocanis (dogs), wenyonii (cattle), haemosuiss (swine), Candidatus Mycoplasma haemolamae (llamas and alpacas)
- Anaplasma marginale (cattle)
- Spherocytes are common
Bone Marrow
- Bone Marrow Aspirate sites:
- Dogs and cats: Femur, humerus, or iliac crest
- Horses, cattle, camelids: Ilium, ribs, or sternum
- Indications: Nonregenerative anemia, neutropenia, thrombocytopenia, gammopathies, and possible neoplastic marrow disease
- Horses: Bone marrow evaluation is essential to determine if anemia is regenerative
Erythroid Cells
- Erythroid cells have round nuclei and moderate to deep blue cytoplasm that becomes pinker as hemoglobin is produced
- Maturation sequence (immature to mature): Rubriblast, prorubricyte, rubricyte, metarubricyte, polychromatophilic erythrocyte, mature erythrocyte, and polychromasia
- Rubriblasts are large with round nuclei, slightly coarse chromatin, and nucleoli. Little cytoplasm that stains deep blue
- Prorubricytes lack nucleoli, are smaller than rubriblasts, and have a little more cytoplasm
- Metarubricytes have condensed, darkly stained nuclei and a small rim of cytoplasm
- Polychromatophilic Erythrocytes have a thin, well-defined rim of blue cytoplasm, a centrally placed, round nucleus, and less chromatin than a metarubricyte
- Mature Erythrocytes are fully hemoglobinized and lack a nucleus. They have a central pallor
Other Bone Marrow Cells
- Myeloid Cells (derived from stem cells)
- Difficult to distinguish from monocyte cells
- Maturation sequence (immature to mature): Myeloblasts, promyelocytes, myelocytes, metamyelocytes, band neutrophils, segmented neutrophils
- Myeloblasts are the largest of the myeloid cells
- Promyelocytes are larger than myelocytes and have a nucleus that is round, oval, or bean-shaped. They contain primary granules
- Myelocytes have round, oval, or kidney-bean-shaped nuclei. They contain secondary granules
- Metamyelocytes have kidney-bean–shaped nuclei, and are smaller than myelocytes
- Band neutrophils have horseshoe-shaped nuclei, with cytoplasm similar to segmented neutrophils
- Segment Neutrophils have a segmented nucleus with 3-5 lobes.
- Macrophages phagocytize debris and often contain hemosiderin
- Osteoblasts appear similar to plasma cells, but are larger.
- Osteoclasts are specialized macrophages that lyse bone, and have a similar appearance to megakaryocytes, but have individual nuclei.
- Mast Cells are rare, large round cells with numerous metachromatic granules within the cytoplasm
Interpretation
- Cellularity: Normally marrow is about 50% cells and 50% fat
- Decreased M:E Ratio is associated with increased RBC production or decreased neutrophil production
- Increased M:E Ratio is associated with increased myeloid cell production or decreased RBC production
- Maturation: Approximately 80% to 90% of the cells should be more mature cells (metamyelocytes, bands, neutrophils; rubricytes, metarubricytes)
- Disorderly maturation can be seen with leukemia, myeloid hyperplasia, immune-mediated hemolytic anemia, or marked inflammation
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Description
This quiz explores key concepts in veterinary hematology, focusing on the determination of plasma protein concentration, leukocyte counting methods, hemoglobin levels, and mean cell volume in various species. Understand how these factors can indicate health conditions in animals, especially in regards to red blood cell characteristics.
