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Experience:  Over 10 years of experience in surgery and internal medicine.
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I need help with my homework. Looked through my entire material

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I need help with my homework. Looked through my entire material and can not seem to find the right answer to those question. Please, help me out! I apprechiate your time and help thanks in fore-hand.

To avoid hemolysis when drawing blood, all of the following are important except:
a. Enter the vein with the bevel of the needle up
b. Use a 25 gauge needle
c. Use the jugular vein when collecting 2 mLs or more of blood
d. If transferring blood from a syringe to a vacuum tube, let the vacuum pull the blood from the syringe without forcing the plunger.

Before centrifuging blood, let the sample clot for a maximum of 20 minutes.
a. True
b. False

The spun microhematocrit tube is used as a basis for determining all except:
a. Dehydration
b. Total protein
c. Sodium
d. PCV

A-1 year-old Labrator retriever is brought into the clinic with signs of vomiting, diarrhea and lethargy. The client tells the doctor that the dog had dug up and ate some of the vegetables in her garden about a week ago which contained lettuce, carrots, radishes, onions, tomatoes and squash. Laboratory tests run in-house included a CBC, chemistry panel and blood smear. The technician reading the blood smear tells you that she saw"bite cells" on the slide. What are "bite cells" and what blood cells does this morphology affect? What do you think may have caused this abnormality?



List the stain components and, in your own words, describe the procedure for staining a blood smear using Wrights Stain.
Submitted: 10 months ago.
Category: Veterinary
Expert:  DrRalston replied 10 months ago.
Ok, I can give you my opinion on these, and I will give you a reason why I think the answer is true, ok? Let me answer each one separately....

Expert:  DrRalston replied 10 months ago.
To avoid hemolysis when drawing blood, all of the following are important except:
a. Enter the vein with the bevel of the needle up
b. Use a 25 gauge needle
c. Use the jugular vein when collecting 2 mLs or more of blood
d. If transferring blood from a syringe to a vacuum tube, let the vacuum pull the blood from the syringe without forcing the plunger.

When drawing blood it is actually best to use a larger needle (smaller gauge) versus a smaller needle (higher gauge). I always draw with a 22 ga needle, but might use a 20 ga in a large vein on a large dog. Think of it like this : think of red blood cells like fragile baloons filled with fluid. The needle is a like a tunnel. If the balloons are moving too fast, or bump into each other to hard or hit the side of the tunnel at a fast speed they will explode on impact - water baloon fight right? So, you don't want that tunnel to be too narrow - this gives the baloons/blood cells more space to enter the tunnel and less change of being damaged. At the same time, you don't want to draw them in too fast either. You want a slow and controlled pull to avoid too much speed which also ruptures the balloons/cells. Does that make sense?
Expert:  DrRalston replied 10 months ago.
Before centrifuging blood, let the sample clot for a maximum of 20 minutes.
a. True
b. False

This is true. Centrifuging blood is done to separate the solid matter (cells) from the fluid matter and particles in the blood (protein/enzymes/electroyltes/etc... all the stuff you test for when you run chemstry tests on the blood).

To get the best sample you want to avoid hemolysis which can affect these values in different ways.

The best way to do this is to be sure the blood has clotted (all the redblood cells stuck together in a big mess) before you remove them. Essentially, you would not want to pull each one out one at a time right? Would take a lifetime. So, we let them clot first, and then use the centrifuge to spin really fast, and throw the clot past the serum separator wax leaving only the clear serum behind.

20 minutes is about long enough. Anything longer and you can also have blood changes. Most notably, glucose tends to start to decrease as the red blood cells in the tube are consuming it for energy.
Customer: replied 10 months ago.

=) Thank you so much

Expert:  DrRalston replied 10 months ago.
The spun microhematocrit tube is used as a basis for determining all except:
a. Dehydration
b. Total protein
c. Sodium
d. PCV

Well, lets think about what would be in a microhematocrit tube. It's sort of like a larger tube that has been spun down right? There will be blood on one end of the tube (red), clear serum on the other side of the tube, and in between what we call the buffy coat, or buffy layer (mostly white blood cells).

You use a microhematocrit tube when you want to know a rough idea of how much blood is in the patient. Often used to monitor redblood cell percentage in anemic patients. Only takes a small amount to check, and can be done easily and often.

SO - d PCV - packed cell volume - is definitely correct
Total protein can also be measured from the serum in the tube. You use a refractometer to do this. So, yes.. b is also correct.

When a patient is dehydrated, they loose fluid in the blood and it becomes thicker. That fluid you lose is part of the serum. You aren't losing blood like when you have a cut and are bleeding. But, you do sweat, which is loss of fluid. You might be ill and vomitting, and this is a loss of fluid as well from stomach content loss. Diarrhea is fluid loss as well.

As the fluid is lost, the fluid portion of the blood decreases, and the overall PCV will increase. A dehydrated pet will have a higher PCV than normal. If you are giving IV fluid to a pet and you are giving them too fast, or too much fluid at a time, this will dilute the blood and the pet will have more fluid portion of the blood which will DECREASE the PCV. So, yes dehydration (a) can be gauged as well this way>>

Sodium can't be tested this way. You need a larger sample of plasma/serum. This is done in the chemistry testing machines.. like above...
Expert:  DrRalston replied 10 months ago.
Sure, no problem. I like helping. And this interests me.

Let me answer the last two. But, I want to be sure you understand the answers. If you have questions, or are not sure, please ask me, ok?

A-1 year-old Labrator retriever is brought into the clinic with signs of vomiting, diarrhea and lethargy. The client tells the doctor that the dog had dug up and ate some of the vegetables in her garden about a week ago which contained lettuce, carrots, radishes, onions, tomatoes and squash. Laboratory tests run in-house included a CBC, chemistry panel and blood smear. The technician reading the blood smear tells you that she saw"bite cells" on the slide. What are "bite cells" and what blood cells does this morphology affect? What do you think may have caused this abnormality?

"bite cells" look like something took a bite out of them. Also called degmacytes - they look like this See the bites?
Customer: replied 10 months ago.

Yes, I can see the bites in the cells

Expert:  DrRalston replied 10 months ago.
They kind of have had bites taken out of them.
These are a result of oxidative damage to the hemoglobin .. drugs/toxins/and some foods in pets can cause these.
The hemoglobin is damaged in the red blood cell from the oxidative damage, and the spleen tries to remove them from circulation. But sometimes, the cell is not completely removed yet, and you see these cells with portions of hemoglobin "heinz body" or the bite cells left behind.

Here's the more complicated explaination off wikipedia:

Heinz bodies are formed by damage to the hemoglobin component molecules, usually through oxidant damage, or from an inherited mutation (i.e. change of an internal amino acid residue). As a result, an electron from the hemoglobin is transferred to an oxygen molecule, which creates a reactive oxygen species (ROS) that can cause severe cell damage leading to premature cell lysis.[6] Damaged cells are cleared by macrophages in the spleen, where the precipitate and damaged membrane are removed, leading to characteristic "bite cells". The denaturing process is irreversible and the continual elimination of damaged cells leads to Heinz body anemia.

There are several pathways leading to the hemoglobin damage.


In this case : it was caused by the onions. They do that for some reason. And, more likely in cats than dogs, but happens in both.
Customer: replied 10 months ago.

Wow, didn't thought it was caused by the onions. =) But I learned something new about veterinary medicine and what it causes and condition of a pet it could lead to. Thank you so much sir

Expert:  DrRalston replied 10 months ago.
List the stain components and, in your own words, describe the procedure for staining a blood smear using Wrights Stain.

This one is harder because this is probably specifically stated in the notes somwhere.

The Wright's stain that is used most commonly these days is a DIff Quick stain.

have you seen that in the notes?
Expert:  DrRalston replied 10 months ago.

Right, isn't that weird that onions do that? I remember when I first learned that, and I thought it was weird as well. This actually does happen in practice ever so often too.

Ok .. here's a link to some info on Diff Quick : (just click here) This one says about 30 seconds for each step, but I have also done 15 dips in the first step, 16 dips in the second, 17 in the last one. But, that's just what I was taught in school. *shrug*

Essentially, three steps.
1. alcohol fixative
2. eosinophilic stain (dyes stuff red like red blood cells, some bacteria (negatives))
3. basophilic stain (it's the purple stuff) ... it's a counter stain. What that means is that it dyes most of the other stuff on the slide purple (or kind of a bluish purple). This helps the eosinophilc stained items stand out, and they are more easily seen. Gram positives like staph bacteria show up as little purple circles.

That is probably not a very good explaination. So, you might need to check the notes for exact types of stain, dyes, etc that are in the ingredients of the Wright's stain. Remember Diff Quick is just one type of commercial Wright's stain. It's a little faster and better than the old fashioned original Wright's stain... so, you might need to know that.

This is probably a better explaination of Wright's Stain : "

The traditional Wrights Stain dates from the early 1890's. The original Wrights Stain was an alcoholic solution of methylene blue and eosin Y. Since then there have been many modificiations, most involving partial oxidative demethylation of the methylene blue to improve polychroming. Modern day samples of the dye usually contain mixtures of methylene blue, azure A, thionin and eosin Y. They also contain some amount of giemsa stain.

The traditional stain is diluted 1:1 with giordano buffer before use. One Step Wrights Stain contains the buffer already dissolved in the stain. The slides are stained in the undiluted stain and differentiated by decolorizing in purified water."



DrRalston, Veterinarian
Category: Veterinary
Satisfied Customers: 2071
Experience: Over 10 years of experience in surgery and internal medicine.
DrRalston and 3 other Veterinary Specialists are ready to help you
Customer: replied 10 months ago.

Thank you so much Sir for all help! I"ll really do appreciate your time and your opinions. Thanks I've learned a lot more about veterinary medicine. Thank you one more time and have a great day!

Expert:  DrRalston replied 10 months ago.
You are very welcome! Good luck in your studies :)

Glad I could help.

If you have questions in the future you can contact me through this link : http://www.justanswer.com/veterinary/expert-drralston/ You can save and bookmark that link for future use.

You have a great day too.
I'm going to the zoo later today :)
DrRalston

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