IMHA (Ngwenyama) Flashcards

1
Q

What will the SPO2 of an anemic patient be?

A

100%, so not an accurate representation of oxygen delivery with anemia

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2
Q

What happens to old RBCs?

A

They are removed by mononuclear cells in the liver and spleen

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3
Q

Are spherocytes more likely with a dog or a cat with IMHA? Why?

A

Dog, cats have smaller RBCs so they don’t make spherocytes when they are being removed during IMHA

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4
Q

What type of hypersensitivity is IMHA?

A

Type II: development of antibodies that react against erythrocyte antigens

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5
Q

If the IMHA is mainly IgG, what type of hemolysis should we see?

A

Extravascular Hemolysis

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6
Q

If the IMHA is mainly IgM, what type of hemolysis should we see?

A

Intravascular Hemolysis

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7
Q

How is Primary IMHA different from secondary IMHA?

A

Primary is true autoantibodies made to target RBCs, secondary is an antibody made against something else but it cross reacts with the RBCs.

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8
Q

What triggers extravascular hemolysis for the spleen and liver monocytes to eat healthy RBCs?

A

Intracellular inclusions, Membrane coating with IgG (or IgM),

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9
Q

Which type of hemolysis is associated more with complement?

A

Intravascular hemolysis

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10
Q

What type of hemolysis do cats get more frequently?

A

Intravascular hemolysis

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11
Q

In which type of hemolysis do you get Hemoglobinemia and hemoglobinuria?

A

Intravascular hemolysis

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12
Q

What are some common causes of secondary IMHA?

A

Drugs, Neoplasia, Infectious disease, toxins, mechanical injury

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13
Q

What is the typical signalment for a dog with IMHA?

A

Middle aged (7 yr), Female, Spaniel in late spring?

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14
Q

Clinical signs?

A

Lethargy, anorexia, weakness, syncope, vomiting, pale mm, icterus, shock, fever (acute)

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15
Q

What are some signs in chronic IMHA?

A

Hepatosplenomegaly, lymphadenomegaly, S3 gallop murmur, petechia, pigmenturia

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16
Q

What is Evan’s syndrome?

A

IMHA and IMT

17
Q

What is a good diagnosis criteria for IMHA?

A

Hx,PE compatible + Anemia <30%, Hemolysis, Autoagglutination, spherocytosis, positive response to immunosuppressive therapy

18
Q

What is the Coomb’s test for?

A

Direct anti-globulin test - washed patient RBCs add antiglobulin reagent - if IMHA then you will see agglutination- low sensitivity,

19
Q

What is the treatment for IMHA?

A

Immunosuppressive dose of glucocorticoids, if that doesn’t work add immunosuppressive. Support tissue oxygen- whole blood *CROSSMATCH

20
Q

Why are animals with IMHA prone to thromboembolism?

A

Stimulus causing hypercoagulable states leads to clotting