Anaemia

Question 1

What is a bicytopenia?

Answer 1

Two cytopenias together at one point in time

Question 2

What four things can cause cytopenia?

Answer 2

• reduced production
• sequestration
• Increased loss
• Increased destruction

Question 3

How does anaemia present itself clinically?

Answer 3

1. lethargic/ collapsed
2. Pale/yellow mucus membranes
3. Tachycardia
4. Hypotension
5. Bounding/Weak peripheral pulses
6. Altered respiration

Question 3

What is the third rule?

Answer 3

haemoglobin should be a third of the haematocrit

Question 3

What is MCV?

Answer 3

Mean Corpuscular volume

measures the average size of your red blood cells

Question 3

How is regenerative anaemia fixed?

Answer 3

The bone marrow responds by increasing the number of red blood cells

Question 4

What is the main thing that causes regenerative anaemias?

Answer 4

Haemorrhage, e.g loss of blood which can be internal or external

Question 4

What is a sign that you have regenerative aneamia?

Answer 4

High concentration of reticulocytes

Question 4

What are the two main things that can cause anaemias?

Answer 4

• Haemorrage (either internal or external)
• Haemolysis

Question 5

Name 5 clinical signs of Anaemia

Answer 5

• Lethargic/ Collapsed
• Pale mucous membranes (potentially jaundice)
• Tachycardia
• Hypotension
• Weak peripheral pulses

Question 6

What does increased Hgb degredation lead to?

Answer 6

Increased billirubin formation

Question 7

What are the main differences between conjugated and unconjugated billirubin?

Answer 7

*Unconjugated billirubin *
* Insoluble in blood
* Toxic to tissues
* Cannot be excreted in the urine

*Conjugated Billirubin *
* Water soluble
* Relatively non-toxic
* can be excreted in the urine

Question 8

What is acute blood loss?

Answer 8

Blood is lost over a few hours
Anaemia occurs from the dilution of remaining erythrocytes

Question 9

How can you recover from acute blood loss?

Answer 9

• reabsorption of erythrocytes
• Tissue hypoxia stimulates more prodcution of erythropoetin

Question 10

What is chronic blood loss?

Answer 10

Blood is lost over days/weeks/months

Question 11

What are the two ways there is increased loss/ destruction (anaemia)?

Answer 11

• Haemorrhage (can be either internal or external)
• Haemolysis ( mechanical/ due to cell damage or immune)

Question 12

What does the blood analysis look like in anaemia?

Answer 12

• Decrease in the mean cell volume
• More reticulocytosis (increase in circulating reticulocytes)
• Haemoglobin decreases
• Increase in billirubin

Question 13

How may you determine anaemia severity?

Answer 13

• Mild- worth monitoring but most likely just reflecting other disease processes
• Moderate- most likely to be a primary concern PCV below 20
• Marked for significant concern- PCV below 12-15% (requires investigation and rapid treatment)

Question 14

What type of anaemia is immature RBC’s a sign of?

Answer 14

regenerative
-reflects the bone marrows attempts to increase the circulating blood cells

Question 15

What is intravascular anaemia?

Answer 15

• The lysis of blood cells within vessels
• severe or rapidly falling anaemia
• present over hours or days

haemoglinaemia-increased haemoglobin

Question 16

What is extravascular anaemia?

Answer 16

• Erythrocyte lysis outside of blood vessels (e.g in macrophages)
• mild to marked anaemia
• Haemoglobinaemia and haemoglobinuria not
  present

Question 17

What is the difference between primary and secondary anaemia?

Answer 17

• Primary- idiopathic
• Secondary- it was caused by an underlying disease

Question 18

What is oxidative damage?

Answer 18

Haemoglobin is damaged and this effects the cell membrane
It produces heinz bodies which tells you that the anaemia is from oxidative damage

Question 19

What is a distemper inclusion?

Answer 19

From infectious stress, e.g from mycoplasma
you need to look for an infectious agent inside of the RBC that therefore causes the RBC to lyse

Question 20

What is an internal haemorrhage?

Answer 20

* haemorrhage into cavities *(regenerative anaemia)

Question 21

What is an external haemorrhage?

Answer 21

haemorrhage outside of the body * External trauma * Epistaxis * Haematemesis * Haematuria * Melena usually in iron-deficiency anaemia

Question 22

What is the evidence of iron deficiency?

Answer 22

* Hypochromic cells * more central pallor is initialaly regenerative but is more likely to be due to external blood loss

Question 23

What are some examples of erythrocyte fragmentation?

Answer 23

* Schistocytes * Keratocytes * Acanthocytes * Spherocyte-like cells

Question 24

What are the three major mechanisms considered in drug-induced IMHA?

Answer 24

* Drug adsorption- e.g. penicillin binds covalently to erythrocytes and stimulates hapten-dependent antibodies * Autoantibody induction- induces formation of autoantibodies – antibodies can bind to normal erythrocytes in absence of drug * Drug-dependent antibody induction- induces antibodies only when soluble drug is present

Question 25

What is neonatal isoerythrolysis?

Answer 25

Can occur in dams or queens Leakage of blood across the placenta during pregnancy leads to the production of antibodies antibodies destroy the foals RBC's

Question 26

What is teh gold standard test for equine infectious anaemia virus and what happens if an animal is infected?

Answer 26

* Coggins test * Confirmed infected animals are destroyed

Question 27

What can cause non-regenerative anaemias?

Answer 27

* Renal disease * Liver disease * Bone marrow disorders * (* Myelofibrosis- can be a sequalae of PK deficiency * Damage following inflammation, necrosis, toxicosis (e.g. oestrogen))

Question 28

What is the main point of non-regenerative anaemias?

Answer 28

either decreased or ineffecive erythropoiesis Absence of reticuolcytes or polychromatophils in peripheral blood (and within bone marrow samples) * Usually normocytic, normochromic, non-regenerative (anaemia present >5 days

Question 29

What nutritional diseases can cause non-regenerative anaemia?

Answer 29

* Lack of Iron * Lack of folate or Coblamin * Copper

Question 30

What are some inherited disorders that can cause non-regenerative anaemia?

Answer 30

* Dyserythropoesis of English Springer Spaniels * Congenital dyserythropoesis of polled Hereford calves

Question 31

What is polycythemia?

Answer 31

rare blood disorder in which there is an increase in all blood cells, particularly red blood cells

Question 32

What can cause polycthenia?

Answer 32

* Splenic contraction due to excitement * relative erythocytosis * Pathological