Anemia Flashcards
(175 cards)
1
Q
What are 3 causes of anemia?
A
Increased loss
Increased destruction
Decreased production
2
Q
What is anemia?
A
Decreasee in RBC mass
3
Q
What does anemia result in?
A
Decreased oxygenation
4
Q
How is red cell mass measured? (3 things)
A
PCV
RBC count
Hemoglobin concentration
5
Q
What are the 5 main clinical signs you see in an anemic patient?
A
Pale MM Lethargy Increased RR Increased HR Murmurs (if < 20%)
6
Q
What can non-specific clinical signs be related to in cases of anemia?
A
Underlying illness
7
Q
T/F: Anemia is a diagnosis.
A
False, anemia is a lab finding. Cause of anemia is the diagnosis.
8
Q
What are 3 clinical signs associated with blood destruction?
A
Splenomegaly
Icterus
Hemoglobinuria
9
Q
What does severity of clinical signs of anema correlate to?
A
Duration of onset.
10
Q
How severe is slow onset anemia?
A
Less severe
11
Q
How severe is fast onset anemia?
A
More severe
12
Q
What are the 3 main diagnostic approaches to anemia?
A
Lab evaluation
History
Physical exam
13
Q
What are the 4 main lab evals for anemia?
A
PCV
MCV
Retic. count
TP
14
Q
What else should you expect to see in acute blood loss?
A
Total protein decrease
15
Q
How do you read a cytogram?
A
Large cells on top, small cells on bottom
Hypochromic cells to the left, hyperchromic cells to the right
16
Q
How do you read a histograms?
A
Small cells are to the left, large cells are to the right
17
Q
What are 2 other types of lab tests you can run with anemia?
A
Tests for specific types of anemia
Biochem profile
18
Q
What is an example of a test for a specific type of anemia? (2 things)
A
Serum iron
Coomb’s test
19
Q
What can a biochem profile detect? (1 thing)
A
Renal failure
20
Q
What other tests might you run on a cat with a non-regenerative, macrocytic anemia?
A
FIV test
21
Q
In acute blood loss, what two things decrease together?
A
PCV and protien
22
Q
In acute blood loss, what is RBC morphology like? What is an exception?
A
Normal
Hemangiosarcoma in a dog
23
Q
What RBC morphology can mean hemangiosarcoma?
A
Acanthocytes
24
Q
What are 4 examples of acute blood loss?
A
Trauma/Surgery
Coag. disorders
Bleeding tumors
Thrombocytopenia
25
T/F: Blood loss causes a thrombocytopenia.
False. Blood loss does NOT cause a thrombocytopenia, however thromobocytopenia does cause blood loss.
26
What are 3 examples of chronic blood loss?
GI Ulcer
Bleeding GI tumor
Blood consuming parasites
27
What is the most common site for chronic blood loss?
Intestines
28
What causes iron deficiency anemia in nursing animals?
Inadequate intake
29
What causes iron deficiency anemia in adults?
Almost always chronic blood loss
30
What type of anemia (micro/macro) is iron deficiency anemia?
Microcytic
31
What do we find with reticulocytes in iron deficiency anemia?
Decreased MCV
32
What do we see in the RDW in iron deficiency anemia?
RDW is increased (anisocytosis)
33
What dowe see in the MCHC in iron deficiency anemia?
Usually normal
34
What two RBC morphologies might we see with iron deficiency anemia?
Keratocytes
| Increased zone of central pallor
35
Is iron deficiency anemia usually regenerative or non-regenerative?
Regenerative
36
What is also common in iron deficiency anemia?
Thrombocytosis
37
What 3 things will decrease with iron deficiency anemia?
Serum iron
Transferrin saturation
Decreased storage iron
38
What 3 things will you see to give an iron deficiency anemia diagnosis?
Anemia
Low serum iron
Microcytosis
39
How can platelets throw off a RBC count?
If they're big enough or clumped, can be counted as RBCs.
40
What is the treatment in neonates with iron deficiency anemia?
Injectable iron
41
Why wouldn't you give oral iron to neonates with iron deficiency anemia?
It's toxic and their livers can't handle it yet.
42
What is the treatment in adults with iron deficiency anemia?
Find the cause of the iron deficiency and source of blood loss.
43
What are 3 causes of microcytosis?
```
Portosystemic shunts
Breed dispositon (Asian breeds)
Anemia of inflammatory disease (rare in dogs)
```
44
In dogs why are anemias of inflammatory disease usually normocytic?
Because they have increased storage iron.
45
What are the two types of hemolysis?
Intravascular
| Extravascular
46
What is the most common cause of RBC destruction in cats?
Heinz body anemia (think Heinz CATsup)
47
On top of general signs of anemia, what else might you see with blood destruction? (4 things)
+/- Splenomegaly
+/- Hyperbilirubinemia
+/- Hemoglobinemia
+/- Hemoglobinuria
48
What will you see with total protein in cases of blood destruction?
TP will be normal
49
IMHA is often..?
Secondary to other disorders
50
What are some disorders that can cause IMHA? (4 things)
Infection
MLV vaccine
Neoplasia
Drugs
51
What 3 things is IMHA associated with in horses?
Penicillin
Clostridials
Neoplasia
52
What 3 things is IMHA associated with in cats?
Mycoplasma haemofelis
FeLV
Neoplasia
53
What species is IMHA most common in?
Dogs
54
What are the top 3 dog breeds for IMHA?
Cocker Spaniels
Poodles
Collies
55
What dogs (not breed) are most at risk for IMHA?
Middle aged to old females
56
What test can be done to determine if IMHA is present?
Coombs' Test
57
What are the two main disadvantages of the Coombs' test?
Many false positives
| Many false negatives
58
What is the reason for a false positive Coombs' test?
Immune complexes attached to RBCs, but destruction isn't increased.
59
What is the reason for a flase negative Coombs' test?
Low concentration of Ab on RBCs
60
When is the Coomb's test not indicated?
When agglutination is present.
61
What are 3 major lab findings in IMHA cases?
Throbocytopenia (maybe)
Inflammatory leukogram
Azotemia (maybe)
62
What are 2 reasons that you would see thrombocytopenia with IMHA?
Immune-mediated
| DIC
63
What is the term for IMHA with thrombocytopenia?
Evan's Syndrome
64
What is the cause for azotemia with IMHA?
Increased creatinine and BUN from RBC destruction
65
What are 5 differentials for spherocytes?
```
Previous mismatched blood transfusions
Rattlesnake envenomation
Heinz body anemia of horses
Zinc toxicosis
Bee stings
```
66
What two things cause eccino-spherocyte cases?
Zinc toxicosis
| Bee stings
67
What are mortality rates when you see spherocytes?
25-50%
68
What do animals with spherocytes usually die from?
Thromboembolism
69
How do you treat IMHA? (3 things)
Glucocorticosteroids
Fluids
Correct acidosis
70
How do glucocorticosteroids help treat IMHA? (3 things)
Decrease Ab production, T-cell activity and macrophage function
71
What two things are not indicated in IMHA cases?
```
Blood transfusion (unless anemia is life threatening)
Splenectomy
```
72
Why is a blood transfusion not indicated in IMHA cases?
Adds fuel to the fire.
73
Is IMHA usually regenerative or non-regenerative?
Regenerative
74
What two things will you always see with IMHA?
Spherocytosis
| Neutrophilia with left shift
75
What two things MIGHT you also see with IMHA?
Agglutination
| Thrombocytopenia
76
What shape changes do you see with rattlesnake envenomation in dogs?
Spheroechinocytosis
NOTE: Spherocytes may remain after echinocytic changes have reversed.
77
What shape changes do you see with clostridial infections in horses?
Spherocytes, spheroechinocytes and type 3 echinocytes
78
What is the cause of Heinz body anemia in horses?
Membranes collapse after eccentrocyte formation OR
| Heinz body formation results in band 3 clustering.
79
What is band 3?
A protein that changes bicarbonate for chloride, increased RBC capatiy to carry CO2
80
What does bee venom contain and what does it do?
Mellitin.
| A band 3 clustering agent and phsopholipase
81
What does zinc toxicosis do?
Results in band 3 clustering
82
What is neonatal isoerythrolysis?
Maternal Abs against the neonates blood group = hemolysis
83
What species is neonatal isoerythrolysis most common in?
Horses and mule foals
84
How do most RBC parasites cause anemia?
By immune mediated mechanisms
85
What two RBC parasites cause intravascular hemolysis?
Babesia
| Theileria
86
What two ways do you diagnose RBC parasites?
```
Blood film (old fashioned)
PCR assay (more accurate)
```
87
What RBC parasite is a common, serious cause of severe anemia?
Mycoplasma haemofelis
88
How is Mycoplasma haemofelis transmitted? (2 ways)
Infected blood
| Vertical transmission
89
What are clinical signs of Mycoplasma haemofelis? (4 things)
```
Signs of anemia:
Splenomegaly
Fever
Lethargy
Sometimes icterus
```
90
What can predispose animals to M. haemofelis? (3 things)
Concurrent disease
Immunosuppression
Splenectomy
91
Is anemia caused by M. haemofelis a regenerative, or non-regenerative anemia?
Regenerative UNLESS underlying disease (eg. FeLV, or severe inflammatory disease)
NOTE: FeLV and FIV titers would be indicated here.
92
How do you treat M. haemofelis? (4 things)
Transfusion (if anemia is severe)
Prednisone to supress RBC destruction
Doxycycline for 3 weeks
Enrofloxacin IF problems with Doxy
93
T/F: Cats remain carriers of M. haemofelis?
True
94
When do you most often see M. haemofelis? (2 things)
Usually only in splenectomized or severely immunosupressed dogs
95
What clinical signs do you see with M. haemocanis?
Signs of anemia (my look like IMHA)
96
What do you use to treat M. haemocanis?
Doxycycline
97
What species is infected my M. wenyonii?
Cattle
98
What do you see in cattle infected with M. wenyonii?
Severe anemia, but ONLY if splenectomized or immunosuppressed.
99
How is M wenyonii commonly transmitted?
Iatrogenic transmission
100
What MIGHT M. wenyonii cause? (2 things)
Dependent edema
Lymphadenopathy
Both without anemia
101
What are two important points about M. haemolamae?
Opportunist
| Causes mild anemia
102
What does M. haemosuis cause severe anemia in?
Baby pigs
103
What does M. haemosuis cause in adult pigs?
Poor weight gain
104
How do you treat M. haemosuis in baby pigs?
Usually treated with one dose of long acting oxytetracycline
105
What two anaplasmas do you see in ruminants?
A. marginale
| A. centrale
106
How is anaplasma transmitted and what is it's distribution?
Tick-borne
| Worldwide
107
What can anaplasma cause, especially in older animals?
Fatal hemolytic anemia
108
How does anaplasma cause the anemia?
Probably immune mediated destruction
109
T/F: A vaccine is available for anaplasma.
True
110
What do you treat anaplasma with?
Tetracycline
111
What two types of babesia do you see in dogs?
B. canis
| B. gibsoni
112
What two typess of babesia do you see in cattle?
B. bovis
| B. bigemina
113
What two types of babesia do you see in horses?
B. equi
| B. caballi
114
What is another name for babesia in horses?
Piroplasmosis
115
What two types of babesia do you see in cats?
B. cati
| B. felis
116
How is babesia transmitted? (3 things)
Ticks
Blood transfusions
Vertically
117
What does babesia cause? (2 things)
Severe disease and hemolytic anemia
118
What might babesia be mistaken for?
IMHA
119
T/F: Dogs that survive usually become chronic carriers of babesia.
True
120
What is theileriosis?
A protozoa
121
What does Theileria cause in ruminants?
Hemolytic anemia
122
What is another name for Theileria parva?
East Coast Fever
123
What stage of Theileria do you see in RBCs?
Merozoite
124
What kind of in vitro shape change can you see in deer blood?
Sickle shape RBCs
125
What causes feline cytauxzoonosis?
A protozoa
126
How is feline cytauxzoonosis transmitted?
Ticks
127
T/F: Feline cytauxzoonosis is rarely fatal.
False, it's almost always fatal.
128
What causes Heinz body anemia?
Oxidative denaturation of hemoglobin
129
What species is most susceptible to Heinz bodies?
Cats
130
What 3 diseases do you often see Heinz bodies with?
Lymphoma
Hyperthyroidism
Diabetes mellitus
131
Many drugs that cause Heinz body anemia also cause..?
Methemoglobinemia
132
What 3 families of plants cause Heinz body formation?
```
Allium family (onions, garlic)
Brassica (kale, cabbage, rape)
WILTED red maple leaves
```
133
What drug causes Heinz bodies?
Acetaminophen
134
What are two ways that Heinz bodies are formed?
Hemichrome formation due to oxidative damage
| Sulfhydral groups susceptible to oxidative damage (cats have 8 groups)
135
What might you see with clustering of protein band 3?
Spherocytes
136
How doe Heinz bodies elicit an anemia?
RBC membrane is more rigid, making them more susceptible to removal by macrophages or lysis
137
What is methemoglobinemia?
Iron is in ferric state and can't carry oxygen
138
What causes methemoglobinemia in cats?
Acetaminophen toxicity
139
What causes methemoglobinemia in cows?
Nitrate poisoning (from rumen bacteria)
140
What causes methemoglobinemia in horses?
Red maple leaf ingestion
141
What can cause methemoglobinemia?
Congenital deficiency of NADH-methemoglobin reductase
142
What causes excessive formation of methemoglobin?
Oxidative damage
143
What two things are caused by oxidative damage?
Methemoglobinemia
| Heinz bodies
144
What percentage of methemoglobin concentration results in the blood appearing chocolate brown?
30%
145
What percentage of methemoglobin concentration causes death?
90%
146
How can ou treat methemoglobinemia?
Methylene blue to reduce to deoxyhemoglobin
147
What species is susceptible to copper toxicosis?
Sheep
148
Where does copper accumulate in copper toxicosis?
In the liver
149
What 4 things do you see in the blood with copper toxicosis?
Hemolytic anemia
Hemoglobinemia
Hemoglobinuria
Heinz body formation
150
What does low phosphorus cause?
Decreased glycolysis
151
What does low phosphorus in cattle cause?
Postparturient hemoglobinuria
152
What does low phosphorus cause in cats?
Diabetes mellitus
153
What in cats can cause hypophosphatemia?
Enteral alimentation
154
What causes hemolytic anemia ("yellow disease") in lambs and calves?
C. perfringens Type A
155
What bacteria causes bacillary hemoglobinuria in cattle?
C. haemolyticum
156
What is another name for bacillary hemoglobinuria?
Red water disease
157
What is bacillary hemoglobinuria/red water disease associated with?
Liver fluke migration
158
What clinical signs do you see in cattle with C. haemolyticum? (6 things)
```
Anemia
Arched back
Bloody diarrhea
Fever
Dyspnea
Hemoglobinuria
```
159
What species does water intoxication occur in?
Cattle (usually calves)
160
How does water intoxication happen?
Cattle are given unlimited access to water after it's unavailable for a while.
161
How does water intoxication lead to hemolysis?
Decreased osmolality (water increases too fast) of plasma.
162
What can make water intoxication more severe?
Iron deficiency anemia
163
What virus induces hemolysis?
Equine infection anemia "Swamp fever"
164
What are 4 inherited RBC membrane defects?
Spherocytosis
Elliptocytosis
Stomatocytosis
Membrane transport defects
165
What dog breeds show pyruvate kinase deficiency? (4 things)
Basenji
Beagle
Westies
Cairn terriers
166
What signs do you see with pyruvate kinase deficiency? (5 things)
```
Moderate to marked anemia
Marked reticulocytosis
Myelofibrosis
Sclerosis
Death by age 4
```
167
What cat breeds show pyruvate kinase deficiency? (3 things)
Abyssinian
Somali
DSH
168
What do you not see in cats with pyruvate kinase deficiency?
Osteosclerosis, cats can live to old age
169
What dog breed do you see phosphofructokinase deficiency in?
English Springer Spaniel
170
What clinical signs do you see with phosphofructokinase deficiency?
PCV will be normal to low normal
| Will see hemolytic crisis when alkalemic
171
What causes porphyria?
Deficiency of uroporphyrinogen III co-synthetase
172
What is porphyria?
An inability to synthesize hemoglobin
173
What are clinical signs of porphyria? (3 things)
Pink teeth and bones
Photosensitivity
Decreased RBC survival
174
What's special about porphyria in pigs?
No photosensitization
175
What's special about porphyria in cats?
No anemia
