Approach to the Anemic patient pt 1 Flashcards
What is Anemia?
Reduced oxygen-carrying capacity from insufficient hemoglobin and red blood cell mass within the vasculature.
What are the 3 broad categories of anemia?
Loss, destruction and hypoplaisa.
When should you suspect anemia?
Weakness/lethargy/collapse
Pale gums
Icterus (bilirubin is product of RBC breakdown)
Recent trauma
Melena
Obvious blood loss
Breathing changes (tissues crying for O2 so takes more breathes)
Heart murmur- change of blood viscosity.
Bounding or weak pulses,
Abdominal effusion
Does acute or chronic anemia usually lead to worse clinical signs?
Acute rapid moderate drops in hemoglobin can lead to more severe clinical signs
the body can adapt to anemia if given time so chronic gradual reduction will have less severe signs.
Which tests are used to confirm the anemia?
The Packed cell volume (PCV) and total solids (TS)
Complete blood count- hematocrit, blood smear, and reticulocyte sounts.
T/F rapid blood loss cannot be confirmed with bloodwork
True- Hct and PCV are measuring the percentages of RBCs in your blood –> rapid loss patient will have minimal changes as changes can take a few hrs.
Which 2 categories of anemia would TS not be affected?
Destruction and lack of production- only RBCs be affected
Loss- you lose everything that makes up the blood volume.
What would the PCV/TS results be for each of the 3 categories of anemia?
Blood loss: early- normal PCV, slightly increased or normal TS due to fluid shifting. Later- low PCV, Low TS
Destruction: Low PCV, normal or increased TS
Lack of production: Low PCV, normal or increased TS
What would the CBC results be for each of the 3 categories of anemia?
Blood loss: early- pre-regenerative low or normal reticulocytes. normocytic, normochromic. Later- regenerative, marocytic, hypochromic, polychromasia, maybe some nucleated RBCs
Destruction: inflammatory leukogram, reticulocytosis, sperocytosis, macrocytic, hypochromic
Lack of production: Low reticulocytes, normocytic, hypochromic
What are the 2 different types of Blood loss anemia
Acute- trauma, coagulopathy, cancer
Chronic- parasites, ulcers, cancer
What are the different causes of hemolytic (destruction) anemia?
Commonly immune-mediated, sometimes infections, oxidative damage/toxins.
Hemolysis can be intravascular or extravascular or both
T/F you will see icterus with extravascualr hemolysis
True
What are the different causes of hypoplastic anemia (lack of production)?
Refractory anemia- anemia of chronic diseases/anemia of chronic inflammation, renal failure or iron deficiency
Bone marrow disorders
BM disorders often require aspirate or biopsy for diagnosis
What are the important features about ZInc Toxicity?
Young dogs common, vomiting common, moderate to severe regenerative anemia. Hyperbilirubinemia, inflammatory leukogram
WILL LOOK LIKE IMHA
