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DWT > Clinical Pathology 3: Bilirubin And Hemolytic Anemia > Flashcards

Clinical Pathology 3: Bilirubin And Hemolytic Anemia Flashcards

1
Q

Approximately 1% of RBC are destroyed and replaced daily. What does it mean when the rate is greater than 1%?

A

Hemolysis

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2
Q

What is hemolysis

A

Processing of a RBC by a macrophage

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3
Q

What are the two types of hemolysis

A
  1. Extravascular
  2. Intravascular
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4
Q

Extravascular hemolysis

A

RBC destruction occurs outside of the blood vessels via phagocytosis by macrophages

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5
Q

Intravascular hemolysis

A

RBC destructions occurs within the blood vessels.

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6
Q

Hemoglobin from Intravascular hemolysis can result in what?

A

Injury to tissue (hemoglobinuric nephrosis)
- Must be scavenged by the body before damage occurs

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7
Q

When a red blood cell is digested by a macrophage what is the waste product?

A

Unconjugated bilirubin

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8
Q

Icteric

A

Jaundice

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9
Q

What is haptoglobin?

A

The scavenging system for hemoglobin
— haptoglobin bind hemoglobins and takes it to the liver to be processed into billirubin

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10
Q

What will the plasma and urine look like when hemoglobin<haptoglobin

A

Normal

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11
Q

If there is more hemoglobin than haptoglobin What are the potential outcomes?

A
  1. Hemoglobinemia
  2. Hemoglobinuria
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12
Q

What is hemoglobinemia?

A

Red plasma
- Intravascular hemolysis

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13
Q

What is hemoglobinuria

A

Red urine from freely floating hemoglobin passing through the glomerulus into the urine
- From Intravascular hemolysis

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14
Q

What is hyperbilirubinemia?

A

Too much billirubin in the blood from either Extravascular or intravascular hemolysis

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15
Q

What is Bilirubinuria?

A

Presence of billrubin in the urine

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16
Q

Causes of hemolysis

A

Infection, Oxidative injury, immune-mediated RBC destruction

17
Q

Hemolysis caused by infection: identification method

A

Blood smear: characteristic RBS parasites

18
Q

Hemolysis caused by infection: causes

A

Infectious agents (Ex: Anaplasma)

19
Q

Forms of hemolysis caused by infectious agents

A

Intravascular hemolysis: RBC membrane instability
Extravascular hemolysis: Splenic macrophage identifying infected cell and phagocytes

20
Q

Hemolysis caused by oxidative injury: Causes

A
  • Ingestion of: garlic, onions zinc (dogs), Tylenol (cats), red maple leaves (horses), Copper( sheep and goats
  • CRI of propofol
21
Q

Hemolysis caused by oxidative injury: diagnostic method

A

Blood smear:
- Heinz bodies
- Eccentrocytes
- Pyknocytes
- Ghost cells

22
Q

Hemolysis caused by Immune-mediated destruction: What happens?

A

Anti-RBC antibodies are formed and attach to surface of RBC.

23
Q

Hemolysis caused by Immune-mediated destruction: Results

A
  • Complete phagocytosis by splenic and hepatic macrophages (EVH)
    -Partial phagocytosis by splenic and hepatic macrophages. Bites off part of RBA membrane —> sphere types (EVH)
    -MAC formation (IVH)
24
Q

Hemolysis caused by Immune-mediated destruction: causes

A
  • Primary autoimmune
  • Secondary autoimmune (due to drugs)
    — Penicillin in horses, phenobarbital
    -Alloantibodies
25
Q

What is an alloantibody

A

Where antibodies attack RBC
- Maternal antibodies via colostrum attack kitten/foal RBC
- Incompatible blood transfusion

26
Q

Hemolysis caused by Immune-mediated destruction: laboratory findings / Diagnosis method

A

Blood smear:
- Spherocytes (difficult to recognize on cats and horse as they have little central pallor)

Positive direct anti globulin test:
- recognizes Antibody on RBC surface

27
Q

Auto-agglutination

A

Immune-mediated anemia:
IgM autoantibody, cross links to other RBCs via antibody
-Strongly regenerative anemia

28
Q

Fasting hyperbilirubinemia

A

-Horses and Sm Ru
-Increased bilirubin bc hepatocytes are busy metabolizing Fat
- INcreased Unconjugated bilirubin

DWT (28 decks)

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