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Flashcards in Erythrocytes Deck (228):
1

What is an erythron?

All erythroid cells in an animals

2

What is erythropoiesis a part of?

Hematopoiesis

3

What is erythropoietin produced by?

Fetal liver and adult kidney
Renal peritubular interstitial cells in response to hypoxia

4

What is hypoxia?

Anemia
Poor oxygenation of the blood
Decreased renal perfusion

5

What signals erythrocytes to stop dividing?

Increasing Hgb concentrations

6

What is produced for protein synthesis including Hgb?

RNA

7

What leads to nucleus extrusion in mammals?

Maturation of erythrocytes

8

What is a reticulocyte?

An erythrocyte without the nucleus but with high concentration of RNA

9

What happens to old erythrocytes?

Loose metabolic ability to keep deformability
Expose hidden antigens in the membrane that naturally occurring antibodies bind to mediating erythrocyte destruction

10

What is hemoglobin?

Tetramer of four globin molecules and bound to a internal Heme molecule

11

Why can heme alone not transport O2?

It has a Ferrous ion associated and that cannot transport O2

12

What percent of CO2 from tissues binds to Hgb? What happens with the rest of CO2?

20%
It reacts with H2O to form H+ hand HCO3-

13

What happens in order to excrete CO2 from the lungs?

The reaction is reversed

14

What is porphyria?

Increased concentration of porphyrins in erythrocytes, plasma, or urine
Can be acquired or congenital

15

What percent of iron is in erythrocytes?

50-70%

16

What percent of iron is in storage?

25-40%

17

What is absorption of iron regulated by?

Hepcidin

18

What is hepcidin produced by?

Hepatocytes

19

What decreases hepcidin production? What then happens to iron absorption?

Hypoxia
Fe absorption decreases

20

What increases hepcidin production?

Inflammation

21

What stains RNA and mitochondria?

New methylene blue causing a reticulated or punctuated structure look in erythrocytes cytoplasm

22

What are the types of reticulocytes?

Most species are all RNA rich erythrocytes will be called reticulocytes
Cats have punctuate with 2-6 granules and aggregate with large aggregates

23

What is reticulocytosis?

Semiquantitative evidence of erythropoiesis
Cats: aggregate started at 2 days, peaks at 4 days; punctate is mild in day 1, peaked at 7-14 days

24

What is the level of reticulocytes like in cattle and dogs when looking for erythropoiesis?

Starts 3-4 days and peak 7-14 days

25

What is the level of reticulocytes like in cats when looking for erythropoiesis?

Aggregate started at 2 days, peaks at 4 days
Punctate is mild in day 1, peaked at 7-14 days

26

What is the level of reticulocytes like in horses when looking for erythropoiesis?

They rarely will have circulating reticulocytes

27

What is polychromasia?

Increased numbers of basophilic erythrocytes in the blood smear

28

What does increased reticulocytes mean?

That bone marrow is responding to EPO

29

What is an erythogram?

Morphologic evaluation
Hematocrit or PCV
Hgb concentration Erythrocytes count
Wintrobe's erythrocytes indices
Nucleated erythrocytes

30

What is a part of the Wintrobe's erythrocytes indices?

MCHC
MCV
MCH

31

What is MCHC?

Average of 100 mL of erythrocytes [Hgb]

32

What is MCV?

Average of erythrocytic volume

33

What is MCH?

Average [Hgb] per average sized erythrocytes

34

How are nucleated erythrocytes counted?

Per 100 leukocytes and if they are present, it is necessary to correct the leukocytes count

35

How are nRBCs usually reported?

#/100 WBC
So, if nRBC= 50/100 WBC that could be a lot or very few
If WBC= 500 μL, nRBC would be 250/μL
If WBC= 50,000 μL, nRBC would be 25,000/μL

36

What is the reticulocyte concentration?

#/μL or L
RC= RP x [RBC]

37

What is the reticulocyte percentage or reticulocyte count?

# of reticulocytes per 100 erythrocytes
Percentage of erythrocytes that are reticulocytes in the blood

38

What is the corrected reticulocyte percentage?

Calculated number if RP if animal was not anemic but had the same RC
CRP= RP x (patient's Htc/avg Hct for species)

39

What are dicocytes?

Mature normal erythrocytes

40

What is rouleaux caused by?

Charges interactions

41

What does agglutination occur in?

Immune hemolytic anemia

42

How is agglutination different from rouleaux?

Will not form stacks of cells
Cannot use a saline dispersion test

43

What is rubricytosis?

Increased number of nRBCs in the blood

44

When is rubricytosis appropriate?

Response to EPO stimulus
With reticulocytosis

45

When is rubricytosis inappropriate?

Loss of control of nRBC release from BM
BM damage
Extramedulary hematopoiesis
Splenic contraction
Splenectomy
Lead poisoning in dogs
BM dyscrasia in poodles with macrocytosis

46

What is central pallor?

Central area of an erythrocytes that is more clear because it is thinner
Increased is hypochromasia
Decreased is abnormal shape

47

What is a ghost cell?

Complement mediated intravascular hemolysis
Artifact

48

What is a hypochromic erythrocyte?

Hyperchromasia: increased number of hypochromic erythrocytes
Decreased MCHC and CHCM
Decreased RBC [Hgb]
Fe deficiency

49

What is a polychromatophil?

An erythrocyte with enough RNA to stain basophilic with Wright stain

50

What reflects accelerrated erythropoiesis?

Polychromasia and reticulocytosis

51

What is the preferred method for evaluating marrow response to anemia?

Reticulocyte concentration

52

Describe anaplasma marginale in erythrocytes

0.5 μm small coccus in the internal margin of the erythrocyte
Usually one, but possibly multiple per cell
Causes hemolysis (immune mediated)

53

Describe anaplasma centrale in erythrocytes

0.5 μm small coccus within the erythrocyte
Usually one, but possibly multiple per cell
Causes hemolysis (immune mediated)

54

Describe Babesia in erythrocytes

Intracellular, oval to teardrop trophozoites
Variable sizes
Pale blue with a darker outer membrane and a purple eccentric nucleus
Hemolus: immune mediated, protease activity, decreased cell pliability, oxidative damage

55

Describe Cytauxzoon felix in erythrocytes

Intacellular, oval, 0.1 to 2 μm with outer thin rim and eccentric nucleus
One to several per cell
Anemia: inflammation, BM damage, hemolysis

56

Describe distemper (dogs) in erythrocytes

Round to variably shaped, pale blue to pink, homogeneous inclusions
0.3 to 3 μm
Diff-quick is better to see than Wright stain
Active distemper infection

57

Describe Mycoplasma (cattle) in erythrocytes

Rind, rod, or cocci on erythrocytes' surface
0.3 to 3 μm
Immune hemolysis

58

Describe Mycoplasma hemocanis in erythrocytes

Thin chain of cocci
Immune hemolysis

59

Describe Mycoplasma hemofelis in erythrocytes

Thin chain of cocci, small rings, pale blue to purple
Less than 0.1 μm
Immune hemolysis

60

Describe Candidatus Mycoplasma haemominutum in erythrocytes

Coccie 0.1 to 0.2 μm, individual or short chains
Immune hemolysis

61

Describe Theileria in erythrocytes

Pleomorphic piroplasm: cocci. rings, rods, pears, and maltese crosses
Anemia: immune, protease, decreased cell pliability, and oxidative damage

62

What are causes of basophilic stippling?

Regenerative anemia
Plumbism

63

What is the pathogenesis of regenerative anemia?

Persistence of ribosomal RNA

64

What is the pathogenesis of plumbism?

Inhibition of pyrimidine 5'-nucleotidase

65

How does a Heinz body develop?

Exposure to oxidants
Pathogenesis: oxidized Hgv precipitates

66

How does a Howell-Jolly body develop?

Increased erythropoiesis, decreased splenic function
Pathogenesis: nuclear remnant free in the cytoplasm

67

How do siderotic granules develop?

Excess Fe in the body, plumbism in dogs, myeloproliferative diseae
Pathogenesis: Fe accumulates in damaged mitochondria or in autophagocytic vacuoles

68

How does an acanthocyte develop?

Hemangiosarcoma; splenic, hepatic, and renal disorders
Pathogenesis: not known how it is formed in domestic mammals, possible changes in membrane lipids or erythrocyte fragmentation

69

How does a codocyte (mexican hat cell) develop?

Regenerative anemias; hepatic, renal, and lipid disorders
Pathogenesis: excess membrane relative to Hgb content, possibly membrane lipid changes

70

How does a dacrocyte develop?

Marrow diseases such as myelofibrosis and neoplasia (pathogenesis: unknown formation mechanism)
Artifact (pathogenesis: stretching during film preparation

71

How does an eccentrocyte form?

Exposure to oxidants, G6PD or FAD deficiencies
Pathogenesis: fusion of damaged membranes

72

What are the different types of echinocytes?

Irregularly shaped cells (type I)
Regularly spaced blunt projections (type II)
Regularly spaced pointed projections (type III)

73

What is the pathogenesis of echinocytes?

Erythrocyte dehydration, strenuous exercise, doxorubicin toxicosis, antonic in dogs, PK deficiency in dogs, rattlesnake and coral snake envenomation

74

What are crenated erythrocytes?

Always an artifact
Features of types I, II, and III echinocytes
All echinocytes should be considered artifact until proven otherwide

75

How does a keratocyte develop?

Vasculitis, intravascular coagulation, hemangiosarcoma, caval syndrome, endocarditis
Pathogenesis: trauma, oxidative injury, vesiculation have been proposed

76

How does an ovalocyte develop?

Protein band 4.1 deficiency in dogs, myelofibrosis, idiopathic in cats, iron deficiency
Pathogenesis: abnormal membrane proteins in hereditary forms, otherwise unknown

77

How do pyknocytes develop?

Exposure to oxidants
Pathogenesis: likely formed from eccentrocytes

78

How does a schistocyte develop?

Intravascular coagulation, vasculitis, hemagiosarcoma, caval syndrome, endocarditis
Pathogenesis: trauma

79

How do spherocytes develop?

Immune hemolysis, fragmentation hemolysis, envenomation, clostridial infections
Pathogenesis: membrane loss due to macrophages partial phagocytosis, trauma

80

How does a stomatocyte develop?

Young erythrocytes, herediatry stomatocytosis in dogs
Pathogenesis: folding of excess membrane

81

What is the pathogenesis of torocytes?

Artifact
Do not confuse these with hypochromia

82

What is anemia?

Decreased Hct, [Hgb], [RBC]
Pathological state, not a disease

83

What are causes of anemia?

Loss
Destruction
Lack of production

84

What is a regenerative anemia?

With reticulocytosis (increased number of reticulocytes)
Following blood loss or erythrocyte destruction (hemolysis); erythroid neoplasia in cats; resolution of nonregenerative anemia
Show active erythropoiesis
May be blunted by other concurrent conditions

85

What is a nonregenerative anemia?

Without reticulocytosis (normal or decreased numbers of reticulocytes)
Defective or reduced erythrocyte production
Persistent status shows that BM is not able to produce cells

86

When does reticulocytosis occur?

3-4 days after EPO stimulus and will peak at 7-10 days

87

What is normocytic?

Based on MCV
Maturation is not defective

88

What is macrocytic?

Based on MCV
Presence of reticulocytes or defective cells

89

What is microcytic?

Based on MCV
Extra mitosis (Fe deficiency); fragments

90

What is normochromic?

Based on MCHC/CHCM
Hgb synthesis is complete

91

What is hypochromic?

Based on MCHC/CHCM
Hgb synthesis is incomplete (young cells or defective synthesis)

92

What is hyperchromic?

Based on MCHC/CHCM
RBCs were not produced hyperchromic. Either lost volume in vitro or artifact

93

What is normocytic normochromic?

Blood smear has uniform erytrocytes
Most anemias begin as normocytic normochromic
Most anemias in the horse are this

94

What is macrocytic hypochromic?

Expect anisocytosis and polychromasia on the blood smear (do not see hypochromic cells, see polychromatophils)
Anemia probably due to blood loss or hemolysis

95

What is macrocytic normochromic?

Anisocytosis and possibly polychromasia on the blood smear
Common in blood loss and hemolysis
Occasionally defective erythopoiesis (FeLV, Folic acid and Cobalamin, Erythroleukemia)
Artifact (erythrocyte agglutination, cell swelling during storage, In vivo hyperosmolar state, too little blood and too much K-EDTA)

96

What is microcytic hypochromic?

Microcytosis, codocytosis, hypochromasia, and anisocytosis on blood smear
Defective Hgb synthesis (Fe deficiency, Copper deficiency, Possibly Vit B6 deficiency

97

What are causes of microcytic normochronic anemias?

Hepatic failure: hepatic disease, or portosystemic shunt
Foals and kittnes (lower MCV); Akitas and Shibas
Hereditary disease

98

What is normocytic hypochromic?

Uncommon: likely inaccurate data, or inadequate reference interval
Possible with Fe deficiency

99

What is macrocytic hyperchromic?

Falsely increased MCHC
Compare to CHCM

100

What is normocytic hyperchromic?

Flasely increased MCHC
Compare to CHCM

101

What is microcytic hyperchromic?

Hypoosmolar plasma cell (cell shrinkage)
If MCHC is flasely increased, think of other causes for microcytic anemias

102

What is the problem with a increased MCHC or CHCM?

It is not physiologically possible: Hgb production stops when optima [Hgb] is reached
Mostle falsely increased with falsely increased MCH

103

What are causes of increased MCHC or CHCM?

CHCM is not affected
Hemolysis
Oxyglobin
Interferences on Hgb tests: lipid droplets, markedly icteric sample, extreme leukocytosis, precipitated IgA

104

What are examples of true cases of increased MCHC?

Eccentrocytosis and pyknocytosis; spherocytosis

105

What are the most common cause of nonregenerative anemias?

Decreased RBC production
Defective erythopoiesis

106

What is the life span of erythrocytes?

2-5 months: dogs- 100 days, cats- 70 days, cattle and horses-150 days

107

What will most diseases do to the production of erythrocytes?

Slow down production, but will not stop completely

108

What determines the severity of nonregenerative anemia?

Duration of disease
Degree of erythropoiesis decrease
Presence/absence of processes that shorten the RBC life span

109

What is the most common cause of nonregenerative anemia in domestic mammals?

Inflammatory disease (AID: anemia of inflammatory disease)

110

What type of anemia
morphology usually occurs with inflammatory disease?

Normocytic normochromic

111

What is the pathogenesis of nonregenerative anemia caused by inflammatory disease?

Shortened RBC survival
Impaired Fe mobilization or utilization
Impaired RBC production

112

What are the ab findings of nonregenerative anemia caused by inflammatory disease?

Normocytic normochromic
Mild to moderate
Hyperproteinemia
BM: normal to mildly decreased erythropoiesis
Hypoferremia

113

What is the anemia severity with chronic renal disease?

Mild to moderate

114

What is the pathogenesis of nonregenerative anemia caused by chronic renal disease?

Inadequate EPO production
Decreased RBC life span
Decreased BM response to EPO
Possible hemorrhage or nutritional status

115

What are the lab findings for a nonregenerative anemia caused by chronic renal disease?

Normocytic normochromic
Evidence of chronic renal disease, such as azotemia, isostenuria, and electrolyte disturbances

116

What are some diseases causing marrow hypoplasia or aplasia of several cell lineages that cause nonregenerative anemia?

Idiopathic
Infectious agents
Toxicosis
Irrafiation
Myelophtisis (marrow replacement)

117

Describe how diseases that cause marrow hypoplasia or aplasia of several cell lineages cause nonregenerative anemias

One or more BM components could be affected: blood vessels, sinusoids, reticular adventitial cells, marrow stroma, hematopoietic stem cells
Nonreversible or reversible damage

118

How can infectious agents cause nonregenerative anemia?

Direct cell damage; myelitis or secondary effects
Suppression with bacterial septicemias
Ehrlichiosis: disseminated micosis, viral infections, protozoal infections

119

How does cytauxzoonosis cause nonregenerative anemia?

Piroplasms in RBCs and schizonts in macrophages
Clinically: rapid progression and highly fatal

120

What is the anemia morphology associaated with nonregenerative anemias caused by cytauxzoonosis?

Normocytic normochromic

121

What are diseases causing erythroid hypoplasia or ineffective erythropoiesis that cause nonregenerative anemias?

Pure red cell aplasia
Immune-mediated nonregenerative anemia
FeLV
Nutrient deficiencies (Iron, Copper, Folate, Cobalamin, endocrine disorders (hypothyroidism, hypoadrenocorticism)
Hyperestrogenism
Liver disease or failure

122

What is the pathogenesis of pure red cell aplasia?

Humans: viral or immune mediated
Not clear in dogs and cats

123

What are the lab findings with nonregenerative anemia caused by pure red cell aplasia?

Normocytic normochromic
Spherocytes
Coomb's test positive
BM with erythroid severe hypoplasia or aplasia

124

What is immune-mediated nonregenerative anemia?

Similar to aplastic anemia, but BM with left shift and maturation arrest, or persistent erythroid hyperplasia and nonregenerative anemia
Coomb's positive

125

What is the pathogenesis of FeLV for causing nonregenerative anemia?

Precursor cell damage and following hypoplasia
Neoplastic transformation caused by mutations, producing a defective cell that may not be able to mature properly

126

What are the lab findings for nonregenerative anemia caused by FeLV?

Normocytic normochromic or macrocytic normochromic
Inappropriate rubricytosis
Dysplastic RBCs

127

How does an iron deficiency cause a nonregenerative anemia?

Chronic external blood loss or inadequate dietary Fe intake

128

What is the morphology of the nonregenerative anemia caused by Fe deficiency?

Microcytic hypochromic, but possible microcytic normochromic

129

What does a deficiency in folate and cobalamin lead to?

Abnormal cell production because they are required for DNA synthesis

130

What are the findings with a nonregenerative anemia due to a folate and cobalamin deficiency?

Macrocytic (or normocytic) normochromic

131

How does hypothyroidism case nonregenerative anemia?

Decreased metabolic rate leading to decreased oxygen need. That causes decreased EPO which leads to anemia

132

What are the lab findings for nonregenerative anemia due to hypothyroidism?

Normocytic normochromic
Evidence of thyroid dysfunction

133

What are the lab findings for nonregenerative anemia due to hypoadrenocorticism?

Normocytic normochromic
Evidence of adrenal dysfunction

134

How does hyperestrogenism cause nonregenerative anemia?

Excessive production or iatrogenic

135

What is the morphology of the nonregenerative anemia caused by liver disease/failure?

Normocytic normochromic

136

What is the pathogenesis of nonregenerative anemia caused by liver disease/failure?

AID
Defective amino acids, protein, and lipid metabolism affecting RBC membranes and life span
Dogs: not total Fe deficiency, but possible functional Fe deficiency

137

What are the lab findings for nonregenerative anemia due to liver disease/failure?

Normocytic (or microcytic) normochromic
Findings are consistent with hepatic disease

138

What are causes of blood loss anemia?

Hemorrhage
Parasitism
Donating blood for transfusions

139

Describe acute blood loss anemia

Sudden loss of blood from vessel creates hypovolemia
Shift of ECF into vessels dilutes erythrocytes and causes anemia
Splenic contraction reduces severity of anemia
Few hours after blood loss
Hemothorax or hemoperitoneum
Tissue hypoxia --> EPO production---> reticulocytes in 3-4 days (horses)

140

What are the clinical findings associated with acute blood loss anemia?

Observation of blood (gross external hemorrhage; hemothorax, hemoperitoneum)
Regenerative anemia
Hypoproteinemia

141

What can chronic blood loss anemia lead to?

Iron deficiency

142

How does chronic blood loss anemia develop?

Compensatory erythropoiesis prevents anemia for weeks to months
Fe deficiency diminishes erythropoiesis and causes mild anemia
Full blown Fe deficiency causes microcytic hypochromic anemia

143

What are the clinical findings associated with chronic blood loss?

Melena, hematuria, parasites, or their eggs/larvae
Poorly or nonregenerative anemia
Microcytic normochromic or hypochromic anemia
Marrow: erythroid hyperplasia but ineffective erythropoiesis
Mild to moderate hypoproteinemia
Hypoferremia, decreased total body Fe and decreased ferritin

144

Are young or old animals more prone to chronic blood loss? Why?

Young
Small Fe storage

145

What causes hemolytic anemia?

Increased rate of erythrocytes destruction

146

What is intravascular hemolysis?

It occurs in the blood, within blood vessels or heart

147

What is extravascular hemolysis?

Occurs outside the vessels, erythrocytes are phagocytized

148

Why should you differentiate between intravascular and extravascular hemolysis?

Different diseases cause different hemolytic anemias
Prognosis and treatment

149

Why is the classification of hemolysis a problem?

Diseases do not read books
May cause both intravascular and extravascular
May switch from one to another

150

What should you look for when examining a blood smear?

Organisms and RBCs morphologic changes

151

What are signs of hemolytic anemia?

Icterus
Bilirubinuria
Urobilinogenuria

152

What is the primary mechanism for hemolytic hemoglobinemia/hemoglobinuria?

Hgb tetramers--> Hgb dimers --> bind to haptoglobin --> hepatocytes --> (unconjugated --> conjugated bilirubin + Fe)

153

What is the secondary mechanism for hemolytic hemoglobinemia/hemoglobinuria?

Hgb tetramers --> Hgb dimers --> bind to hemopexin --> hepatocytes --> (unconjugated --> conjugated bilirubin + Fe)

154

What is the overflow mechanism for hemolytic hemoglobinemia/hemoglobinuria?

Hgb tetramers --> Hgb dimers --> glomerular filtration --> hemoglobinuria

155

What causes immune-mediated hemolytic anemias?

Animal produces Ig that bind directly or indirectly to RBC surface (erythrocyte surface associated immunoglobulin: ESAIg)
If Ig, fix complement MAC can cause hemolysis

156

What can ESAIg be?

IgM
IgG
IgA

157

What is used to detect ESAIg or complement factors on RBC surface?

Coomb's test

158

What are the clinical findings associated with IMHA (idiopathic immune hemolytic anemia)?

Regenerative anemia
Icterus
Possibly hemoglobinuria
Spherocytosis
Positive Coomb's or flow cytometry for ESAIg
Acute inflammatory leukogran
Lack findings of other immune hemolytic anemia

159

What drugs can induce hemolyic anemia?

Penicillin (horse)
Propylthiouracil (cats)
Cephalosporins (suprapharmological doses in dogs)
TMS (horses)
Lecamisole (dogs)
Pirimicarb (dogs)

160

What can vaccine-induced hemolytic anemia occur in?

Dogs

161

How does neonatal isoerythrolysis cause alloimmune hemolysis?

Colostral Ig --> intestinal absorption --> bind to RBCs paternally inherited antigens
Cats: Anti-A antibodies
Horses: Anti-A or anti-Q antibodies
Dogs: possible anti DEA 1.1

162

How does an incompatible blood transfusion cause alloimmune hemolysis?

Donor's erythrocytes are attacked by recipient's antibodies

163

What causes feline infectious anemia?

Feline hemic Micoplasma spp.
M. hemofelix is more pathogenic and larger
Candidatus M. Haemominuturm is considered opportunistic

164

What can happen during feline infectios anemia caused by Micoplasma?

Parasitemia is usually present during hemolysis but may disappear fast
May detach from RBCs

165

How does canine hemic Mycoplasma spp cause hemolytic anemia?

M. haemocanis: splenectomized or immunologically compromised dogs
May detach from RBCs

166

What are otehr mycoplasma spp that cause hemolytic anemias?

M. haemosuis and M. parvum in pigs
M. wenyonii in cattle
Candidatus M. haemolamae in llamas and alpacas

167

What is the pathogenesis of hemothropic mycoplasma species causing hemolytic anemia?

Immune-mediated mechanisms

168

What are the lab findings with hemothropic mycoplasma species causing hemolytic anemias?

Mycoplasma spp on erythrocytes (most numerous when Hct is falling)
Moderate to severe anemia
Reticulocytosis/polychromasia
Hyperbilirubinemia/hyperbilirubinuria
Positive Coomb's test
Spherocytosis
Autoagglutination
PCR positive for Mycoplasma spp

169

What Anaplasma spp can cause hemolytic anemia?

Anaplasma marginale (cattle)
Anaplasma ovis (sheep and goats)
Anaplasma centrale (cattle)

170

What is the pathogenesis of hemolytic anemias caused by Anaplasma spp?

Immune-mediated

171

What are the lab findings for hemolytic anemia caused by Anaplasma?

Moderate to severe anemia
Reticulocytosis/polychromasia
Mild to marked hyperbilirubinemia/hyperbilirubinuria
PCR positive for Anaplasma spp

172

What Leptospira spp can cause hemolytic anemia?

L. interrogans serovars pomona and icterohemorrhagica

173

What do L. interrogans serovars pomona and icterohemorrhagica cause?

Do not infect RBCs
Cause vasculitis, infection of liver and kidneys --> hemolytic state in calves, lambs, and pigs

174

What is the pathogenesis of hemolytic anemia caused by Leptospira?

Immune-mediated (IgM clod agglutinins or Leptospiral phospholipase)

175

What are the lab findings associated with hemolytic anemia caused by Leptospira?

Moderate to severe anemia
Hemoglobinemia/hemoglobinuria
Hyperbilirubinemia/hyperbilirubinuria
Neutrophilia
Leptospiral spirochetes in urine or other fluids
4-fold increase in titers for pomona and icterohemorrhagica serovars
Positive PCR for Leptospira spp

176

What Clostridium spp cause hemolytic anemia?

C. haemoliticum
C. novyii type D
C. perfringens type A

177

What do C. haemoliticum and C. novyii type D cause in cattle and sheep?

Bacillary hemoglobinuria

178

What is the pathogenesis of hemolytic anemia caused by C. haemoliticum and C. novyii type D?

Beta-toxin with phospholipase and lecithinase activity

179

What are the lab findings associated with hemolytic anemia caused by C. haemoliticum and C. novyii?

Severe anemia
Hemoglobinemia/hemoglobinuria

180

How can you diagnose hemolytic anemia caused by C. haemoliticum and C. novyii postmortem?

Bacilli in spleen and liver or fluids
Culture

181

What does C. perfringens type A cause in lambs and calves?

Yellow lamb disease

182

What is the pathogenesis of hemolytic anemia caused by C. perfringens type A?

Alpha-toxin with phospholipase C activity

183

What are the major lab findings more hemolytic anemia caused by C. perfingens type A?

Acute severe cases: anemia; hemoglobinemia/hemoglobinuria; icterus
Less severe: anemia; polychromasia/reticulocytosis; rubricytosis; leukocytosis

184

What is Equine Infectious Anemia Virus?

Retrovirus that infect cells from the mononuclear phagocytic system in horses, mules, donkeys, and ponies
Disease: equine infectious anemia

185

What is the pathogenesis of EIA?

Production of TNF and other cytokines that decrease RBC production
Hemolysis: immune complexes or complement adhered to RBCs --> extravascular hemolysis

186

What are the lab findings associated with EIA?

Acute: intravascular hemolysis, hemoglobinemia
Chronic: extravascular hemolysis
Macrocytosis, thrombocytopenia, neutropenia, neutrophilia, positive Coomb's test, positive Coggin's test

187

What is the pathogenesis of FeLV?

Decreased RBC production

188

What can FeLV predispose the cat to?

Mycoplasma spp infectio or can cause immune hemolytic anemia

189

What is the pathogenesis for hemolytic anemia caused by Babesia?

Nonhemolytic and hemolytic processes
Hemolytic: proteases, immune-reaction to parasitized RBCs, oxidative damage to RBCs

190

What are the lab findings for hemolytic anemia caused by Babesia?

Chronic: few/rare organisms in RBCs, mild anemia, mild lymphocytosis, seropositive and PCR positive for Babesia spp
Acute or subacute: many organisms in RBCs, moderate to severe anemia, reticulocytosis/polychromasia, macrocytosis, hyperbilirubinemia/bilirubinuria, possiblee hemoglobinuria, possible spherocytosis, and occasionally eccentrocytosis

191

What species of Theileria can cause hemolytic anemia?

Theileria buffeli

192

What is the pathogenesis associated with hemolytic anemia caused by Tehileria buffeli?

It is not clear

193

What are the lab findings wtih hemolytic anemia caused by Theileria buffeli?

Organisms in RBCs, macrocytosis, polychromasia, basophili stippling, lymphocytosis, hyperbilirubinemia/bilirubinuria

194

What are causes of feline heinz bodies?

Spleen with closed circulation
Feline Hgb is prone to form oxidized forms
Feline erythrocytes have lower reductive ability

195

How are Heinz bodies hemolytic anemia in cats diagnosed?

Presence of anemia
Presence of evidence of hemolysis (hyperbilirubinermia/bilirubinuria)
Presence of Heinz bodies in erythrocytes

196

What is the pathogenesis of eccentrocutic hemolytic anemias?

Eccentrocytes are more rigid and are trapped and removed by macrophages in the spleen
Eccentrocytes are more fragile and are prone to lysis

197

What can oxidative insult form?

Eccentrocytes or Heinz bodies

198

What is the pathogenesis of postparturient hemoglobinuria in cattle?

Decreased phosphate mobilization from bone and increased loss via milk production--> decreased phosphorus plasma concentration --> decreases ATP production in RBCs --> unstable RBCs membrane --> lysis

199

What are the lab findings associated with postparturient hemoglobinuria in cattle?

Hypophophatemia
Hemoglobinemia/hemoglobinuria
Moderate to marked anemia

200

What are causes of hypoosmolar hemolysis?

Rapid infusion of hypoosmolar fluids IV
Water intoxication in calves

201

What is the pathogenesis of hypoosmolar hemolysis?

Infusion of hypoosmolar fluids or large volume of water intake --> hypoosmolar plasma --> rapid movement of water into RBCs --> RBC swelling and lysis

202

What are the lab findings associated with hypoosmolar hemolysis?

Anemia
Hemoglobinemia/hemoglobinuria

203

What is the cause of erythrocyte fragmentation?

Trauma: presence of rigid structures or rheologic forces

204

What is the pathogenesis of erythrocyte fragmentation?

Erythrocyte trauma --> form poikilocytes or lysis
Primary diseases are frequently infectious or noninfectious inflammatory diseases (inflammatory process may be causing anemia)

205

What are the lab findings associated with erythrocyte fragmentation?

Mild to moderate anemia
presence or absence of reticulocytes/polychromasia
Schistocytes
Keratocytes
Acanthocytes
Thrombocytopenia

206

What is erythrocytosis?

Increased number of erythrocytes that will increase PCV and Hct

207

What is relative erythrocytosis?

When there is an increase in production of cells because there was hemo concentration due to water loss or splenic contraction

208

What is primary absolute erythrocytosis due to?

Neoplastic circulation

209

What is secondary absolute erythrocytosis due to?

Secondary to something else

210

What occurs with appropriate absolute erythrocytosis?

Hypoxia

211

What type of absolute erythrocytosis do you have if things are influencing EPO production and there is no hypoxia?

Inappropriate

212

What are causes of hemoconcentration?

Dehydration
Endotoxic shock

213

What is the most common cause of erythrocytosis in mammals?

Dehydration

214

What are the lab findings associated with hemoconcentration due to dehydration?

Hyperproteinemia
Hyperalbuminemia
Hypernatremia
Hypercholremia

215

What is endotoxic shock?

Shift of water from intravascular to extravascular space

216

What is the pathogenesis of hemoconcentration due to endotoxic shock?

Endotoxins --> endothelial cells damage --> increase permeability to proteins --> decreased oncotic pressure --> plasma fluid migrates from intravascular to extravascular

217

What are the lab findings associated with hemoconcentration due to endotoxic shock?

Mild to moderate erythrocytosis
Inflammatory leukogram
Thrombocytopenia

218

What does splenic contraction cause?

Physiologic erythrocytosis

219

What is the pathogenesis of physiologic erythrocytosis due to spenic contraction?

Physical exercise/fright/excitement --> epinephrine --> splenic contraction --> shift of RBCs from spleen to peripheral blood

220

Why is secondary appropriate erythrocytosis secondary?

Because erythropoiesis is stimulated by EPO and not autononmous

221

Why is secondary appropriate erythrocytosis appropriate?

Because EPO is increased due to hypoxia

222

What is erythrocytosis caused by?

Increased production

223

What are causes of secondary appropriate erythrocytosis?

Cardiac diseases
Pulmonary disorders
Hyperthyroidism: increased metabolic rate --> increased oxygen consumption --> increased hypoxia --> increased EPO production
Physiologic (high altitudes, prolonged exercise training)

224

What is the pathogenesis of secondary appropriate erythrocytosis caused by physiologic changes?

Hypoxemia or increased oxygen consumption --> sustained renal tissue --> hypoxia --> increased EPO produtcion --> increased erythropoiesis --> erythrocytosis

225

What is the cause of secondary inappropriate erythrocytosis?

Inappropriate increased EPO production due to renal cysts, renal neoplasma, or other benign neoplasms that are not renal

226

What is the cause of primary erythrocytosis?

Autonomous erythropoiesis (not dependent on EPO)
Mild to marked erythrocytosis --> increased viscosity of blood --> poor tissue perfusion --> secondary EPO production

227

What disorders are associated with primary erythrocytosis?

Neoplastic or nonneoplastic disease that lead to increased RBC production independent of EPO

228

What disorders are associated with polycythemia vera?

Neoplastic disease of erythroid, myeloid, and megakacariocytic cell lines