Erythrocytes Flashcards
1
Q
What is an erythron?
A
All erythroid cells in an animals
2
Q
What is erythropoiesis a part of?
A
Hematopoiesis
3
Q
What is erythropoietin produced by?
A
Fetal liver and adult kidney
Renal peritubular interstitial cells in response to hypoxia
4
Q
What is hypoxia?
A
Anemia
Poor oxygenation of the blood
Decreased renal perfusion
5
Q
What signals erythrocytes to stop dividing?
A
Increasing Hgb concentrations
6
Q
What is produced for protein synthesis including Hgb?
A
RNA
7
Q
What leads to nucleus extrusion in mammals?
A
Maturation of erythrocytes
8
Q
What is a reticulocyte?
A
An erythrocyte without the nucleus but with high concentration of RNA
9
Q
What happens to old erythrocytes?
A
Loose metabolic ability to keep deformability
Expose hidden antigens in the membrane that naturally occurring antibodies bind to mediating erythrocyte destruction
10
Q
What is hemoglobin?
A
Tetramer of four globin molecules and bound to a internal Heme molecule
11
Q
Why can heme alone not transport O2?
A
It has a Ferrous ion associated and that cannot transport O2
12
Q
What percent of CO2 from tissues binds to Hgb? What happens with the rest of CO2?
A
20%
It reacts with H2O to form H+ hand HCO3-
13
Q
What happens in order to excrete CO2 from the lungs?
A
The reaction is reversed
14
Q
What is porphyria?
A
Increased concentration of porphyrins in erythrocytes, plasma, or urine
Can be acquired or congenital
15
Q
What percent of iron is in erythrocytes?
A
50-70%
16
Q
What percent of iron is in storage?
A
25-40%
17
Q
What is absorption of iron regulated by?
A
Hepcidin
18
Q
What is hepcidin produced by?
A
Hepatocytes
19
Q
What decreases hepcidin production? What then happens to iron absorption?
A
Hypoxia
Fe absorption decreases
20
Q
What increases hepcidin production?
A
Inflammation
21
Q
What stains RNA and mitochondria?
A
New methylene blue causing a reticulated or punctuated structure look in erythrocytes cytoplasm
22
Q
What are the types of reticulocytes?
A
Most species are all RNA rich erythrocytes will be called reticulocytes
Cats have punctuate with 2-6 granules and aggregate with large aggregates
23
Q
What is reticulocytosis?
A
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
Q
What is the level of reticulocytes like in cattle and dogs when looking for erythropoiesis?
A
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?
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Mild to moderate anemia
presence or absence of reticulocytes/polychromasia
Schistocytes
Keratocytes
Acanthocytes
Thrombocytopenia
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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?
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Autonomous erythropoiesis (not dependent on EPO)
Mild to marked erythrocytosis --> increased viscosity of blood --> poor tissue perfusion --> secondary EPO production
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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
