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Exam 1 Flashcards

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1
Q

Anemia

A

Decrease in red cell mass

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2
Q

Anemia causes 3

A

Loss of RBC, Destruction of RBC (Hemolysis), Failed production of RBC

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3
Q

reticulocytes

A

immature RBC, see increase In bone marrow at 2-3 days and peak at 7 to 10 days

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4
Q

Definitive of regenerative anemia

A

reticulocyte counts

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5
Q

Subjective of regenerative anemia

A

polychromatophil

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6
Q

Best Regenerative Indicator

A

Reticulocytes for Cats and DOGs

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7
Q

Reticulocyte Above RI

A

regenerative

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8
Q

Reticulocyte within or below RI

A

Non-regenerative

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9
Q

4 descriptions of anemia

Red Cell Indices

A

Severity, RBC size, Hgb Concentration, regeneration status

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10
Q

Of the causes which are regenerative?

A

Loss of RBC, Destruction of RBC

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11
Q

Of the causes which are not regenerative?

A

Failure of production

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12
Q

Phase 1 of Anemia

A

CBC, Retic Count, plasma proteins

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13
Q

Phase 2 Anemia

A

Chemistry, Coombs, Iron panel

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14
Q

Phase 3 Anemia

A

Bone marrow evaluation

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15
Q

Iron deficiency is regenerative or not?

A

both, gray area

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16
Q

Hemorrhage

A

Both RBC and Proteins are lost.

Internal hemorrhage may not change proteins

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17
Q

Hemorrhage lost not in proportion

A

Loss of blood and the Plasma volume will increase with fluid. HCT and plasma proteins will not decrease until the volume is replaced.
Once volume returns this will be when ANEMIA sets in.

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18
Q

Acute hemorrhage

A

onset within the first 24 to 72 hours

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19
Q

Hemolysis

A

decreased RBC life due to increased RBC destruction

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20
Q

Extravascular hemolysis

A

RBC destroyed by macrophages (spleen)

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21
Q

intravascular hemolysis

A

RBC destroyed in circulation

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22
Q

pathophysiologic mechanisms of hemolysis (4)

A

Immune-mediated, oxidative damage, fragmentation, RBC parasites

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23
Q

Immune-mediated hemolytic anemia

A

Anti-erythrocyte Abs bind to RBC, often regenerative (non regenerative is when it happens to up stream cell types) and either intra or extra vascular.
idiopathic or secondary
PRIMARY more common

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24
Q

Diagnosing Immune-mediated Hemolytic anemia

A

Find Spherocytes, +/- agglutination, Positive Coomb’s Test (measure of surface immunoglobulin)

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25
Oxidative (Heinz Body) Anemia
Oxidative damage to erythrocytes, intra or extra vascular hemolysis May see eccentrocytes Heinz bodies are descriptive
26
Causes of Oxidative Damage to RBC
Toxins, acetominophen, onion/garlic, zinc, proplyene Glycol, zinc
27
Endogenous Oxidants
Mild anemia with evidence of RBC lysis, minor morph change
28
exogenous oxidants
Magnitude of anemia can vary, associated with toxicity
29
Neonatal Isoerythrolysis
Form of IMHA in neonates due to alloantibodies from colostrum
30
Fragmentation Anemia
Direct physical trauma to RBC (DIC, Vasculitis, Hemangiosarcoma) See Schistocytes and keratocytes
31
Erythrocyte Enzyme deficienies
G6PD - horses Pk - dogs and cats PFK - dogs
32
Iron deficiency Anemia
Chronic GI Blood Loss, large parasite burden, coagulopathies, neonates
33
Lymphocyte production
in lymphoid tissues and NOT bone marrow dependent
34
Lymphoid pool
1:1 of marginated to circulating pools
35
Lymphocytosis
increase in concentration above RI
36
Lymphopenia
Decrease in concentration to less than RI
37
Mechanism of Lymphocyte changes
chronic inflammatory lymphocytosis
38
chronic inflammatory lymphocytosis
Look up, adult animals
39
Physiologic (shift) lymphocytosis
shift in the pool. Young excitable animals
40
Lymphocyte morphology
dog: small relative to neutrophils, persistent is probable of neoplasia
41
lymphoblast vs. Small Lymphocyte
Lymphoblast is probable of neoplasia (larger) | small is normal
42
Bovine Lymphocytes
very prone to large lymphocyte population and larger in size
43
Reactive Lymphocyte (abnormal)
increase cell size/cell volume, irregular shape, considered to be reactive with antigenic stimulation
44
epinephrine (cause of lymphocytosis)
due to catecholamines (fear, stress, exercise), short lived. Cats and young horses. Shift from marginated to circulating pool (doubling is max)
45
Lymphoproliferative disorders (cause lymphocytosis)
leukemia or lymphoma can be viral or not neoplastic production of lymphocytes
46
Chronic inflammation (cause of lymphocytosis)
link is largely anecdotal (dogs). Difficult to separate from epinephrine. Cats are more complex. Should be VERY LOW ON DDX especially if it is persistent
47
Other Causes of lymphocytosis
Hypoadrenocorticism (addison's dz may have increase) Thymoma Canine ehrilichiosis Young animals (post Vx) 4 MO
48
All causes of Lymphocytosis | THEY LIVE
``` Thymoma Hypoadrenocorticism Ehrlichiosis Young Animals Lymphoproliferative Dz Inflammation Vaccine (post) Excitement/Epinephrine ```
49
Cause of Lymphopenia
STEROID/STRESS LYMPHOPENIA
50
Less common causes of lymphopenia
Acute bacterial/viral infections, Depletion/loss, | Congenital
51
Monocyte production/kinetics
from bone marrow into circulation into tissues (where they mature to macrophages or dendritic cells) long lifespan of years in tissues
52
Causes of Monocytosis 3
Inflammation, steroids (more common, stress in dogs more common than cats), neoplasia
53
Monocytopenia
Not diagnostically significant (nobody cares)
54
Eosinophils Production/kinetics (more pink)
from bone marrow and from peripheral blood they circulate for minutes to hours and die in the tissues FOR ANTI-PARASITIC, HYPERSENSITIVITY REACTIONS
55
Causes of Eosinophila 7
parasitism, hypersensitivity (allergy) rxn, mast cell degranulation, Paraneoplastic, idiopathic conditions neoplasia hypoadrenocorticism
56
Eosinopenia
Do not care (possible stress) | Not significant
57
Basophil Production/kinetics (more purple)
originate from bone marrow, circulate and after 6 hours they go to tissues and die. Similar to mast cells Rare to encounter THEY DON'T MATTER
58
Basophilia
Similar to eosinphilia | Parasitism, hypersensitivity, neoplasia-basophilic leukemia(rare)
59
Basopenia
No one cares
60
Mastocytemia
rarely identified in peripheral blood Associated with: inflammatory/allergic Rxn, skin and mucosal surfaces Mast Cell Neoplasia (typically larger #)
61
Leukogram patterns 4 major ones
VERY IMPORTANT use direction change and magnitude of change. Patterns will be superimposed. Species will have differences
62
Leukogram changes
There is a (severity) (change in WBC concentration) characterized by/resulting from (lineage specific finding).
63
Epinephrine Leukogram
``` Mild to moderate leukocytosis (increase). Mature Neutrophilia (toxic not expected) ``` Lymphocytosis: cats and young horses transient change
64
Steroid leukogram
Mild/moderate leukocytosis, mature neutrophilia (toxic not expected and rare bands possible). Neutrophils have normal morph. LYMPHOPENIA (MOST COMMONLY SEEN)
65
Inflammatory leukogram 1
neutrophilia (+/- left shift *hallmark*, +/- toxic change), Mild to marked neutrophil magnitude, +/- monocytosis +/- lymphopenia
66
Inflammatory leukogram 2
Neutropenia (+/- left shift, +/- toxic Species differences are vital (ruminants lack the reserve compared to others) Demand for neutrophils is being outpaced by bone marrow production and release
67
LYMPHOPENIA SHOULD RESPOND:
STRESS AND STEROID
68
Endotoxin leukogram
``` Acute effects (hours) leukopenia/neutropenia. Later effects are endotoxin + inflammation (overlapping) ```
69
Bone marrow failure/suppression
neutropenia (+/-anemia, +/- thrombocytopenia) both due to longer half life Lymphocyte is normally WNL Not dependent on marrow production
70
666 rules Lifespan
6 hours (neutrophils), 6 days (platelets), 60 days (RBC)
71
superimposed patterns
steroid + inflammatory marrow suppression masking an inflammatory leukogram Patterns are additive
72
other scenarios
left shift w/normal neutrophil count or normal segmented count. left shift alone could mean inflammation

Clin Path (3 decks)

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