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Acvim Journals 2015-2019 > Hematology 2015-2019 > Flashcards

Hematology 2015-2019 Flashcards

1
Q

What is the correlatio between B vitamins and anemia in dogs?

A

None

Relationship between cobalamin and folate deficiencies and anemia in dogs JVIM 2019

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2
Q

What are the characteristic features of veno-occlusive disease in dogs?

A

Ccclusive remodeling of small and median pulmonary veins leading to upstream congestion of alveolar capillaries and pulmonary arterial remodeling

Clinical features of canine pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis JVIM 2019

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3
Q

What is capillary hemangiomatosis?

A

Angioproliferative disorder w/ proliferation of alveolar capillaries and possible infiltration into pulmonary veins, arteries and bronchioles

Clinical features of canine pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis JVIM 2019

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4
Q

Cryoprecipitiate was shown to most effectively increase which hemostatic proteins?

A

Mean recovery highest VWF 67%, fibringoen 47% and FVIII 37%

Influence of canine donor plasma hemostatic protein concentration on quality of cryoprecipitate JVIM 2019

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5
Q

Should greyhounds be avoided for cryoprecipitate donation?

A

They have lower VWF and fibringoen factor but still meet human standards

Normal Factor VIII

Influence of canine donor plasma hemostatic protein concentration on quality of cryoprecipitate JVIM 2019

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6
Q

What is the clinical value of angiopoitin-2 in patients with SIRS or sepsis?

A

Angio-2 sig higher in SIRS and sepsis than healthy dogs
Hihger in non-surviviros
Predicted negative outcome with sens 50% andspec 87%

Evaluation of plasma angiopoietin-2 and vascular endothelial growth factor in healthy dogs and dogs with systemic inflammatory response syndrome or sepsis JVIM 2019

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7
Q

What is the clinical value of VEGF in patients with SIRS or sepsis?

A

VEGF higher in sepsis than SIRS or healthy
Higher in non-survivors but ability to predict outcome was poor

Evaluation of plasma angiopoietin-2 and vascular endothelial growth factor in healthy dogs and dogs with systemic inflammatory response syndrome or sepsis JVIM 2019

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8
Q

What is the association of serum calprotectin and serum lipids inminiature schnauzer dogs

A

Hypertriglyceridemia and hypercholesterolemia independently assoiciated with calprotectin but not S100A12

Serum calprotectin is sig higher in hypertriglyceride or combined hyperlipidemic states, but no with hypercholesterolemia alone

Serum triglyceride and cholesterol levels decreased w/in 14-26 weeks of being placed on an ultra-low fat diet but calprotectin did not

Association of serum calprotectin (S100A8/A9) concentrations and idiopathic hyperlipidemia in Miniature Schnauzers JVIM 2019

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9
Q

What degree of fat restrictuion is considered to be ultralow fat?

A

<20 g/1000 kcal

Association of serum calprotectin (S100A8/A9) concentrations and idiopathic hyperlipidemia in Miniature Schnauzers JVIM 2019

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10
Q

What breeds are prone to hypercholesterolemia?

A

HCHOL occurs in the Shetland Sheepdog, Rough Collie and Briard breeds.

Association of serum calprotectin (S100A8/A9) concentrations and idiopathic hyperlipidemia in Miniature Schnauzers JVIM 2019

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11
Q

Is therapeutic plasma exhange a viable treatment option for dogs with NSAID intoxication?

A

In a study of 11 dogs, all survived
1/6 with follow up had persistent azotemia
3 developed AKI
Bleeding abnormalities were common (50%)

Use of therapeutic plasma exchange to treat nonsteroidal anti-inflammatory drug overdose in dogs JVIM 2019

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12
Q

What is the recommendation for first time transfusions in cats and where the foundation for this?

A

Blood type (of course)
Cross match at first
transfusion

An antiglobulin-enhaned gel column technique detected an additional 15 incompatibilities in a population of cats
This suggests that there are unknown antigens that may contribute to poor transfusion acceptance

Detection of naturally occurring alloantibody by an in-clinic antiglobulin-enhanced and standard crossmatch gel column test in non-transfused domestic shorthair cats JVIM 2019

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13
Q

Is a monoclonal antibody-based urine Histoplasma antigen ELISA (IMMMY) acceptable for the diagnosis of histoloplasma in cats?

A

Investigated as an alternativeto Mira Vista
Moderate aggreement:
Snes 77% and spec 97% w/ 89% accuracy at 1.1ng/mL (higher sens at 0.25 ng/mL but lower spec)
Miravista - 94% sens and 96% spec

A monoclonal antibody-based urine Histoplasma antigen enzyme immunoassay (IMMY®) for the diagnosis of histoplasmosis in cats JVIM 2019

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14
Q

What is the clinical significance of B vitamin levels in pregnant bitches?

A

B12 decreaed late in pregnancy, folate did not
Decrease in RBC in late pregnancy wekaly correlated with folate levels
Did not correlated w/ fetal survival

Time course of serum cobalamin, folate, and total iron binding capacity concentrations in pregnant bitches and association with hematological variables and survival JVIM 2019

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15
Q

What is the clinical relavence of iron metabolism in pregnant bitches?

A

Serum iron and transferrin saturation increased in late pregnancy
Did not impact neonatal survival

Time course of serum cobalamin, folate, and total iron binding capacity concentrations in pregnant bitches and association with hematological variables and survival JVIM 2019

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16
Q

What percentage of dogs developed citrate accumulation during therapeutic plasma exchancein dogs?

A

All dogs
Worse in those with renal impiarement (5.5 umol/kg/min vs 9.0 umol/kg/min)

rare clinical signs
:sneezing in 2 dogs and vomiting in 5 dogs.
More severe signs commonly associated with hypocalcemia such as facial rubbing, muscle cramping, or seizure‐like activity were not observed in these treatments.

Membrane‐based therapeutic plasma exchange in dogs: Prescription, anticoagulation, and metabolic response JVIM 2019

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17
Q

What were the noted lab changes in dogs undergoing therapuetic plasma exchange?

A

Decreased total protein, decreased fibringogen, decreaed bilirubin, decreased BUN, decreased creatinine

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18
Q

Is mycophenolate a viable treatment option for immune suppresion in cats?

A

Unknown
Not well tolerated at doses >15 mg/kg po q 8 hr (significant GI signs)
No change in Cd4/Cd8 ratios - best way to monitor response currently but may not be adequate to evaluate all of the mechanisms of action for this drug
Succesful biotransformation to active compound

Pharmacokinetics of mycophenolic acid and its effect on CD4+ and CD8+ T cells after oral administration of mycophenolate mofetil to healthy cats JVIM 2019

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19
Q

Do dogs with AKI have changes in primary hemostatic function?

A

Yes - consistent with type II vWF
PCV lower in aki
platelet higher
bmbt prolonged

Unknown if this is clinically relavent

Primary hemostatic function in dogs with acute kidney injury JVIM 2019

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20
Q

What is the general recommendation for dogs receiving blood transfusions?

A

First time corss match not necessary
DEA 1.1- develop clinically relavent sensitization after one transfusion with DEA 1.1 + blood
Additional undetermined antigens may contribute to this response

Alloimmunization of a dog erythrocyte antigen 1− dog transfused with weakly dog erythrocyte antigen 1+ blood JVIM 2019

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21
Q

What gene in Persian cats has been linked to methemoglobinemia?

A

CYB5R

Clinical outcome is variable w/ this

Clinical, metabolic, and genetic characterization of hereditary methemoglobinemia caused by cytochrome b5 reductase deficiency in cats JVIM 2019

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22
Q

What is the recommended treatment of methemoglobinemia in cats?

A

Methylene blue
may cause additie hemolytic anemia - recommend HCT monitoring over a few days after treatment w/

Inically, cyanosis is noted when methemoglobin fraction of blood Hb is >15%, and is considered fatal when >70

Clinical, metabolic, and genetic characterization of hereditary methemoglobinemia caused by cytochrome b5 reductase deficiency in cats

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23
Q

Does breed and degree of fitness have an impact on proBNP levels?

A

Yes - healthy herding Huntaways and herding dogs were shown to have increaed levels

Greyhounds as well (Couto KM, Iazbik MC, Marín LM, et al. Plasma N‐terminal pro‐B‐type natriuretic peptide concentration in healthy retired racing Greyhounds. Vet Clin Pathol 2015;44:405–409)

Plasma NT-proBNP and Cell-Free DNA Concentrations after Prolonged Strenuous Exercise in Working Farm Dogs JVIM 2018

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24
Q

What drug has been shown to inhibit compliment activated hemolysis in vitro?

A

C1-INH (recombinant human 1-esterase inhibitor)

In vitro Inhibition of Canine Complement-Mediated Hemolysis JVIM 2018

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25
Q

Is a regional citrate anticoagulation practical in hemodialysis?

A

Yes
anticoagulation stisfactory in 92% of treatments
hemodialysis treatment was also effective

Regional Citrate Anticoagulation for Intermittent Hemodialysis in Dogs JVIM 2018

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26
Q

What canine breeds has been shown to have a genetic mutation for methemoglobinemia?

A

Pomeranian CYB5R3

Others:
Chihuahua, Borzoi, English Setter, MIiature boodle, Alaskan eskimo

Familial Congenital Methemoglobinemia in Pomeranian Dogs Caused by a Missense Variant in the NADH-Cytochrome B5 Reductase Gene JVIM 2018

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27
Q

What are the criteria utilized in establishing the ITP bleeding score in dogs? *DOGiBAT

A 
Petechiation
Bleeding around venipuncture/catheter
Hyphema
Epistaxis
GI bleeding
Urinary bleeding
Pulmonary bleeding
Intracranial bleeding

higher score is worse

Development and implementation of a novel immune thrombocytopenia bleeding score for dogs JVIM 2018

28
Q

Is the DOGiBAT score for ITP helpful in determining clinical outcomes?

A

Yes - correlated with product administration and duration of hospitalization

Development and implementation of a novel immune thrombocytopenia bleeding score for dogs JVIM 2018

29
Q

How long can feline whole blood products be stored after acquisition with citrate-phosphate-dextrose-adenin-1 ?

A

Up to 35 days.
Adequate pH and red blood cell numbers confirmed at to the time frame
Bacterial growth detected (Serratia marescens at day 35)

In vitro assessment of quality of citrate-phosphate-dextrose-adenine-1 preserved feline blood collected by a commercial closed system

30
Q

How does a pulse dose vs a daily dose of melphalan compare as treatment for multiple myeloma in dogs?

A

MST = 930 days overall with no sig difference bt groups

Comparison of two melphalan protocols and evaluation of outcome and prognostic factors in multiple myeloma in dogs JVIM 2018

31
Q

What are known prognositc indicators in dogs with multiple myeloma?

A

Renal disease and a high neutrophil to lymphocyte ratio negative

Hypercalcemia and lytic bone lesions not noted (this is an inconsistent finding across studies)

Comparison of two melphalan protocols and evaluation of outcome and prognostic factors in multiple myeloma in dogs JVIM 2018

32
Q

Is the major cross match technique adequate to determine transfusion intolerance in transfusion naive cats?

A

No

Effect of cross-match on packed cell volume after transfusion of packed red blood cells in transfusion-naïve anemic cats JVIM 2018

33
Q

What coagulation parameters are impacted during administration of cyclosporine in dogs?

A

No change in platelet function
Increased prostacycline degredation product 6-keto-PGF1alpha

Cyslosporine is kknown to increase thromboxane function - only 30% of dogs have receptors on platelets
Combination of increaed prostacyclin or lack of platelet response may correlate with lack of platelet function changes

Effects of immunosuppressive agents on the hemostatic system in normal dogs JVIM 2018

34
Q

What coagulation parameters are affected during administration of azathioprine and mycophenolate?

A

None

Effects of immunosuppressive agents on the hemostatic system in normal dogs JVIM 2018

35
Q

What are some hemostatic changes noted during infection with E. canis?

A

Lower platelet count, platelet activation, antiplatelet antibodies
Hypercoagulable and hypofibrinolytic on TEG
No clinical bleeding

Characteristics of hemostasis during experimental Ehrlichia canis infection JVIM 2018

36
Q

What babesia species has been correlated with coyote hunting in dogs?

A

B. conradae
Patients had Anemia, thrombocytopenia, hypoalbuminemia and hyperglobulinemia

Dogs were concurrently infected with other tick agents

Babesia conradae infection in coyote hunting dogs infected with multiple blood-borne pathogens JVIM 2018

37
Q

What percentage of transfusion-naive cats may have a major crossmatch incompatibility?

A

Up to 15%
Cross match is not associated w/ survival

Prevalence of naturally occurring non-AB blood type incompatibilities in cats and influence of crossmatch on transfusion outcomes JVIM 2018

38
Q

Does majorcrossmatch compatibility affect the median positive change in PCV in cats?

A

No

~0.8%/ml/kg regardless of incompatibility
Febrile tranfusion reaction noted more often in transfusion incompatible patients.

Prevalence of naturally occurring non-AB blood type incompatibilities in cats and influence of crossmatch on transfusion outcomes JVIM 2018

39
Q

What sort of coagulation abnormalities are present in peritoneal effusions and does it differ by effusiontype?

A

Fibrinogen lower than plasma
FDP and D-dimers are sig higher
Activation of coagulation noted with no correlation to effusion type.

Hemostatic findings in ascitic fluid: a cross-sectional study in 70 dogs JVIM 2017

40
Q

What is the most common reason for thrombocytosis?

A

Inflammation (46.6%), Neoplasia (55.7%)
Endocrine (12.0%)

Thrombocytosis in 715 dogs (2011-2015) JVIM 2017

41
Q

What is the correlation between blood transfusions and patients receiving hemodialysis?

A

Administration of blood products is associated with a higher risk of death in dogs but not cats

5) Blood transfusions in dogs and cats receiving hemodialysis: 230 cases JVIM 2017

42
Q

What is the correlation between glutathione peroxidicase activity and anemia?

A

Deccreased activity in anemic patients

Anemia increases peripheral oxygen tissue deman which can deplete antioxidants such as glutathione peroxidase

43
Q

What histopathology stains are used to assess for plasma cell origin?

A

Multiple myeloma oncogene -1 (MUM-1), lamda light chain
Present in patients with cutaneous plasmacytosis

Canine cutaneous plasmacytosis: 21 cases JVIM 2017

44
Q

What is the expected outcome for dogs with cutaneous plasmacytosis that are chemotherapy treated ?

A

RR of 73.7% w/ melphalan and prednisone resulting in PFI of 143 days

Canine cutaneous plasmacytosis: 21 cases JVIM 2017

45
Q

What are some risk factors for the development of hospital-acquied anemia in critically ill dogs and cats>

A 
Anemia prevalent in 32% of patients rose to 56% by end
More blood saples increaed anemia
(5 vs 7)
Cayts more likely to be anemia than dogs
Dogs less likely to survive if anemic
Surgical patients > medical patients

Anemic patients less likely to survive

Hospital-acquired anemia in critically ill dogs and cats: a multi-institutional study JVIM 2017

46
Q

What is the real risk of bacterial contamination for stored canine whole blood?

A

E. Coli at 35 d.

A second paper demonstrated E. coli and enterococcus in 2/49 samples at 42 days

Stored canine whole blood units: what is the real risk of bacterial contamination? JVIM 2017

47
Q

Is the Kai blood type related to existing DEA blood types?

A

No - various comvinations of Kai 1 and 2 wer enoted amongs all DEA blood types

Survey of two new (Kai 1 and Kai 2) and other blood groups in dogs in North America (2016)

48
Q

What are some of the features of precursor-targed immune mediated anemia in dogs?

A

Median HCT at the time of presentation 13%
Rubriphagocytosis in BM of 61/66
Mature cell targeting uncommon
55/66 acheived regenerative response at a median of 29 days
50/55 w/ regenerative acheived remission at 59 days post diagnosis and treatment start
MST 913 days

Clinical features of precursor-targeted immune-mediated anemia in dogs: 66 cases (2004–2013)

49
Q

What is the overall mortality rate for cats with pure red cell aplasia or non-regenerative immune-mediated anemia?

A

27% mortality
time to remission 12-42 days
Relapse rate in 27% of patients that acheived remission

JAVMA 2018

50
Q

Is the mean plasma platelet component cocentration associated with survival in dogs with IMHA?

A

Yes
MPC <19.1 g/dL were associated with death
Mean risk for death increased by 16% for every unit increase in plasma MPC

Low MPC correlates with high valutes of activated plateletsJAVMA 2018

51
Q

Is prednisone associated with platelet activation?

A

No

52
Q

What is the most common signalment and concurrent morbidity associated with aortic thrombic disease in dogs?

A

No difference in age, sex and breed
Shetland sheepdogs
PLN

Multicenter evaluation of signalment and comorbid conditions associated with aortic thrombotic disease in dogs
JAVMA 2017

53
Q

What factors are most important to discern between regenerative and nonregenerative anemia?

A

Reticulocyte percentage, number and production index

Sens, spec and auc vary depending on method used and if preregenerative anemia is considered to be regenerative or non.

Sensitivity and specificity of manual and automated measurements of reticulocyte parameters for classification of anemia in dogs: 174 cases (1993–2013) JAVMA 2016

54
Q

What is the clinical relavence of lactate levels in critically ill, hypotensive dogs?

A

Hypotensive w/high lactate are less likely to survive.

19/67 critically ill, hypotensive dogs survived to discharge

Survival analysis of critically ill dogs with hypotension with or without hyperlactatemia: 67 cases (2006–2011) JAVMA 2015

55
Q

What effect does PCV have on blood glucose levels obtained by a POC glucometer

A

Values of lab BG were relatively similar at any PCV
POC glucose is false increased w/ anemia and decreased w/ hemocencentration
POCglucose +(1.6X PCV) - 81.3

2) Formulation and validation of a predictive model to correct blood glucose concentrations obtained with a veterinary point-of-care glucometer in hemodiluted and hemoconcentrated canine blood samples JAVMA 2015

56
Q

What is the correlation between serum, plasma and whole blood used on POC glucometer?

A

serum and plasma is more accurate

Correlation between glucose concentrations in serum, plasma, and whole blood measured by a point-of-care glucometer and serum glucose concentration measured by an automated biochemical analyzer for canine and feline blood samples JAVMA 2015

57
Q

What is the association between blood lactate concentration and outcome in cats treated on ER?

A

Lactate w/ white MM, abnormal periphearl pulse quality, hypothermia had sig higher lactate than those that did not
Median lactate at admission did not correlated bt. survivors and non survivors
Change in lctate did correlate bt survivors and nonsurvivors

Association of blood lactate concentration with physical perfusion variables, blood pressure, and outcome for cats treated at an emergency service JAVMA 2015

58
Q

What are te expected outcomes of dog with precursor-targeted immune mediated anemia in dogs?

A

Median HCT 13%
Reticulocyte count 17,900 retic/uL
Rebriphagocytosis in BM is common
Hemolysis is uncommon
55/66 developed regenerative resposne at a median of 29 days
Thromboempbolic events noted in 9 dogs and were assocaiated with decreased survival time
MST 913 days

Clinical features of precursor-targeted immune-mediated anemia in dogs: 66 cases (2004–2013) JAVMA 2019

59
Q

What is the incidence of hospita- acquired anemia in hospitalized dogs and cats?

A

70% in cats, 43% in dogs
Patients that underwent SX were sig more likely
Cumulative phlebotomy volume > 3% more likely

Incidence of hospital-acquired anemia in hospitalized dogs and cats JAVMA 2018

60
Q

What is the mean platelet component associated with survival in patietns with IMHA?

A

19.1 g/dL

Case-control study of plasma mean platelet component concentration and survival analysis for dogs with immune-mediated hemolytic anemia JAVMA 2018

61
Q

Is a refractometery able to accurately interpretate protein levels in pleural and abdominal effusions in dog and cats when compared to labratory standard?

A

Yes

Comparison of refractometry and biuret assay for measurement of total protein concentration in canine abdominal and pleural fluid specimens JAVMA 2016

62
Q

What is the formula to correct blood glucose levels using a point of care glucometer in the face of hemoconcentration or anemia?

A

POCgluc + (1.6X PCV)-81.3
POC falsely increased w/ anemia and falsy decreased with hemoconcentration

Formulation and validation of a predictive model to correct blood glucose concentrations obtained with a veterinary point-of-care glucometer in hemodiluted and hemoconcentrated canine blood samples JAVMA 2015

63
Q

Is whole blood or plasma/serum more accurate as a mesasure of BG on a POC glucometer?

A

Plasma/serum
Correlation between glucose concentrations in serum, plasma, and whole blood measured by a point-of-care glucometer and serum glucose concentration measured by an automated biochemical analyzer for canine and feline blood samples JAVMA 2015

64
Q

Which interleukens are decreased in GSD intestinal lining during chronic enteropathy?

A

IL-33 and iL 13

Interleukin-13 and interleukin-33 mRNA are underexpressed in the duodenal mucosa of German Shepherd dogs with chronic enteropathy JVIM 2019

65
Q

What are some key features in dogs with erosive IMPA in dogs?

A

More likely to occur in carpal joints
More likely to affect small breed dogs
More lymphocytes were present in the joints than non-erosive

JAVMA 2016

66
Q

Is prednisone or cyclosporine superior as a treatment for IMPA in dogs?

A

Treatment success in 70%
Normal joint fluid on day 45 in 50% of prednisone treated vs 80% with cyclosproine
Opportunistic infections were noted in 20% of cyclosporine treated dogs - small number of dogs, not sue if we can say that cyclosporine is more likely

Comparison of the efficacy of prednisone and cyclosporine for treatment of dogs with primary IMPA
JAVMA 2016

67
Q

What is serum calprotectin and what type of inflammation does it correlate with?

A

Marker of inflammation
Correlates with mononuclear or mixed type inflammation

Association of serum calprotectin (S100A8/A9) concentrations and idiopathic hyperlipidemia in Miniature Schnauzers JVIM 2019

Acvim Journals 2015-2019 (11 decks)

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