Lecture 3: Non-regenerative anemias and erythrocytosis

Question 1

What is reticulocyte count with non-regenerative anemia

Answer 1

normal or decreased

Question 2

what are the 2 mechanisms for nonregenerative anemia

Answer 2

1. Reduced erythropoiesis
2. Defective erythropoiesis

Question 3

what are the analyzer findings for MCV and MCHC in non-regenerative anemia

Answer 3

Normal or decreased

Question 4

what are the blood smear findings for non-regenerative anemia

Answer 4

1. Minimal or mild anisocytosis
2. Minimal or mild polychromasia
3. Minimal basophilic stippling- ruminants

Question 5

which of the following is indicative or regenerative vs non-regenerative anemia

Answer 5

Left: non-regenerative
Right: regenerative

Question 6

do you have inappropriate or appropriate metarubriocytosis with non-regenerative anemia

Answer 6

inappropriate

Question 7

what is inappropriate metarubricytosis

Answer 7

increase nRBC in circulation due to endothelial damage, lacking other signs of regeneration like polychromatophils/ reticulocytosis

Question 8

is anemia of chronic disease/anemia of inflammation mild, moderate or severe anemia

Answer 8

mild to moderate anemia

Question 9

what are MCV and MCHC values for anemia of chronic disease/ anemia of inflammation

Answer 9

normal

Question 10

what is MOA for anemia of chronic disease/ anemia of inflammation

Answer 10

up regulation of hepcidin which inhibits Fe utilization for erythropoiesis

Question 11

what are some infectious causes of anemia of chronic disease/ anemia of inflammation

Answer 11

infectious: bacteria, fungi, viruses, Protozoa

Question 12

what are some non-infectious causes of anemia of chronic disease/ anemia of inflammation

Answer 12

endocrinopathies, pancreatitis, chronic disease, toxins, neoplasia

Question 13

is the anemia mild, moderate, or marked with anemia of chronic renal disease

Answer 13

can be mild, moderate or marked

Question 14

what are MCV and MCHC values for anemia of chronic renal disease

Answer 14

normal

Question 15

what is MOA of anemia of chronic renal disease

Answer 15

decrease Erythropoietin production

Question 16

is the anemia mild, moderate, or severe with pre-acute hemorrhage

Answer 16

mild or moderate

Question 17

what are MCV and MCHC values for pre-acute hemorrhage

Answer 17

normal

Question 18

what is MOA of pre-acute hemorrhage causing non-regenerative anemia

Answer 18

BM has not had time tor respond

Question 19

is the anemia of bone marrow disease mild, moderate or marked

Answer 19

can be mild moderate or marked

Question 20

what are MCV and MCHC values for anemia of bone marrow disease

Answer 20

normal

Question 21

what are 3 MOA for anemia of bone marrow disease

Answer 21

1. Myelophthisic disorders
2. Toxins/injury
3. Precursor immune mediated anemia

Question 22

what cell lines are affected/ what would be blood work finding with anemia of bone marrow disease

Answer 22

bicytopenia or pancytopenia

Question 23

what is a myelophthisic disorder

Answer 23

something that invades and takes over bone marrow

Question 24

what are some examples of myelophthisic disorders

Answer 24

1. Leukemia, metastatic neoplasia
2. Infectious agents
3. Replacement of bone marrow with CT (myelofibrosis) or gelatinous transformation

Question 25

what are some toxins that target the bone marrow

Answer 25

1. Estrogen 2. Chloramphenicol 3. Chemo 4. Bracken fern

Question 26

what is precursor immune mediated anemia

Answer 26

antigen-antibody complexes target erythroid precursors not mature RBC’s

Question 27

what is MCV and MCHC with PIMA

Answer 27

normal

Question 28

what disease in cats can cause bone marrow erythroid hypoplasia

Answer 28

FeLV

Question 29

FeLV causes selective damage of __

Answer 29

erythroid precursors

Question 30

FeLV causes increased RBC, but __maturation

Answer 30

defective

Question 31

what is MCV and MCHC for FeLV

Answer 31

macrocytic and normochromic anemia

Question 32

what is the only cause of microcytic hypochromic anemia

Answer 32

iron deficiency

Question 33

what are some causes of iron deficiency

Answer 33

1. Chronic external blood loss (most common)- ulcerations, parasites, 2. Inadequate absorption- GI disease 3. Defect in iron metabolism (PSS) 4. Inadequate dietary intake

Question 34

is iron deficiency anemia regenerative or non-regenerative

Answer 34

non-regenerative

Question 35

why do cells become microcytic with iron deficiency anemia

Answer 35

lack of Hgb—> no signal to stop mitosis—> extra cell division

Question 36

what is the appearance of iron deficiency on blood smear

Answer 36

expansion or presence of erythrocyte central pallor, may see fragmentation associated poikilocytes (schistocytes)

Question 37

what do you see in this blood smear from dog and what is likely cause

Answer 37

Increase central pallor of RBC’s (hypochromasia), small RBC’s (microcytic) Cause: iron deficiency anemia

Question 38

Define erythrocytosis

Answer 38

increased RBC mass

Question 39

what can cause erythrocytosis

Answer 39

1. dehydration/ hemoconcentration 2. Splenic contraction

Question 40

what is the most common cause of erythrocytosis

Answer 40

dehydration

Question 41

what other blood work finding do you see with dehydration besides erythrocytosis

Answer 41

hyperproteinemia

Question 42

what blood work findings become increased with dehydration

Answer 42

1. PCV and HCT 2. Total solids 3. Total proteins 4. Pre-renal azotemia 5. Na 6. Cl 7. K

Question 43

what causes splenic contraction to occur

Answer 43

excitement, fright, exercise

Question 44

case ex: 11yr, M miniature schnauzer with hx of lethargy, “gotten fat” PU/PD, pendulous abdoen, muscle wasting. Following CBC was taken and note white looking plasma. Characterize erythron and what is likely cause

Answer 44

1. Total proteins- normal 2. Hematocrit: low (anemia) 3. MCV: normal 4. MCHC: hyper chromatic (Lies) 5. Reticulocyte within RI (non-regenerative) Plasma- lipemic Erythron: normochromic, hyperchromic non-regenerative anemia Likely cause is Cushing causing anemia of chronic disease/inflammation

Question 45

case ex: 18yr old MC Persian cross, 5 month hx of weight loss, PU/PD, lethargy, muscle wasting, unthrifty. Following CBC was taken. Characterize erythron

Answer 45

1. Total protein normal 2. Hematocrit- low (anemia) 3. MCV: normal 4. MCHC: normal 5. Reticulocyte count: normal 6. NRBC: elevated Normocytic, normochromic, non-regenerative anemia With inappropriate metarubricytosis