Lecture 6/7: Anemia and Regeneration Flashcards
(99 cards)
1
Q
leading antibiotic that causes some sort of immune-mediated anemia
A
cephalexin
2
Q
what affect can colostrum consumption have on bloodwork?
A
it is protein rich so it can throw off acute protein value
3
Q
hemoglobinuria and how to dx
A
Hb in urine. Urine appears red but no RBCs in plug. Pigment still in urine after spinning.
4
Q
When you suspect dehydration it must be at least __%
A
5%
5
Q
10% dehydration char. by:
A
big lag in tented skin
6
Q
relative erythrocytosis
A
means you have more RBCs than normal but it is not from increased production. RBCs make up a bigger percentage of blood than they should.
7
Q
causes of relative erythrocytosis**
A
- splenic contraction
- dehydration**
8
Q
KNOW: dehydration gives you relative erythrocytosis whereas hypoxemia will increase RBC production**
A
:)
9
Q
primary erythrocytosis
A
normal or low EPO (i.e. due to polycythemia vera)
10
Q
secondary erythrocytosis
A
high EPO (occurs in high altitude, heart dz, inappropriate EPO production, etc.)
11
Q
causes of selective erythroid aplasia (s.o.)
A
-immune-mediated
-FelV subgroup
-chloramphenicol
-congenital
parvo
12
Q
causes of dyserythropoiesis (s.o.)
A
(defective devel. of erythrocytes)
-inherited disorders
-myeloproliferative disorders
-
13
Q
causes of nonregenerative anemia (with leukopenia and/or neutropenia)
A
- hypoplastic (incomplete devel.) or aplastic (unable to form) bone marrow
- proliferation or infiltration of abnormal cells
- disease combinations
14
Q
transferrin binds
A
Fe
15
Q
slide 33
A
:)
16
Q
How does hemorrhage affect TPP?
A
decreases
17
Q
Normal HCt, Low TPP:
A
GI protein loss
proteinuria
liver disease
18
Q
Normal Hct, high TPP:
A
increased globulin synthesis
dehydration masked anemia
19
Q
High Hct, low TPP:
A
protein loss with erythrocytosis
20
Q
High Hct, normal TPP:
A
splenic contraction
absolute erythrocytosis
dehydration
21
Q
High Hct, high TPP:
A
dehydration
22
Q
Low Hct, low TPP:
A
hemorrhage, overhydration
23
Q
Low Hct, normal TPP:
A
-increased erythrocyte destruction
decreased erythrocyte prod.
chronic hemorrhage
24
Q
Low Hct, Hight TPP:
A
anemia of inflamm. dz
multiple myeloma
25
How can you tell if anemia is definitely regenerative?****
presence of increased polychromasia in blood film (absolute reticulocytosis is a secondary indicator)
26
macrocytic hypochromic =
big cells with less Hb. Suggestive of regen. anemia
27
2 main indices to characterize anemia
MCV and MCHC
28
macrocytic
MCV above reference interval
29
normocytic
MCV within ref. int.
30
microcytic
MCV w/n ref. int.
31
portosystemic shunt can cause what type of anemia?
microcytic anemia
32
3 things that cause increased Heinz bodies (esp. in cats)?**
lymphoma (inc. ox. met.)
hyperthyroidism
diabetes (altered carb met.)
33
hyperchromic
MCHC above ref. int.
34
normochromic
MCHC w/n ref. int.
35
hypochromic
MCHC below ref. int.
36
T/F: anemia of inflamm. dz alone typically only causes a mild to moderate anemia
T
37
possible causes of anemia of inflamm. dz
- chronic inflammation
- neoplasia
- mild to mod. nonregen. anemia
38
anemia of inflamm. dz is usually characterized how?*
normocytic normochromic. Sometimes slight microcytosis. Body hides Fe from RBCs
39
Prussian blue stain
stains iron blue
40
Know you need Fe and Cu to make Hb and their deficiency will lead to disorders of heme synthesis**
:)
41
decreased MCHC, decreased MCV = **
hypochromic microcytic
42
lab findings with chronic Fe def. anemia**
- mild to severe anemia
- microcytosis
- normal to decreased MCHC
- high retics early on, then low
- poikilocytosis (abnormal shaped cells)
- thrombocytosis (increased platelets)
43
low reticulocytes indicates
non-regen. anemia, or early regenerative anemia
44
increased plasma bilirubin conc. can be seen with
intra and extravascular hemolysis
45
dx of anemia based on what factors?
- blood and plasma appearance
- PP conc.
- retic count
- erythrocyte indices
- erythrocyte morph.
- Coombs test
- plasma bilirubin conc.
46
possible causes for anemia (hemodilution)
- expansion of vasc. space
- overhydration
- splenic sequestration
- young animal
47
low EPO --> RBC production
decreased
48
colostrum --> RBC concentration
decreases (has dilutional effect)
49
How to determine regen. vs. non-regen. in horses?
Bone marrow evaluation, MCV, RDW, serial PCV
50
T/F: trust PCV over Hct
T
51
Appearance of regen. anemia on blood films
- increased polychromasia***
- increased anisocytosis (and increased RDW)
- metarubricytosis
- Howell-Jolly bodies
- basophilic stippling (ruminants)
52
If anemia is regenerative, it is due to:**
hemorrhage or hemolysis
53
If anemia is non-regenerative, it is due to:**
decreased bone marrow production +/- hemorrhage or hemolysis
54
likely cause of thrombocytopenia
increased destruction or decreased production. NOT hemorrhage
55
T/F: There is no such thing as hyperchromic**
T
56
MCV is highest in what anemia?
hemolytic anemia
57
Will be shown picture of Fe def. anemia!
RBC with pale center and pink rim
58
What could cause MCV to be low?
chronic blood loss
59
stress retics
huge polychromatophils. Form in severe cases of hemolytic anemia
60
regen. anemia is char. by ___ MCV and ___MCHC
increased MCV, decreased MCHC
61
signs of hemolytic anemia
- icterus
- red plasma (in intravascular hemolysis)
- hemoglobinuria (in intravascular hemolysis)
- agglutination (in IMHA)
- increased retic count
- hemoglobinemia
- PP normal or increased
- leukocytosis
- abnormal erythrocyte morphology
62
which is worse: intra or extravascular hemolysis**
intravascular
63
How to differentiate intra from extravascular hemolysis?**
Intravascular hemolysis will have red plasma (hemoglobinemia) and hemoglobinuria
64
only species we can say are spherocytes**
dog
65
extravascular hemolysis
- abnormally rapid RBC death but in a normal location for RBC destruction (liver, spleen, BM)i
- acute or chronic
- macrophages remove RBCs in spleen
- DIC possible
66
intravascular hemolysis
- abnormally rapid RBC destruction in ABNORMAL location (bloodstream)
- usually acute
- circulating RBC fragments can cause DIC, shock
67
bilirubin results from
Hb from lysed RBCs. First causes bilirubinuria, then bilirubinemia, then icterus
68
What things artifactually increase MCHC?***
```
intravascular hemolysis
hemoglobinemia
Heinz bodies
Lipemia
(will be 1 fake stupid answer not on this list)
```
69
Do bilirubinuria and bilirubinemia differentiate intravascular from extravascular hemolysis?
NO. These things can happen in either type
70
hypophosphatemia
- don't have enough phosphorus to make ATP
- can occur in re-feeding syndrome
- results in hemolysis (degradation of cell memb.)
- immune system not involved*
71
causes of hemolytic anemia
- Immune-mediated erythrocyte destruction
- erythrocyte parasites
- other infectious agents
- chemicals and plants
- fragmentation
- hypoosmolality
- hypophosphatemia
- hereditary erythrocyte defects
72
causes of immune-mediated erythrocyte destruction
- IMHA
- neonatal isoerythrolysis
- lupus erythematosus
- incompatible blood transfusion
- drugs
73
IMHA
- common cause of extravascular hemolysis
- immunoglobulin/complement attaches to RBC and phagocitized by macrophages
- forms spherocytes
- tested for with Coombs test
74
erythrocyte parasites
```
anaplasma
mycoplasma
babesia
cytauxzoon felis
theileria
```
75
zinc toxicity effects
- hemolysis and spherocytes
| - NO microagglutination
76
causes of erythrocyte frag.
- DIC
- dirofilariasis
- hemangiosarcoma
- vasculitis
- hemolytic uremic syndrome
77
hypoosmolality causes:
ghost cell formation (from hypotonic fluid admin.)
78
causes of hypophosphatemia
- dec. erythrocyte ATP conc.
- postparturient hemoglobinuria
- ketoacidotic diabetes
- hepatic lipidosis
- hyperalimentation (re-feeding syndrome)
79
causes of blood loss anemia
- trauma
- blood sucking parasites
- coag. disorders
- platelet disorders
- neoplasia
- GI ulcer
- inflamm. bowel disorder
80
external vs. internal hemorrhage
External: erythtocytes, PP, and Fe LOST. Dec. PCV and TP
Internal: Fe conserved. Some erythrocytes and PP reabsorbed. Slight hyperbilirubinemia may occur. Dec. PCV, Inc. TP
81
causes of acute hemorrhage
- trauma, sx
- bleeding ulcers
- bleeding tumors
- marked decrease in platelets (thrombocytopenia)
- inherited/acquired coagulopathies
82
Sign of external hemorrhage***
decreased PCV and TP
83
lab findings in acute hemorrhage
- usually NOT thrombocytopenia
- variable Hct
- PPC variable (decreased PCV and TP occurs approx. 12-24 hrs after blood loss as a result of dilution of interstitial fluid*)
84
3 main fragmentation morphologies**
schistocytes
acanthocytes
karatocytes
85
lab findings in chronic hemorrhage**
- usually signs of regen. anemia
- hypoproteinemia
- thrombocytosis seen in 50% cases of Fe def. anemia ***
- frag. morph.
- microcytic hypochromic anemia
86
Cu def. leads to
Fe def.
87
most common cause of Fe deficiency*
chronic external blood loss
88
Q: what is something that positively affects the production of RBCs?**
Fe, EPO
89
most common source of blood loss**
GI tract in adult animals
90
cat with chronic renal failure will have what type anemia**
non-regen. normocytic normochromic (can't make enough EPO)
91
cats that have hyperthyroidism typically have slight ____
erythrocytosis, due to inc. metabolism
92
hypothyroidism and addison's disease both cause
slight anemia
93
#1 type of non-regen. anemia**
anemia of chronic inflamm. disease
94
causes of non-regen. anemia
- chronic renal dz
- hormone def.
- anemia of inflamm. disease***
- cytotoxic damage to marrow
- infectious agent
- immune-mediated
- myelophthisis
95
causes of microcytic anemia
- chronic Fe def.
- anemia of inflamm. disease (usually normocytic/normochromic!)***
- Cu and pyridoxine def.
96
tx for cat with renal disease**
(doesn't have enough EPO)
feed low protein diet so kidney doesn't have to deal with protein breakdown products such as urea, N. Give fluids to carry waste away
97
Effects of chronic renal disease
- decreased EPO prod.
- suppression of erythropoiesis
- decreased RBC lifespan
- hemorrhage
98
endocrine disorders (hypothyroidism/hypoadrenocorticism) cause:**
mild normocytic normochromic non-regenerative anemia due to generalized decrease in metabolism.
99
Non-regen. anemia is/is not usually assoc. with poikilocytosis
is not
