Quick Review from Exams 1 + 2

Question 1

Regenerative anemias

Answer 1

• hemorrhage = external, internal, chronic, acute

- hemolysis = extravascular, intravascular, acquired, congenital, IMHA, oxidative damage

Question 2

Non-regenerative anemias

Answer 2

• chronic renal disease
• chronic liver disease
• chronic inflammatory disease
• cancer outside the marrow
• endocrine deficiency
• bone marrow problems
• iron deficiency
• lead poisoning

Question 3

Coagulation abnormalities

Answer 3

• snake envenomation
• DIC
• vW disease
• vitamin K deficiency/antagonism
• liver disease
• hyper-coagulable states: IMHA, protein losing nephropathy, pancreatitis, neoplasia, sepsis, endocrine disease

Question 4

Erythrocytosis

Answer 4

• relative
• transient
• absolute

Question 5

Thrombocytosis

Answer 5

• primary = neoplasia

- secondary = increased production (inflammation, cushion’s, iron deficiency anemia, post-splenectomy) or redistribution

Question 6

Thrombocytopenia

Answer 6

• decreased production
• increased destruction = MOST SEVERE
• increased consumption
• abnormal distribution

Question 7

Dominant WBC most species

Answer 7

neutrophils

Question 8

Dominant WBC in ruminants, swine, rodents, reptiles, birds

Answer 8

lymphocytes

Question 9

Left-shift or neutrophils

Answer 9

increased demand = inflammation

- can be degenerative (more bands) or regenerative (more segs)

Question 10

Neutrophilia

Answer 10

• glucocorticoids (stress)
• epinephrine (excitement)
• inflammation
• leukemia

Question 11

Neutropenia

Answer 11

• excess tissue demand d/t inflammation
• decreased marrow production d/t injury
• increased margination
• autoimmune destruction

Question 12

STRESS RESPONSE LEUKOGRAM***

Answer 12

GLUCOCORTICOIDS
"SMILED" - segs/monos increased, lymphs/eos decreased
- mature neutrophilia
- monocytosis
- lymphocytopenia**
- eosinopenia

Question 13

EPINEPHRINE RESPONSE LEUKOGRAM***

Answer 13

EXCITEMENT = common in cats/horses

• leukocytosis
• erythrocytosis
• mature neutrophilia
• lymphocytosis**

Question 14

Lymphocytosis

Answer 14

• physiologic leukogram = epinephrine
• prolonged antigenic stimulation
• persistent lymphocytosis in bovine leukemia virus infected cattle
• lymphocytic leukemia

Question 15

Lymphocytopenia

Answer 15

• stress leukogram = corticosteroids
• severe systemic bacterial infection (horses)
• loss of lymphocyte rich fluid as effusion
• chemotherapy
• acute viral infections = lympholytic

Question 16

Monocytosis

Answer 16

• acute/chronic inflammation
• canine stress leukogram
• monocytes leukemia

Question 17

Monocytopenia

Answer 17

Not clinically significant

Question 18

Eosinophilia

Answer 18

“NAACP”

• neoplasia
• addison’s
• allergy/hypersensitivity
• collagen/vascular disorders
• parasites with tissue migration phase
• inflammation rich with mast cells
• hypereosinophilic syndrome

Question 19

Eosinopenia

Answer 19

Not clinically significant

Question 20

Basophilia

Answer 20

often parallel’s eosinphilia

• HW disease
• MCT
• leukemia

Question 21

Basopenia

Answer 21

Not clinically significant

Question 22

Fibrinogen increased with:

Answer 22

• active inflammation = LA

- physiologic stress

Question 23

Fibrinogen decreased with:

Answer 23

• DIC
• snake bites
• liver failure

Question 24

Lab findings with iron-deficiency anemia

Answer 24

Microcytic, hypochromic/normochromic anemia
Fragmentation: schistocytes, keratocytes, acanthocytes
THROMBOCYTOSIS
Panhypoproteinemia
Early polychromasia, then diminished

Question 25

Two classic signs of lead toxicity

Answer 25

Metarubricytosis (NERBS) | Basophilic stippling

Question 26

What clinical findings differentiate intravascular and extravascular hemorrhage?

Answer 26

Intravascular: hemoglobinemia, hemoglobinura | Both have bilirubinemia, bilirubinuria, icterus

Question 27

What RBC morphology accompanies extravascular hemolytic anemia?

Answer 27

Spherocyte = immune/other causes, erythrocytes coated with antibody

Question 28

What RBC morphology accompanies intravascular hemolytic anemia?

Answer 28

Ghosts = immune-mediated attack, Hgb leaks out

Question 29

IMHA lab findings

Answer 29

``` Regenerative anemia Agglutination Spherocytosis (no central parlor) Neutrophilia Pigmenturia/emia - bilirubinuria, bilirubinemia, icterus (NOT HEMOGLOBINEMIA/URIA BC IMHA IS EXTRAVASCULAR) Variable platelets Abnormal liver enzymes ```

Question 30

RBC changes seen with oxidative damage

Answer 30

Heinz bodies Eccentrocytes, pyknosis Methemoglobin - can't carry O2

Question 31

Lab findings for hemolytic anemia caused by oxidative damage

Answer 31

``` Regenerative anemia = polychromasia Heinz bodies (NMB stain) Eccentrocytes, pyknocytes Methemoglobinemia on spot test filter Hgb crystals ```

Question 32

Common non-regenerative anemia lab findings

Answer 32

Normocytic, normochromic anemia (mild to moderate) Non-regenerative - no polychromasia Other cells lines affected with intramarrow disease - leukopenia, thrombocytopenia

Question 33

DIC lab findings

Answer 33

Anemia Thrombocytopenia (mild to mod) Fragmentation morphology = acanthocytes, schistocytes May also have prolonged clotting tests, or faster if phase 1 Increased FDPs

Question 34

Lab findings for vW disease

Answer 34

Bleeding, cutaneous bruising, hemorrhage Prolonged BMBT* Normal platelet count Normal PT, PTT (PTT prolonged in horses)