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equine-04-hematology > 01 - anemia > Flashcards

01 - anemia Flashcards

1
Q

(regenerative anemia)

  1. horses don’t release reticulocytes into circulation
  2. ^ mean cell volume and red cell distribution width after hemorrhage or hemolysis are unreliable indicators of regeneration
A
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2
Q

(regenerative anemia)

  1. what is the best method of assessing the equine erythroid regenerative response?
A
  1. determination of bone marrow myeloid-erythroid (M:E) ratio or bone marrow reticulocyte count
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3
Q

(regenerative anemia)

  1. what M:E ratio is consistent with erythrocyte regeneration?
  2. normal BM contains 3% reticulocytes

may increase to what after acute severe hemorrhage?

A
  1. 0.5
  2. 66%
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4
Q

(regen anemia)

  1. if bone marrow analysis is not an option, what may be monitored to assess regeneration?
A
  1. PCV
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5
Q

1-2. What are the two main causes of regenerative anemia?

A
  1. blood loss
  2. RBC destruction
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6
Q

1-4. what 4 things can cause RBC destruction?

A
  1. immune mediated
  2. neonatal isoerythrolysis
  3. heinz body anemia (oxidative dmg)
  4. RBC parasites
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7
Q

(intravascular hemolysis)

  1. hemoglobin from lysed RBCs released directly into plasma
  2. some excess hemoglobin is taken up by mononuclear phagocytes and metabolized to bilirubin
  3. other hemoglobin is filtered through the renal glomerulus -> resulting in hemoglobinuria and potential renal tubular damage
A
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8
Q

(extravascular hemolysis)

  1. damaged RBCs are removed from circulation by mononuclear phagocytes
  2. do gross hemoglobinemia and hemoglobinuria occur?
  3. hemoglobin is degraded directly into bilirubin inside the phagocytic cell, therefore serum conc of what increase?
A
  1. no
  2. serum bilirubin
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9
Q

(blood loss)

(treatment of acute severe hemorrhage)

  1. considered loss of what % of blood volume?
  2. what are the two most important aspects of therapy?
  3. what are options for fluid volume replacement?
  4. 1 mL of whole blood/lb of body weight should increase the recipient’s PCV by what?
A
  1. 15-30%
  2. stopping loss and replacing blood volume
  3. hypertonic saline

isotonic saline (total volume should exceed estimated blood loss by 2-3x)

whole blood transfusion

  1. 1%
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10
Q

(Heinz body anemia)

  1. caused by oxidative denaturation of hemoglobin -> heinz bodies
  2. these cells removed from circulation by either intravascular hemolysis or macrophages as part of the reticulo-endothelial system
A
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11
Q

(Heinz body anemia)

A
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12
Q

(heinz body anemia)

1-3. three toxins that cause?

A
  1. phenothiazine
  2. wilted red maple leaves (^methemoglobin conc)
  3. wild onions
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13
Q

(heinz body anemia)

(differentials)

A
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14
Q

(heinz body anemia)

(diagnosis)

(CBC, chem, UA)

A
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15
Q

(heinz body anemia)

(imaging)

  1. may see enlargement of what two organs?
A
  1. spleen and liver
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16
Q

(heinz body anemia)

(treatment)

  1. remove source of oxidant
  2. blood transfusion if indicated - when would it be indicated?
  3. IV fluids to prevent what?
  4. oxygen therpay - often ineffective why?
  5. no specfic medicine for this
A
  1. evidence of tissue hypoxia, PCV less than 12%
  2. pigment nephropathy
  3. O2 carrying capacity is too low
17
Q

(heinz body anemia)

  1. what are three possible side effects?
A
  1. laminitis, nephrosis, abortion
18
Q

(heinz body anemia)

  1. prognosis?
A
  1. if cause removed and methemoglobinemia minimal, prog is good - may take a few weeks for recovery though
19
Q

(immune mediated anemia)

A
20
Q

(immune mediated anemia)

A
21
Q

(immune mediated anemia)

  1. see enlargement of what on necropsy?
  2. what else?
A
  1. liver and spleen
  2. pale/icteric tissues
22
Q

(immune mediated anemia)

(causes)

  1. example of primary immune mediated?
  2. autoimmune hemolytic anemia can result from what?
A
  1. neonatal isoerythrolysis
  2. incompatible blood transfusion
23
Q

(immune mediated anemia)

(causes)

(secondary immune mediated)

  1. three causes of toxicosis?
A
  1. phenothiazine, red maple leaves, wild onions
24
Q

(immune mediated anemia)

(causes)

(secondary immune mediated)

  1. cause of infectious?
  2. a neoplasm that can cause?
  3. 3 drugs that can cause?
A
  1. equine infectious anemia
  2. lymphosarcoma
  3. penicillins, cephalasporins, sulfas
25
Q

(immune mediated anemia)

A
26
Q

(immune mediated anemia)

A
27
Q

(immune mediated anemia)

  1. enlarged spleen/liver with US
  2. radiograph of thorax looks normal unless there is neoplasia
A
28
Q

(immune mediated anemia)

discontinue currnets meds to rule out drug assoc IMHA

  1. what is the drug of choice to treat?
A
  1. dexamethasone (glucocorticoids)

then a decreaseing dose program of prednisolone

29
Q

(immune mediated anemia)

  1. two adverse side effects?
A
  1. pigment nephropathy

laminitis

30
Q

(immune mediated anemia)

  1. prognosis
A
  1. if primary cause id’ed and treated - prog is good

horses requiring constant corticosteroid tx may have incurable underlying disorder - prog is poor

31
Q

(neonatal isoerythrolysis)

1.

A
32
Q

(neonatal isoerythrolysis)

  1. there are seven major blood group systems in horses.

mass majority is due to incompatability of what two blood types?

A

Aa and Qa

equine-04-hematology (2 decks)

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