2 – RBC Intro

Question 1

What is the definition of anemia?

Answer 1

• Decreased [RBC] in peripheral blood

Question 2

How do you detect anemia?

Answer 2

• Decreased RBC count
• Decreased [Hgb]
• And/or decreased hematocrit (Hct) on CBC

Question 3

What does anemia look like clinically?

Answer 3

• Exercise intolerant
• Weakness
• Depression
• Tachypnea
• Pale mucous membranes

Question 4

What are the different ways to classify anemia?

Answer 4

• Cause
• Degree of anemia
• Regenerative vs. non-regenerative
• Erythrocyte indices (MCV, MCHC)
• Erythrocyte morphology

Question 5

What are the 3 big picture causes of anemia?

Answer 5

• Blood loss anemia: RBC LOST
• Hemolytic anemia: RBC destroyed
• Non-regenerative anemia: RBC not made

Question 6

How do you grade the degree of the anemia? (mild, moderate or marked)

Answer 6

• Use Hct
  o Only guidelines, but you will develop your own feel for it

Question 7

Regenerative anemia

Answer 7

• Erythropoiesis is ongoing-steady state
  o Increased is an appropriate response of bone marrow to anemia
  o Ex. presence of polychromatophils/reticulocytes (immature RBC) (EXCEPT HORSES)
   Same cell, just differently stained depending what technique

Question 8

What is non-regenerative anemia?

Answer 8

• Lack of RBC production by bone marrow
• Absence of polychromasia/reticulocytosis

Question 9

Erythropoiesis general

Answer 9

• 1. Differentiation: loss of nucleus and hemoglobinization
• 2. Multiplication: mitotic divisions
• *takes time
  o Get EPO released in minutes, then 7-10d for peak response (dog)

Question 10

Hemoglobinization

Answer 10

• Requires iron
• NO time, NO iron = NO regeneration

Question 11

How do you grade the regenerative response?

Answer 11

• Using absolute reticulocyte count (x10^9/L)
• *horses do NOT generally release reticulocytes

Question 12

Why do you grade the regenerative response?

Answer 12

• **Help determine if response is sufficient or not
  o If marked anemia but only moderate regenerative response=not good, need to figure out why it is inadequate

Question 13

Regenerative anemia in horse

Answer 13

• NO release of polys/retics
• Need to rely on other indicators
  o Increasing Hct over time
  o Macrocytosis, increased anisocytosis
  o Bone marrow-erythroid hyperplasia

Question 14

What is MCV?

Answer 14

• Mean cell volume (fL)
• Microcytic, normocytic, macrocytic

Question 15

What is MCHC?

Answer 15

• Mean cell hemoglobin concentration (g/L)
• Hypochromic, normochromic
• (hyperchromic=artifact)