4: Haematology 2 (Anaemia) Flashcards
What is RDW a measure of?
Red cell distribution width - measure of anisocytosis
What kind of heart murmur does anaemia give?
Systolic
How long does the regenerative response take?
3-5 days
What do you see on a blood smear during the regenerative response?
Increased reticulocytes or polychromasia
In which species do you not see polychromasia during the regenerative response?
Horses
How can you quantify the regenerative response?
Reticulocyte or polychromatophil count
Which reticulocyte count should you use?
Absolute, not %
Do you get a larger regenerative response if larger anaemia?
Yes
If which species does anisocytosis especially show a regenerative response?
Horse
What kind of stippling shows a regenerative response?
Basophilic
Which other cell features can indicate anaemia?
Macrocytosis, Howell-Joll bodies, target cells
Which are the usual nRBCs indicating a regenerative response?
Metarubricytes
What are three conditions, other than a regenerative response, that can cause macrocytosis?
Dyserythropoiesis, erythroleukaemia, FeLV
What are three conditions that can cause microcytosis?
Iron deficiency, PSS, severe liver dysfunction
In which species is rubricytosis sometimes normal?
Dogs and cats
In what situation is rubricytosis appropriate?
If with polychromasia
In what situations is rubricytosis inappropriate?
Lead poisoning, erythroleukaemia, marrow damage (heat stroke), splenic contraction
Why don’t horses have polychromasia or reticulocytosis?
Only mature erythrocytes are released into the circulation
In which species are Howell-Jolly bodies normal?
Cats, and sometimes dogs and horses
After which procedure are Howell-Jolly bodies seen?
Splenectomy
In what conditions are target cells seen?
Due to low Hb seen in regenerative anaemia, iron deficiency, liver dysfunction
Where is the Hb in a codocyte?
Ring at periphery
Which species especially have basophilic stippling due to ribosomes?
Ruminants
Which condition can cause basophilic stippling?
Lead poisoning, regenerative anaemia
How sensitive is increased MCV and decreased MCHC in supporting regeneration?
Only 20% sensitive and 90% specific
What is the only marker of regeneration in horses?
Serial PCV increase
In which breeds can decreased MCV be normal?
Akita, Shiba Inu
In which conditions can MCV be decreased?
Iron deficiency anaemia, PSS, liver dysfunction
In which species can increased MCV be inherited?
Poodles
In which conditions can MCV be increased?
FeLV, hyperNa, B12 deficiency
How can MCV be artefactually increased?
Cell swelling in transit
What usually causes high MCHC?
Artefact - due to lipaemia or haemolysis causing falsely increased MCH
How can MCV be falsely elevated?
In vitro cell swelling
When can MCHC be decreased?
Iron deficiency
How long after haemorrhage do PCV and PP both decrease due to fluid from the interstitium?
4 hours
How long after internal haemorrhage are 65% of erythrocytes resorbed into the circulation?
2-3 days
How long after internal haemorrhage are 80% of erythrocytes resorbed into the circulation?
2 weeks
How long after internal haemorrhage are globulins resorbed?
Rapidly, and globulin production increases quickly
What condition is internal haemorrhage associated with?
Leucocytosis and thrombocytopaenia
How long after external haemorrhage does PP normalise?
5-7 days
How long after haemorrhage does PCV normalise?
2-3 weeks
What blood smear change may also be seen following external haemorrhage?
Mild-moderate thrombocytopaenia
What kind of anaemia do you eventually get after chronic haemorrhage?
Poorly regenerative, iron deficiency anaemia with hypochromic, microcytic cells
Why must you feed white meat only before a faecal occult blood test?
Myoglobin
What happens to PCV and PP initially during chronic haemorrhage?
Change little
Why do you eventually get non-regenerative anaemia following chronic haemorrhage?
Will eventually get iron deficiency
What is PP like in haemolytic anaemia?
Normal or increased
Why are haemolytic anaemias more regenerative than haemorrhage?
Iron is not lost, BUT does sometimes involve progenitor loss
What are the two possible pathological mechanisms of haemolytic anaemia?
Extravascular or intravascular
What degree of anaemia does extravascular haemolysis give?
Mild-severe
What degree of anaemia does intravascular haemolysis give?
Severe
What is prognosis for intravascular haemolysis?
Poor
How long is the onset for extravascular haemolysis?
Insidious
How long is the onset for intravascular haemolysis?
Rapid
How does extravascular haemolysis give splenomegaly?
Erythrocytes phagocytosed by macrophages in spleen/liver
What is happening in intravascular haemolysis?
Erythrocytes lysed within vessels due to membrane damage.
What happens to the Hb in extravascular haemolysis?
Become bilirubin so get jaundice, bilirubinuria, bilirubinaemia
What happens to the Hb in intravascular haemolysis?
Also get jaundice etc, but also haemoglobinaemia/uria
