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Clinical Pathology > 5: Haematology 3 > Flashcards

5: Haematology 3 Flashcards

1
Q

What are some primary causes of secondary haemolytic anaemia?

A

Neoplasia, drugs, alloimmune

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2
Q

What are two non-immune mediated causes of haemolytic anaemia?

A

Oxidative damage, envenomation

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3
Q

Which sex and breed usually get IMHA?

A

Female Cockers, not cats

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4
Q

What’s the normal cause of IMHA?

A

Idiopathic

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5
Q

What are four drugs that can cause IMHA?

A

NSAIDs, cephalosporins, sulphonamides, vaccinations

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6
Q

What are three infectious agents that can cause IMHA?

A

Babesia, Leishmania, FeLV

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7
Q

Which antibodies are produced in IMHA?

A

IgG/M

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8
Q

What happens to the RBCs following recognition by macrophage Fc receptor?

A

Either fully destroyed or form a spherocyte following removal of part of the membrane

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9
Q

Other than IMHA, what other conditions can cause spherocytosis?

A

Zn toxicity, envenomation, PFK deficiency

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10
Q

When can spherocytosis be artefactual?

A

In tail of the smear

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11
Q

Why can’t you see spherocytosis in cats?

A

Their blood cells don’t have central pallor

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12
Q

In which species in Rouleaux normal?

A

Cats and horses

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13
Q

How do you tell apart Rouleaux vs agglutination?

A

Rouleaux will disperse in saline, agglutination won’t

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14
Q

WHen doing an agglutination test for IMHA, what must you do to remove other causes of agglutination?

A

Wash cells and do it again to remove other causes

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15
Q

What is the definitive test for IMHA?

A

Coombs test

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16
Q

How do you treat idiopathic IMHA?

A

High dose pred or cyclosporin or azathioprine

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17
Q

How do you treat the hypercoagulable state in IMHA?

A

Aspirin, transfusion, anti-thrombin therapy

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18
Q

How can you remove the problem macrophages in IMHA?

A

Splenectomy

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19
Q

Which species gets haemolytic anaemia due to haemotropic mycoplasmas?

A

Cats

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20
Q

Which species gets haemolytic anaemia due to Babesia?

A

Dogs and cattle

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21
Q

Which species gets haemolytic anaemia due to Leptospirosis?

A

Cattle, lambs, pigs

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22
Q

Which species gets haemolytic anaemia due to Clostridium?

A

Ruminants, horses

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23
Q

Which species gets haemolytic anaemia due to equine infectious anaemia virus?

A

Horses

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24
Q

How many species of haemolytic mycoplasmas are there?

A

4

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25
Q

What is the most common species of haemolytic mycoplasma?

A

M. heamofelis

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26
Q

Which part of the cell to haemolytic mycoplasmas attach to?

A

Cell membrane

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27
Q

Which kind of haemolysis does haeotropic mycoplasma cause?

A

Extravascular

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28
Q

What duration of parasitaemia does haemotrpic mycoplasma cause?

A

Cyclical

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29
Q

How do you test for haemotropic mycoplasma?

A

Hard to see on blood smear so use PCR

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30
Q

Which kind of cats are most likely to get haemotropic mycoplasma?

A

FeLV infected

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31
Q

What kind of parasite is babesia?

A

Intracellular protozoan

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32
Q

How is babesiosis spread?

A

Tick

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33
Q

Which kind of haemolysis does babesiosis give?

A

Extravascular or intravascular +/- IMHA

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34
Q

How do you diagnose babesiosis?

A

Can see on capillary blood smear but PCR is best

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35
Q

What are two examples of alloimmune haemolysis?

A

Transfusion reactions and neonatal isoerythrolysis

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36
Q

What causes neonatal isoerythrolysis?

A

Ingest antierythrocyte antibodies from colostrum

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37
Q

What is the most relevant dog blood group?

A

DEA1.1

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38
Q

How many times can you transfuse a dog without cross-matching?

A

Once

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39
Q

How do DEA1.1 dogs get alloantibodies?

A

From transfusion reaction or pregnancy/parturition of a positive pup

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40
Q

What are the three cat blood groups?

A

A (weak anti-B), B (strong anti-A), AB (no reaction)

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41
Q

When must you especially cross match in cats?

A

Type A given to type B

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42
Q

What happens if a type B cats has type A kittens?

A

Neonatal isoerthyrolysis from colostrum

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43
Q

How can you prevent neonatal isoeryhtrolysis in kittens?

A

Pre-breeding blood typing

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44
Q

What is formed by oxidation of haemoglobin chains?

A

Heinz bodies

45
Q

Oxidant damage to what leads to eccentrocytes?

A

RBC cell membrane

46
Q

How is methaemoglobin formed?

A

Oxidation of Fe3+ to Fe2+

47
Q

What stain is used to see Heinz bodies?

A

Methylene blue

48
Q

Which kind of haemolysis are Heinz bodies associated with?

A

Intra or extravascular

49
Q

What are four toxins that can result in Heinz bodies?

A

Onions, garlic, paracetamol, zinc

50
Q

In which species can Heinz bodies be normal?

A

Cats

51
Q

Which other diseases can cause Heinz bodies?

A

Liver disease, diabetes, hyperthyroidism, recent propofol

52
Q

Which conditions can cause erythrocyte fragmentation?

A

Abnormal vessels e.g. haemangiosarcoma, fibrin clots, valvular disease

53
Q

Which kind of cells are formed by erythrocyte fragmentation?

A

Acanthocytes and schistocytes

54
Q

Why do you get mild anaemia following acanthocyte and schistocyte production?

A

Removed by spleen

55
Q

Which breeds are prone to PK deficiency?

A

Various

56
Q

What is degree of anaemia and prognosis like in PK deficiency?

A

Severe regenerative, poor prognosis

57
Q

Which breeds are prone to PFK deficiency?

A

Cocker

58
Q

What is degree of anaemia and prognosis like in PFK deficiency?

A

Mild, regenerative, good prognosis

59
Q

Why is PFK deficiency worse with hyperventilation?

A

Shows “alkaline fragility”

60
Q

When does hypoP commonly occur?

A

Following insulin or post-parturient

61
Q

What kind of haemolysis does hypoP cause?

A

Intravascular

62
Q

Why does hypoP cause haemolysis?

A

Reduces ATP so can’t maintain membranes so more likely to be haemolysed

63
Q

Which cells are reduced in aplastic anaemia?

A

Pancytopaenia

64
Q

What is happening to bone marrow in aplastic anaemia?

A

Marrow stem cells are replaced by fat

65
Q

What are the three causes of an aplastic anaemia?

A

Infection (parvo, FeLV), drugs (oestrogen, bute), immune mediated

66
Q

Why do leucopaenia and thrombocytopaenia precede anaemia in aplastic anaemia?

A

Shorter cell life span

67
Q

What is another name for pure red cell aplasia?

A

Intramedullary IMHA

68
Q

Which cells are damaged in pure red cell aplasia?

A

Erythroid precursors only

69
Q

What is the normal cause of pure red cell aplasia?

A

Immune-mediated

70
Q

What kind of anaemia do you see in pure red cell aplasia caused by FeLV?

A

Macrocytic

71
Q

What are cells in bone marrow doing in pure red cell aplasia?

A

Erythroid hypoplasia or maturational arrest

72
Q

Which kind of -penias does luekaemia cause?

A

Anaemia, neutropenia, thrombocytopenia

73
Q

Other than in leukaemia, which other neoplasias can replace bone marrow cells?

A

Stage V lymphoma in dogs, histiocytic sarcoma, mammary or mast cell

74
Q

Which cells lines are reduced in myelofibrosis?

A

Anaemia only

75
Q

What is an example of a disease myelofibrosis can be secondary to?

A

IMHA

76
Q

How well do cells exfoliate in myelofibrosis?

A

Not well

77
Q

How do you diagnose myelofibrosis?

A

Bone marrow core biopsy

78
Q

WHat is the most common cause of secondary non-regenerative anaemia?

A

Anaemia of inflammatory disease

79
Q

How long must inflammatory disease be present to cause anaemia?

A

A long time

80
Q

What do WBCs look like on CBC in anaemia of inflammatory disease?

A

Inflammatory leucogram

81
Q

WHat three processes cause anaemia in inflammatory disease?

A

Increased hepcidin (decreased Fe absorption), shortened RBC survival (oxidative injury), blurred release and response to EPO

82
Q

What three processes cause anaemia in CKD?

A

Reduced EPO due to reduced renal mass, reduced RBC lifespan due to uraemia, chronic GI haemorrhage due to ulceration

83
Q

Which endocrine hormones enhance EPO’s effects?

A

Thyroid hormone and cortisol

84
Q

Which endocrine diseases can cause anaemia?

A

Hypothyroid, Addisons

85
Q

Which three nutritional deficiencies can cause non-regenerative anaemia?

A

Iron, copper, B12/folate

86
Q

What are the two types of erythrocytosis?

A

Relative or absolute

87
Q

In which cases is iron deficiency anaemia caused by dietary deficiency?

A

Fleas or piglets, but not usually dietary deficiency other than this

88
Q

What kind of anaemia does iron deficiency result in?

A

Microcytic or hypochromic

89
Q

Which toxin is associated with methaemoglobinaemia in cats?

A

Paracetamol

90
Q

What does blood look like in methaemoglobinaemia?

A

Chocolate brown

91
Q

How do you test for methaemoglobinaemia?

A

Drops venous blood onto blotting paper, stays brown

92
Q

What kind of haemolysis occurs when eccentrocytes are removed by the spleen?

A

Extravascular

93
Q

What toxin is assocaited with methaeoglobinaemia in ruminants and pigs?

A

Nitrite

94
Q

Which are the most relevant blood groups in horses?

A

Aa, Ac, Ca, Qa

95
Q

Horses lacking which blood antigen may have natural antibodies?

A

Aa, Ac, Ca

96
Q

How can Qa -ve mares get anti-Qa antibodies?

A

After having a +ve foal

97
Q

Can negative horses have natural alloantibodies?

A

Yes

98
Q

When do you get neonatal isoeryhtrolysis in horses?

A

Aa/Qa -ve mare gets alloantibodies during foaling or transfusion. Then next foal gets autoantibodies from mother causing haemolysis

99
Q

How do you treat primary erythrocytosis?

A

Phlebotomise to reduce PCV and viscosity and do chemo

100
Q

How do you treat secondary absolute erythrocytosis?

A

Treat cause, then phlebotomise to reduce PCV and viscosity

101
Q

Which cells are not seen in relative erythrocytosis?

A

No polychromasia/reticulocytes

102
Q

What are two causes of relative erythrocytosis?

A

Dehydration (PP also increased) or splenic contration (PP normal)

103
Q

Which cells are seen in absolute erythrocytosis?

A

polychromasia/reticulocytes

104
Q

What causes primary erythrocytosis?

A

Neoplastic proliferation of red cells and sometimes other cell lines

105
Q

Which hormone is secondary erythrocytosis caused by?

A

EPO

106
Q

What’s an example of appropriate secondary erythrocytosis?

A

Hypoxia in CPD or cardiovascular shunting

107
Q

What’s an example of inappropriate secondary erythrocytosis?

A

EPO secreted from renal tumour

108
Q

What are some conditions caused by absolute erythrocytosis?

A

Epistaxis, congested retinal vessels, seizures

109
Q

Why do you get poor perfusion in absolute erythrocytosis?

A

Increased blood volume, sludging of blood, distended blood vessels

Clinical Pathology (30 decks)

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