Anaemia Flashcards
What is a bicytopenia?
Two cytopenias together at one point in time
What four things can cause cytopenia?
- reduced production
- sequestration
- Increased loss
- Increased destruction
How does anaemia present itself clinically?
- lethargic/ collapsed
- Pale/yellow mucus membranes
- Tachycardia
- Hypotension
- Bounding/Weak peripheral pulses
- Altered respiration
What is the third rule?
haemoglobin should be a third of the haematocrit
What is MCV?
Mean Corpuscular volume
measures the average size of your red blood cells
How is regenerative anaemia fixed?
The bone marrow responds by increasing the number of red blood cells
What is the main thing that causes regenerative anaemias?
Haemorrhage, e.g loss of blood which can be internal or external
What is a sign that you have regenerative aneamia?
High concentration of reticulocytes
What are the two main things that can cause anaemias?
- Haemorrage (either internal or external)
- Haemolysis
Name 5 clinical signs of Anaemia
- Lethargic/ Collapsed
- Pale mucous membranes (potentially jaundice)
- Tachycardia
- Hypotension
- Weak peripheral pulses
What does increased Hgb degredation lead to?
Increased billirubin formation
What are the main differences between conjugated and unconjugated billirubin?
*Unconjugated billirubin *
* Insoluble in blood
* Toxic to tissues
* Cannot be excreted in the urine
*Conjugated Billirubin *
* Water soluble
* Relatively non-toxic
* can be excreted in the urine
What is acute blood loss?
Blood is lost over a few hours
Anaemia occurs from the dilution of remaining erythrocytes
How can you recover from acute blood loss?
- reabsorption of erythrocytes
- Tissue hypoxia stimulates more prodcution of erythropoetin
What is chronic blood loss?
Blood is lost over days/weeks/months
What are the two ways there is increased loss/ destruction (anaemia)?
- Haemorrhage (can be either internal or external)
- Haemolysis ( mechanical/ due to cell damage or immune)
What does the blood analysis look like in anaemia?
- Decrease in the mean cell volume
- More reticulocytosis (increase in circulating reticulocytes)
- Haemoglobin decreases
- Increase in billirubin
How may you determine anaemia severity?
- Mild- worth monitoring but most likely just reflecting other disease processes
- Moderate- most likely to be a primary concern PCV below 20
- Marked for significant concern- PCV below 12-15% (requires investigation and rapid treatment)
What type of anaemia is immature RBC’s a sign of?
regenerative
-reflects the bone marrows attempts to increase the circulating blood cells
What is intravascular anaemia?
- The lysis of blood cells within vessels
- severe or rapidly falling anaemia
- present over hours or days
haemoglinaemia-increased haemoglobin
What is extravascular anaemia?
- Erythrocyte lysis outside of blood vessels (e.g in macrophages)
- mild to marked anaemia
- Haemoglobinaemia and haemoglobinuria not
present
What is the difference between primary and secondary anaemia?
- Primary- idiopathic
- Secondary- it was caused by an underlying disease
What is oxidative damage?
Haemoglobin is damaged and this effects the cell membrane
It produces heinz bodies which tells you that the anaemia is from oxidative damage
What is a distemper inclusion?
From infectious stress, e.g from mycoplasma
you need to look for an infectious agent inside of the RBC that therefore causes the RBC to lyse
What is an internal haemorrhage?
- haemorrhage into cavities
*(regenerative anaemia)
What is an external haemorrhage?
haemorrhage outside of the body
* External trauma
* Epistaxis
* Haematemesis
* Haematuria
* Melena
usually in iron-deficiency anaemia
What is the evidence of iron deficiency?
- Hypochromic cells
- more central pallor
is initialaly regenerative but is more likely to be due to external blood loss
What are some examples of erythrocyte fragmentation?
- Schistocytes
- Keratocytes
- Acanthocytes
- Spherocyte-like cells
What are the three major mechanisms considered in drug-induced IMHA?
- Drug adsorption- e.g. penicillin binds covalently to erythrocytes and stimulates hapten-dependent antibodies
- Autoantibody induction- induces formation of autoantibodies – antibodies can bind to normal erythrocytes in
absence of drug - Drug-dependent antibody induction- induces antibodies only when soluble drug is present
What is neonatal isoerythrolysis?
Can occur in dams or queens
Leakage of blood across the placenta during pregnancy
leads to the production of antibodies
antibodies destroy the foals RBC’s
What is teh gold standard test for equine infectious anaemia virus and what happens if an animal is infected?
- Coggins test
- Confirmed infected animals are destroyed
What can cause non-regenerative anaemias?
- Renal disease
- Liver disease
- Bone marrow disorders
- (* Myelofibrosis- can be a sequalae of PK deficiency
- Damage following inflammation, necrosis, toxicosis (e.g. oestrogen))
What is the main point of non-regenerative anaemias?
either decreased or ineffecive erythropoiesis
Absence of reticuolcytes or polychromatophils in peripheral blood (and within bone marrow samples)
* Usually normocytic, normochromic, non-regenerative (anaemia present >5 days
What nutritional diseases can cause non-regenerative anaemia?
- Lack of Iron
- Lack of folate or Coblamin
- Copper
What are some inherited disorders that can cause non-regenerative anaemia?
- Dyserythropoesis of English Springer Spaniels
- Congenital dyserythropoesis of polled Hereford calves
What is polycythemia?
rare blood disorder in which there is an increase in all blood cells, particularly red blood cells
What can cause polycthenia?
- Splenic contraction due to excitement
- relative erythocytosis
- Pathological
