Anemia

Question 1

Define anemia

Answer 1

a decrease in the amount of circulating RBCs

Question 2

What things are usually decreased with anemia (regardless of type)

Answer 2

Packed Cell Volume (PCV)/Hematocrit (HCT)
RBC count
Hemoglobin concentration

Note: PCV and HCT are essentially the same test

Question 3

Define regenerative anemia

Answer 3

The ability of the bone marrow to recognize that a decreased number of RBCs is present, responding to that decrease via production and release of immature RBCs (reticulocytes- slightly larger & contains less Hb than mature RBCs) into circulation.

Question 4

How is regenerative anemia identified

Answer 4

• decreased HCT (or PCV)
• decreased RBC count
• decreased Hb concentration
• increased reticulocyte count
• polychromasia
• hypochromasia
• macrocytosis

+/- RBC parasites

Question 5

define polychromasia

Answer 5

presence of multicolored RBCS with some RBCs showing up bluish-grey in certain dye stain

Question 6

What does polychromasia indicate about the RBC

Answer 6

that there are different amounts of Hb present in the RBCs

Question 7

Name 2 blood parasites

Answer 7

Babesia

Hemobartonella

Question 8

Define macrocytosis

Answer 8

larger than normal RBC size

remember, reticulocytes are larger than normal RBCs

Question 9

Define hypochromasia and why the color change is present

Answer 9

lighter than normal RBC color due to containing less Hb and therefore less red pigment;

pale RBCs with wide central pallor; different from polychromatic which is a light blue colored immature RBC, with the blue color being caused by residual RNA that can be stained

Question 10

What is a reticulocyte, and what does it look like as compared to a mature RBC?

Answer 10

• immature RBC
• has nucleus
• larger
• contains less Hb, so paler in color

Question 11

What are the 2 umbrella causes of regenerative anemia?

Answer 11

hemorrhage (loss or RBCs)

Hemolysis (destruction of RBCs)

Question 12

Causes of hemorrhage (4)

Answer 12

• obvious external injury
• injury to internal organs that leads to rupture
• internal bleeding (trauma or coagulation abnormality)
• parasites

Question 13

Causes of hemolysis

Answer 13

Primary–> immune system targets RBCs as abnormal and removes them from circulation; IMHA can be idiopathic or it can be secondary to another condition that alters RBCs or immune system to attack RBCs

Secondary –> administration or exposure to certain drugs/toxins

Question 14

Define non-regenerative anemia

Answer 14

The inability of the bone marrow to either recognize that anemia is present or to respond through the production of immature RBCs.

Question 15

How is nonregenerative anemia identified

Answer 15

• lack of polychromasia
• presence of normocytosis & normochromasia,
• normal or decreased reticulocyte count

Question 16

Define normocytosis

Answer 16

normal sized RBCs

Question 17

define normochromasia

Answer 17

normal colored RBCs also meaning normal Hg concentrations

Question 18

_________________________ anemia may look like non-regenerative anemia because __________________.

Answer 18

• early regenerative

- it takes time for the bone marrow to respond if it is able to respond

Question 19

What two things are evaluated for both types of anemia?

Answer 19

CBC

reticulocyte count

Question 20

Two umbrella causes for nonregenerative anemia

Answer 20

• primary bone marrow disease

- effects of another disease upon the bone marrow

Question 21

causes of primary bone marrow disease (3)

Answer 21

• neoplasia
• myelofibrosis
• bone marrow aplasia/hypotplasia

Question 22

What is myelofibrosis?

Answer 22

scar tissue formation within the bone marrow

Question 23

What is bone marrow aplsaia/hypoplasia? What are 3 things that can cause it?

Answer 23

a situation where some underlying reason causes the bone marrow to not produce precursors or mature RBCs;

can be the result of…

• giving certain drugs (estrogen)
• certain infectious agents (FeLV, FIV)
• immune mediated destruction of the precursors within the bone marrow itself

Question 24

What are examples of another disease acting on the bone marrow that causes nonregenerative anemia? (4)

Answer 24

• Anemia of chronic disease (ACD)
• Iron deficiency (IDA)
• Anemia associated with renal disease
• Anemia associated with endocrine disease (Cushing’s/Addison’s)

Question 25

How is anemia of chronic disease associated with anemia?

Answer 25

longstanding inflammation/degenerative/neoplastic disease creates the presence of chronic disease that sequesters iron within certain cells in the bone marrow making it unavailable to RBC precursor cells, resulting in decreased RBC production

Question 26

What is the role of the RBC?

Answer 26

to transport hemoglobin (a molecule that carries O2) throughout the body

Question 27

How does anemia affect O2 carrying capacity? How does that impact the body?

Answer 27

decreased O2 carrying capacity –> tissue hypoxia –> tissue dysfunction

Question 28

How does anemia affect blood viscosity? How does that affect the body?

Answer 28

Decreased blood viscosity –> decreased resistance to blood flow –>body notices tissue hypoxia –> body increases HR & cardiac output to get more O2 to tissues
–>offsets tissue hypoxia if chronic, but usually can’t if acute

Question 29

List clinical signs & reasons of acute onset anemia

Answer 29

• Tachypnea –> generalized hypoxia prompts NS to increase RR to get more O2 into the blood
• Tachycardia –> cardiac compensation increases HR
• Heart murmur –> due to thinner blood being more likely to “swirl” and cause turbulence
• Weak pulses –> due to decreased viscosity of blood
• Lethargy/weakness –> due to muscle hypoxia and generalized hypoxia
• Pale/white MMC –> due to decrease in RBC mass resulting in decrease of Hb concentration
• Icterus if hemolysis is present