ANEMIA Flashcards
Differentiate nonregenerative anemia and regenerative anemia.
Regenerative - bone marrow responds appropriately to the body’s demand of RBC
Nonregenerative - bone marrow cannot respond appropriately to the body’s demand of RBC
What happens when the body loses a third of its blood?
Shock or death
How is splenomegaly related to anemia?
When an organ is abnormally enlarged, it tends to be overactive. In the case of splenomegaly, the spleen tends to trap and remove too many cells from circulation. It traps and removes more cells than what the body can normally produce resulting in cell deficiency.
Formula for “corrected reticulocyte %”
(observed retoculocyte percentage) PCV of patient/Normal PCV for the specie
what type of anemia is expressed when the result shows macrocytosis? And what lab test should be performed to measure macrocytosis?
Macrocytosis is often displayed when an animal has regenerative anemia.
CBC is performed to measure the MCV of an animal. (Increased MCV=macrocytosis)
What is the hallmark for iron-deficiency anemia?
Microcytosis (decrease in MCV)
What is MCHC? And what is normochromic and hypochromic?
Mean corpuscular hemoglobin concentration - measures the hemoglobin concentration for each RBC g/dL
Normochromic - normal MCHC
Hypochromic - low MCHC
What is the histologic morphology of basophils when an animal is exposed to too much lead?
Basophilic stippling.
An oxidative injury which causes RBC’s to breakdown
Heinz Body formation
What are spherocytes and schistocytes?
Morphologic abnormality of cells. In RBC’s, these are often observed when an animal is showcasing signs of anemia.
Spherocytes - sphere shaped rbc that breakdown easily
Schistocytes - fragmented rbc primarily caused by mechanical damage caused by fibrin strands on the endothelium
What is the absolute reticulocyte count in cats and dogs to be considered regenerative anemia?
D - >60k microliter
C - >50k microliter
A corrected reticulocyte percentage which indicates regenerative anemia.
> 1%
Ecchymosis and petechiaetions are the hallmark of what hematologic abnormality?
Thrombocytopathy
Confirmatory test to diagnose autoimmune hemolytic anemia
Coombs test
First line of treatment for AIHA
Cortecosteroids
Biopsy or Aspirates
Evaluates the architecture and degree of cellularity of cells. Cytologic evaluation.
Evaluates cellular morphology. Histopathologic evaluation
1st - b
2nd a
Test for unexplained nonregenerative anemia
Bone marrow biopsy and or aspirate
Hallmark of iron deficiency anemia
Hypochromic and microcytosis
Likely cause of microcytosis and hypochromia in young animals? In old animals?
Y - parasitism (intestinal or tick and flea)
O - GI ulcers or tumor
Define
Hemoglobinuria
Hemoglobinemia
Hemoglobinuria - presence of hemoglobin in urine
Hemoglobinemia - saturation of hemoglobin in the blood plasma due to over saturation of haptoglobin with hemoglobin dimers
If haptoglobin is saturated, hemoglobin dimers accumulate in the plasma (hemoglobinemia) and pass through the glomerulus where they are resorbed and degraded by proximal tubule cells or excreted in the urine (hemoglobinuria).
Hematologic hallmarks of IMHA
Positive Coomb’s test, hyperbellirubinemia, spherocytosis, regenerative anemia, and autoagglutination
Test to diagnose anti-RBC antibody
Flow cytometry. (88-100% specific for diagnosing anti-rbc antibody)
Drug of choice for IMHA indl dogs and cats (with dosage)
Prednisone, bid, 2mg/kg
Azathioprine, 5mg/kg (replace with chlorambucil for cats)
Why is aspirin added to drug regimen when prednisone and azathioprine are medicated?
Low dose of aspirin, 0.5mg/kg/day can improve times in dogs treated with prednisone and azathioprine. Okus, pred and azat can cause platelet aggregation which may cause thromboembolism, aspirin helps in platelet decumulation.
Drug of choice for acute hemolytic crisis.
Human prep, IVIG (0.5-1.5mg/kg as a single dose)
Cyclosporine (10mg/kg/day)
Platelet count concentration of dogs which should be treated with heparin and antiplatelet therapy.
> 40k microliter
Test to measure heparin therapy
APTT (activated partial thromboplastin time)
Define Neonatal Isoerythrolysis
Immune mediated hemolytic disease where the mare produces antibodies against the foals’s rbc and transfer these antibodies through colustrun
Animals which are highly predisposed in Neonatal Isoerythrolysis.
Mules and thoroughbred horses.
(Horses, mules, cattle, pigs and cats, rarely dogs)
How is Neonatal Isoerythrolysis confirmed?
Screening maternal serum, plasma, or colustrum against paternal or neonatal RBCs. If agglutination is present, then the diagnosis is confirmed.
Type of hemolysis caused by mechanical damage of RBCs along the vessels. Typically caused by intravascular coagulation.
Microangiopathic hemolysis
Hemangiosarcoma
Vascular tumors
Normal level of phosphate in the serum
2.5 - 4.5mg/dl (0.81-1.45mmol/L)
What is the hallmark of refeeding syndrome?
Hypophosphatemia
Equation for computing osmotic pressure
Von ‘t Hoff Equation
pi=iMRT
pi = o.p.
i = VHE
M = molar conc of solute
R = ideal gas constant
T = temp in Kelvin
Treatment for Hypophosphatemia.
IV or oral phosphorus (potassium acid phosphate)
Treatment for water intoxication
Diuretics (mannitol) and hypertonic solution (2.5% saline)
Symptoms for water intoxication
Hypochloremia, hyponatremia, decreased serum osmolality, and low urine SG.
Define pyruvate kinase defficiency
A congenital hemolytic anemia that causes rbcs to break down faster than they should. (A type of regenerative anemia)
Define Phosphofructokinase deficiency
A heritable hemolytic anemia that causes hemolysis set off by alkalosis and over excitement and exercise. (Setting off these situations can cause these animals to have a normal life)
Phosphofructokinase together with PFKM are responsible for the metabolism of glycogen to provide energy to muscle cells
Hallmark of pyruvate kinase deficiency
Myelofibrosis and osteosclerosis in the bone marrow.
Treatment for cats with pyruvate kinase deficiency
Splenectomy and steroids
A heritable disease caused by the build up of porphyrins in cats, cattle, and pigs.
Porphyria
Breed of cattle highly susceptible to build up of porphyrins
Holstein
Diagnostic test for animals positive in porphyria
Increase level of porphyrins in bone marrow, urine, or plasma. Teeth of animals fluoresce under ultraviolet light.
What is the likely cause of iron deficiency anemia?
Blood loss and chronic renal failure
Animals which are predisposed to iron deficiency
Young animals especially rapid growing piglets.
Why are young animals susceptible to iron deficiency anemia?
Young animals rely on milk and milk has low levels of iron. Also, young animals have very low iron stores.
Nutrient deficiency developed when cattle are fed with high levels of molybdenum or sulfate and pigs fed with whey proteins.
A deficiency of this nutrient will also hinder iron metabolism.
Copper defficiency.
Diagnostic test and treatment for copper deficiency.
DT - Low blood copper concentrations and liver biopsy (more definitive)
Treatment - oral or injectable copper suplementation
The enterocyte of this breed is unable to absorb cobalamin.
Giant Schnauzers
Type of drug that interferes with folate metabolism
Anticonvulsants.
A type of nutritional deficiency which can likely cause normocytic, normochromic, nonregenerative anemia.
B vitamin deficiencies (folate or cobalamin deficiency)
T or F.
Cattle grazing in cobalt-deficient pasture may lead to B vitamin deficiency.
T
T or F
Treatment for animals with nutrient deficiency is either oral or parenteral supplementation of the deficient nutrient.
T.
Differentiate anemia and normocytic anemia
A - decrease in the circulating rbc mass.
N. A - normal MCV units but the hgb and hct are decreased
A type of glycoprotein hormone that has less impact in inducing reactive antibodies than recombinant human erythropoietin in treating chronic anemia.
Darbepoeitin.
What part of the kidney produces EPO? And what type of its cell is responsible for the production of EPO?
Renal cortex, peritubular endothelial cells.
Line of treatment for animals with renal anemia
Recombinant human erythropoeitin (44-133 U/kg 3x/wk with most animals starting at 88U/kg) plus iron supplementation
What catalyzes phosphoenolpyruvate and ADP to form pyruvate and ATP for glycolysis?
Pyruvate Kinase
Define aplastic anemia
Non regenerative anemia that causes your bone marrow to produce insufficient cells for the body. There is no cure for aplastic anemia (stem cell kana lang boi)
Antibiotic drugs which can cause aplastic anemia
Chloramphenicol and trimethoprimsulfa.
Nonregenerative anemia that causes severe depletion of erythroid precursors in the bone marrow. This type of disease can be treated with immunosuppressent drugs as the first line of defense.
Pure Red Cell Aplasia
Diseases which may be caused by Recombinant Human EPO.
autoimmunity diseases.
Pure Red Cell Aplasia
Treatment for Aplastic Anemia
Immunosuppressive agents and recombinant human epo and granulocyte stimulating factor (5 mcg/kg/day PO)
Give some Immunisuppressive agents
Prednisone, prednisolone, azathioprine, cyclosporine, mycophenolate.
Uncontrolled growth of immature white blood cells or blast cells filling up the bone marrow and preventing the production of other cell lines.
Leukemia
Name all myeloid lines and lymphoid lines.
M - erythrocytes, granulocytes (baso, eosino and neutro), monocytes (dendritic and macrophage) megakaryocytes
L - T cell, B cell (plasma cell), NK cell
Abnormal conditions where abnormal levels of proteins called paraprotein are located in the blood.
Monoclonal gammopathy. (Some of these abnormalities are linked to Monoclonal Gammopathies of Unknown Significance)
What is the most common site for bone marrow biopsy
Humerus (preferably the greater tubercle, ata? Basta humerus)
Common sites for bone marrow biopsy
Costochondral junction, iliac crest, trochanteric fossa of the femur, tibial crest, and the hreater tubercle of the humerus
During biopsy, the animal is positioned in ___(1)___ recumbency when using the trochanteric fossa or the greater tubercle, and in ___2___ recumbency when using the iliac crest.
1 - lateral
2 - sternal
Types of bone marrow aspiration needles
Rosenthal, illionoos, and Jamshidi Needles (rigid and hollow with stylet)
Primary bone marrow disease can lead to which of the ff.?
Pancytopenia and N.R.A.
Pancytopenia and R.A.
P and N.R.A.
What organ produces ADH? What releases it?
P - Hypothalamus
R - Pituitary Gland
