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Anemia Flashcards

1
Q

What is Anemia?

A
  • any condition that results in a low O2 carrying capacity of blood
  • NOT a diagnosis
  • clinical sign of an underlying conditon
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2
Q

What are Clinical Signs associated with Anemia?

A
  • low oxygenation
  • lethargy
  • exercise intolerant
  • ADR
  • inappetence => anorexia
  • dehydration
  • weight loss
  • low blood (low RBCs)
  • pale mucus membranes
  • slow CRT
  • increased heart rate
  • fast, thready pulse
  • low BP
  • heart murmurs
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3
Q

Depending on the cause of Anemia, you may also see:

A
  • jaundice/icterus
  • extravascular hemolysis
  • RBCs with abnormal surfaces
  • Heinz bodies
  • RBC parasites
  • hemoglobinuria/ hemoglobinemia
  • intravascular hemolysis
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4
Q

What is the Clinical Definition of Anemia?

A

Absolute decrease in total RBC count, PCV, HB concentration or all of the above

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5
Q

What does Anemia result from?

A

Decrease or inefficient rate of production of RBC or increased rate of destruction or loss of RBCs

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6
Q

What is Non-Regenerative Anemia?

A
  • abnormal response
  • NO blood loss
  • lost senesent RBCs that aren’t being replaced
  • no new RBCs are being made
  • kidney receptors sense no Hypoxia => produce no Erythropoietin
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7
Q

What are the causes of Non-Regenerative Anemia?

A
  • Kindeys
  • Bone Marrow
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8
Q

Why are the Kidneys a cause in Non-Regenerative Anemia?

A
  • receptors aren’t detecting hypoxia
  • kidney failure: not making enough erythropoietin
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9
Q

Why is Bone Marrow a cause of Non-Regenerative Anemia?

A

not knowing to make new RBCs

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10
Q

What is Acute Hemmorhage?

A
  • losses greater than 30% of total blood
  • leads to shock and death
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11
Q

What are the clinical signs of Acute Hemmorhage?

A
  • Pulse: rapid, weak
  • BP: low, hypotension
  • MM:: pale
  • PCV: normal
  • Blood Film: normocytic, normochromic
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12
Q

How long does it take for Reticulocytes to appear in blood?

A

72 hours

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13
Q

What are the causes of Acute Hemmorhage?

A
  • Trauma
    • External: HBC, dog fights
    • Internal: surgical, blunt force, ruptured spleen
  • Coagulation Disorders (Internal or External)
    • rodenticide poisioning
  • Large Bleeding Ulcers
  • Bleeding Tumors
    • mammary tumors (most common)
    • splenic tumors
  • Occult Bleeding
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14
Q

How does Chronic Hemmorhage show on RBC Indicies?

A
  • hypochromic
  • microcytic
  • low MCV, MCHC
  • blister cells (keratocytes)
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15
Q

What type of Anemia will Chronic Hemmorhage lead to ?

A

iron deficency anemia

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16
Q

What are the clinical signs for Chronic Hemmorhage?

A
  • vague
  • ADR
  • lethargic and exercise intollerant
  • inappetence / anorexia
  • low water intake => dehydration
  • weight loss
  • HR: rapid
  • BP: low
  • Pulse: thready
  • Heart murmur
  • MM: pale
  • CRT: slow
  • cold extremities
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17
Q

What are the causes of Chronic Hemmorhages?

A
  • Parasites
    • Internal: hookworms (ancylostoma caninum), coccidia (isospora, Eimeria)
    • External: fleas, ticks, lice (blood sucking)
  • G.I Ulcers
  • Neoplasms
    • new tissue growth (tumors)
  • IBD (inflammatory bowel disorder
    • immune mediated/ allergies/ infections
  • Overuse of blood donors (research anemia)
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18
Q

What are the 2 types of Hemolysis?

A
  • Intravascular (vessels)
  • Extravascular (spleen)
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19
Q

What are the Clinical Signs of Intravascular Hemolysis?

A
  • hemoglobinemia
  • hemoglobinuria
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20
Q

What are the clinical signs of Extravascular Hemolysis?

A
  • jaundice
  • icterus
    • buildup of unconjugated Bilirubin. fat soluble
  • splenomegaly
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21
Q

What clinical signs can also sometimes occur in Intravascular Hemolysis?

A
  • jaundice
  • icterus
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22
Q

What are the causes of Hemolysis?

A
  • Immune mediated
  • Heinz Body Anemia
  • Microorganisms
  • Drugs
  • Water Intoxication
  • Microangiopathic Hemolysis
  • RBC Defects
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23
Q

What is IMHA?

A

immune mediated hemolytic anemia

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24
Q

What RBCs are seen in IMHA?

A
  • spherocytes
  • agglutination => hemolysis
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25
Q

What are the 2 causes of IMHA?

A
  • primary
  • secondary
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26
Q

What are the primary causes of IMHA?

A

-idiopathic

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27
Q

What are the secondary causes of IMHA?

A
  • vaccine reactions
  • drug therapy
  • neoplasia
  • infection
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28
Q

What is the “Hallmark” of IMHA?

A

spherocytes (spherocytosis)

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29
Q

What is the Coomb’s Test?

A

serum test used to detect auto antibodies

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30
Q

What are the ranges of IMHA?

A

mild -> moderate -> acute/severe

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31
Q

What is the Prognosis of IMHA?

A
  • depends on severity of the disease
  • also look at causes
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32
Q

What is the Mortality Rate of IMHA?

A

20-75%

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33
Q

What are the treatments for IMHA?

A
  • steroids
    • prednisolone
    • cyclosporins
  • fluid therapy
  • blood transfusions
  • heparin therapy
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34
Q

What are the problems of using sterioids to treat IMHA?

A
  • may cause secondary infections
  • supresses immunity
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35
Q

When is Heparin therapy used for IMHA?

A

when worried about pulmonary thromboembolism

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36
Q

What is Neonatal Isoeryhrolysis?

A
  • cat drawing
  • uncommon in dogs
  • “fading kitten syndrome”
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37
Q

What is Fading Kitten Syndrome?

A
  • bacteria, viral, fungal infections
  • congenital malformations
  • neonatal isoerythrolysis
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38
Q

What blood type are most cats?

A

type A

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39
Q

What is in Colostrum?

A
  • antibodies
  • nutrients
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40
Q

How many blood types are there in dogs?

A

19

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41
Q

What is the most common blood type in dogs?

A

DEA 1.1

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42
Q

What type of dogs have DEA 1.1?

A
  • lab retievers
  • golden retrievers
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43
Q

What type of dogs are good donors?

A

dogs with up ears

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44
Q

How do you determine Major Blood Type crossmatches?

A
  • mix donor RBCs with recipent plasma
  • look for hemolysis
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45
Q

How do you determine Minor Blood Type crossmatches?

A
  • mix donor plasma with recipent RBCs
  • observe for agglutination
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46
Q

What are the causes of Heinz Body Anemia?

A
  • plants
    • onions and garlic
  • baby food
  • drugs and toxins
  • diseases in cats
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47
Q

What % of Heinz Bodies are cats born with?

A

5%

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48
Q

What type of Drugs and Toxins cause Heinz Bodies Anemia?

A
  • acetaminophen (tylenol)
  • propofol
  • napthelene (moth balls)
  • propylene glycol
  • zinc and copper (pennies, vitamins, sunblock)
  • benzocaine (topical anesthetic)
  • crude oil (motor oil)
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49
Q

What cat diseases cause Heinz Bodies Anemia?

A
  • hyper thyroidism
  • diabetes mellitus
  • lymphoma
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50
Q

What Microorganisms cause Hemolysis?

A
  • protozoal blood parasites
  • bacteria
  • viruses
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51
Q

What Protozoal Blood Parasites cause Hemolysis?

A
  • hemotropic microplasms
  • babesia species
  • cytauxzoon species
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52
Q

What type of Bacteria causes Hemolysis?

A
  • ehrlichia canis
  • leptospira species
  • clostridium species
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53
Q

What type of Viruses cause Hemolysis?

A
  • EIA (equine infectious anemia)
  • FeLv
  • FLV
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54
Q

What kind of Drugs cause Hemolysis?

A
  • fenbendazole (panacur)
  • heparin
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55
Q

What are the types of Water Intoxication that cause Hemolysis?

A
  • psychogenic polydypsia
  • fluid admin miscalculations
  • water disease in cats
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56
Q

What is Microangiopathic Hemolysis?

A

turbulent / abnormal blood flow through vessels

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57
Q

What does Microangiopathic Hemolysis result from?

A
  • heartworm disease (microfliaremia)
  • hemangiosarcoma
  • D.I.C (fibrin strands causing schistocytes)
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58
Q

What are the 2 types of RBC Defects?

A
  • congenital (hereditary) membrane defects
  • nutritional defiencies
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59
Q

What is an example of a Congenital Membrane Defect?

A

-congenital stomatocytosis

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60
Q

What are Nutritional Deficencies?

A
  • iron (keratocytes)
  • copper
  • vitamin B
  • hypophosphatemia
    • inhibits RBC glycolysis
61
Q

What are the causes of Hypophosphatemia?

A
  • diabetes mellitus
  • parenteral feeding
62
Q

What is Non-Regenerative Anemia?

A
  • evidenced as a lack of circulating RBCs in the face of anemia
  • no replacement of senscent RBCs
63
Q

How does Non-Regenerative Anemia show up on a blood film?

A
  • normocytic
  • normochromic
64
Q

What does Non-Regenerative Anemia result from?

A

decrease or defective erythropoiesis

65
Q

What are the causes of Non-Regenerative Anemia?

A
  • nutritional deficencies
  • chronic disease
  • renal disease/failure
  • bone marrow disorder/disease
66
Q

What Chronic Diseases are secondary to infection?

A
  • canine parvovirus
  • ehrlichiosis
  • FeLv / FIV
  • inflammation
  • neoplasia
  • liver disease
  • hypothyroidism
  • addison’s
  • cushings
67
Q

What is Renal Disease / Failure?

A
  • produces no erythropoietin
  • receptors arent’ detecting hypoxia

-

68
Q

What are examples of Bone Marrow Disorders/ Diseases?

A
  • aplastic anemia
  • pure RBC aplasia
  • leukemia
  • myelodysplasia
  • myelofibrosis
69
Q

What is Aplastic Anemia?

A
  • bone marrow stops producing
  • idopathic
70
Q

What can Aplastic Anemia be secondary to?

A
  • infections
  • drug therapy
  • toxins
  • irradiation
71
Q

What is the treatment for Aplastic Anemia?

A
  • bone marrow transplants
  • blood transfusions
  • antibiotics (for prevention: prophylaxis)
72
Q

What is Pure Red Blood Cell Aplasia?

A
  • occurs with IMHA
  • auto antibodies are directed against RBC precursors in the marrow
  • autoimmune problem
73
Q

What does Pure Red Blood Cell Aplasia result from?

A
  • FeLv
  • continued treatment with recombinant erythropoietin
74
Q

What are treatments for Pure Red Blood Cell Aplasia?

A

immunosuppresent therapy (steriods)

75
Q

What is Leukemia?

A
  • rare
  • abnormal proliferation of 1 or more WBC lines
  • can be chronic or acute
76
Q

What are the characteristics of Chronic Leukemia?

A
  • usually 1 line of WBCs are effected
  • responds well to treatment
77
Q

What are the characteristics of Acute Leukemia?

A

-more than 1 line of WBCs affected

78
Q

What is the Mean Survival Time of Acute Leukemia?

A
  • about 4 months
  • usually results in panleukopenia
  • low RBCs and platelets
79
Q

Why do patients with Acute Leukemia become immunocompromised?

A
  • mostly circulating blast cells
  • have no granules
  • they are useless WBCs
80
Q

What is Myelodysplasia?

A

-“pre leukemic syndrome”

81
Q

What does Myelodysplasia result from?

A
  • FeLv
  • mutation in stem cell lines
  • neoplasia
  • drug therapy
82
Q

What is the survival time for Myelodysplasia?

A
  • variable
  • depends on what type of leukemia and progression
  • usually progresses into leukemia
84
Q

What is the Bone Marrow Response in Regenerative Anemia?

A
  • bone marrow is responding appropriately to blood loss
  • increased production and delivery of immature RBCs into circulation
85
Q

How long does it take for new immature RBCs to enter the blood stream?

86
Q

How is Regenerative Anemia see on a Blood Film?

A
  • anisocytosis
  • polychromasia
  • reticulocytosis
  • nucleated RBCs
87
Q

How does Regenerative Anemia show up on RBC indicies?

A
  • Macrocytosis (increased MCV)
  • Hypochromasia (decreased MCHC)
88
Q

How is Regenerative Anemia verified?

A

Absolute Reticulocyte Count

89
Q

What is Mtelofibrosis?

A

-bone marrow elements are replaced with fibrous tissue

90
Q

Myelofibrosis can be primary or secondary to:

A
  • irradiation
  • drug therapies
  • IMHA
91
Q

What is the treatment for Myelofibrosis?

A

immunosuppression

92
Q

What are the types of Secondary Bone Marrow Damage?

A
  • radiation
  • cytotoxic drugs
  • chloramphenical
  • estrogen toxicity
  • other drugs
93
Q

What types of Radiation cause Secondary Bone Marrow Damage?

A
  • cancer treatment
  • xray radiation
94
Q

What type of Cytotoxic Drugs cause Secondary Bone Marrow Damage?

A

chemotherapy

95
Q

What is Chloramphenical?

A
  • antibiotic
  • harmful especially to cats
  • also harmful to person administering drugs
96
Q

What type of Estrogen Toxicity causes Secondary Bone Marrow Damage?

A

-hyperestrogenism

97
Q

How does an animal get Hyperestrogenism?

A
  • getting into owners B.C. pills
  • estrogen pills
98
Q

How do you identify the underlying causes of anemia?

A
  • paitents history/owners chief complaint
  • physical exam findings
  • lab test results
  • results of other tests
99
Q

What questions do you ask to find out the Patient History/CC?

A
  • time of onset of C/S?
  • evidence of blood loss?
  • exercise intolerance?
  • existence of underlying condition?
  • exposure to drugs?
  • exposure to environmental toxins and chemicals?
100
Q

What does Abrupt Onset of C/S suggest?

A
  • regenerative anemia
  • caused by:
    • acute blood loss
    • hemolysis
101
Q

What does Gradual Onset of C/S suggest?

A
  • non-regenerative anemia
  • caused by (NRA):
    • bone marrow
    • kidneys
  • caused by (RA):
    • chronic blood loss
    • hemolysis
102
Q

What are examples of Evidence of Blood Loss?

A
  • hematuria
  • melena or frank blood
  • hemoptysis
  • hematemesis
103
Q

What is Hematuria?

A
  • hemoglobinuria
    • increased intravascular hemolysis
104
Q

What is Melena Blood?

A
  • tarry, black, coffee ground stool
  • results from digested blood
105
Q

What causes Melena Blood?

A

upper GI bleeding

106
Q

What is Frank Blood?

A

-bright red

107
Q

What causes Frank Blood?

A
  • coccidia (chronic blood loss RA)
  • parvovirus (RA -> NRA)
108
Q

What does Frank Blood mean?

A

lower GI bleeding

109
Q

What causes Hemoptysis?

A
  • URI (RA)
  • resp. parasites (RA)
  • neoplasia (RA)
  • ehrlichiosis
110
Q

What causes Hematemesis?

A
  • upper GI bleeding
  • ulcers
  • neoplasia
  • parasites
111
Q

What does Exercise Intolerance result from?

A

low oxygenation

112
Q

What does Exercise Intolerance occur with?

A

-chronic anemia

113
Q

What does recent Weight Loss suggest?

A

chronic anemia

114
Q

Fenbendazole and Heparin

A
  • causes:heinz bodies
  • RA
  • extravascular hemolysis
115
Q

Propofol

A
  • heinz body anemia
  • RA
116
Q

Benzocaine

A
  • heinz body anemia
  • RA
117
Q

Birth Control Pills

A
  • estrogen toxicity
  • NRA
118
Q

Chloramphenicol

119
Q

Multivitamins

A
  • hemolysis
  • RA
120
Q

Vaccines

A
  • acute vaccine reaction
  • reaction causes IMHA
  • RA ->NRA
121
Q

What are examples of Environmental Toxins and Chemicals?

A
  • plants
  • lead, zinc, copper, iron
  • rodenticides
122
Q

What types of plants are Environmental Toxins and Chemicals?

A
  • onions and garlic: H.B.A (RA)
  • sago palms: hemolysis and death
123
Q

Lead, Zinc, Copper, Iron

124
Q

Rodenticides

A
  • coagulapathy -> acute blood loss
  • RA
125
Q

What things do you check when doing Physical Examinations?

A
  • fever
  • pulse/HR
  • mm/CRT
  • palpations
  • physical signs of underlying disease
  • external wounds
126
Q

What does a Fever indicate?

A
  • infection (acute or chronic)
  • leukemia
127
Q

What Pulse/HR indicates Anemia?

A
  • pulse: thready, weak but fast
  • HR: tachycardia
128
Q

What CRT indicates Anemia?

A

prolonged, greater than 2 seconds

129
Q

What does a pale mm mean?

A

decrease number of RBCs

130
Q

What does a yellow mm mean?

A

-icterus (liver diease, increase extravascular hemolysis)

131
Q

What does a pale and yellow mm mean?

A

hemolysis (extravascular)

132
Q

What does a blue mm mean?

133
Q

What causes Petechia or Ecchymoses in mm?

A
  • rodenticides
  • coagulations
  • Von Willebrans
  • thrombocytopenia
134
Q

What are you looking for during palpation?

A
  • splenomegaly
  • hepatomegaly
135
Q

What are Physical Signs of Underlying Diseases?

A
  • hyperestrogenism
  • hypothyroidism
  • cushing’s
136
Q

What Physical Sign does Hyperestrogenism, Hypothyroidism and Cushing’s show?

A

bilateral symmetrical alopecia

137
Q

What are examples of External Wounds?

A
  • HBC
  • gunshot
  • dog fight
138
Q

What tests are run during Laboratory Evaluations of Anemia?

A
  • total RBC count
  • PCV
  • Hb concentration
  • RBC indicies
  • blood smear
  • reticulocyte count
  • total WBC count
  • total protein concentration
  • bone marrow evaluation
139
Q

How does Iron Deficency Anemia show on a Hb concentration test?

A
  • hypochromic
  • normocytic
  • schistocytes
  • keratocytes
140
Q

What does Iron Deficency Anemia result from?

A
  • chronic blood loss
  • nutritional defiencies
141
Q

What does a increase in total WBC count mean (with blast cells)?

A
  • leukemia
  • blast cells
  • NRA
142
Q

What does an increase in total WBC count mean (without blast cells)?

A
  • infection
  • RA or NRA
143
Q

What does a decrease in total WBC count mean?

A
  • immunosuppression (bone marrow)
  • NRA
144
Q

What does a increase in Total Protein Concentration mean?

A
  • kidneys affected
  • NRA
145
Q

What does a decrease in Total Protein Concentration mean?

A
  • liver disease
  • acute: RA (hemolysis)
  • chronic: NRA
146
Q

When do you do a Bone Marrow Evaluation?

A

-MUST be done when you have unexplained NRA

147
Q

What are you looking for when doing a Bone Marrow Evaluation?

A
  • blast cells
  • RBC precursors
  • can be done by aspirate or biopsy procedure
148
Q

What are other tests that can be run and what can they find?

A
  • xrays (pennies)
  • ultrasound (neoplasia)
  • SNAP tests (parvo, etc)
  • fecals (parasites)

Clin Path (8 decks)

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