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Clinical Pathology > Anemia > Flashcards

Anemia Flashcards

0
Q

What are 3 potential causes of anemia?

A
  • Increased loss (hemorrhage)
  • Increased destruction (hemolysis)
  • Decreased production by marrow
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1
Q

Low cell counts in all categories can indicate what?

A

A problem with the bone marrow.

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2
Q

A decrease in RBC mass, resulting in decreased oxygenation of tissues is known as what?

A

Anemia

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3
Q

What are 3 ways to measure RBC mass?

A
  • PCV (hematocrit)
  • RBC count
  • Hemoglobin concentration
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4
Q

Decreased oxygenation can result in what?

A

Numerous clinical signs

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5
Q

What are 5 possible clinical signs that can be seen with anemia?

A
  • Pale mucous membranes
  • Lethargy, reduced exercise tolerance
  • Increased respiratory rate, dyspnea
  • Increased heart rate
  • Murmurs in <20% (increased turbulence)
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6
Q

What are 5 examples of non-specific clinical signs that may be related to underlying illness?

A
  • Weight loss
  • Fever
  • Lymphadenopathy
  • Polyuria
  • Polydypsia
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7
Q

What are 3 clinical signs associated with blood destruction?

A
  • Splenomegaly
  • Icterus (jaundice)
  • Hemoglobinuria
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8
Q

Severity of lcinical signs correlates to duration of onset:

  • Slow onset = ?
  • Rapid onset = ?
A
  • Slow onset = Less severe

- Rapid onset = More severe

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9
Q

What are 3 types of diagnostic approaches that can be taken?

A
  • Laboratory evaluation
  • History
  • Physical examination
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10
Q

What are 4 things that are evaluated in the laboratory?

A
  • RBC mass (PC)
  • Mean cell volume
  • Reticulocyte count
  • Total protein
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11
Q

With a cytogram, where are large cells located?

Where are hypochromic cells located?

A
  • Top

- Left

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12
Q

With a histogram, where are small cells located?

Where are large cells located?

A
  • Left

- Right

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13
Q

What are 2 pieces of information that can help determine the cause of the anemia?

A
  • Bone marrow responding?

- Size of RBCs?

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14
Q

What are 2 causes of regenerative anemia?

A
  • Blood loss

- Blood destruction

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15
Q

Protein decrease along with PCV decrease, usually returning to normal within one week if blood loss is not ongoing is seen with which type of blood loss?

A

Acute blood loss

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16
Q

Is RBC morphology usually normal or abnormal with acute blood loss caused anemia?
What is an example of an exception to this?

A
  • Usually normal

- Hemangiosarcoma in dogs

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17
Q

What are 4 examples of acute blood loss?

A
  • Trauma & surgery
  • Coagulation disorders
  • Bleeding tumors
  • Thrombocytopenia
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18
Q

T/F: Blood loss does not cause a significant amount of thrombocytopenia.

A

True

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19
Q

What are 3 examples of chronic blood loss?

A
  • GI ulcer
  • Bleeding GI tumor
  • Blood consuming parasites
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20
Q

Chronic blood loss is most commonly seen where?

A

Intestines

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21
Q

Iron deficiency anemia in nursing animals can be seen with what?

A

Inadequate intake of iron.

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22
Q

The most common cause of iron deficiency anemia in adults is what?

A

Chronic blood loss

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23
Q

What are 7 examples of lab findings that can be seen with iron deficiency anemia?

A
  • Microcytosis
  • Reticulocytes also have decreased MCV
  • RDW usually increased (anisocytosis)
  • MCHC often normal (unlike in humans)
  • Blood film examination often useful (keratocytes formation, increased central pallor)
  • Anemia usually regenerative, unless concurrent anemia of inflammatory disease
  • Thrombocytosis common
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24
Q

What are 4 other examples of possible lab findings that can be seen with iron deficiency anemia?

A
  • Decreased serum iron concentration
  • Decreased transferrin saturation
  • Decreased storage iron (ferritin concentrations or hemosiderin in bone marrow)
  • Total iron binding capacity usually normal in dogs and cates (usually increased in other species)
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25
Q

What are 3 findings that indicate a diagnosis of iron deficiency anemia?

A
  • Anemia
  • Low serum iron
  • Microcytosis
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26
Q

What do you do for adults with iron deficiency anemia?

A

Find cause and source of blood loss.

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27
Q

What is a therapy option for neonates with iron deficiency anemia?

A

Injectable iron

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28
Q

What do you not want to give to neonates with iron deficiency anemia?

A

Oral iron (give parenterally)

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29
Q

What are 3 other possible causes of microcytic anemia other than iron deficiency anemia?

A
  • Portosystemic shunt
  • Breed disposition
  • Anemia of inflammatory disease (see deceased MCV with AID common in humans, rare in dogs)
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30
Q

How can you differentiate iron deficiency anemia from anemia of inflammatory disease?

A

Anemia of inflammatory disease will have increased storage iron.

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31
Q

What are 2 types of blood destruction?

A
  • Intravascular hemolysis

- Extravascular hemolysis

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32
Q

Most common source of blood loss in dogs in US is what?

A

Immune-mediated hemolytic anemia

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33
Q

What are 7 possible causes of blood destruction?

A
  • Immune-mediated hemolytic anemia
  • Heinz body anemia
  • RBC parasites
  • Hypophosphatemia
  • Thermal injury
  • Zinc toxicosis
  • Inherited RBC enzyme deficiencies
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34
Q

What are 5 general signs of blood destruction associated with anemia?

A
  • +/- splenomegaly
  • +/- hyperbilirubinemia, icterus
  • +/- hemoglobinemia
  • +/- hemoglobinuria
  • Total protein normal
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35
Q

T/F: IMHA is often secondary to other disorders or events.

A

True

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36
Q

What are 4 examples of disorders or events that IMHA can be secondary to?

A
  • Infection
  • Modified live virus vaccination
  • Neoplasia (lymphoma)
  • Drugs
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37
Q

What are 4 examples of drugs that can cause IMHA?

A
  • Penicillin
  • Cephalosporins
  • Trimethoprim-sulfamethoxazole
  • Levaminsole
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38
Q

With horses, IMHA can be associated with what 3 things?

A
  • Penicillin
  • Clostridial infections
  • Neoplasia
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39
Q

In cats, what 3 things can cause IMHA?

A
  • Mycoplasma haemofelis
  • FeLV
  • Neoplasia
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40
Q

IMHA is most common in what species?

A

Dogs

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41
Q

What breed has the highest incidence of IMHA?

What are 2 other breeds it is common in?

A
  • Cocker spaniels

- Poodles, Collies

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42
Q

Is the incidence of IMHA slightly higher in males or females?

A

Females

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43
Q

IMHA is more common in what age group?

A

Middle aged to old

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44
Q

What are 2 disadvantages of the Coombs test?

A
  • Many false positives

- Many false negatives

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45
Q

Why is IMHA easier to recognize in dogs?

A

They have larger RBCs than other species.

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46
Q

Immune complexes, antibodies or attachment to RBCs , but not seeing destruction of RBCs is not increased may indicate a false positive for which test?

A

Coombs Test

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47
Q

A low concentration of antibody on RBCs or problems with performing the test can cause false negatives for which test?

A

Coombs Test

48
Q

If you are already seeing agglutination, do you need to perform a Coombs test?

A

No

49
Q

If an animal has IMHA and immune-mediated thrombocytopenia, what syndrome do they have?

A

Evan’s syndrome

50
Q

What can be commonly seen with IMHA?

A

DIC

51
Q

What type of leukogram do you see with IMHA?

A

Almost always inflammatory

52
Q

What are 2 possible causes for the type of leukogram seen with IMHA?

A
  • Cytokines from activated macrophages

- Inflammation secondary to necrosis

53
Q

Animals with IMHA may also be what?

A

Azotemic

54
Q

What are 5 other possible causes of spherocytes on a ddx for IMHA?

A
  • Previous mismatched blood transfusion
  • Rattlesnake envenomation
  • Heinz body anemia in horses can look like spherocytes
  • Zinc toxicosis
  • Bee stings
55
Q

What is the mortality rate of IMHA?

A

25-50%

56
Q

What is the most common cause of death with IMHA?

A

Thromboembolism

57
Q

T/F: The recurrence of IMHA is uncommon.

A

False - it is common.

58
Q

What is an anti-inflammatory drug commonly used to treat IMHA?

A

Glucocorticosteroids

59
Q

What are 3 things glucocorticosteroids do that aid in the treatment of IMHA?

A
  • Decrease antibody production
  • Decrease T-cell activity
  • Decrease macrophage function
60
Q

Are fluids used in the treatment of IMHA?

A

Yes

61
Q

Blood transfusions are not indicated in the treatment of IMHA unless what condition is present?

A

Life-threatening anemia

62
Q

Is splenectomy used as a treatment of IMHA still?

A

No

63
Q

What are 5 factors that help determine if you have IMHA?

A
  • Usually regenerative
  • Spherocytosis
  • May or may not have agglutination
  • Neutrophilia with left shift
  • May or may not have thrombocytopenia
64
Q

What is the best way to detect IMHA?

A

Presence of spherocytosis.

65
Q

When differentiating IMHA from this, note that pheroechinocytosis is noted and spherocytes may remain after echinocytic changes have reversed.
In what species is this most common?

A
  • Rattlesnake envenomation

- Dogs

66
Q

When differentiating form IMHA, spherocytes, spheroechinocytes and type 3 echinocytes may also be seen in horses with this condition, related to phospholipase hydrolyzing RBC membrane phospholipids, producing lysolecithin, which is echinogenic.

A

Clostridial infections

67
Q

When differentiating from IMHA, possible membrane collapse after eccentrocyte formation or Heinz body formation resulting in band 3 clustering with secondary antibody attachment can be seen with what?

A

Heinz body anemia in horses

68
Q

What 2 things does bee venom includes?

A
  • Mellitin (band 3 clustering agent)

- Phospholipase

69
Q

What does Band 3 clustering in bee venom induce?

A

Antibody attachment and subsequent spherocyte formation.

70
Q

What does zinc toxicosis result in?

A

Band 3 clustering

71
Q

What do foreign antigens induce with an incompatible blood transfusion?

A

Antibody production, resulting in spherocytes.

72
Q

What do you call the protein that exchanges bicarbonate ion for chloride in RBCs, thus greatly increasing capacity of blood to carry CO2?

A

Band 3

73
Q

What protein is important in maintaining cell shape, and if absent spherocytosis and hemolytic anemia can occur?

A

Band 3

74
Q

What is the condition where maternal antibodies act against the neonates blood group antigen attach ted to the neonate’s RBCs, with subsequent RBC hemolysis?

A

Neonatal isoerythrolysis

75
Q

Neonatal isoerythrolysis is most common in which two species?

A

Horse and mule foals

76
Q

Animals with what condition become weak and anemic after ingesting colostrum and may also see hemoglobinemia, hemoglobinuria, splenomegaly and hepatomegaly?

A

Neonatal isoerythrolysis

77
Q

Can thrombocytopenia and DIC be present with neonatal isoerythrolysis?

A

Yes

78
Q

Most of these cause anemia by immune mediated mechanisms (antibody against parasite, with complement fixation & phagocytosis by macrophages).

A

Erythrocyte parasites

79
Q

What are 2 erythrocyte parasites that can cause intravascular hemolysis?

A
  • Babesia

- Theileria

80
Q

What are 2 ways to diagnose erythrocyte parasites?

A
  • Blood film examination

- PCR assays

81
Q

What are 7 examples of Haemotrophic mycoplasmas?

A
  • Mycoplasma haemofelis
  • M. Haemominutum
  • M. haemocanis
  • M. wenyonii
  • M. haemosuis
  • M. haemolamae
  • M. ovis
82
Q

What is a common serious cause of severe anemia?

A

Mycoplasma haemofelis

83
Q

What are 4 ways Mycoplasma haemofelis can be transmitted?

A
  • Blood feeding arthropods
  • Cat bites
  • Iatrogenic exposure (blood transfusions)
  • Vertically
84
Q

What are 2 ways to diagnose Mycoplasma haemofelis?

A
  • Blood film exam

- PCR

85
Q

What are 5 possible clinical signs of Mycoplasma haemofelis?

A
  • Anemia
  • Splenomegaly
  • Fever
  • Lethargy
  • Sometimes icterus
86
Q

What are 3 conditions that can predispose an animal to Mycoplasma haemofelis?

A
  • Concurrent disease
  • Immunosuppression
  • Splenectomy
87
Q

What type of anemia is usually seen with Mycoplasma haemofelis?
What is an exception to this?

A
  • Regenerative anemia

- Underlying disease, such as FeLV or severe inflammatory disease

88
Q

Titers should be done on what 2 viruses with Mycoplasma haemofelis?

A
  • FeLV

- FIV

89
Q

What are 4 possible treatments for a Mycoplasma haemofelis infection?

A
  • Blood transfusion if anemia is severe.
  • Prednisone will suppress RBC destruction.
  • Doxycycline for 3 weeks.
  • Enrofloxacin if problems with doxycycline.
90
Q

Are cats likely to remain carriers of Mycoplasma haemofelis?

A

Yes

91
Q

Which Mycoplasma is an opportunist that is usually only seen in splenectomized or severely immunosuppressed dogs?

A

M. haemocanis

92
Q

What are 3 possible clinical signs of Mycoplasma haemocanis?

A
  • Anemia
  • May look like IMHA
  • Icterus occasionally
93
Q

What is Mycoplasma haemocanis treated with?

A

Doxycycline

94
Q

With which Mycoplasma do you see severe anemia only if the animal is splenectomized or immunosuppressed?
In what species is it seen?

A
  • Mycoplasma wenyonii

- Cattle

95
Q

What is the most common form of transmission for Mycoplasma wenyonii?

A

Iatrogenic transmission

96
Q

What are 2 conditions that Mycoplasma wenyonii may cause?

A
  • Dependent edema

- Lymphadenopathy without anemia

97
Q

Which mycoplasma is an opportunist that causes mild anemia?

A

Mycoplasma haemolamae

98
Q

Which Mycoplasma causes severe anemia in baby pigs?

A

M. haemosuis

99
Q

Mycoplasma haemosuis in adults is usually associated with what clinical sign?

A

Poor weight gain

100
Q

Baby pigs with Mycoplasma haemosuis are usually treated with what?

A

A single dose of long acting oxytetracycline.

101
Q

What are 2 causes of anaplasmosis in ruminants?

A
  • Anaplasma marginale

- Anaplasma centrale

102
Q

What is a very common tick-borne rickettsial infection that can be found world wide?

A

Anaplasmosis

103
Q

What can anaplasmosis cause, especially in older animals?

A

Fatal hemolytic anemia

104
Q

What is something that will probably be seen with anaplasmosis?

A

Immune mediated destruction

105
Q

What are 2 ways anaplasmosis is diagnosed?

A
  • Blood film

- PCR

106
Q

Is there a vaccine available for anaplasmosis?

A

Yes

107
Q

What is anaplasmosis treated with?

A

Tetracycline

108
Q

B. canis and B. gibsoni are seen in which species?

A

Dogs

109
Q

B. bovis and B. bigemina are seen in which species?

A

Cattle

110
Q

B. equi and B. caballi are seen in which species?

A

Horse

111
Q

Babesiosis in horses is usually called what?

A

Piroplasmosis

112
Q

B. cati and B. felis are seen in which species?

A

Cats

113
Q

Babesiosis is cause by what kind of organism?

A

Hemoprotozoan

114
Q

What are the 2 types of babesiosis?

A

Large and small

115
Q

What are 3 ways babesiosis can be transmitted?

A
  • Ticks
  • Blood transfusions
  • Vertically
116
Q

What are 2 things that babesiosis causes?

A
  • Severe disease

- Hemolytic anemia

117
Q

Which Babesia is becoming important in the US in dogs east of Mississippi?

A

B. gibsoni

118
Q

What might babesiosis be mistaken for?

A

IMHA

Clinical Pathology (12 decks)

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