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Clinical Pathology > Anemia > Flashcards

Anemia Flashcards

1
Q

What are 3 causes of anemia?

A

Increased loss
Increased destruction
Decreased production

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2
Q

What is anemia?

A

Decreasee in RBC mass

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3
Q

What does anemia result in?

A

Decreased oxygenation

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4
Q

How is red cell mass measured? (3 things)

A

PCV
RBC count
Hemoglobin concentration

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5
Q

What are the 5 main clinical signs you see in an anemic patient?

A 
Pale MM
Lethargy
Increased RR
Increased HR
Murmurs (if < 20%)
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6
Q

What can non-specific clinical signs be related to in cases of anemia?

A

Underlying illness

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7
Q

T/F: Anemia is a diagnosis.

A

False, anemia is a lab finding. Cause of anemia is the diagnosis.

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8
Q

What are 3 clinical signs associated with blood destruction?

A

Splenomegaly
Icterus
Hemoglobinuria

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9
Q

What does severity of clinical signs of anema correlate to?

A

Duration of onset.

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10
Q

How severe is slow onset anemia?

A

Less severe

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11
Q

How severe is fast onset anemia?

A

More severe

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12
Q

What are the 3 main diagnostic approaches to anemia?

A

Lab evaluation
History
Physical exam

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13
Q

What are the 4 main lab evals for anemia?

A

PCV
MCV
Retic. count
TP

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14
Q

What else should you expect to see in acute blood loss?

A

Total protein decrease

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15
Q

How do you read a cytogram?

A

Large cells on top, small cells on bottom

Hypochromic cells to the left, hyperchromic cells to the right

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16
Q

How do you read a histograms?

A

Small cells are to the left, large cells are to the right

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17
Q

What are 2 other types of lab tests you can run with anemia?

A

Tests for specific types of anemia

Biochem profile

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18
Q

What is an example of a test for a specific type of anemia? (2 things)

A

Serum iron

Coomb’s test

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19
Q

What can a biochem profile detect? (1 thing)

A

Renal failure

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20
Q

What other tests might you run on a cat with a non-regenerative, macrocytic anemia?

A

FIV test

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21
Q

In acute blood loss, what two things decrease together?

A

PCV and protien

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22
Q

In acute blood loss, what is RBC morphology like? What is an exception?

A

Normal

Hemangiosarcoma in a dog

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23
Q

What RBC morphology can mean hemangiosarcoma?

A

Acanthocytes

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24
Q

What are 4 examples of acute blood loss?

A

Trauma/Surgery
Coag. disorders
Bleeding tumors
Thrombocytopenia

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25
Q

T/F: Blood loss causes a thrombocytopenia.

A

False. Blood loss does NOT cause a thrombocytopenia, however thromobocytopenia does cause blood loss.

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26
Q

What are 3 examples of chronic blood loss?

A

GI Ulcer
Bleeding GI tumor
Blood consuming parasites

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27
Q

What is the most common site for chronic blood loss?

A

Intestines

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28
Q

What causes iron deficiency anemia in nursing animals?

A

Inadequate intake

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29
Q

What causes iron deficiency anemia in adults?

A

Almost always chronic blood loss

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30
Q

What type of anemia (micro/macro) is iron deficiency anemia?

A

Microcytic

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31
Q

What do we find with reticulocytes in iron deficiency anemia?

A

Decreased MCV

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32
Q

What do we see in the RDW in iron deficiency anemia?

A

RDW is increased (anisocytosis)

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33
Q

What dowe see in the MCHC in iron deficiency anemia?

A

Usually normal

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34
Q

What two RBC morphologies might we see with iron deficiency anemia?

A

Keratocytes

Increased zone of central pallor

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35
Q

Is iron deficiency anemia usually regenerative or non-regenerative?

A

Regenerative

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36
Q

What is also common in iron deficiency anemia?

A

Thrombocytosis

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37
Q

What 3 things will decrease with iron deficiency anemia?

A

Serum iron
Transferrin saturation
Decreased storage iron

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38
Q

What 3 things will you see to give an iron deficiency anemia diagnosis?

A

Anemia
Low serum iron
Microcytosis

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39
Q

How can platelets throw off a RBC count?

A

If they’re big enough or clumped, can be counted as RBCs.

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40
Q

What is the treatment in neonates with iron deficiency anemia?

A

Injectable iron

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41
Q

Why wouldn’t you give oral iron to neonates with iron deficiency anemia?

A

It’s toxic and their livers can’t handle it yet.

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42
Q

What is the treatment in adults with iron deficiency anemia?

A

Find the cause of the iron deficiency and source of blood loss.

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43
Q

What are 3 causes of microcytosis?

A 
Portosystemic shunts
Breed dispositon (Asian breeds)
Anemia of inflammatory disease (rare in dogs)
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44
Q

In dogs why are anemias of inflammatory disease usually normocytic?

A

Because they have increased storage iron.

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45
Q

What are the two types of hemolysis?

A

Intravascular

Extravascular

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46
Q

What is the most common cause of RBC destruction in cats?

A

Heinz body anemia (think Heinz CATsup)

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47
Q

On top of general signs of anemia, what else might you see with blood destruction? (4 things)

A

+/- Splenomegaly
+/- Hyperbilirubinemia
+/- Hemoglobinemia
+/- Hemoglobinuria

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48
Q

What will you see with total protein in cases of blood destruction?

A

TP will be normal

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49
Q

IMHA is often..?

A

Secondary to other disorders

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50
Q

What are some disorders that can cause IMHA? (4 things)

A

Infection
MLV vaccine
Neoplasia
Drugs

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51
Q

What 3 things is IMHA associated with in horses?

A

Penicillin
Clostridials
Neoplasia

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52
Q

What 3 things is IMHA associated with in cats?

A

Mycoplasma haemofelis
FeLV
Neoplasia

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53
Q

What species is IMHA most common in?

A

Dogs

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54
Q

What are the top 3 dog breeds for IMHA?

A

Cocker Spaniels
Poodles
Collies

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55
Q

What dogs (not breed) are most at risk for IMHA?

A

Middle aged to old females

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56
Q

What test can be done to determine if IMHA is present?

A

Coombs’ Test

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57
Q

What are the two main disadvantages of the Coombs’ test?

A

Many false positives

Many false negatives

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58
Q

What is the reason for a false positive Coombs’ test?

A

Immune complexes attached to RBCs, but destruction isn’t increased.

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59
Q

What is the reason for a flase negative Coombs’ test?

A

Low concentration of Ab on RBCs

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60
Q

When is the Coomb’s test not indicated?

A

When agglutination is present.

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61
Q

What are 3 major lab findings in IMHA cases?

A

Throbocytopenia (maybe)
Inflammatory leukogram
Azotemia (maybe)

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62
Q

What are 2 reasons that you would see thrombocytopenia with IMHA?

A

Immune-mediated

DIC

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63
Q

What is the term for IMHA with thrombocytopenia?

A

Evan’s Syndrome

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64
Q

What is the cause for azotemia with IMHA?

A

Increased creatinine and BUN from RBC destruction

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65
Q

What are 5 differentials for spherocytes?

A 
Previous mismatched blood transfusions 
Rattlesnake envenomation
Heinz body anemia of horses
Zinc toxicosis
Bee stings
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66
Q

What two things cause eccino-spherocyte cases?

A

Zinc toxicosis

Bee stings

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67
Q

What are mortality rates when you see spherocytes?

A

25-50%

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68
Q

What do animals with spherocytes usually die from?

A

Thromboembolism

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69
Q

How do you treat IMHA? (3 things)

A

Glucocorticosteroids
Fluids
Correct acidosis

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70
Q

How do glucocorticosteroids help treat IMHA? (3 things)

A

Decrease Ab production, T-cell activity and macrophage function

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71
Q

What two things are not indicated in IMHA cases?

A 
Blood transfusion (unless anemia is life threatening)
Splenectomy
72
Q

Why is a blood transfusion not indicated in IMHA cases?

A

Adds fuel to the fire.

73
Q

Is IMHA usually regenerative or non-regenerative?

A

Regenerative

74
Q

What two things will you always see with IMHA?

A

Spherocytosis

Neutrophilia with left shift

75
Q

What two things MIGHT you also see with IMHA?

A

Agglutination

Thrombocytopenia

76
Q

What shape changes do you see with rattlesnake envenomation in dogs?

A

Spheroechinocytosis

NOTE: Spherocytes may remain after echinocytic changes have reversed.

77
Q

What shape changes do you see with clostridial infections in horses?

A

Spherocytes, spheroechinocytes and type 3 echinocytes

78
Q

What is the cause of Heinz body anemia in horses?

A

Membranes collapse after eccentrocyte formation OR

Heinz body formation results in band 3 clustering.

79
Q

What is band 3?

A

A protein that changes bicarbonate for chloride, increased RBC capatiy to carry CO2

80
Q

What does bee venom contain and what does it do?

A

Mellitin.

A band 3 clustering agent and phsopholipase

81
Q

What does zinc toxicosis do?

A

Results in band 3 clustering

82
Q

What is neonatal isoerythrolysis?

A

Maternal Abs against the neonates blood group = hemolysis

83
Q

What species is neonatal isoerythrolysis most common in?

A

Horses and mule foals

84
Q

How do most RBC parasites cause anemia?

A

By immune mediated mechanisms

85
Q

What two RBC parasites cause intravascular hemolysis?

A

Babesia

Theileria

86
Q

What two ways do you diagnose RBC parasites?

A 
Blood film (old fashioned)
PCR assay (more accurate)
87
Q

What RBC parasite is a common, serious cause of severe anemia?

A

Mycoplasma haemofelis

88
Q

How is Mycoplasma haemofelis transmitted? (2 ways)

A

Infected blood

Vertical transmission

89
Q

What are clinical signs of Mycoplasma haemofelis? (4 things)

A 
Signs of anemia:
Splenomegaly
Fever
Lethargy
Sometimes icterus
90
Q

What can predispose animals to M. haemofelis? (3 things)

A

Concurrent disease
Immunosuppression
Splenectomy

91
Q

Is anemia caused by M. haemofelis a regenerative, or non-regenerative anemia?

A

Regenerative UNLESS underlying disease (eg. FeLV, or severe inflammatory disease)

NOTE: FeLV and FIV titers would be indicated here.

92
Q

How do you treat M. haemofelis? (4 things)

A

Transfusion (if anemia is severe)
Prednisone to supress RBC destruction
Doxycycline for 3 weeks
Enrofloxacin IF problems with Doxy

93
Q

T/F: Cats remain carriers of M. haemofelis?

A

True

94
Q

When do you most often see M. haemofelis? (2 things)

A

Usually only in splenectomized or severely immunosupressed dogs

95
Q

What clinical signs do you see with M. haemocanis?

A

Signs of anemia (my look like IMHA)

96
Q

What do you use to treat M. haemocanis?

A

Doxycycline

97
Q

What species is infected my M. wenyonii?

A

Cattle

98
Q

What do you see in cattle infected with M. wenyonii?

A

Severe anemia, but ONLY if splenectomized or immunosuppressed.

99
Q

How is M wenyonii commonly transmitted?

A

Iatrogenic transmission

100
Q

What MIGHT M. wenyonii cause? (2 things)

A

Dependent edema
Lymphadenopathy

Both without anemia

101
Q

What are two important points about M. haemolamae?

A

Opportunist

Causes mild anemia

102
Q

What does M. haemosuis cause severe anemia in?

A

Baby pigs

103
Q

What does M. haemosuis cause in adult pigs?

A

Poor weight gain

104
Q

How do you treat M. haemosuis in baby pigs?

A

Usually treated with one dose of long acting oxytetracycline

105
Q

What two anaplasmas do you see in ruminants?

A

A. marginale

A. centrale

106
Q

How is anaplasma transmitted and what is it’s distribution?

A

Tick-borne

Worldwide

107
Q

What can anaplasma cause, especially in older animals?

A

Fatal hemolytic anemia

108
Q

How does anaplasma cause the anemia?

A

Probably immune mediated destruction

109
Q

T/F: A vaccine is available for anaplasma.

A

True

110
Q

What do you treat anaplasma with?

A

Tetracycline

111
Q

What two types of babesia do you see in dogs?

A

B. canis

B. gibsoni

112
Q

What two typess of babesia do you see in cattle?

A

B. bovis

B. bigemina

113
Q

What two types of babesia do you see in horses?

A

B. equi

B. caballi

114
Q

What is another name for babesia in horses?

A

Piroplasmosis

115
Q

What two types of babesia do you see in cats?

A

B. cati

B. felis

116
Q

How is babesia transmitted? (3 things)

A

Ticks
Blood transfusions
Vertically

117
Q

What does babesia cause? (2 things)

A

Severe disease and hemolytic anemia

118
Q

What might babesia be mistaken for?

A

IMHA

119
Q

T/F: Dogs that survive usually become chronic carriers of babesia.

A

True

120
Q

What is theileriosis?

A

A protozoa

121
Q

What does Theileria cause in ruminants?

A

Hemolytic anemia

122
Q

What is another name for Theileria parva?

A

East Coast Fever

123
Q

What stage of Theileria do you see in RBCs?

A

Merozoite

124
Q

What kind of in vitro shape change can you see in deer blood?

A

Sickle shape RBCs

125
Q

What causes feline cytauxzoonosis?

A

A protozoa

126
Q

How is feline cytauxzoonosis transmitted?

A

Ticks

127
Q

T/F: Feline cytauxzoonosis is rarely fatal.

A

False, it’s almost always fatal.

128
Q

What causes Heinz body anemia?

A

Oxidative denaturation of hemoglobin

129
Q

What species is most susceptible to Heinz bodies?

A

Cats

130
Q

What 3 diseases do you often see Heinz bodies with?

A

Lymphoma
Hyperthyroidism
Diabetes mellitus

131
Q

Many drugs that cause Heinz body anemia also cause..?

A

Methemoglobinemia

132
Q

What 3 families of plants cause Heinz body formation?

A 
Allium family (onions, garlic)
Brassica (kale, cabbage, rape)
WILTED red maple leaves
133
Q

What drug causes Heinz bodies?

A

Acetaminophen

134
Q

What are two ways that Heinz bodies are formed?

A

Hemichrome formation due to oxidative damage

Sulfhydral groups susceptible to oxidative damage (cats have 8 groups)

135
Q

What might you see with clustering of protein band 3?

A

Spherocytes

136
Q

How doe Heinz bodies elicit an anemia?

A

RBC membrane is more rigid, making them more susceptible to removal by macrophages or lysis

137
Q

What is methemoglobinemia?

A

Iron is in ferric state and can’t carry oxygen

138
Q

What causes methemoglobinemia in cats?

A

Acetaminophen toxicity

139
Q

What causes methemoglobinemia in cows?

A

Nitrate poisoning (from rumen bacteria)

140
Q

What causes methemoglobinemia in horses?

A

Red maple leaf ingestion

141
Q

What can cause methemoglobinemia?

A

Congenital deficiency of NADH-methemoglobin reductase

142
Q

What causes excessive formation of methemoglobin?

A

Oxidative damage

143
Q

What two things are caused by oxidative damage?

A

Methemoglobinemia

Heinz bodies

144
Q

What percentage of methemoglobin concentration results in the blood appearing chocolate brown?

A

30%

145
Q

What percentage of methemoglobin concentration causes death?

A

90%

146
Q

How can ou treat methemoglobinemia?

A

Methylene blue to reduce to deoxyhemoglobin

147
Q

What species is susceptible to copper toxicosis?

A

Sheep

148
Q

Where does copper accumulate in copper toxicosis?

A

In the liver

149
Q

What 4 things do you see in the blood with copper toxicosis?

A

Hemolytic anemia
Hemoglobinemia
Hemoglobinuria
Heinz body formation

150
Q

What does low phosphorus cause?

A

Decreased glycolysis

151
Q

What does low phosphorus in cattle cause?

A

Postparturient hemoglobinuria

152
Q

What does low phosphorus cause in cats?

A

Diabetes mellitus

153
Q

What in cats can cause hypophosphatemia?

A

Enteral alimentation

154
Q

What causes hemolytic anemia (“yellow disease”) in lambs and calves?

A

C. perfringens Type A

155
Q

What bacteria causes bacillary hemoglobinuria in cattle?

A

C. haemolyticum

156
Q

What is another name for bacillary hemoglobinuria?

A

Red water disease

157
Q

What is bacillary hemoglobinuria/red water disease associated with?

A

Liver fluke migration

158
Q

What clinical signs do you see in cattle with C. haemolyticum? (6 things)

A 
Anemia
Arched back
Bloody diarrhea
Fever
Dyspnea
Hemoglobinuria
159
Q

What species does water intoxication occur in?

A

Cattle (usually calves)

160
Q

How does water intoxication happen?

A

Cattle are given unlimited access to water after it’s unavailable for a while.

161
Q

How does water intoxication lead to hemolysis?

A

Decreased osmolality (water increases too fast) of plasma.

162
Q

What can make water intoxication more severe?

A

Iron deficiency anemia

163
Q

What virus induces hemolysis?

A

Equine infection anemia “Swamp fever”

164
Q

What are 4 inherited RBC membrane defects?

A

Spherocytosis
Elliptocytosis
Stomatocytosis
Membrane transport defects

165
Q

What dog breeds show pyruvate kinase deficiency? (4 things)

A

Basenji
Beagle
Westies
Cairn terriers

166
Q

What signs do you see with pyruvate kinase deficiency? (5 things)

A 
Moderate to marked anemia
Marked reticulocytosis
Myelofibrosis
Sclerosis
Death by age 4
167
Q

What cat breeds show pyruvate kinase deficiency? (3 things)

A

Abyssinian
Somali
DSH

168
Q

What do you not see in cats with pyruvate kinase deficiency?

A

Osteosclerosis, cats can live to old age

169
Q

What dog breed do you see phosphofructokinase deficiency in?

A

English Springer Spaniel

170
Q

What clinical signs do you see with phosphofructokinase deficiency?

A

PCV will be normal to low normal

Will see hemolytic crisis when alkalemic

171
Q

What causes porphyria?

A

Deficiency of uroporphyrinogen III co-synthetase

172
Q

What is porphyria?

A

An inability to synthesize hemoglobin

173
Q

What are clinical signs of porphyria? (3 things)

A

Pink teeth and bones
Photosensitivity
Decreased RBC survival

174
Q

What’s special about porphyria in pigs?

A

No photosensitization

175
Q

What’s special about porphyria in cats?

A

No anemia

Clinical Pathology (9 decks)

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