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RUSVM Clinical Pathology > Anemia > Flashcards

Anemia Flashcards

1
Q

What are the 3 main causes of anemia?

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

Or combo of these

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2
Q

What are clinical signs of anemia?

A

Pale mucous membranes
Lethargy
Increase resp rate, dyspnea
Increased heart rate

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3
Q

Spenomegaly, icterus, and hemoglobinuria are clinical signs associated with ??

A

Blood destruction

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4
Q

What 4 tests would you used to assess an anemia?

A

PCV- Red blood cell mass

Mean cell volume
Recticulocytes count
Total protein

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5
Q

What test do you used to confirm IMHA?

A

Coombs test

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6
Q

an anemia with a high reticulocyte count tells you what??

A

Bone marrow is responding (regenerative anemia)

-anemia due to blood loss or blood destruction

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7
Q

What can you use to differentiate if an anemia is due to destruction or blood loss

A

Total protein

Low TP-> blood loss (acute)

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8
Q

In a dog..

PCV 13%
Rectics 100,000 (high)
TP 5.0 (low)

Hematology -> acanthocytes and schistocytes

A

Hemangiosarcoma

-> acute blood loss due to rupture

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9
Q

What are common causes of chronic blood loss?

A

GI ulcers
Bleeding GI tumors
Blood consuming parasites

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10
Q

In adults, and iron deficiency anemia is almost always due to ???

A

Chronic blood loss

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11
Q

PCV 15%
Reticulocytes high
Microcytosis
RDW is increased

Histopathology -> keratocytes and increased central pallor

A

Regenerative anemia
Microcytosis and keratocytes are evidence of….

iron deficiency anemia

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12
Q

How does the therapy differ in adults and neonates for iron deficiency anemia?

A

Adult- > find source of chronic bleed

Neonate -> injectable iron

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13
Q

Microcytosis can have multiple causes .. what are they?

A

Portosystmic shunt
Breed predisposed
Anemia of inflammatory disease
Iron deficiency anemia

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14
Q

Case : 10yr old yellow lab
4months earlier: PCV 44% and TP 8.2

PCV 16%
Rectics 342 (range 0-60)
TP 6.2 (range 6.0-8.0)

What would you suspect?

A

Anemia due to blood loss

High reticulocyte count => regeneration
TP - is within range but much lower than it was at a check up 4months ago

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15
Q

CASE - 1yr old female pointer
History of back pain, vomiting, previously treated with steroids for the back pain

PCV: 18%
MCV 47 (60-72)
MCHC 33 (34-38)
Rectics 18.8 (0-60)
TP 5.9 (6-8)
Inflammatory leukogram 
Hematology-> keratocytes, schistocytes, blister cells, and giant platelets
A

MCV is low -> microcytosis
Rectics 18.8(relatively low)-> non regenerative
TP minorly low-> chronic blood loss

MCV and keratocytes/schistocytes –> Iron deficiency

Chronic blood loss

  • GI ulcer
  • hookworms
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16
Q

In cats, immune hemolytic anemia is often associated with what conditions?

A

Mycoplasma hemofelis
FeLV
Neoplasia

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17
Q

In horses, immune mediated hemolytic anemia is associated with ??

A

Penicillins, clostridial infections, and neoplasia

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18
Q

What species of dogs do we see the highest incidence of IMHA?

A

Cocker spaniels

Also in poodle and collies

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19
Q

What is the diagnostic test for immune mediated hemolytic anemia?

A

Coombs test (Direct antiglobulin test)

In IMHA, antibodies are binding to RBCs
Coombs adds and antibody against the IgG –> cause agglutination in positive animals by binding the IgG which is bound to RBCs

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20
Q

Does Dr Thrall like the Coombs test? Why or why not?

A

Nope

Many false negative -> immune competes attached to erythrocytes but destruction of RBC is not increased

Many false positives -> low concentration of AB of RBC

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21
Q

What is your DDx for spherocytosis?

A

Previous mismatched blood transfusion
Rattlesnake envenomation
Heinz body anemia in horse

Zinc toxicosis
Bee stings

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22
Q

What do you call the disease of having both an immune mediated hemolytic anemia AND immune mediated thrombocytopenia ?

A

Evans syndrome

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23
Q

In IMHA, the leukograms almost always is _____

A

Inflammatory

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24
Q

What is the therapy for IMHA?

A

Glucocorticosteriods (decrease AB production, Tcell activity, and macrophage function)
Fluids
Correct acidosis

Blood transfusion and splenectomy are not usually indicated

25
Q

How can zinc toxicosis result in spherocyte formation?

A

Band 3 is a protein that exchanges bicarbonate ion for chlorine in RBCs -> zinc results in clustering of the protein -» rounding of cell

26
Q

What is a common cause of IMHA in horse/mule foals?

A

Neonatal isorytholysis
-maternal AB against the neonates blood group bind the foals RBCs -> hemolysis

Will see the foal become weak after ingesting colostrum

27
Q

What erythrocytes parasites cause intravascular hemolysis

A

Babesia and Theileria

-> AB against parasites –> complement fixations and phagocytosis my macrophages

28
Q

What is a common cause of serious anemia in cats and can be a cause of IMHA. How does the cat get this?

A

Mycoplasma hemofelis

Transmitted through blood feeding anthropoids/cat bites/ iatrogenic exposure

29
Q

Cat..

Anemia 
Splenomegaly 
Fever
Lethargy 
Icterus

Blood smear shows small eosinophilic dots on the peripheral of the RBCs

A

mycoplasma hemofelis

30
Q

Mycoplasma hemofelis will cause a regenerative anemia exception in what cases?

A

There is underlying disease like FeLV or severe inflammatory disease

31
Q

In a doggo..

Blood smear shows eosinophilic line of dogs in the RBCs and you also see a Howell jolly body

A

M. Hemocanis

32
Q

What mycoplasma is found in cattle and only causes sever anemia in splenecomized or immunosuppressed animals?

A

M. Wenyonii

33
Q

What parasite of RBCs can cause a severe anemia in baby pigs and in adults is associated with poor weight gain

A

Mycoplasma hemosuis

34
Q

Tick borne rickettsial infection of ruminants that can cause fatal hemolytic anemia

A

Anaplasmosis

A. Marginale and A. Centrale

35
Q

Hemoprotozoan organism that is transmitted by ticks and blood transfusions causing severe disese and hemolytic anemia

A

Babesia sis

36
Q

Babesia sis in horses is usually called??

A

Piroplasmosis

37
Q

Theileriosis is a protozoan causing hemolytic anemia in what sp?

A

Ruminants

38
Q

What stage of the theileriosis organism is in the RBC

A

Merozoite (piroplasm)

39
Q

T/F: blood smear of a deer, the RBCs are sickle shaped therefore they have sickle cell anemia

A

FALSE ..

all the other clinical pathologist will laugh at you and will never respect you again, if you say this

This shape change is normal change that occurs in vitro due to changes in oxygen concentration

40
Q

Protozoan of cats that has a piroplasm RBC phase and a schizont phase in the macrophages in tissue

A

Feline cytauzoonoisis

41
Q

What is a heinz body anemia?

A

Oxidatively denatured hemoglobin

42
Q

What plants can form heinz body aneimia?

A

Allium (onion and garlic)

Brassica (kale, cabbage, rape)

Wilted red maple leaves

43
Q

What drugs/chemicals can cause heinz body formation?

A 
Acetaminophen 
Propylene glycol 
Naphthalene 
Crude oil 
Methylene blue

Zinc
Copper selenium deficiency

44
Q

How are heinz bodies formed?

A

Hemochrome formation due to oxidative damage–> irreversible -> aggregate

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

45
Q

How does heinz body formation lead to anemia?

A

Hemochromes complex with protein band 3 -> clustering of protein band 3 –> creates a recognition site for auto-antibodies

Spherocytosis

Spectin-hemoglobin cross linkage -> increase membrane rigidity and decrease deformabiltiy –> removal by macrophages or lysis

46
Q

What is methemoglobinemia?

A

Form of hemoglobin that cannot carry oxygen
-iron is in the ferric state

Caused by oxidative damage

47
Q

Blood appears what colour when 30% of the hemoglobin is methemoglobin

A

Brown

-> death at 90%

48
Q

Copper toxicosis accumulates where? What species is most susceptible?

A

Accumulates in liver

Sheep

49
Q

Hypophasphatemia will have what effect on the blood?

A

Low P -> decreased glycolysis –> hemolysis

50
Q

What are causes of hypophosphatemia in cats?

A

Diabetes mellitus

Enteral alimentation

51
Q

What two bacteria can cause a hemolytic anemia

A

Clostridium sp

Leptospirosis sp

52
Q

What is yellow lamb disease?

A

Hemolytic anemia caused by clostridium perfringins type A

53
Q

What is the etilogy of Red water disease AKA bacillary hemoglobinuria in cattle?

A

Clostridum hemolyticum

Associated with fluke migration

54
Q

Cattle

Anemia
Arched back 
Bloody diarrhea
 Fever 
Dyspnea 
Hemoglobinuria
A

Clostridum hemolyticum

Red water disease

55
Q

What can occur in cattle that have free access to water after a period of unavailability

A

Water intoxication

Decreased osmolailty of plasma leads to hemolysis

56
Q

What is a virus induced hemolysis of horses

A

Equine infectious anemia

Aka Swamp fever

57
Q

What is ‘pink tooth’ in catttle?

A

Porphyria

Deficiency in uroporphyrinogen III co-synthetase

Can’t make hemoglobin -> accumulate uroporphyrin and coporporhyrin in bone and teeth

Fluorescent pink
Photosensitive
Decreased RBC survival

58
Q

T/F: porphyria is an autosomal dominant trait in cats resulting in anemia

A

False

Will not result in anemia in cats

59
Q

T/F:

Porphyria in pigs does not cause photosensitization

A

True

RUSVM Clinical Pathology (18 decks)

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