Anemia Flashcards by Danielle Stone

What is anemia?

The decreased oxygen-carrying capacity of the blood

How well did you know this?

Not at all

Perfectly

What is anemia is caused by?

Decreased red blood cell production
Increased loss from bleeding
Destruction from hemolysis

How well did you know this?

Not at all

Perfectly

What is anemia measured by?

The decrease in the hemoglobin value
The decrease in the PCV
The red blood cell count below normal

How well did you know this?

Not at all

Perfectly

How can anemia be revealed based on the stained smear?

The shape, size, and color of red blood cells

How well did you know this?

Not at all

Perfectly

Is anemia a disease?

No, it is a symptom of a disease process

How well did you know this?

Not at all

Perfectly

How do you classify anemia?

Morphology
Etiology
Regenerative or non-regenerative

How well did you know this?

Not at all

Perfectly

Classification of anemia by Morphology

Based on red blood cell size (MCV) and hemoglobin concentration (MCHC)

How well did you know this?

Not at all

Perfectly

What is normocytic, normochromic anemia?

The cells are normal in size and color

How well did you know this?

Not at all

Perfectly

Macrocytic anemia

Large red blood cells

Transitory increase in response to regenerative anemia

How well did you know this?

Not at all

Perfectly

What is the most common type of anemia?

Microcytic, Hypochromic anemia

How well did you know this?

Not at all

Perfectly

Hypochromic

Reduced hemoglobin concentration
Pale hemoglobin
Iron deficiency

How well did you know this?

Not at all

Perfectly

Is Hyperchromic possible?

No, because red blood cells have a fixed capacity for hemoglobin

How well did you know this?

Not at all

Perfectly

What are the causes of normocytic and normochromic anemia?

Trauma with sufficient hemorrhage

Depression of bone marrow resulting in too slow production of cells

How well did you know this?

Not at all

Perfectly

What is the primary cause of microcytic, hypochromic anemia?

The continuous, gradual loss of iron from the circulatory system, faster than it can be replaced

How well did you know this?

Not at all

Perfectly

What are other causes of microcytic, hypochromic anemia?

Blood-sucking parasites
Dietary iron deficiency may occur in baby pigs
Can be caused by anything that causes red blood cell loss

How well did you know this?

Not at all

Perfectly

Etiologic Classification of anemia

Classified according to the cause  
Hemolytic
Hemorrhagic
Iron deficiency
Production disorders

How well did you know this?

Not at all

Perfectly

What is Hemolytic Anemia?

Due to red blood cells rupturing within the vasculature
Affects the liver and the kidney
Usually regenerative

How well did you know this?

Not at all

Perfectly

Why does hemolytic anemia have an excess amount of bilirubin?

Because of the breakdown of hemoglobin

How well did you know this?

Not at all

Perfectly

What are the causes of hemolytic anemia?

Bacteria and viruses
Blood parasites
Toxins and chemicals
IMHA

How well did you know this?

Not at all

Perfectly

Etiologic classification: Hemorrhagic or Blood loss

Acute blood loss due to traumatic injuries

Young animals heavily infected with blood-sucking parasites

How well did you know this?

Not at all

Perfectly

Can normocytic normochromic anemia change to microcytic hypochromic anemia?

Yes it can due to gradual blood loss

How well did you know this?

Not at all

Perfectly

Etiologic classification: What is iron deficiency?

Continual loss of red blood cells
Caused by a deficiency of necessary chemicals for complete maturation
Microcytic, hypochromic anemia

How well did you know this?

Not at all

Perfectly

Iron deficiency may be caused by improper dietary amounts of:

B-12, folic, nicotinic, pyridoxine, protein, copper, cobalt, nickel

How well did you know this?

Not at all

Perfectly

What does an acute condition of bone marrow suppression look like? Is there treatment?

Appear as normocytic, normochromic at first
no treatment
Erythropoiesis is reduced or defective

Metabolic inhibition of bone marrow is caused by:

Chronic renal or liver disease Severe infection Malignancy Endocrine disturbances-hyperthyroid, hypoadrenocorticism

What does the CBC of a bone marrow depressed patient look like?

Pancytopenia

Nucleated Red Blood cells

Metarubricytes | Not found in healthy blood, especially in high numbers

If you see more than 5 nucleated red blood cells what must you do?

Perform a Corrected White Blood cell count

What information do you need to perform a corrected white blood cell count?

Total WBC count (from CBC machine) | Total # nucleated red blood cells

What is the formula for corrected white blood cell count?

Total WBC x 100/100 + #nRBC

Why must you perform the corrected white blood cell count?

The CBC machine may have counted nucleated red blood cells as white blood cells, this corrected number gives you the number of WBCs

What is Non-regenerative anemia?

Bone marrow is unable to respond to blood loss Reticulocytes are absent in blood Decreased PCV, hemoglobin, and red blood cell

What is regenerative anemia

Appropriate bone marrow response with the release of increased numbers of normal immature red cells

What laboratory tests can you run to determine if it is regenerative anemia?

Reticulocyte count Erythrocyte indices RBC morphology Plasma color, turbidity, total plasma protein concentration Serum blood iron measurement, bilirubin measurement, and bone marrow evaluation

What are the common causes of non-regenerative anemia?

``` Iron deficiency Ehrlichiosis Drug toxicity Histoplasmosis Hypothyroidism Renal insufficiency ```

What is the best clinical index that an animal is responding to anemia?

``` Reticulocyte count A measurable (quantifiable) method for looking at new red blood cells ```

What are reticulocytes?

Immature erythrocytes with no nucleus but with retained ribosomal material

What is the difference between polychromatophils and reticulocytes?

Staining | They are the same stage of maturation

Polychromatophil staining

``` Romanowsky stains (Diff Quick) You can not see remnant ribosomes ```

Reticulocyte staining

Supravital stain--> New methylene blue | You can see remnant ribosomes

Reticulocyte Staining: Method 1

Place a drop of new methylene blue onto a coverslip and invert it onto the monolayer of a smear

Reticulocyte Staining: Method 2

``` Better method Mix equal parts of new methylene blue and blood Allow to stand for 10-15 minutes Mix the sample and make a smear Can stain with Romanowsky stain ```

What are the two forms of reticulocytes that cats have?

Aggregate and Punctate

Aggregate

Large clumps of reticulum

Punctate

Unique to cats | 2 to 8 small singular basophilic granules

What is normal aggregate and punctate for cats?

Aggregate: 0.4% Punctate: 1.5% to 10%

What is a reticulocyte count?

Expression of the percentage of red blood cells that are reticulocytes Percentage per 1000 red blood cells on oil-immersion

What anemic animal should a reticulocyte count not be performed on?

Horses | They do not release reticulocytes, you have to look at a bone marrow sample

What is a reticulocyte count useful in determining?

Bone marrow response

What can reticulocytes be confused with?

Basophilic Stippling

Basophilic stippling

Also retained organelles | found commonly in lead poisoning

How can you tell the difference between reticulocytes and basophilic stippling?

Stain Reticulocytes need New Methylene Blue Basophilic Stippling stains easily with Diff Quick

How many days usually pass before an animal shows signs of anemia?

4 to 7 days from the cause of anemia

What is an adequate response to regenerative anemia?

The percentage of reticulocytes is greater than or equal to the expected percentage for the corresponding PCV

What are the normal reticulocyte ranges for dogs?

0-1.5%

What is the normal aggregate range of reticulocytes in cats?

0-0.4%

What is the normal punctate range of reticulocytes in cats?

1.5-10%

What are other signs of immaturity?

Howell Jolly Bodies Polychromasia Nucleated Red blood cells