Anemia Flashcards
Anemia
decreased oxygen carrying capacity of blood
reduced numbers of RBC
or decreased hemoglobin concentration
Anemia Causes
decreased production
increased loss or destruction
Anemia Measured By
decrease in Hgb values
decrease in PCV
RBC count below normal
(also shape, size, color of RBC when stained)
Classification of Anemia
Morphology
Etiology
Regenerative/Non-regenerative
Morphology
color and size RBC size (MCV) and hemoglobin concentration (MCHC)
Etiology
cause
Regenerative or Non-regenerative
is bone marrow responding?
making new RBCs?
Non-regenerative anemia
maturation defect
hypo-proliferative
need bone marrow
Regenerative Anemia
appropriate response
increased numbers of immature RBC
Lab Tests: Regenerative
reticulocyte counts
erythrocyte indices
RBC morphology
plasma color, turbidity, and total plasma
protein concentration
serum blood iron measurement, bilirubin measurement, bone marrow evaluation
Reticulocyte
immature erythrocytes
with no nucleus
ribosomal material
Difference Polychromatophil vs. Reticulocyte
when stain:
polychromatophil (diff quick)=can’t see ribosomes
reticulocytes (supravital-NMB)-can see ribosomes
Reticulocyte Staining: Method 1
smear
let dry
1 drop NMB
coverslip invert on monolayer
Reticulocyte Staining: Method 2
mix equal parts NMB and blood (3 drops each)
stand 10-15 min
mix sample
make smear
optional: stain w/ Romanawsky
Cat Reticulocytes: Aggregate
true reticulocytes
large clumps of reticulum
Cat Reticulocytes: Puncatate
mature RBC
unique to cats
2-8 small singular basophilic granules
Normal Values Cat Reticuloycytes
- 4% aggregate
1. 5-10% punctate
Reticulocyte Count
% of 1,000 RBC
oil immersion
(horses no reticulocytes, need bone marrow)
Reticulocyte Count Example
8 retics out of 1,000 RBC=0.8%
80 retics out of 1,000 RBC=8%
Basophilic Stippling
retained organelles
lead poisoning
Basophilic Stippling
Vs.
Reticulocytes
Reticulocytes=NMB stain
Basophilic Stippling=Diff Quick
Regenerative Anemia: when to look?
4-7 days from cause of anemia
Regenerative Anemia: adequate response
percentage of reticulocytes greater than or equal to PCV
Dog: Normal Reticulocytes
0%-1.5%
Other Signs of Immaturity
Howell Jolly Body
Polychromasia
nucleated RBCs
None Regenerative Anemia: Causes
iron deficiency Erlychiosis drug toxicity histoplasmosis hypothyroidism renal insufficiency
Normocytic Anemia
normal RBC size
secondary to acute or chronic disorders
Macrocytic Anemia
large RBCs
response to regenerative anemia
rarely seen in Vet Med
Microcytic Anemia
small RBC
iron deficiency
Hypochromic
reduced Hgb concentration
iron deficiency
Normochromic
normal levels Hgb
other types of anemia
Hyperchromic
not possible
Erythrocyte indices
classify anemia based on morphology:
microcytic-normocytic-macrocytic
hypochromic-normochromic
Normacytic, Normochroic: causes
trauma/hemmorage:
cell production too slow
hemolysis of RBC by toxin, bacteria, viral infection
plasma=yellow/icteric
Microcytic, Hypochromic: causes
gradual loss of iron:
blood sucking parasites
dietary iron deficiency (baby pigs no parasites)
…anything cause RBC loss
Etiology Classifications: cause
Hemolytic (RBC break open)
Hemmoragic (blood loss)
Iron Deficiency
Production Disorders
Hemolytic Anemia
due to RBC rupture
affect liver and kidney (excess bilirubin)
usually regenerative
Hemolytic anemia: causes
bacteria (lepto and viruses) blood parasites toxins and chemicals IMHA neonatal isoerythrolysis incompatible transfusions
Blood loss
acute: trauma or blood sucking parasites
changes normacytic/normachromic to microcytic/hypochromic anemia
gradual blood loss
Iron Deficiency: causes
improper amounts of: B-12 folic nictinic pyridoxine protein copper cobalt nickel
Bone Marrow Depression
no treatment acute appear normocytic/normochromic erythropoiesis=reduced and defective metabolic inhibition panycyptopenia end in death
Bone Marrow: Metabolic Inhibition
chronic rental or liver disease
sever infection
malignancy
endocrine disturbances (hyperthyroid, hypoadecorhrticism)
Nucleated RBC
metarubricytes
not healthy in high numbers
if see more than 5 must perform corrected WBC count
Corrected WBC Count
total WBCx100/100+nRBC
Corrected WBC Count Example
total WBC 17k µL
total nRBC 7
17,000x100/100=7=15,887 wbc/µL
