Anemia, Blood Loss, Hemolysis

Question 1

what is anemia?

Answer 1

decrease in circulating red cell mass

Question 2

how can you recognize anemia due to hemolysis?

Answer 2

low PCV
normal protein

Question 3

how can you recognize blood loss?

Answer 3

low PCV
low protein

Question 4

what factors should you consider when a horse presents with anemia?

Answer 4

sex
hydration status
excitement
age
breed

Question 5

what type of heart murmur might be present with anemia?

Answer 5

usually systolic

Question 6

what do we evaluate for anemia?

Answer 6

HCT/PCV and total solids
hemoglobin concentration
red blood cell count
blood smear
red blood cell indices
bone marrow (chronic/long term anemia)

Question 7

what do we look at in horses to see if anemia is regenerative?

Answer 7

increased percentage of macrocytes
not reticulocytes

Question 8

what is the circulating volume of blood?

Answer 8

approximately 8% of body weight

Question 9

how much can horses increase their PCV by contracting their spleen?

Answer 9

acutely double their PCV

Question 10

how long does it take for the PCV and total solids to drop after acute blood loss?

Answer 10

8-24 hours

Question 11

what are some causes of blood loss that loses blood outside of the body?

Answer 11

trauma
epistaxis
hematuria
gastrointestinal bleeding

Question 12

what is the positive of bleeding inside the body?

Answer 12

the blood may have a chance of being recovered by the body
increase PCV’s faster

Question 13

what are the causes of gastrointestinal hemorrhage?

Answer 13

ulcerations
NSAID toxicity
parasites
granulomatous intestinal diseases
neoplasia
coagulopathy

Question 14

how does hypertonic saline help with restoring blood volume?

Answer 14

high oncotic pressure will cause rapid expansion of blood volume

Question 15

why might high volumes of crystalloids be a problem with restoring blood volume?

Answer 15

may lead to dilution of clotting factors

Question 16

is blood the fluid of choice for rapid resuscitation?

Answer 16

no

Question 17

when should you give a blood transfusion in chronic blood loss?

Answer 17

elevated lactate
persistent hypotension
PCV <12%

Question 18

how much blood can you safely take from a 450kg donor?

Answer 18

6-8 liters

Question 19

what horses are ideal donors for nonmatched?

Answer 19

gelding
mare that has never been pregnant

Question 20

what do antifibrinolytic lysine analogs do?

Answer 20

prevent clot breakdown

Question 21

how can you recognize intravascular hemolysis?

Answer 21

hemoglobinuria
hemoglobinemia

Question 22

what infectious diseases can cause hemolysis?

Answer 22

piroplasmosis
equine infectious anemia

Question 23

what is oxidant induced damage characterized by?

Answer 23

heinz body formation
hemolytic anemia
methemoglobinemia

Question 24

how can you differentiate intravascular hemolysis from extravascular hemolysis with hemoglobin?

Answer 24

hemoglobin high in intravascular hemolysis
hemoglobin low in extravascular hemolysis

Question 25

is hemoglobin low or high in lack of production anemia?

Answer 25

low

Question 26

what is hemoglobin in reference to hematocrit?

Answer 26

1/3 of hematocrit higher in intravascular hemolysis

Question 27

what does nonregenerative anemia result from?

Answer 27

abnormal bone marrow erythropoiesis

Question 28

how much can an animal bleed and still have a chance of survival?

Answer 28

33% of circulating blood volume

Question 29

where is there the most vasoconstriction in compensatory mechanisms for decreased blood volume?

Answer 29

splanchnic cutaneous skeletal tissue beds

Question 30

why might PCV not be abnormal immediately (up to 8-24 hours) after acute blood loss?

Answer 30

splenic contraction

Question 31

what are some blood loss causes from inside the body?

Answer 31

trauma mesenteric vessel rupture verminous arteritis uterine artery rupture abdominal abscess neoplasia coagulopathy

Question 32

what can cause hematuria?

Answer 32

neoplasia pyelonephritis urolithiasis trauma coagulopathy

Question 33

what can cause GI hemorrhage?

Answer 33

ulcerations NSAID toxicity parasites granulomatous intestinal diseases neoplasia coagulopathy

Question 34

is it okay to give hypertonic saline if the bleeding is not controlled?

Answer 34

no- deleterious

Question 35

what is the dose of hypertonic saline?

Answer 35

4-6 ml/kg

Question 36

what are the natural colloids?

Answer 36

blood plasma

Question 37

what are thee advantages of colloids?

Answer 37

plasma volume expanders increase cardiac output

Question 38

what does giving blood help with?

Answer 38

restores oxygen-carrying capacity, clotting proteins, and oncotic pressure

Question 39

what is a major cross match?

Answer 39

donor red blood cells recipient plasma

Question 40

what is a minor cross match?

Answer 40

donor plasma recipient red blood cells

Question 41

when should you give a blood transfusion for chronic blood loss?

Answer 41

elevated lactate persistent hypotension PCV <12%

Question 42

when should you give a blood transfusion for acute severe hemorrhage?

Answer 42

PCV <20%

Question 43

what should you collect blood into for a blood transfusion?

Answer 43

acid-citrate-dextrose

Question 44

how much of the calculated blood loss should you administer?

Answer 44

30-40%

Question 45

what types of hypersensitivity can be seen with transfusions?

Answer 45

1, 2, 4

Question 46

what can you give naloxone for?

Answer 46

decrease cardiovascular derangements

Question 47

what infectious diseases can cause hemolysis?

Answer 47

piroplasmosis equine infectious anemia

Question 48

what can cause oxidant induced damage hemolysis?

Answer 48

red maple onion phenothiazine

Question 49

what can be seen on a chem with IMHA?

Answer 49

increased total and indirect bilirubin

Question 50

why should you monitor the feet of horses with oxidant-induced hemolysis?

Answer 50

laminitis