Anemia things

Question 1

List the physiologic adaptions to anemia

Answer 1

• increased sympathetic tone - increaed preload from vasoconstriction, increased cardiac contractility and HR
• decreaed blood viscosity decreases afterload and decreaes preload
• redistribution of blood flow from splanchnic circulation to coronary and cerebral perfusion
• increase in 2,3-DPG (dogs) - right shift of oxygen dissociation curve

Question 1

What are RBC changes consistent with regeneration?

Answer 1

• increased reticulocytes
• polychromasia
• macrocytosis (high MCV)
• anisocytosis (high RDW)
• low MCHC - low hemoglobin in cells

Question 2

What MCV MCHC changes are consistent with nonregenerative anemia

Answer 2

normal MCV and MCHC

Question 3

What MCV MCHC changes are consistent with iron-deficiency anemia?

Answer 3

microcytic hypochromic
i.e., low MCV and low MCHC

Question 4

What are alternative differentials for macrocytosis other than regeneration?

Answer 4

B12 deficiency
FeLV

Question 5

What is a differential for microcytosis other than iron deficiency anemia?

Answer 5

PSS

Question 6

What do hemoglobinemia or hemoglobinuria indicate?

Answer 6

intravascular hemolysis

Question 7

List 3 morpholic RBC changes that can be seen with fragmentation hemolysis

Answer 7

• schistocytes
• acanthocytes
• keratocytes

Question 8

List RBC morphology changes indicative of oxidative injury

Answer 8

• Heinz bodies
• Eccentrocytes
• Pyknocytes

Question 9

What changes do you see?

Answer 9

Eccentrocytes/Poikilocytes

Question 10

Describe the RBC changes you see

Answer 10

Eccentrocytes (cells with half moon)
Fragment/Schistocyte
shrunken ecchinocyte
some Heinz bodies

Question 11

What do you see on each of these pictures?

Answer 11

Left image: Accanthocytes
Right image: Ecchinocytes

Question 12

What are the most common heritable hemolysis disorders?

Answer 12

• increased osmotic fragility
• deficient phosphofructokinase
• deficient Pyruvate kinase

Question 13

What are the 3 most important infectious causes of RBC hemolysis in north america? What are each of their treatments?

Answer 13

• Mycoplasma spp. - Doxycycline
• Cytauxzoon felis - atovaquone + azithromycin
• Babesia spp. - atovaquone + azithromycin (small form), Imidocarb (large form)

Question 14

How does the coombs’ test work?

Answer 14

species specific antisera containing antibodies to IgG, IgM, and complement –> combined with patient’s washed RBC

if there are Ab or complement on RBC surface –> will agglutinate in the antisera –> positive