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Y3 MOD clinical pathology > Approach to anaemia 2 > Flashcards

Approach to anaemia 2 Flashcards

1
Q

What is the overall role of treatment for IMHA?

A

Immunosuppressive therapy

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2
Q

Which drugs is used for first line immunosuppressive therapy?

A

Prednisolone - Oral

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3
Q

If an animal is inappetent and wont take prednisolone orally which drug can be used instead?

A

Dexamethasone - IV

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4
Q

Give examples of other immunosuppressive drugs

A
  • Azathioprine
  • Ciclosporin
  • Leflunomide
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5
Q

Which immunosuppressive drugs is toxic to cats?

A

Azathioprine

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6
Q

Give some side effects related to prednisolone

A
  • Polyuria, polydipsia, polyphagia
  • GI toxicity
  • Muscle wastage
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7
Q

How can you decide if it is necessary to use a second immunosuppressive treatment?

A
  • Clinical features of severe /life threatening disease
  • No response to corticosteroids over first 7d
  • Patient with or at risk of severe corticosteroid side effects
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8
Q

Describe dosing and length of treatment for IMHA

A
  • Start ‘high’ and gradually reduce doses if anaemia under control
  • Minimum 2-3 weeks between dose reductions
  • Prednisolone treatments lasts 3-6 months
  • Some animals may relapse and be on treatment for life
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9
Q

How do immunoglobulins work as an immunosuppressive treatment?

A

Block Fc receptor of macrophages and bind/block circulating antibodies

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10
Q

Immune mediated haemolytic anaemia leads to a high risk of what disease?

A

Thromboembolic disease

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11
Q

Which drugs would be used for:

  • primary haemostasis?
  • secondary haemostasis?
A
  • Antiplatelet drug e.g. Clopidogrel

- Anticoagulant e.g. unfractionate heparin

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12
Q

Describe neonatal isoerythrolysis in a dogs

A
  • Very rare but can occur in puppies
  • Destruction of neonates RBCs by maternal antibodies
  • DEA1.1 positive puppies affected
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13
Q

Describe neonatal isoerythrolysis in a cat

A
  • Rare
  • Type A or AB kitten born to a type B queen
  • British shorthairs
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14
Q

What is microangiopathic haemolytic anaemia?

A
  • RBCs are mechanically damaged or fragmented as they pass through fibrin mesh works in the microvasculature
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15
Q

What could be the possible underlying causes of microangiopathic haemeolytic anaemia

A
  • Altered vasculature e.g. haemangiosarcoma
  • Fibrin nets - DIC
  • Glomerulonephritis
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16
Q

What is the name given to fragmented RBCs?

A

Schistocytes

17
Q

A RBC with multiple, rounded projections of variable length is a ?

A

Acanthocyte

18
Q

What are the causes of acanthocytes?

A
  • Liver disease
  • Lymphoma
  • Glomerulonephritis
  • Cholesterol metabolism abnormalities
19
Q

What can cause oxidative injury to RBCs in:

  • dogs
  • cats
A
  • Onions, zinc

- Paracetamol

20
Q

Oxidative injury results in … ?

A
  • Heinz body formation

- RBC membrane oxidation (eccentrocytes)

21
Q

What are Heinz bodies?

A

Clumps of damaged haemoglobin attached to your red blood cells

22
Q

Which stain highlights Heinz bodies?

A

New Methylene blue

23
Q

Give some examples of blood parasites

A
  • Mycoplasma haemofelis
  • Babesia canis
  • Ehrlichia
24
Q

What type of anaemia is caused by Mycoplasma haemofelis?

A
  • Regenerative anaemia

- Immune mediated haemolysis

25
Q

Mycoplasma haemofelis usually only causes anaemia in dogs which have undergone which surgical treatment?

A

Splenectomy

26
Q

How can mycoplasma haemofelis be diagnosed?

A

PCR

- once infected, always infected

27
Q

Non-regenerative anaemia has the absence of which cells?

A

Reticulocytes

28
Q

What are the causes of non-regenerative anaemia?

A
  • Primary marrow disease

- Lack of erythropoietin (e.g. due to kidney disease)

29
Q

What are some causes of intramarrow disease?

A
  • idiosyncratic drug reactions
  • Oestrogen toxicity
  • Pure red cell aplasia
  • Myelofibrosis
30
Q

What is an idiosyncratic drug reaction?

A

Unpredictable, individual adverse reaction to a drug

31
Q

What is myelofibrosis?

A

Proliferation of collagen and reticulin fibres in bone marrow

32
Q

Describe the features of anaemia of chronic disease

A
  • very common
  • normocytic, normochromic
  • non-regenerative
33
Q

Does anaemia of chronic disease require treatment?

A

Doesn’t require specific therapy - it should resolve once the underlying disease is cured

34
Q

Why does chronic kidney disease cause anaemia?

A

Reduced erythropoietin production => reduced erythropoiesis

35
Q

Which 2 feline retroviruses can cause non-regenerative anaemia?

A

Feline immunodeficiency virus (FIV)

Feline Leukaemia virus (FeLV)

Y3 MOD clinical pathology (10 decks)

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