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Clinical Pathology Exam 1 > Chapter 5 - Regenerative anemia and tests > Flashcards

Chapter 5 - Regenerative anemia and tests Flashcards

1
Q

If hemolysis is occuring in the spleen what do you expect to see on blood film

A

spherocytes

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2
Q

If hemolysis is occuring in the blood vessels what do you expect to see on blood film

A

ghost cells

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3
Q

__ undergo extravascular or intravascular hemolysis bc of their rigidity and fragility.

A

spherocytes

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4
Q

RBC coated with __ undergo extravascular hemolysis by macrophages and are conveverted to spherocytes

A

surface-associated Ig and/or complement protein 3

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5
Q

Some RBC surface IgM may bind complement which activates the complement cascade and leads to intravascular hemolysis via the __

A

membrane attach complex (MAC attach)

complex of complement factors 5b through 9

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6
Q

damaged cells are removed from circulation by

A

macrophages

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7
Q

7 lab findings for IMH

A
  1. Regenerative anemia (usually) - polychormatophils, howell jolly bodies
  2. macro or microagglutination
  3. Spherocytosis
  4. Neutrophilia
  5. pigmentemia/uria
  6. variable platelets
  7. abnormal liver enzymes
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8
Q

__ test is used to distinguish rouleaux from autoagglutination. It should be ran at __ temperature.

A

saline, Body

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9
Q

microagglutination looks like __ where rouleaux looks like __

A

grapes, stack of coins

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10
Q

what animals normally have rouleaux RBC

A

Cats, horses, pigs, bovides

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11
Q

how will you treat autoagglutination

A

steroids (do not treat rouleaux usually)

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12
Q

__ is the nonspecific binding of RBC due to high blood protein

A

rouleaux (do not treat)

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13
Q

__ is the specific binding of RBC by Ab seen in IMHA

A

agglutination (treat with steroids)

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14
Q

what animals are spherocytes difficult to ddx and other tests need to be preformed

A

cats and horses, less central palar

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15
Q

__ can occur due to inflammation or infection, seen with IMHA

A

Neutrophilia (high neutrophil count)

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16
Q

2 types of Primary IMHA

A

idiopathic auto-immune hemolytic anemia (AIMA)

neonatal isoerythrolysis

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17
Q

most common ddx IMHA

A

idiopathic AIHA

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18
Q

most commonly IMHA is __

A

secondary

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19
Q

__ is common in horses and can happen in cats but is rare in small animals

A

neonatal isoerythrolysis

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20
Q

First steps when suspecting p with IMHA

A

Get a good history, test for underlying causes

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21
Q

what are 4 class of infectious dz that can cause secondary IMHA

A
  1. RBC parasite (babesia, hemoplasma)
  2. Tick borne dz (anaplasma)
  3. virus (FeLV, EIA)
  4. bacterial infection anywhere
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22
Q

chemicals that can cause secondary IMHA

A

Drugs, vaccines, toxins

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23
Q

type of neoplasia that causes secondary IMHA

A

Lymphoma

24
Q

other Immune mediated dz such as __ can cause secondary IMHA

A

systemic lupus erythematosus (SLE), IM thrombocytopenia, others

25
Q

what are some common tests used to work-up an IMH case

A
  1. good history (vx, ticks, travel, drugs, etc)
  2. ddx imaging
  3. serology (Ab against infectious dz present)
  4. PCR (and infectious dz DNA present)
  5. cultures (test fluid/tissue samples for infectious dz)
  6. coomb’s test
  7. erythrocyte osmotic fragility (cats)
26
Q

__ is done when anemic animals exhibit signs of hemolysis and there is clinical suspicion that the hemolysis may be caused by autoimmune dz

A

Coombs’ test (if have autoagglutination do not have to do this test)

27
Q

Coombs’ test is used in cases when there is evidence of hemolysis but __ is abscent

A

autoagglutination

28
Q

What is the purpose of a coombs’ test

A

detect immune system proteins on p RBCs

29
Q

What are 2 tests to ddx IMHA

A

autoagglutination or coombs’ test

30
Q

what are 4 disadvantages to the Coombs test

A
  1. doesn’t tell what’s causing the hemolysis
  2. doesn’t differentiate primary v secondary IMHA
  3. False positives
  4. False negative (doesn’t rule IMHA out)
31
Q

positive coombs test determines what

A

there is an immune mediated component of hemolysis

32
Q

if you get a negative coombs test can IMHA be excluded from ddx list

A

NO!

many things that can result in a negative test, p may still have IMHA

33
Q

how is infectious dz that may be causing secondary IMHA ddx

A

ID of parasite in blood or ancillary testing (PCR, serology, microbiology)

34
Q

occurrence of oxidative damage depends on what 2 things

A
  1. quantity and duration of exposure

2. p ability to metabolize oxidant

35
Q

oxidative damage results in decreased RBC __ and/or __ of damaged cells leading to hemolysis

A

deformability, premature removal

36
Q

5 common oxidants (cause hemolysis)

A
  1. acetaminophen (tylenol and panadol tablets)
  2. allium genus (onions, garlic)
  3. red maple leaves (horses, alpacas)
  4. brassica genus (kale, rapeseed - ruminants)
  5. propylene glycol in semi-moist foods (cats)
37
Q

What oxidant is most likely to effect ruminants

A

brassica genus (kale)

38
Q

what oxidant is most likely to effect horses and alpacas

A

red maple leaf

39
Q

what animal is more sensitive to oxidative damage bc it has more sulfahydryl groups on it’s RBC (targets for oxidation)

A

cats

40
Q

is skunk musk and oxidant in dogs

A

yes

41
Q

__ portion of hgb forms heinz bodies (oxidized ppt of hgb), cats can normally have a few of these.

A

globin

42
Q

membrane of erythrocytes form __ due to lipid membrane oxidation

A

eccentrocytes

43
Q

iron portion of hgb becomes ___, causes chocolate syrup blood, does not cause hemolysis but decreases O2 delivery to tissue

A

methemoglobin

44
Q

3 targets for oxidative damage

A
  1. globin of Hgb (heinz bodies)
  2. iron of Hgb (methemoglobin, decreased O2)
  3. lipid membrane (eccentrocytes)
45
Q

seeing __ and __ on blood film is characteristic of oxidative damage

A

eccentrocyte shape and heinz body inclusions of RBCs

46
Q

6 signs of hemolytic anemia caused by oxidant includes

A
  1. regenerative anemia
  2. history of exposure and clinical signs
  3. lots of heinz bodies (NMB stain)
  4. eccentrocyte and pyknocytes
  5. methemoglobinemia (spot or filter paper test)
  6. hgb crystals
47
Q

__ is seen in puppies that have ingested pennies post 1982 which causes hemolysis

A

acute zinc toxicity

48
Q

__ cells are seen in envenomation cases due to venom phospholipases causing hemolysis

A

spheroechinocytes (no central palar with spicules)

49
Q

__ is a large animal issue after calving due to metabolic state/low ATP causing RBC to be fragile, normally rare

A

hypophosphatemia (can also be seen in small animals with diabetic ketoacidosis or lipidosis)

50
Q

___ hemolysis is seen with rapid infusion of hypotonic fluid (“drown”) or with calf milk replacer that has too much water

A

hypo-osmolar

51
Q

__ and __ are common cell changes seen with regenerative anemia

A

anicocytosis and polychromasia

52
Q

spherocytes are seen with __ hemolysis

A

extravascular

53
Q

microscopic autoagluttination, spherocytes, ghost cells, anicocytosis, polychromasia, macrocytosis, nRBC =

A

IMHA

54
Q

Bilirubenemia is ddx for intra or extravascular hemolyssi

A

neither! it occurs in both. only hemoglobinemia/uria is ddx

55
Q

High WBC count but IMHA, can you give immunosuppressants?

A

yes, wbc count is due to immune response to hemolysis not infection

56
Q

decreased PCV with increased TS helps exclude __ from being cause of regenerative anemia

A

hemorrhaging

Clinical Pathology Exam 1 (12 decks)

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