Clin Path 2: Hemorrhage Flashcards
What is acute hemorrhage associated with?
acute blood loss happening for the first time over a short interval such as in cuts and lacerations,
Will there be iron deficiency with internal or external hemorrhage?
external hemorrhage
What is the difference between internal and external hemorrhage?
Internal hemorrhage occurs when RBCs are retained within the body such as with a ruptured aorta or a blood pool in a body space
External hemorrhage occurs with parasites and GI neoplasms
With acute hemorrhage explain the progression from less than 30-60 minutes up until greater than 2-3 days.
Initially, there will be a normal PCV and plasma ratio since with acute blood loss both are lost at the same time and in the same ratio, then after about an hour, there will be fluid redistribution resulting in a lower PCV then after 2-3 days, there will be an increase in PCV due to regeneration and reticulocytosis meaning it is regenerative
In chronic external hemorrhage, how will iron stores change over time?
Gradual decrease
In chronic external hemorrhage, how will PCV change over time?
PCV will gradually decrease
In chronic external hemorrhage, how will MCV change over time?
Initially there will be an increase and then it will gradually decrease
In chronic external hemorrhage, how will MCHC change over time?
Gradual decrease
In chronic external hemorrhage, how will reticulocyte number change over time?
There will be an increase followed by a decrease/absence
No iron = ______ hemoglobin = _________ reticulocytes
no hemoglobin
decrease in reticulocytes
In which type of hemorrhage is there compensatory mechanisms? Explain what that means
Chronic hemorrhage
As hematocrit is decreased there is compensation to deal with the decrease in oxygen as red cell mass is decreasing
What are examples of internal chronic hemorrhage?
Blood pool in body space due to ruptured aorta
What are examples of external chronic hemorrhage?
GI parasites, GI neoplasms
Can a chronic external hemorrhage lead to iron deficiency? How would you be able to tell this?
Yes
Need to do a blood smear as it would not be apparent on CBC unless there was a great amount of them
What are some components you would observe on a blood smear in the case of chronic external hemorrhage that has progressed into iron deficiency?
Hypochromic cells
Anisocytosis
Poikilocytisis specifically schistocytes
Thrombocytosis
What is Poikilocytosis? Schistocytes
Poikilocytosis is variation in shape
Schistocytes are an irregular sickle due to less Hgb making the RBC more fragile
What is the last thing that would be seen in an iron deficiency on a blood smear of a chronic external hemorrhage case?
Thrombocytosis
Define thrombocytosis. What causes this?
increased number of platelets due to EPO driving bone marrow to release RBC and spleen to contract
Define anemia
reduction in RBC, HGB, and PCV (or HCT)
What are the associated clinical signs of anemia?
pale mm, weakness, exercise intolerance, lethargy, tachypnea, tachycardia, syncope
What are some common ways the body will respond to anemia?
Lowered oxygen tension in arterial blood leading to hypoxia
EPO stimulating erythropoiesis, increased reticulocytes
What are the 3 general causes of anemia?
blood loss (hemorrhage)
hemolysis
decreased production of RBC
Of the general causes of anemia which are regenerative and which are non-regenerative?
Regenerative = blood loss and hemolysis
Non-regenerative = decreased production of RBC (hypoplasia)
What are some common reasons for blood loss or hemorrhage?
blood vessel damage, hemostatic abnormalities (coag factor deficiencies), parasitism, iatrogenic
What are some common causes for hemolysis?
RBC destruction, oxidative injury, immune-mediated
What are some common causes for decreased production of RBC also known as hypoplasia?
chronic renal failure
selective erythroid hypoplasia
iron deficiency
What are the mild, moderate, and marked anemia ranges in dogs and cats?
Mild: dogs > or = 33% // cats > or = 26%
Moderate: dogs > or = 24% // cats > or = 23%
Marked: dogs < or = 23% // cats < or = 23%
When plasma proteins such as albumin and globulin are low what does that indicate?
blood loss
The regenerative status could be pre-generative, what does this mean?
It could be regenerative but cannot be certain until 2-3 days following the cause of anemia
Do young animals have higher or lower PCV?
LOWER
What does macrocytic, hypochromic and increased reticulocyte # on cbc results indicate?
regenerative but does not indicate cause
What does microcytic, hypochromic cbc results indicate?
iron deficiency
What can increased bilirubin indicate?
hemolysis
On a blood smear what are RBC morphologies that would support iron deficiency as a result from external chronic hemorrhage?
microcytes, hypochromasia, schistocytes, acanthocytes, asinocytosis
