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SAM 2 scs RUSVM > IMHA and Immune Mediated Diseases (E2) > Flashcards

IMHA and Immune Mediated Diseases (E2) Flashcards

1
Q

What type of HS rxn is IMHA and against what does the reaction occur?

A

Type II (2)

Glycophorin on Erythrocytes

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2
Q

What are the clinical signs accompanying IMHA due to tissue hypoxia?

A

Tachypnea

Tachycardia

Grade II-III systolic hemic murmur

S3 gallop

Increased CO

Vomiting, diarrhea

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3
Q

What antibody mainly causes extracascular hemolysis in IMHA? Which causes intravascular hemolysis? Which one activates the compliment system?

A

IgG

IgM- activates compliment system

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4
Q

What drugs can cause secondary IMHA?

A

Penicillins

Cephalosporins

Sulfas

Methimazole

Levamisole

Dipyrone

Chlorpromazine

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5
Q

How does Feline neonatal isoerythrolysis occur?

A

When a type A or AB kitten consumes colostrum from a type B cat

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6
Q

What should you include in your clinical exam to ensure no secondary cause of IMHA is present?

A

3 view thoracic rads

Abdominal US

Heartworm antigen test

PCR (e.g.4Dx)

Fecal exam for hookworm

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7
Q

If you have a low hematocrit but a normal [Hb] what does this indicate?

A

Hemoglobinemia

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8
Q

What does a Coobs test look for?

A

Auto-antibodies against RBCs

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9
Q

What does an Osmotic Fragility Test confirm?

A

Hemolysis

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10
Q

What would warrent administration of packed RBCs for a dog with IMHA?

A

Elevated respiratiojn rate, dyspnea

Elevated cardiac rate

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11
Q

How do you calculate the amount of blood a patient needs to get via transfusion?

A

BW (kg) x K x [(25-recipient PCV)/ PCV of doner blood]

K in dogs = 90

K in cats= 66

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12
Q

A 18kg dog is diagnosed with primary IMHA. The current PCV is 12% and the donor blood PCV is 70%. How much blood is required (mL) ?

A
  1. 8mL
    * BW=18kg*
    * K=90*
    * PCV(recipient)= 12*
    * PCV(doner)=70*

18kg x 90 x [(25-12)/70]

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13
Q

What is the best treatment for idiopathic IMHA? What second line therapies can be given for immunosuprresion in combination with prednisone?

A

Prednisolone (2mg/kg BID) +Azathioprine (2mg/kg SID then EOD)

Second line: Cyclosporin SID or Mycophenolate mofetil BID

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14
Q

What can be given to a dog with IMHA to prevent a coagulopathy?

A

Aspirin (low dose)

Clopidogrel

Individually adjusted unfractionated heparin

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15
Q

Hypoalbuminemia is a negative prognostic indicator for a dog with IMHA, what does this indicate?

A

Severe hepatopathy

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16
Q

What is the hallmark of immune-mediated thrombocytopenia (ITP)?

A

Surface bleeding: petechiae, ecchymosis, epistaxis

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17
Q

What is the typical platelet count in a dog with ITP?

A

<150,000/ mcL

(N= 200,000-500,000)

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18
Q

Where is the most common place for petechial hemorrhage? What does prolonged surface bleeding eventually lead to?

A

Gums

Pinna

Anemia

19
Q

Which ITP disease rarely causes petechiae, but does cause bleeding post-op or from trauma?

A

Von Willebrands Disease

20
Q

You are spaying a young, healthy dog and note inappropriately long clotting times and intra-op bleeding when there should not be any. You check the PTL count, which was normal. What other test should you perform, which would if negative strongly indicate that the dog has Von Willebrands Disease?

A

PT/aPTT

21
Q

What factors are decreased in a dog with vWB disease? Depletion of which factor causes the most severe bleeding?

A

Type 1, 2, or 3 vWB factors

Type 3 is most severe (no circulating vWBF)

22
Q

A BMBT time over _____ is abnormal. List a few breeds predisposed to vWB disease.

A

4 minutes

Doberman, Bernese Mnt Dog (get type 1, sometimes 2 dz)

Dutch Kooiker (gets type 3 dz)

Goldendoodle (get type 2 dz)

23
Q

What 2 diagnostics exist for vWB disease?

A

ELISA plasma vWB

DNA testing

24
Q

What therapies exist for vWB Disease?

A

Desmopressin (ADH, Vasopressin…)

Blood components: FWB, FFP, Cryp

25
Q

What do antibodies target in pripary ITP? How does secondary ITP occur? Which is more common?

A

Fibrinogen receptor (GpIIb/IIa)

Antigenic stimulation (drug, disease, neoplasia) leading to Ab formaiton

Secondary is most common, specifically due to neoplasia

26
Q

Name one inflammatory diseaase and one toxin that can cause ITP.

A

Pancreatitis (SIRS)

Africna bee envenomation

27
Q

What must you do in addition to a CBC when diagnosing ITP?

A

Blood smear (count PTLs)

28
Q

What is the downside of the PTL-bound antibodiy test from Kansas university?

A

Does not differentiate between primary and secondary ITP

29
Q

How many PTL should you see per high power field? What does it indicate if you count <2 PTL per field?

A

6-8+

<2PTL/ hpf = <50000 total PTLs

30
Q

In addition to removing the offendng cause, what can be given to treat secondary ITP (i.e. what is the best line therapy)? How long does it take to take effect?

A

Glucocorticoids (immunosuppressive) + Vincristine (anti-mitotic)

7 days

31
Q

What is the basic MOA of human IgG therapy (IV)? Is it better than vincristine for increasing PTLs?

A

Blocks the macrophages from phagocytising PTLs

Not better, and much more expensive

32
Q

What can you use to treat ITP if glucocorticoids are counterindicated?

A

Mycophenolate mofetil

(Chlorambucil for cats)

33
Q

What is the best source of PTLs in practice? How long does a PTL live in circulation?

A

FWB

(Ideally DEA 1.1. neg for dogs if not typed)

Last 8-12 days

34
Q

What can be seen in a radiograph of joints affected by immune-mediated polyarthritis?

A

Loss of joint space (Loss of cartilage)

Sclerosis

Osteophyte formation

+/- Periosteal reaction

35
Q

What does neutrophilic inflammaiton of a single joint most commonly indicate?

A

Bacterial infection

36
Q

What are the 3 general causes of IMP?

A

Infectious

Reactive

Primary idiopathic immune-mediated

37
Q

What are the forms of prmary IMP? What are some causes and breed predispositions of each?

A

Non-erosive: SLE, Shar-pei Fever, Akitas

Erosive: Greyhounds, idiopathic rheumatoid arthritis, Cats- periosteal proliferative polyartritis

38
Q

Overexpression of what causes Familial Shar-Pei Fever? How is it treated?

A

Hyluronic acid

NSAID, corticosteroids (for cutaneous mucinosis), colchicine (amyloidosis of kidney and liver)

39
Q

What are the typical findings when diagnosing systemic lupus erythematpsos (SLE)?

A

At least 2 separate manifestations of autoimmunity

+

Presence of antinuclear antibodies

40
Q

What are the 4 general causes for SLE?

A

Genetics

Environmental factors (IV light, estrogen, prolactin…)

Drugs

Infectious agents

41
Q

What is the most common complaint in dogs with SLE? What other CS commonly occur? How many of clinical signs need to be present for a diagnosis of SLE?

A

Lameness (due to polyarthropathy)

Fever, Renal disorders, dermatologic lesions

At least 2 needed

42
Q

What diagostics can you perform to help you diagnose SLE?

A

ANA

Lupus erythematosus Cell Test

43
Q

What does proteinuria in a dog with SLE indicate?

A

Glomerulonephritis and a poor prognosis

SAM 2 scs RUSVM (14 decks)

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