Lecture 2 8/27/24 Flashcards

1
Q

What is polychromasia?

A

morphologic description of what a reticulocyte looks like on routine blood smear

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2
Q

What do spherocytes indicate?

A

immune-mediated hemolytic anemia

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3
Q

What are spherocytes?

A

RBCs with membrane-bound antibodies that are removed by macrophages; removal of part of the membrane causes the cells to have a spherical shape

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4
Q

What does agglutination indicate?

A

immune-mediated hemolytic anemia

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5
Q

What is rouleaux?

A

linear arrangements of RBCs due to increased globulins

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6
Q

What are heinz bodies?

A

a projection off of a RBC that indicates oxidant injury

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7
Q

What are eccentrocytes?

A

RBCs with a white “fingernail” appearance that indicates oxidant injury

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8
Q

What are schistocytes?

A

torn or fragmented RBCs

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9
Q

What are the potential causes of schistocytes?

A

-disseminated intravascular coagulation
-hemangiosarcoma
-cardiac disease

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10
Q

What is basophilic stippling?

A

diffuse stippling of RBCs on a routinely stained blood smear

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11
Q

What are the potential causes of basophilic stippling?

A

-regenerative anemia in ruminants
-lead toxicity in any species

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12
Q

What are the mechanisms of anemia?

A

-hemorrhage
-hemolysis
-decreased RBC production in the bone marrow

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13
Q

Which mechanisms of anemia are regenerative?

A

-hemorrhage
-hemolysis

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14
Q

Which mechanism of anemia is non-regenerative?

A

decreased bone marrow production of RBCs

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15
Q

What does it mean for an anemia to be regenerative?

A

bone marrow responds appropriately to RBC loss by increasing RBC production

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16
Q

What findings in the bone marrow and blood are expected in a regenerative anemia?

A

bone marrow: erythroid hyperplasia
blood: increased numbers of reticulocytes

17
Q

What findings in the bone marrow and blood are expected in a non-regenerative anemia?

A

bone marrow: erythroid hypoplasia and/or ineffective erythropoiesis
blood: normal or decreased numbers of reticulocytes

18
Q

What is the caveat with regenerative anemia?

A

it takes 3-4 days following hemorrhage or hemolysis for the bone marrow to begin releasing increased reticulocytes into the blood

19
Q

What is the sole definitive way to distinguish regenerative vs non-regenerative anemia?

A

absolute reticulocyte count

20
Q

What are the possible patterns seen on CBC that could indicate a regenerative anemia?

A

-increased MCV and decreased MCHC
-normal MCV and MCHC, but with MCV at the high end of normal and MCHC at the low end of normal

21
Q

What are other possible CBC/blood smear findings that can indicate regenerative anemia?

A

-increased nRBCs
-Howell-Jolly bodies
-increased RDW
-basophilic stippling

22
Q

How do horses uniquely present with regenerative anemia?

A

-do not release reticulocytes into circulation during a regenerative response
-instead release macrocytic RBCs

23
Q

How is anemia definitively classified in horses?

A

bone marrow evaluation

24
Q

What indirect indicators of regenerative anemia can be present in horses?

A

-increased RDW
-increasing MCV
-identified cause of hemorrhage or hemolysis

25
Q

When is pre-regenerative anemia unlikely?

A

if an animal has been sick for more than a few days but is not showing a reticulocyte count

26
Q

When is pre-regenerative anemia more likely?

A

-acute traumatic blood loss
-acute hemolytic anemia w/ abnormalities on microscopic exam

27
Q

Why are no changes in CBC values seen a few minutes after a hemorrhagic episode?

A

even though the animal is hypovolemic, there has not been enough time for proportional changes to occur in the blood

28
Q

Which changes in CBC values can be seen a few hours after a hemorrhagic episode?

A

-decreased HCT
-decreased protein

29
Q

What causes the changes in CBC values seen a few hours after a hemorrhagic episode?

A

movement of water into the vasculature to replace lost volume, which dilutes the blood components

30
Q

Which changes in CBC values can be seen 3-5 days after a hemorrhagic episode?

A

-decreased HCT
-normal to increased MCV
-normal to decreased MCHC
-increased reticulocytes
-normal to decreased protein

31
Q

What are examples of chronic external hemorrhage causes?

A

-GI hemorrhage
-ectoparasites

32
Q

What are the expected CBC results with chronic external hemorrhage?

A

-regenerative anemia
-possible decrease in total protein
-potential iron deficiency if duration is long enough

33
Q

Why can chronic hemorrhage result in iron deficiency?

A

-most iron used for erythropoiesis is recycled from aged RBCs
-loss of RBCs from the body prevents iron recycling
-over time, this can result in bone marrow iron store depletion

34
Q

What are the consequences of iron-restricted erythropoiesis?

A

-anemia
-impaired reticulocyte production
-decreased CHr
-decreased MCHC
-decreased MCV