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Clinical Pathology Exam 1 > Lecture 3 - anemia and regenerative response > Flashcards

Lecture 3 - anemia and regenerative response Flashcards

1
Q

__ is a sign of underlying dz NOT A DDX

A

Anemia

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2
Q

Anemia is based on

A

individual (spp, breed, gender, age)

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3
Q

What 4 things need to be don toe dx the dz causing anemia

A
  1. history (dz, travel, drugs)
  2. PE (large organs, masses)
  3. clincial signs
  4. ddx tests (imaging, labs)
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4
Q

clinical signs of anemia are due to

A

decreased O2 delivery to tissues

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5
Q

clinical sings of anemia are influenced by

A
  1. rate and severity of decrease in RBC
  2. cardiopulmonary function
  3. age and activity of animal
  4. cause of anemia
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6
Q

severe anemia in cats and dogs

A

cats:

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7
Q

Clinical signs of anemia

A
  1. weakness, lethargy, exercise intol
  2. poor peripheral perfusion (pale MM and scleral vessels)
  3. CV issues (tachycardic, poor pulse, systolic murmur)
  4. pulmonary issues (tachypnea, dyspnea)
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8
Q

why would an anemic patient be tachycardic

A

blood viscosity decreases = systemic vascular resistance decreases (vasodilation). body tries to increase SV and HR to maintain CO (CO = SV x HR)

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9
Q

why would an anemic patient have tachypnea and dyspnea

A

increases RR to increase O2 delivery, but difficulty breakthing bc poor O2 carrying capacity

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10
Q

What body systems are involved in regenerative anemia

A
  1. liver
  2. kidney
  3. Thyroid, gonads, adrenals, pituitary
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11
Q

BM should be stimulated/”turn on” to make new RBC in __ days but it may take up to __ to see the regenerative response

A

3-4d, one week

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12
Q

when the BM responds and makes more RBC this is called

A

erythroid hyperplasia

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13
Q

If the bone marrow is working extra hard/strong regenerative response may see __ in circulation

A

nRBC (along with polychoromatophils and mature RBC)

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14
Q

What is the order of erythrocyte production

A

rubriblast - prorubricyte - rubricyte - metarubricyte - polychromatophilic erythrocyte (reticulocyte) - mature RBC (“RPRMPM”)

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15
Q

If there is anysocytosis what values will you see on analyzer results

A

RDW increase, MCV increase (macrocytosis)

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16
Q

how long does it take for a nRBC to mature into a RBC (except cats)

A

about 1-2 days

17
Q

the more severe the anemia the higher the __ count in response to the anemia should be

A

reticulocyte

18
Q

cats release reticulocytes in but in 12 hours they mature into __ which take 10-12 days to mature into RBC

A

punctate reticulocytes (“pin point”)

19
Q

Punctate reticulocytes look like mature RBC so need to stain with __ and do a manual count to assess regeneration.

20
Q

analyzer doesn’t count __, only aggregate reticulocytes

A

punctate reticulocytes (why manual NMB stained count is needed for cats!)

21
Q

what is the hallmark for regenerative response?!

A

polychromasia (reticulocytes if stained with NMB)

22
Q

What might you see on blood film for a regenerative anemia?

A
  1. polychromasia (hallmark!)
  2. increased anisocytosis
  3. nRBC
  4. howell-Jolly bodies (micronucleus)
  5. basophilic stippling
23
Q

machine may count nRBC as lymphocytes causing a false

A

lymphocytosis

24
Q

Why are howell-Jolly bodies seen more in cats?

A

nonsinusoidal spleen = cat spleen doesn’t work as well at removing things as other animals. Spleen normally would remove the micronuclei remnants from RBCs.

25
Q

__ is a regenerative response seen more in ruminants and is a normal feature of immature ruminant RBC

A

basophilic stippling

26
Q

Is basophilic stippling seen in other animals besides ruminants?

A

yes, with a very strong regeneration response

27
Q

__ are larger (high MCV, macrocytic) and contain less Hgb (low MCHC, hypochromia) than mature RBC

A

polychromatophils (reticulocytes)

28
Q

The __ and __ usually increase and __ may decrease (if severe anemia) with RBC regeneration

A

MCV and RDW(anisocytosis), MCHC (hypochromic)

29
Q

__ decreases with robust regenerative response, it takes a lot of cells to change it!

30
Q

4 characteristics of regernative anemia

A
  1. polychromatophils (reticulocytes)
  2. High MCV
  3. Low MCHC
  4. High RDW
31
Q

What are 2 causes that initiate regenerative anemia

A
  1. hemorrhage

2. hemolysis

32
Q

what are 3 causes when a regenerative anemia is ABSENT

A
  1. less than 4 days of hemorrhage/hemolysis (BM hasn’t been “turned on”
  2. extramarrow disease
  3. intramarrow disease
33
Q

for regenerative anemia look for increase __ from analyzer and __ on blood film

A

reticulocyte count increased, polychromasia

34
Q

What species does not release reticulocytes at all? how do you ddx anemia?

A

horses, BM evaluation or repeat PCV

35
Q

4 pathophysiological causes of anemia

A
  1. hemorrhage or blood loss
  2. increased RBC destruction
  3. decreased or defective erythropoiesis (BM issue)
  4. hemodilution (not a true anemia)

Clinical Pathology Exam 1 (12 decks)

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