Lecture 3: Non-regenerative anemias and erythrocytosis Flashcards
What is reticulocyte count with non-regenerative anemia
normal or decreased
what are the 2 mechanisms for nonregenerative anemia
- Reduced erythropoiesis
- Defective erythropoiesis
what are the analyzer findings for MCV and MCHC in non-regenerative anemia
Normal or decreased
what are the blood smear findings for non-regenerative anemia
- Minimal or mild anisocytosis
- Minimal or mild polychromasia
- Minimal basophilic stippling- ruminants
which of the following is indicative or regenerative vs non-regenerative anemia
Left: non-regenerative
Right: regenerative
do you have inappropriate or appropriate metarubriocytosis with non-regenerative anemia
inappropriate
what is inappropriate metarubricytosis
increase nRBC in circulation due to endothelial damage, lacking other signs of regeneration like polychromatophils/ reticulocytosis
is anemia of chronic disease/anemia of inflammation mild, moderate or severe anemia
mild to moderate anemia
what are MCV and MCHC values for anemia of chronic disease/ anemia of inflammation
normal
what is MOA for anemia of chronic disease/ anemia of inflammation
up regulation of hepcidin which inhibits Fe utilization for erythropoiesis
what are some infectious causes of anemia of chronic disease/ anemia of inflammation
infectious: bacteria, fungi, viruses, Protozoa
what are some non-infectious causes of anemia of chronic disease/ anemia of inflammation
endocrinopathies, pancreatitis, chronic disease, toxins, neoplasia
is the anemia mild, moderate, or marked with anemia of chronic renal disease
can be mild, moderate or marked
what are MCV and MCHC values for anemia of chronic renal disease
normal
what is MOA of anemia of chronic renal disease
decrease Erythropoietin production
is the anemia mild, moderate, or severe with pre-acute hemorrhage
mild or moderate
what are MCV and MCHC values for pre-acute hemorrhage
normal
what is MOA of pre-acute hemorrhage causing non-regenerative anemia
BM has not had time tor respond
is the anemia of bone marrow disease mild, moderate or marked
can be mild moderate or marked
what are MCV and MCHC values for anemia of bone marrow disease
normal
what are 3 MOA for anemia of bone marrow disease
- Myelophthisic disorders
- Toxins/injury
- Precursor immune mediated anemia
what cell lines are affected/ what would be blood work finding with anemia of bone marrow disease
bicytopenia or pancytopenia
what is a myelophthisic disorder
something that invades and takes over bone marrow
what are some examples of myelophthisic disorders
- Leukemia, metastatic neoplasia
- Infectious agents
- Replacement of bone marrow with CT (myelofibrosis) or gelatinous transformation
what are some toxins that target the bone marrow
- Estrogen
- Chloramphenicol
- Chemo
- Bracken fern
what is precursor immune mediated anemia
antigen-antibody complexes target erythroid precursors not mature RBC’s
what is MCV and MCHC with PIMA
normal
what disease in cats can cause bone marrow erythroid hypoplasia
FeLV
FeLV causes selective damage of __
erythroid precursors
FeLV causes increased RBC, but __maturation
defective
what is MCV and MCHC for FeLV
macrocytic and normochromic anemia
what is the only cause of microcytic hypochromic anemia
iron deficiency
what are some causes of iron deficiency
- Chronic external blood loss (most common)- ulcerations, parasites,
- Inadequate absorption- GI disease
- Defect in iron metabolism (PSS)
- Inadequate dietary intake
is iron deficiency anemia regenerative or non-regenerative
non-regenerative
why do cells become microcytic with iron deficiency anemia
lack of Hgb—> no signal to stop mitosis—> extra cell division
what is the appearance of iron deficiency on blood smear
expansion or presence of erythrocyte central pallor, may see fragmentation associated poikilocytes (schistocytes)
what do you see in this blood smear from dog and what is likely cause
Increase central pallor of RBC’s (hypochromasia), small RBC’s (microcytic)
Cause: iron deficiency anemia
Define erythrocytosis
increased RBC mass
what can cause erythrocytosis
- dehydration/ hemoconcentration
- Splenic contraction
what is the most common cause of erythrocytosis
dehydration
what other blood work finding do you see with dehydration besides erythrocytosis
hyperproteinemia
what blood work findings become increased with dehydration
- PCV and HCT
- Total solids
- Total proteins
- Pre-renal azotemia
- Na
- Cl
- K
what causes splenic contraction to occur
excitement, fright, exercise
case ex: 11yr, M miniature schnauzer with hx of lethargy, “gotten fat” PU/PD, pendulous abdoen, muscle wasting. Following CBC was taken and note white looking plasma. Characterize erythron and what is likely cause
- Total proteins- normal
- Hematocrit: low (anemia)
- MCV: normal
- MCHC: hyper chromatic (Lies)
- Reticulocyte within RI (non-regenerative)
Plasma- lipemic
Erythron: normochromic, hyperchromic non-regenerative anemia
Likely cause is Cushing causing anemia of chronic disease/inflammation
case ex: 18yr old MC Persian cross, 5 month hx of weight loss, PU/PD, lethargy, muscle wasting, unthrifty. Following CBC was taken. Characterize erythron
- Total protein normal
- Hematocrit- low (anemia)
- MCV: normal
- MCHC: normal
- Reticulocyte count: normal
- NRBC: elevated
Normocytic, normochromic, non-regenerative anemia
With inappropriate metarubricytosis
