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.systems based core clinical specialties > Pale Mucous Membranes > Flashcards

Pale Mucous Membranes Flashcards

1
Q

Identifying the problem for pale mm?

A

Poor peripheral perfusion or anemia

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2
Q

CS of anemia

A

Hemorrhage
Hemolysis
BM failure
Pale mm

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3
Q

CS of Poor peripheral perfusion

A

Heart failure
Shock
Dehydration

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4
Q

Different classifications of anemia

A

Acute, regenerative or non-regenerative

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5
Q

BM response

A

3-4 days
Full marrow response by 7 days

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6
Q

Microcytosis

A

Small RBCs
From iron deficiency and partacaval shunt

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7
Q

Macrocytosis

A

Large RBCs
From Regeneration*, breed effect (poodles), and FeLV

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8
Q

Evidence of regeneration

A

Polychromasia (size variation), macrocytosis, poikilocytosis, reticulocytosis (retained nuclear material) , nucleated RBCs

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9
Q

What is the best assessment of regeneration?

A

Reticulocyte count (corrected v uncorrected, absolute count)

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10
Q

Cat reticulocytes

A

Punctate (mature, past regeneration, not included in reticulocyte count)
Aggregate (true indicator of recent regeneration)

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11
Q

Nucleated RBCs (normoblasts)

A

More immature than reticulocytes (less of them)
Should be >1

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12
Q

Appropriate normoblastemia

A

Intense regenerative anemia from blood loss and hemolysis
+ significant reticulocytes

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13
Q

Inappropriate normoblastemia

A

More NRBCs than reticulocytes
Peracute anemia, splenic disorders (hemangiosarcoma), normal mini schnauzers and dachshunds, lead toxicity, BM disorders

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14
Q

Cat normoblasts

A

Few, sometimes numerous in peripheral blood of sick cats (conditions other than lead toxicity)
Without evidence of intense erythrogenesis

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15
Q

Hemolytic anemia classifications

A

Extravascular or intravascular

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16
Q

Intravascular hemolysis

A

In centrifuged plasma
With Hburia
Jaundice common

17
Q

What causes hemolytic anemia?

A

Immune mediated
Microangiopathic (RBCs damaged)
Congenital (enzyme deficiency)
Infectious
Drugs/toxins (heinz bodies from garlic and onions)

18
Q

Hemorrhagic anemia causes

A

External: trauma, coagulopathy and bleeding lesion in GI or urinary tract
Internal: Trauma, hemangiosarcoma, coagulopathy

19
Q

Hemolytic anemia v internal hemorrhage

A

More regenerative than anemia due to external blood loss
Plasma protein levels normal or ↑ (hemolysis)

20
Q

What affects plasma protein levels?

A

Acute hemorrhage (↓)
Chronic external hemorrhage (↓)
Hemolysis (↑)

21
Q

What can cause Spherocytosis?

A

Immune mediated hemolysis
Mononuclear phagocytic neoplasm
Splenic pathology

22
Q

What can cause shistocytosis?

A

Blood forced through narrow passages (microangiopathy) → splenic damage, hemangiosarcoma, DIC, vasc. neoplasm, glomerulonephritis
Physically damaged (endocarditis)
Caval syndrome

23
Q

Acanthocytosis

A

Forms due to altered lipid: cholesterol ratios in RBC membrane
Associated with hemangiosarcoma, glomerulonephritis, lymphoma and hepatic disease

24
Q

Heinz bodies

A

Round structure from RBC or retractile spot in cytoplasm
Oxidation → denatured, precipitated Hb
If removed may leave spherocyte

25
Q

Heinz bodies will __________ RBC flexibility and cause ___________

A
  1. ↓
  2. Intravascular hemolysis
26
Q

Heinz bodies in cats

A

Most common because more susceptible to oxidation (spleen less efficient @ removal)
10% of RBCs may contain HBs

27
Q

What causes heinz bodies in cats?

A

Onions, garlic, wilted red maple leaves, paracetamol (acetaminophen), propylene glycol and propofol

28
Q

Non-regenerative anemia

A

Anemia of chronic disease
Renal failure
Oestrogen toxicity
Primary BM disorders: Red cell aplasia, myelophthisis, dyserythropoiesis
Iron deficiency
Immune mediated
Hypothyroidism

29
Q

Most common cause of non-regenerative anemia

A

Anemia of a chronic disease
Associated with inflamm or neoplastic disease

.systems based core clinical specialties (27 decks)

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