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MODULE 2 - Natural Defences > PATHOLOGY- Blood > Flashcards

PATHOLOGY- Blood Flashcards

- Anaemia (Regenerative and Non-regenerative) - Erythrocytosis - Leukocyte abnormalities - Haematopoietic Neoplasia (Leukaemia) - Haemostasis abnormalities diagnostic tests - Common Haemostasis disorders

1
Q

What do mean corpuscular volume (MCV) results determine?

A

The average erythrocyte size

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2
Q

What do mean corpuscular haemoglobin (MCH) results determine?

A

The average haemoglobin concentration in each erythrocyte

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3
Q

What do mean corpuscular haemoglobin concentration (MCHC) results determine?

A

The average haemoglobin concentration relative to the size of the erythrocyte

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4
Q

What is anaemia?

A

Anaemia is a condition in which the number of erythrocytes or the haemoglobin concentration within them is lower than normal

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5
Q

Which tests indicate anaemia?

A

RBC, Hb, PCV results below the reference range all indicate anaemia

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6
Q

What are the clinical signs of acute anaemia?

A

Pallor (pale mucous membranes)
Tachycardia
Muscular weakness
Subnormal temperature
Coma
Death

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7
Q

What are the clinical signs of chronic anaemia?

A

Lethargy
Exercise intolerance
Tachycardia
Syncope
Pallor (pale mucous membranes)
Cardiac murmur

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8
Q

What are the two types of regenerative anaemia?

A

Haemorrhagic anaemia
Haemolytic anaemia

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9
Q

How could you determine if anaemia is regenerative from a blood smear?

A

Reticulocytes (macrocytic, hypochromic cells)
Polychromasia
Anisocytosis
Sometimes nucleated cells
Basophillic stippling (in cattle)
Howell-jolly bodies
Heinz bodies

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10
Q

(T/F) Reticulocytes are not produced in horses

A

TRUE

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11
Q

What are four causes of acute haemorrhagic anaemia?

A

Trauma
Surgery
Coagulation disorders
Parasites

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12
Q

What are five causes of chronic haemorrhagic anaemia?

A

Gastrointestinal lesions
Ulcers
Neoplasms
Coagulation disorders
Parasites

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13
Q

How does the degree of regeneration differ between external and internal haemorrhage?

A

Internal blood loss: more pronounced regenerative response as the components of the lost erythrocytes are still present in the body for regeneration

External blood loss: less pronounced regenerative response as the components of the lost erythrocytes are lost to the environment so aren’t present in the body for regeneration

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14
Q

What are some of the indicators of haemorrhagic anaemia that you could find on a blood smear/haematology report?

A

Reticulocytes
Polychromasia
Anisocytosis
Howell-jolly bodies
Thrombocytosis
Neutrophilia
Panhypoproteinaemia

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15
Q

What are the two kinds of haemolytic anaemia?

A

Extravascular lysis
Intravascular lysis

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16
Q

Describe the progression of haemolytic anaemia due to extravascular lysis

A

Damaged or abnormal erythrocytes are cleared from the circulation by hepatic and splenic macrophages. This can cause splenic enlargement and even cause macrophages in the spleen to engulf normal erythrocytes

Bilirubin can also accumulate due to the overwhelming saturation of albumin caused by the rapid lysis of the erythrocytes and jaundice can occur

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17
Q

Describe the progression of haemolytic anaemia due to intravascular lysis

A

The lysis of erythrocytes within the circulation with the release of cell contents into the plasma.

Free haemoglobin in the blood causes haemoglobinaemia (red plasma). Free haemoglobin binds to haptoglobin proteins to be filtered out of the body via the liver but these proteins quickly become saturated due to the rapid lysis of the erythrocytes. Saturation of the haptoglobin proteins leaves the haemoglobin to flow free in the bloodstream and travel to the kidneys causing haemoglobinuria (red urine) and nephrosis

Bilirubin can also accumulate due to the overwhelming saturation of albumin caused by the rapid lysis of the erythrocytes and jaundice can occur

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18
Q

What are the five causes of haemolytic anaemia?

A

Inherited (very rarely)
Infectious agents
Toxic substance ingestion/oxidative damage
Immune-mediated
Fragmentation

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19
Q

How can haemolytic anaemia caused by infectious agents be confirmed?

A

Identification of pathogen on a blood smear
PCR test

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20
Q

Describe how toxic substance ingestion/oxidative damage can cause haemolytic anaemia

A

The ingestion of oxidative substances leads to the oxidation of glutathione and then of the iron bound to haem (Fe2+ to Fe3+), causing methaemoglobinaemia which cannot bind O2

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21
Q

What is the appearance of blood with methaemoglobinaemia?

A

Chocolate brown coloured blood is indicative of methaemoglobinaemia

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22
Q

What can be an indicator of haemolytic anaemia caused by toxic substance ingestion/oxidative damage that can be identified on a blood smear?

A

Heinz bodies (aggregates of denatured haemoglobin)

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23
Q

What is immune-mediated haemolytic anaemia?

A

An immune response against the natural iso-antigens present on the erythrocyte surface

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24
Q

What are some of the causes of immune-mediated haemolytic anaemia?

A

Blood transfusion reactions
Neonatal isoerythrolysis
Idiopathic
Immunopathology

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25
What is an indicator of immune-mediated haemolytic anaemia that could be identified on a blood smear?
Spherocytes (rounded erythrocytes caused by partial phagocytosis)
26
What are some of the diagnostic tests that can be done to identify immune-mediated haemolytic anaemia?
Direct Coombs test Slide agglutination test
27
Describe neonatal isoerythrolysis
When the maternal antibodies are absorbed by the neonate through colostrum and destroy the neonate erythrocytes This occurs when the mother's blood type is different from the newborn and the mother has been previously sensitised to the neonates blood type (through previous pregnancy, blood transfusion etc.)
28
In which animals is neonatal isoerythrolysis most common in?
Cats and horses
29
What is fragmentation haemolytic anaemia?
Intravascular haemolysis of erythrocytes due to excessive trauma caused by damaged/abnormal vasculature
30
What are two of the causes of fragmentation haemolytic anaemia?
Thrombus Neoplasms/neoplastic metastases
31
What can be an indicator of fragmentation haemolytic anaemia that could be identified on a blood smear?
Schistocytes (fragmented erythrocytes)
32
What is the cause of non-regenerative anaemia?
Bone marrow disorders
33
Give two examples of primary bone marrow disorders
Aplastic anaemia Bone marrow neoplasia
34
Give three examples of secondary bone marrow disorders
Nutritional deficiencies Inflammation Chronic renal failure
35
What is aplastic anaemia?
Reduced cellularity of the bone marrow
36
Describe the two types of aplastic anaemia
Pancytopenia: a reduction or absence of multiple blood cell lines Red cell aplasia: a reduction or absence of the erythrocyte cell line
37
What are some of the causes of pancytopenia?
Drugs/chemicals Radiation Infectious agents Neoplasia Idiopathic
38
What are some of the causes of red cell aplasia?
Immune mediated Infectious agents Erythropoietin (EPO) replacement therapy Pre-leukaemic conditions
39
How can an iron deficiency cause non-regenerative anaemia?
Iron deficiency interferes with haemoglobin production, resulting in the production of microcytic, hypochromic erythrocytes
40
What are some of the common causes of iron deficiency that can lead to anaemia?
Decreased iron intake (common in young mammalian animals on a milk diet) or chronic haemorrhage
41
What are some of the causes of anaemia of inflammation?
- Decreased erythropoietin (EPO) production due to cytokine mediated inhibition - Decreased pluripotent stem cell differentiation due to cytokine mediated inhibition
42
How can chronic renal failure cause anaemia?
Decreased erythropoietin (EPO) production in the kidneys
43
What is erythrocytosis?
An abnormal increase in erythrocytes
44
What are the two types of erythrocytosis?
Absolute (primary or secondary) erythrocytosis Relative erythrocytosis
45
What is relative erythrocytosis?
Relative erythrocytosis is a decrease in the blood plasma volume
46
What are the two causes of relative erythrocytosis?
Dehydration Splenic contraction
47
What is primary absolute erythrocytosis?
Abnormal erythrocyte production by the bone marrow without the influence of external factors
48
What causes primary absolute erythrocytosis?
Chronic myeloproliferative disorder
49
What is secondary absolute erythrocytosis?
An excessive production of erythropoietin (EPO) leading to an increase in erythrocyte production
50
What is left shift?
When there is a high neutrophil demand, immature (band) neutrophils can be released from the bone marrow
51
What is the difference between regenerative and degenerative left shift?
Regenerative left shift: mainly mature neutrophils with few band forms Degenerative left shift: mainly band neutrophils present in comparison to the mature neutrophils
52
Describe the physiological response seen on a leukogram
Mild mature neutrophilia, lymphocytosis and monocytosis
53
What commonly results in a physiological response on a leukogram?
Secondary to adrenaline release Common in young, excited animals
54
Describe the stress response seen on a leukogram
Mild to moderate mature neutrophilia, lymphopenia, eosinopenia, monocytosis (sometimes)
55
What commonly results in a stress response on a leukogram?
Endogenous or exogenous corticosteroids
56
Describe the inflammatory response seen on a leukogram
Mild to marked neutrophilia, lymphopenia and monocytosis Left shift Toxic change
57
What can be seen on a blood sample that could identify toxic change?
Dohle bodies Increased cytoplasmic basophilia Cytoplasmic vacuolation Toxic granulation Cellular and nuclear swelling Annular nuclei (ring nuclei)
58
Why do ruminants typically see transient neutropenia in the initial stages of inflammation?
Ruminants have a small neutrophil storage in their bone marrow so when there is an inflammatory response their stores are emptied very fast. This results in a lag phase until the bone marrow can produce enough neutrophils
59
Which species are more capable of a marked neutrophilia?
Dogs and cats > Horses > Ruminants
60
When would neutrophilia occur?
Physiological response (excitement) Stress Inflammation
61
When would neutropenia occur?
- Ruminants experience transient neutropenia in response to an inflammatory response - Severe, overwhelming inflammation - Bone marrow disorders - Immune-mediated
62
Why is neutropenia so clinically significant?
Animals with neutropenia are more susceptible to infection
63
When would eosinophilia occur?
In response to IL-5 cytokine secretion from T-lymphocytes Histamine secretion from mast cells Parasitic infection Allergy/hypersensitivity reactions
64
When would eosinopenia occur?
- Exogenous or endogenous steroid inhibit mast cell degranulation and histamine release - Stress
65
When would monocytosis occur?
Physiological response (excitement) Stress Inflammation Monocytic leukaemia (rare)
66
When would lymphocytosis occur?
Physiological (excitement) Post-vaccination Infectious agents Lymphoid leukaemia (rare)
67
When would lymphopenia occur?
Acute inflammation Stress Infectious agents
68
How does haematopoietic neoplasia occur?
Caused by an accumulation of mutations which can lead to clonal proliferation of mutated haematopoietic progenitor cells
69
List the different tumour groups categorised within haematopoietic neoplasia?
Leukaemia Lymphoma Plasma cell tumours Histiocytic disease Mast cell tumours
70
Which viruses have the ability to cause haematopoietic neoplasia?
Retroviruses Herpesviruses
71
What are the different classifications of lymphoid leukaemia?
B-lymphocytic leukaemia T-lymphocytic leukaemia
72
What are the different classifications of myeloid leukaemia?
Erythroid leukaemia Ganulocytic leukaemia Monocytic leukaemia Megakarocytic leukaemia
73
What is subleukaemic leukaemia?
Subleukaemic leukaemia is when the neoplastic cells don't move from the bone marrow into the bloodstream
74
What are five of the clinical consequences of leukaemia?
Myelophthisis Extramedullary haematopoiesis Splenomegaly Hepatomegaly Haemodynamics
75
What is myelophthisis?
Myelophthisis is the replacement of bone marrow cells with neoplastic cells
76
What is extramedullary haematopoiesis?
Extramedullary haematopoiesis is erythrocyte production outside of the bone marrow
77
What are haemodynamics?
Haemodynamics is the thickening of the blood due to a high leukocyte count, impairing the blood flow through the vasculature
78
What are the eight clinical signs of acute leukaemia?
Lethargy Anorexia Weight loss Haemorrhage from nose/mouth Pyrexia Lameness Melaena Neurological signs
79
On a physical exam, what are some of the clinical signs of acute leukaemia?
Splenomegaly Hepatomegaly Pallor Enlarged lymph nodes Petechiae/ecchymoses (bleeding into the skin and tissue)
80
What are the clinical signs of chronic leukaemia?
Gradual weight loss Lethargy Possible mild splenomegaly/hepatomegaly May be asymptomatic
81
What does bleeding time test for?
Vascular and platelet disorders
82
What does whole blood clotting time test for?
Severe deficiencies of one or more coagulation factors (doesn't specify if its the intrinsic or extrinsic pathway)
83
What does an activated partial prothrombin test detect?
Intrinsic coagulation and final common pathway defects

MODULE 2 - Natural Defences (10 decks)

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