Pathology Exam- Anemia 2

Question 1

Reasons for nutritional anemia?

Answer 1

• vitamin B12 and folic acid deficiency
• iron deficiency
• copper deficiency

Question 2

Reasons for hypoproliferative anemia?

Answer 2

• inflammation or chronic disease
• chronic renal or hepatic failure
• neoplasia
• endocrine disease

Question 3

What is megaloblastic anemia?

Answer 3

Due to vitamin B12 and folic acid deficiency
- leads to low proliferation and differentiation of erythroblast
Causes:
- diet deficiencies
- malabsorption syndrome
- high requirements (pregnancy, lactation)
-chemoteraphy and anticonvulsion teraphy
Pathophysiology:
-inhibition of DNA synthesis= inefficient erythropoiesis
-macrocytic and normochromic
Diagnosis:
-big RBCs
-megaloblasts, erythroblasts
-hyper segmented neutrophils

Question 4

What is iron deficiency anemia?

Answer 4

Lack of iron needed for Hb synthesis
Causes:
-chronic bleeding
-low iron intake
-malabsorbtion
- high consumption in nursing animals
Normo- or microcytic, normo- or hypochromic anemia

Question 5

What is copper deficiency anemia?

Answer 5

Copper is required to absorb and release iron
Signs:
-Neurological=“swayback”, hematological signs
-low growth rates
- GI signs

Question 6

What are anemia’s of inflammation/chronic disease?

Answer 6

1. High inflammatory cytokines
   -reduces iron availability
   - inhibition of EPO production/release
   - decreased biological activity of EPO2. Decreased RBC lifespan
   Normochromic, normocytic mild anemia

Question 7

What is anemia’s due to neoplasia?

Answer 7

Could be due to:
- chronic disease
-blood loss
- immune mediated hemolysis
- chronic antineoplastic treatment
Inflammatory anemia: normochromic, normocytic

Question 8

What is anemia due to renal disease?

Answer 8

Causes:

• deficiency in EPO
• effects of uremic toxins (GI ulcers, suppression BM, urea)
• chronic inflammatory disease

Question 9

What is anemia of liver disease?

Answer 9

• anemia of chronic disease
• interference with EPO synthesis
• alteration of iron metabolism

Question 10

What is anemia of endocrine disease?

Answer 10

Most endocrinopathies cause mild anemia

• diabetes mellitus (ketoacidosis=oxidative damage)
• hypothyroidism (generalized decrease in metabolism= low EPO, low proliferation in BM)

Question 11

What are the types of primary BM anemia?

Answer 11

Aplastic= destruction of BM hematopoietic cells
- pancytopenia
- pure red cell aplasia
Mieloptisis= BM infiltration
- myeloproliferative or lymphoprilferative diseases

Question 12

What is pancytopenia in aplastic anemia?

Answer 12

Clinical syndrome, BM doesn’t produce blood cells at all
Features:
- pancytopenia
- replacement of normal BM cells by fat
Causes:
- infection
- drugs
- immune mediated
Acute or chronic, BM biopsy

Question 13

What is red cell aplasia in aplastic anemia?

Answer 13

Involves only red cell precursors
Findings:
- normocytic, normochromic anemia
- reticulocytopenia
- absence of red cell precursors in BM aspirate
- white cells are normal
Causes:
- immune mediated
- infectious

Question 14

What is polycythaemia/erythrocytosis?

Answer 14

Absolute increase in RBC mass
- increased HCT and Hb concentration
- high RBC count, Hb and HCT
Relative or absolute

Question 15

What is relative polycythaemia?

Answer 15

• Decrease in plasma volume relative to no of RBCs
• increase of concentration of RBCs due to loss of plasma
• haemogram= high PCV, high TP
  1. Haemocincentration
• dehydration
• diarrhea
• burns
  2. Splenic contraction in horses and greyhounds

Question 16

What is absolute polycythemia?

Answer 16

Polycythaemia Vera:
- myeloproliferative disorder with abnormal increase in RBCs
- serum EPO activity is usually low
Secondary polycythaemia:
- physiological due to compensatory tissular hypoxia (hypoxia driven)
- non physiological due to pathological high EPO (hypoxia independent)

Question 17

What are the consequences of erythrocytosis?

Answer 17

Hyperviscosity syndrome:
- spontaneous bleeding from mucous membranes
- visual disturbances (retinopathy)
- neurological signs
Heart failure
Hypoxia