RBC 2

Question 1

you look at a blood smear and you see this, what is this called? what does this mean for the patient?

Answer 1

they are acanthocytes, the splat lookin cells

they can be due to:
- incidental finding
- high fat diets
- lipid metabolism disorders
- hepatic disease
- hemangiosarcoma !!!!!

Question 2

define anemia and describe how it can be identified

Answer 2

reduced hemoglobin concentration due to decreased RBC mass
it can be identified via PCV/Hct, RBC count, or hemoglobin concentration below the reference interval

Question 3

list some clinical signs of anemia

Answer 3

exercise intolerance, weakness, depression, tachypnea, pale mucus membranes

Question 4

what are the 5 ways you can classify an anemia?

Answer 4

1. the grade, how severe is it?
2. how is the bone marrow responding/is it regenerative or non regernative
3. the cause and the 3 H’s: hemorrhage, hemolysis, and hypoplasia
4. RBC morphology: use the MCV and the MCHC
5. etiology: oxidizing agent, parasites, trauma, etc

Question 5

what is regeneration and how does it apply to anemia?

Answer 5

regernation is increased erythropoiesis (appropriate response) due to anemia to compensate/correct the low oxygen

Question 6

what organ detects low blood oxygen levels???

Answer 6

the KIDNEYS OMG YAY WE LOVE THE KIDNEYS

Question 7

using values from a CBC, how do you tell a regernative anemia apart from a non regernative one?

Answer 7

with regenerative anemia you will see polychromatophils/reticulocytes since the bone marrow is having an appropriate response and trying to release more RBCs into circulation

with non regernative anemia there will NOT be polchromatophils/reticulocytes since the bone marrow is NOT producing new RBCs and sending them into circulation

Question 8

in the case of a regernative anemia, how many days does it take to see reticulocytes in circulation and how many days does it take to have a peak response? why is this important?

Answer 8

to see them in circulation it takes 2-4 days and peak response is 7-10 days. this is important to consider because you might have a patient with a seemingly non regernative anemia, but you may have just caught a regernative anemia too early.

Question 9

what is the difference between a polychromatophil and a reticulocyte?

Answer 9

they are the same cells just with different staining. polychromatophils are stained with wright’s stain and appear sort of bland and slightly pinkish-blue, wheras reticulocytes are stained with methylene blue and appear with a reticulated pattern within the cell.

Question 10

what are some words you can use to describe the grade of the regernative response for anemia?

Answer 10

slight, moderate, marked/severe

Question 11

should you use the reticulocyte percentage or the absolute count when evaluatning anemia?

Answer 11

ALWAYS use the absolute count

Question 12

what is the MCV value on a CBC an what does it tell you?

Answer 12

mean cell volume, it tells you how big the cells are. if your value is high it means there are an increasing number of larger RBCs, and if the number is low it means there is an increasing number of smaller RBCs

Question 13

if your MCV is high, it is called _____
if it is low, it is called ______
if it is normal it is called

Answer 13

macrocytic
microcytic
normocytic

Question 14

what is MCHC and what does it tell you?

Answer 14

mean cell hemoglobin concentration: it tells you the average concentration of hemoglobin per RBC or how “much” hemoglobin is in the RBCs

Question 15

if your MCHC is high it is called_____
if your MCHC is low it is called _____
if your MCHC is normal it is called _____

Answer 15

trick question, hyperchromic is an artifact!
hypochromic
normochromic

Question 16

what are the 3 H’s as possible causes for anemia? Are they regernative or non regernative for each cause?

Answer 16

hemorrhage (regernative), hemolysis (regernative), and hypoplasia (non regenerative)

Question 17

tell me why horses are special in regards to anemia

Answer 17

horses do not show evidence of polychromatophils or reticulocytes in peripheral blood in cases of regenerative anemias. the bone marrow does ot release these early stage RBCs like in other species. What you may see instead is evidence of macrocytosis.

Question 18

what is a good way to monitor a potentially (hopefully) regernative anemia in a horse?

Answer 18

monitor the hematocrit/PCV over time to see if it is going up since you won’t likely see reticulocytes

Question 19

why is it important to determine if blood loss is internal vs external?

Answer 19

because with internal blood loss, the RBCs can be recycled and the animal can reuse the iron and proteins

with external blood loss this opportunity is missed so the animal has a chance to become iron deficient

Question 20

with acute blood loss or hemorrhage, besdies the anemia you will also see _____ on the CBC

Answer 20

hypoproteinemia (decreased TP)

Question 21

we know that chronic or recurrent external blood loss can lead to the development of iron deficiency anemia. What are some examples of what might cause chronic external blood loss?

Answer 21

parasites, GI and urinary tract bleeding, neoplasia

Question 22

with iron deficiency anemas we often see microcytic and hypochromic RBCs. Explain why

Answer 22

there is not enough iron for hgb synthesis so the bone marrow is not adequately able to regernate RBCs, so the precursors undergo additional divisions leading to a decreased MCV (microcytosis) and these cells will have less hemoglobin as well leading to a decrease in MCHC (hypochromic)

Question 23

with iron deficinecy anemia you can often see keratocytes and schizocytes on a smear. why?

Answer 23

the RBCs have a decreased lifespan and are more fragile

Question 24

What happens to the platelet levels in a iron deficiency anemia?

Answer 24

they increase/thrombocytosis

Question 25

what are keratocytes and schizocytes?

Answer 25

helmet lookin crab mimickin RBCs formed in mechanical shearing usually due to fibrin strand deposition
schizocytes are red cell fragments usually as a result of the shearing that forms keratocytes

Question 26

a 10 yo spaniel comes to you lethargic with bloody diarrhea and pale mucus membranes with marked anemia, microcytic and hypochromic RBCs. On the blood smear you see schizocytes and keratocytes. There is also mild thrombocytosis. Interpretation?

Answer 26

iron deficinecy anemia due to a GI hemorrhage (chronic blood loss)