RBC 4

Question 1

what are the two borad pathomechanisms of non regernative anemias?

Answer 1

intramedullary (disease within the bone marrow that results in erythroid hypoplasia or ineffective erythropoiesis)
extramedullary (disease outside the bone marrow that secondarily suppresses the ability of the bone marrow to respond to an anemia or produce RBCs)

Question 2

what some examles of intramedullary disease?

Answer 2

-acute leukemia, FeLV infection, nutritional deficinecy (Fu, Cu), direct drug or toxin effects

Question 3

what are some examples of extramedullary disease that might causes a non regernative anemia?

Answer 3

anemia of inflammatory disease (very common)
anemia of chronic kidney disease
anemia of endocrine disease

Question 4

early on, what conditions might appear like a non regernative anemia?

Answer 4

• acute blood loss/hemorrhage or hemolysis
• iron deficiency anemia in chronic stages

Question 5

this is a blood smear of a dog. what do you see and what is your diagnosis?

Answer 5

atypical neoplasic lymphocytes, leukemia

Question 6

with bone marrow hypoplasia, the severity of the anemia is usually __________ and typically __________ regarding MHC and MCHC

Answer 6

mild to marked
normocytic, normochromic (unless iron deficinecy)

Question 7

decrease in any 2 bone marrow cell lines is called:
decrease in all bone marrow cell lines is called:

Answer 7

bicytopenia
pancytopenia

Question 8

why does an FeLV infection cause a non regernative anemia?

Answer 8

the virus damages the erythroid precursor cells, resulting in ineffective erythropoiesis and anemia, and defective RBCs may be produced resulting in apoptosis

Question 9

why might a FeLV associated NR anemia be macrocytic?

Answer 9

since the virus attacks the RBC precursor, the RBCs do not undergo a normal number of cell divisions (less divisons than normal), which can make the cells bigger

Question 10

what is the most common type of non reernative anemia?

Answer 10

anemia of inflammatory disease

Question 11

for anemia of inflammatory damage, what are the “usual” characteristics of:
- hct
- MHC
- MCHC
- chemistry findings
- leukogram findings

Answer 11

• mild to moderate anemia
• normocytic and normochromic
• inflammatory leukogram
• hyperglobinemia

Question 12

anemia of inflammatory disease is mediated through…

Answer 12

inflammatory cytokines and thus can occur in any disease or disorder with an inflammatory component!

Question 13

explain the pathogenesis of anemia of inflammatory disease

Answer 13

inflammatory cytokines cause:
- decreased RBC lifespan
- inhibition of EPO
- decreased erythropoiesis through decreased iron availability

Question 14

why is there decreased iron availability during inflammation?

Answer 14

• less iron is absorbed from the GIT
• macrophages sequester iron

***both of these processes occur unde the influence of hepcidin made from the liver, trying to prevent infectious organisms from using iron/stealing it

Question 15

what does hepcidin do?

Answer 15

made in the liver, key player in homeostasis of iron, acts in the presence if inflammation to block iron release from enterocytes in the GI tract and prevents iron release from macrophages that are recycling RBCs, and also prevents mobilization of all stored iron

this is a host defense mechanism to limit extracellular iron availability to microorganisms

Question 16

what is the pathogenesis of anemia of chronic kidney disease?

Answer 16

there is decreased EPO production due to damage to the renal tubule interstitial cells where EPO is produced. there is also a decreased marrow response to EPO because uremic toxins alter bone marrow environment which affects its response to any EPO present and its ability to preform erythropoiesis

Question 17

NR anemia can be seen with what two endocrine diseases?

Answer 17

hypothyroidism (due to decreased metabolism and decreased oxygen demand) and hypoadrenocorticism (unknown mechanism)

Question 18

when globulin goes up and albumin goes down, what should you think of?

Answer 18

inflammation!

there will be more globulins because the body is making antibodies

albumin is a negative acute phase protein, meaning when there is inflammation, albumin will go down to balance the oncotic pressure!