Regenerative anaemia

Question 1

What is anaemia

Answer 1

A reduction in erythrocyte number

Question 2

Anaemia is identified by a decrease in one or more of

Answer 2

Red blood cell count
Packed cell volume/ haemocrit- PCV or HCT

Question 3

Acute clincial features of anaemia

Answer 3

Pallor
Tachycardia
Muscular weakness
Subnormal temp
Coma
Death

Question 4

Chronic clinical feature of anaemia

Answer 4

Fatigue/ lethargy
Exercise intolerance
Tachycardia
Fainting
Pallor
Cardiac number

Question 5

Anaemia gives what colour change of membranes

Answer 5

Salmon colour to pale mucosal membranes

Question 6

Anaemia can be caused by

Answer 6

Decreased erythrocytes entering the blood and decreased production or increase in erythrocytes exiting the blood

Question 7

Anaemia can either be

Answer 7

Non regenerative
Regenerative

Question 8

If bone marrow is functioning normally then

Answer 8

Increases number of reticulocytes appear in blood- takes 3-5 days to occur

Question 9

Reticulocytes

Answer 9

Immature rbcs

Question 10

How do we tell if anaemia is regenerative

Answer 10

Increased number of reticulocytes in the blood
Increased polychromasia
Increased anisocytosis
Manual or automated count
Macrocytic hypochromic
Nucleated red cells

Question 11

What stain do we use

Answer 11

Methyl blue stain

Question 12

What animal has no reticulocytes

Answer 12

Horses

Question 13

What is basophilic stripping in cattle

Answer 13

Will release polychromasia but will have another variation- common in ruminants

Question 14

What happens in regenerative anemia to the cell counts

Answer 14

Increased MCV
Decreased MCH
Decreased MCHC

Question 15

Haemorrhagic anaemia is related to

Answer 15

Blood loss

Question 16

Types of haemorrhagic anaemia

Answer 16

Acute eg. After accidents or surgery
Chronic eg. Bleeding from ulcers or tumours
Coagulopathies- clotting disorders eg, rat baits
Internal or external- bleeding through GI tract

Question 17

Haemotology cbc findings features

Answer 17

Normocytic normochromic in first few days

Question 18

In haemorrhagic regenerative anaemia features include

Answer 18

Macrocytic hypochromic
Polychromasia
Anisocytosis
Howell jolly bodies
Thrombocytosis
Neutrophilia

Question 19

Degree of regeneration in haemorrhagic anaemia depends on

Answer 19

Severity of blood loss
Location of bleeding- internal or external
Internal bleeding, Fe is available for Hb synthesis which is greater regeneration

Question 20

What else is lost in haemorrhagic regenerative anaemia

Answer 20

Proteins- not just rbcs being lost
Hypoproteinaemia- decrease in albumin and globulin

Question 21

Haemolytic anaemia affects rbc survival time by

Answer 21

Reducing it

Question 22

Haemolytic anaemia is

Answer 22

Reduced rbc survival time- early destruction of red cells

Question 23

Blood picture features

Answer 23

Markedly regenerative- iron from destroyed erythrocytes is retained in the body
Additional findings depending on pathogenesis- colour of plasma, morphology of cells

Question 24

Methods of red cell destruction

Answer 24

Extravascular lysis
Intravascular lysis

Question 25

Extravascular lysis pathway

Answer 25

Phagocytosis of rbc or splenic enlargement Iron and globin Haem Biliverdin Bilirubin Circulation Bilirubin and albumin Jaundice

Question 26

Intravascular lysis pathway

Answer 26

Lysis of rbc in circulation Free Hb in the blood or Haemoglobinaemia- red colour in plasma Free Hb Haptoglobins Phagocytosis jaundice

Question 27

From addition of haptoglobins

Answer 27

Saturation of haptoglobins Hb appears in kidney Haemoglobinuria- red urine due to free Hb Toxic nephrosis

Question 28

Acquired causes of haemolytic anaemia

Answer 28

Infectious agents Toxic/ oxidative compounds Fragmentation Immune mediated

Question 29

Infectious haemolytic anaemia

Answer 29

Mycoplasma infection- cats Babesiosis Rbcs destroyed by intra or extravascular lysis Pathogen visible on blood smear detected by PCR

Question 30

Toxic and oxidative haemolytic anaemia

Answer 30

Oxidative agents in drugs/ chemicals can reduce glutathione levels on red cells Haem iron can be oxidised to methaemoglobin

Question 31

Haem Fe oxidation to

Answer 31

Methaemoglobin

Question 32

What causes Heinz body formation

Answer 32

Oxidative damage to Haemoglobin

Question 33

red cells destroyed by

Answer 33

Lysis

Question 34

Examples of things that cause haemolytic anaemia

Answer 34

Paracetamol Onions Copper poisoning Zinc Brassicas Red maple leaf

Question 35

What causes fragmentation haemolytic anaemia

Answer 35

Rbcs subjected to excessive trauma Features of Intravascular lysis may be present Schistocytes, acanthocytes- different cell types Small vessel disorder- microangiopathic Large vessel disorder

Question 36

Immune mediated haemolytic disorders pathway

Answer 36

Production of antibodies Bind to red cells Haemolysis

Question 37

Blood group incompatibilities is

Answer 37

When blood groups mix

Question 38

Blood group incompatibilities why

Answer 38

Blood transfusion reactions Neonatal isoerythrolysis

Question 39

Immune mediated haemolytic anaemia-IMHA

Answer 39

Primary/ autoimmune- idiopathic Secondary- underlying trigger -drugs/toxins -infectious agents -neoplasia -vaccines

Question 40

Canine autoimmune haemolytic anaemia. What happens?

Answer 40

Production of autoantibodies against own red cells

Question 41

Autoantibodies lead to

Answer 41

Phagocytosis

Question 41

Immunoglobulins involved in canine autoimmune haemolytic anaemia

Answer 41

IgM or IgG

Question 42

Antibodies coat

Answer 42

Red cells

Question 43

Aggulation is

Answer 43

When rbcs stick together

Question 44

The direct Coombs test. Tests for

Answer 44

Immune mediated haemolytic disorder by identifying antibodies.

Question 45

In the direct Coombs test once we have the antibody what is the next step

Answer 45

Add in reagent specific for canines then rbc will cause aggulation

Question 46

What type of antibodies cause autoagglutation

Answer 46

IgM

Question 47

What is the process of the slide agglutation test

Answer 47

Add saline on a slide, then add cells. This tells agglutation, as blood cells will stick together

Question 48

What is neonatal isoerythrolysis

Answer 48

A haemolytic disease of the newborn animals.

Question 49

What is the cause of neonatal isoerythrolysis

Answer 49

Mother has antibodies of different blood group, if newborn has the different blood group then there is destruction of the neonates rbcs

Question 50

How do a mother and neonates antibodies combine?

Answer 50

Absorbed through colostrum

Question 51

How long does neonatal isoerythrolysis take to show signs

Answer 51

12 to 48hrs

Question 52

What are the feline blood groups

Answer 52

A B AB

Question 53

What blood group of felines have naturally occurring antibodies to blood group A felines

Answer 53

B

Question 54

When does feline neonatal isoerythrolysis occur

Answer 54

When kittens with type A or AB are born to type B mothers

Question 55

How can feline neonatal isoerythrolysis be prevented

Answer 55

In house blood typing kits Prevent access to colostrum for susceptible kittens