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Clinical Pathology > UNIT 1 - Lecture 4: Regenerative Anemia > Flashcards

UNIT 1 - Lecture 4: Regenerative Anemia Flashcards

1
Q

What are the 2 major mechanisms of anemia?

A

Regenerative (increased loss and hemolysis)

Non-regenerative (decreased production)

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2
Q

When anemia is due to hemorrhage, it is regenerative if what 2 things occur?

A
  1. Marrow has had time to respond (3-5 days min, 7 days max)
  2. Patient has ability to respond
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3
Q

What are causes of acute hemorrhage?

A
  1. Trauma
  2. Coagulation disorders
  3. Marked thrombocytopenia
  4. Platelet function disorders
  5. Neoplasia
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4
Q

What are causes of chronic hemorrhage?

A
  1. Parasites
  2. GI ulcers
  3. Neoplasia
  4. Hematuria
  5. Coagulation disorders
  6. Platelet function disorders
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5
Q

What happens in peracute hemorrhage?

A

Lose all blood components in equal proportions (cells, plasma, water, proteins)

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6
Q

What is the pathogenesis for peracute hemorrhage?

A

Hypovolemia stimulates thirst –> restores extracellular fluid vol –> extravascular fluid shift to intravascular space –> blood vol expands by increasing plasma volume –> dilutes blood –> PCV drops

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7
Q

What is the pathogenesis for acute hemorrhage?

A

Anemia becomes regenerative (~3-5 days) –> CBC returns to normal within 1-2 weeks, hypoproteinemia resolves after a few days

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8
Q

What happens in chronic external hemorrhage?

A

Bone marrow responds at first via RBC hyperplasia

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9
Q

When can iron deficiency anemia be regenerative?

A

initially

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10
Q

What are MCV and MCHC in iron deficiency anemia?

A

Microcytic and hypochromic

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11
Q

What are causes for iron deficiency anemia?

A
  1. Chronic external blood loss
  2. Diet (iron def, copper def, zinc excess)
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12
Q

Why is copper essential in diet?

A

Essential cofactor for enzymes required for iron uptake from the GIT

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13
Q

Why is zinc excess bad?

A

It impairs absorption or availability of copper

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14
Q

What are the 3 classic findings of hemolytic anemia?

A
  1. Usually regenerative
  2. Hyperbilirubinemia +/- icterus
  3. Can be extra or intravascular
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15
Q

What is intravascular hemolysis associated with?

A

Hemoglobinemia and hemoglobinuria

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16
Q

Where does extravascular hemolysis occur and what happens?

A

Within MPs in liver, spleen, or marrow;

Accelerated phagocytosis of RBCs by the MPs

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17
Q

What are the 2 main mechanisms of hemolytic anemia?

A
  1. Immune-mediated
  2. Mechanical trauma or fragmentation injury
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18
Q

What occurs in IMHA?

A

Ab binds RBCs –> facilitates phag. by MPs

C’ activation forms MAC –> RBC lysis

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19
Q

Infectious agents can incite hemolysis via _____ or _____ means.

A

intravascular, extravascular

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20
Q

What RBC changes can you expect with IMHA?

A

Spherocytes, ghost cells, RBC agglutination

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21
Q

What is Rouleaux? What spp is it normal in?

A

RBCs form a stack of coins;

Normal in horses and cats

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22
Q

Rouleaux forms when there is increased _____ and/or _____.

A

fibrinogen, Ig’s (inflammation, neoplasms)

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23
Q

What is agglutination and what can it artifactually do?

A

RBC grouped like cluster of grapes;

Can artifactually increase MCV

24
Q

What is a saline dispersion/dilution test used for?

A

To differentiate on a smear between agglutination and severe Rouleaux

25
What is the Coomb's test used for?
Tests for presence of Ab or C' on RBCs
26
What is the most common cause of IMHA in dogs?
Autoimmune
27
What type of IMHA is due to incompatible blood transfusions?
Alloimmune
28
What is neonatal isoerytholysis? What spp?
Animals with different blood types are mated and neonate inherits blood group of sire; Neonate ingests colostrum containing Ab's against their RBCs, resulting in hemolysis; Cats, dogs, cattle, pigs, horses
29
What foreign Ag's can cause IMHA?
Meds, erythroparasites
30
How are spherocytes identified? What can they be indicative of?
**Can only ID on smear** Low #s may be seen with frag injury, snake envenomations, hemophagocytic syndrome, bee stings Can be smearing artifact
31
How are spherocytes formed in IMHA?
Ab coating RBCs bind to Fc portion of MPs --\> partial phag of RBC --\> RBC has reduced SA to vol --\> forms sphere rather than disc
32
What is erythrophagocytosis?
RBCs are completely "consumed" by MP
33
What are ghost cells indicative of?
Intravascular hemolysis
34
How can ghost cells be created artifactually?
Wiggly patient, too much pressure thru needle, heavy handed smear prep, lipemic sample
35
What is a siderocyte? When can it be seen?
Anucleated RBC with iron-containing cytoplasmic inclusions; may be seen with **hemolytic anemia** may be seen with admin of some drugs, lead poisoning, vit B6 and Cu deficiency, PSS, dyserythropoiesis
36
IMHA is a diagnosis of \_\_\_\_\_.
exclusion
37
What is more sensitive at detecting organisms in a suspect infectious hemolytic anemia (IHA) case?
PCR
38
How is infectious HA transmitted?
**Biting arthropods**, blood transfusion, dirty needles/instruments, in utero, colostrum
39
What organism causes bacterial infectious HA in dogs, cats, and camelids?
*Mycoplasma*
40
What organism causes bacterial infectious HA in cattle?
*Anaplasma marginale*
41
What organism causes indirect hemolysis thru kidney infections in calves, lambs and pigs?
*Leptospira spp.*
42
What *Clostridium spp* can cause infectious HA?
*C. haemolyticum, C. novyii* D, *C. perfringens* A
43
What are 2 common causes of viral infectious HA?
1. Equine infectious anemia virus (EIAV) 2. Feline leukemia virus (FeLV)
44
What does EIAV cause?
Acute HA and/or decreased RBC production
45
What does FeLV cause?
Anemia due to decreased RBC production; May cause immume hemolytic processes or predispose cats to other infectious anemias such as *M. felis*
46
What protozoal spp. can cause infectious HA?
*Theileria, Babesia, Cytauxzoon felis, Trypanosoma*
47
What happens with oxidative damage HA?
1. Denaturation of Hgb --\> Heinz bodies formation 2. Oxidation and cross-linking of membrane proteins --\> eccentrocyte formation 3. Oxidation of Hgb iron --\> Methgb
48
What are some exogenous causes for oxidative damage HA?
1. Ingestion of onion or garlic 2. Zinc ingestion 3. Ingestion of wilted red maple leaves 4. Ingestion of acetaminophen
49
What are some endogenous oxidants/causes for oxidative damage HA?
Production of oxygen free radicals (DKA, pancreatitis, feline lymphoma)
50
What are pyknocytes and when are they seen?
Look like eccentrocytes with "membrane tag" removed; Seen with ocidative injury
51
In fragmentation injury HA, what is hemolysis secondary to?
RBC trauma
52
When can we see frag injury HA?
1. RBCs sheared in small diameter vessels by fibrin strands (DIC, vasculitis, HWD) 2. Abnormally shaped blood vessels (HSA) 3. Some liver and renal dz 4. Severe heart disease
53
In addition to shearing from fibrin strands, you may also see _____ with iron deficiency anemia since iron deficient cells are more fragile.
schistocytes
54
What are acanthocytes? In what animals are they are normal finding?
Spherical cells with blunt or club-shaped spicules of different lengths projecting at irregular intervals; Normal in young rmts
55
What are the main mechanisms of formation of acanthocytes?
1. Frag injury 2. Alterations in lipid composition
56
What are keratocytes? What can they be seen with in larger #s?
RBCs with blister-like vesicles; Seen with frag injury, oxidant injury, liver dz, iron deficiency
57
What is the main difference between in vitro and in vivo hemolysis?
With in vivo hemolysis, you will see hemoglobinuria

Clinical Pathology (22 decks)

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