Anemias

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Author:
duncables
ID:
71303
Filename:
Anemias
Updated:
2011-03-07 13:43:58
Tags:
Clinpath anemia regenerative non regenerative
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Description:
Clintical Pathology Class on Anemias
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  1. Normocytic:
    • -Normal Size Cell
    • -Normocytic-Normochromic anemia: chronic disease, hypothyroidism, chronic inflammation, neoplasia
  2. Macrocytic:
    • -Large Size Cells
    • -Usually regenerative becauce young RBC's are larger
    • -Reticulocytosis in regenerative anemia
  3. Microcytic:
    • -Small Size Cells
    • -Iron dificiency anemia, chronic blood loss
    • -Asian Breeds
    • -May e associated with bone marrow disease
  4. Normochromic
    Nomal Color/ Hb
  5. Hypochromic
    • Diminished Color/ Hb
    • -usually pale with increased central pollor
    • -Reticulocytosis= Macrocytic hypochromic Anemia
    • -Iron Deficiency= Microcytic Hypochromic Anemia
  6. Erthrocyte Index
    • -Values reflect cells size and hemoglobin concentration and helps classify anemias
    • -Calulated by 3 values from CBC: Hemoglobin, RBC Count, PCV
  7. Hemoglobin Concentration
    • -A measure of the total amount of hemoglobin per unit of blood
    • -Measured as g/dl
    • -cen be done manually but subject to error
  8. MCV:
    • Mean Corpuscular Volume
    • -Average volume of a RBC
    • -Calculated from PCV and RBC Count
    • -Now done electronically by cell counter
    • -Classify as normo/micro/macrocytic
  9. MCHC
    • Mean Corpusular Hemoglobin Concentration
    • -Concentration of hemoglobin in the average RBC
    • -Calculated by Hb councentration and PCV
    • -Cassify as Normo/hypochromic
  10. MCV Calculation
    • Now this is done electronicly but...
    • PCV/RBC Concentration*10=MCV
  11. MCHC Calculation
    • MCHC(g/dl)= HB(g/dl)*100/PCV
    • -Mostanimals- 30-40 g/dl
  12. Hemoglobin Calculation
    • PCV/3=Hemoglobin
    • -Estimiate
  13. In healthy animals daily production of new RBC production equals what?
    Daily loss due to age
  14. Anemias result from an increase of one of 3 things:
    Increased loss, increased destruction, increased production
  15. Anemia
    • -Common abnormal finding in sm. animal
    • -Eguals a decrease in functional RBC
    • -Low PCV, total RBC, and/or Hb
    • -Lack of function->lack of O2 carrage
  16. Clinical Signs of Anemia
    • -Pale mm
    • -Loc CRT
    • -Lethargy
    • -Rapid Respiration
    • -Ralid shallow pulses
  17. Regenerative=
    Non-Regenerative=
    • -Regenerative the body is trying
    • -Non-regenerative the body/bone marrow no responding
  18. Regenerative Anemia simply put
    • -Increaced production and releasing immature RBC's
    • -Bone Marrow is working to keep up
  19. Regenerative Anemia Secondary to Hemolysis:
    • -Polychromatphils
    • -Anisocytosis
    • -Reticulocytes
    • -nRBC's
    • -Howell-Jolly Bodies and/or Heinz Bodies
  20. Regenerative Anemia Secondary to Blood Loss:
    • -24-72 hours for body to respond
    • -Anisocytosis
    • -Polychromasia (Wright's Stain)
    • -Reticulocytes (New Meth Blue Stain)
  21. What stain is the best to determine reticulocyte count?
    New Methylene Blue
  22. Regenerative Reticulocyte Count
    • More than 80,000/ul in dogs
    • More than 60,000/ul in cats
    • Peak count 4-8 days after onset
    • often >300,000
  23. Non-Regenerative Reticulocyte Count
    • Less than 80,000/ul in dogs
    • Less than 60,000/ul in cats
    • Bone Marrow just not responding
  24. How do we test the Bone Marrow?
    Bone Marrow Aspirate
  25. Bone Marrow Hypoplasia Indicates
    • -Inflammation
    • -Chronic Disease
    • -Renal Disease
    • -Primary Bone Disease
    • -Chemotherapeutic Agents
  26. Bone Marrow Hyperplasia-
    w/ Ineffective Erythropoiesis
    • -Nutritional (iron, Vit C or Copper)
    • -FeLV
    • -Drug toxicity
    • -Lead poisoning->defect in the cytoplasm formation
  27. What are the 3 terms that describe cell SIZE?
    • -Normocytic
    • -Microcytic
    • -Macrocytic
  28. What are the 2 terms that describe Hemoglobin Concentration?
    • -Normochromic
    • -Hypochromic
  29. What are some causes of Anemia?
    Hemorrhage/ Blood Loss, Blood Parasite, bacteria, virus, Hemolysis, Toxins, Neoplasia
  30. Secondary to Acute Hemorrhage:
    • -Injury
    • -Surgery
    • -Pcv, Crt may not respond quickly enough to give accurate assessment
    • -> 30-40% loss-> hypovolemic, shock, and death
  31. Secondary to Chronic Hemorrhage:
    • -Gastric Ulcer
    • -Bleeding Tumor
    • -Secondary to Bleeding Disorder (ex. ITP/vWB)
    • -
  32. Secondary to Blood Parasite:
    • -Haemobartonella felis
    • -Babesia canis/ bovis/ bigemina gibsoni
    • -Ehrlichia
    • -AnaplasmamMarginale/ ovis
  33. Secondary to Viral:
    • -EIA
    • -Parvo
    • -FeLV
    • -FIV
  34. Secondary to Bacteria:
    Leptospirosis- esp. in cattle, pigs, and sheep
  35. Secondary to Hemolysis:
    • -Blood Parasite
    • -Toxin/ Medication
    • -Immune Mediated Disorder
  36. Secondary to Toxins:
    • -Heinz Body Anemia (Onion, garlin, aspirin)
    • -Warfarin
    • -Acetaminophen
  37. Secondary to Neoplasia:
    • -Leukemia
    • -Lymphosarcoma
    • -Hemangiosarcoma
  38. nRBC Responce:
    • -<4 nRBC's/ 100 WBC's normal
    • -Appropriate: Regenerative Responce->elevated reticulocytes
    • ~High nRBC's+High Retic=App
    • -Inappropriate: >5nRBC's/100 WBC w/o polychromasia
    • ~Diseases such as Cushing's, FeLV, Lead Toxicity, Splenic Disease/ Removal
  39. The Reticulocyte Count is an estamated number of what?
    • Immature Erythrocytes in the Blood
    • ~used to classify as regenerative/non-regenerative
  40. Reticulocytes:
    • -Immature RBC's
    • -Contain an irregular net-like structure call Reticulum(RNA) in the cytoplasm
    • -Regenerative Responce
    • ~1% or lessin dogs, <1% in cats, 0% ruminants
    • -Horses will not show with anemia!!
  41. Staining Reticulocytes:
    • -Supravital Staining~ stained while cells are still alive
    • -Stains used are New Methylene Blue, Brilliant Crystal Blue, Nile Blue Sulfate
    • -counted as reticulocytes/ 1000 RBC
  42. What are the 2 forms of Reticulocytes?
    Aggregate and Punctate
  43. Aggregate Reticulocytes:
    • -Contain large Clumps of reticulum (RNA)
    • -Seen in most species
  44. Punctate Reticulocytes:
    • -Unique in cats
    • -Contain 2-8 samll, single basophilic granules
    • -Not a lot of granules
  45. How can you express the Reticulocyte Count?
    • -Percentage (most common)
    • -Absolute Number/ul
    • -Corrected % (correct for degree of anemia)
  46. Reticulocyte % Calculation
    • %=# of Retics*100/1000RBC
    • -0-1% normally
  47. Corrected Reticulocyte % Calculation
    Corrected retic%= retic %*patient PCV/normal PCV
  48. Absolute Number Calculation
    Absolulte#=%*RBC/100

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