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129 Cards in this Set
- Front
- Back
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Reasons for microcytic anemia.
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Iron deficiency
Portosystemic shunt Japanese dog breeds Foals under 6 months Copper deficiency |
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Reasons for macrocytic anemia.
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Reticulocytosis
Some poodles Agglutination artifact FeLV Folate/cobalamine deficiency |
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2 causes of regenerative anemia.
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Loss and lysis
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Why is the HCT initially normal with acute hemorrhage?
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Splenic contraction releases stored RBC and platelets
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A blood panel shows a regenerative anemia with hemoglobinemia, hemoglobinuria, hyperbilirubinemia, and an HBG that is greater than 1/3 PCV. What is the cause of these findings?
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Intravascular hemolysis
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A regenerative anemia is present with hyperbilirubinemia. Spherocytes are observed on the blood smear. HCT is normal, and the urinalysis only shows elevated bilirubin. What is the cause of these findings?
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Extravascular hemolysis
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Where does extravascular hemolysis take place?
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Splenic macrophages
Liver macrophages SInusoidal macrophages |
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Test to screen for anti-RBC antibodies and complement bound to RBC surface.
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Coomb's test, or Direct Antiglobulin Test
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How does a Coomb's test/DAT appear when positive?
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Hemagglutination present
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In which species is rouleaux normal?
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Equine
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Autoagglutination will affect MCV and RBC in what ways?
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Lower RBC, raise MCV
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Which species is more likely to have a small amount of bilirubin (1+) present in normal urine?
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Dog
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True or false: Extravascular hemolysis usually has a chronic and insidious onset.
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True
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How will plasma proteins be affected if there is extravascular hemolysis?
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Normal or increased
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How will plasma proteins be affected if there is blood loss?
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Normal or low
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List some reasons that a RBC may be marked for extravascular hemolysis.
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Parasitism
Heinz bodies Auto-AB binding Senescence |
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List some causes of oxidative RBC damage.
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Onions, garlic, acetaminophen, zinc, red maple
(Cats: Also lymphoma, diabetes, etc) |
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What makes up a Heinz body?
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Hemoglobin precipitates from denatured hemoglobin.
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List some reasons for hyperchomic anemia.
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Red cell lysis in vivo or in vitro.
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How is HGB related to HCT?
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HGB * 3 = PCV (normally)
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Hemoglobin free in circulation may damage these structures...
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Renal tubules
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What does haptoglobin do?
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Binds free HGB and takes to liver for metabolism.
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Describe the onset of intravascular hemolysis.
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Acute or peracute
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Regeneration is more likely with what kind of hemolysis? Why?
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Extravascular (more chronic, slow onset)
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List some reasons for decreased RBC production.
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Decreased EPO (renal failure)
Anemia of chronic disease (ACD/AID) Bone marrow disease Altered erythropoiesis (Destruction of precursors, iron deficiency, endocrine) |
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WHy does anemia of chronic disease occur?
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Iron diverted to macrophages, less available for erythropoesis. (Hepcidin reduces iron mobilization from hepatocytes and GIT)
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Describe the degree of severity of the usual anemia of chronic disease.
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Mocerate (PCV in mid 20's)
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List some different kinds of bone marrow infiltrates that can cause myelopthisis.
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Neoplasia, fungal agent, fibrosis
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How long after blood loss begins may reticulocytosis be seen in the blood?
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3 days
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List some conditions causing acanthocyte/burr cell formation.
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Splenic/hepatic disease
Intravascular shearing Iron deficiency |
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What causes eccentrocyte formation?`
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Oxidative damage and RBC membrane bonding
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List some conditions causing spherocyte formation.
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Immune mediated hemolytic anemia
Partial phagocytosis |
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List some conditions causing echinocyte/crenated cell formation.
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Artifact from dryong
Metabolic derangement Dehydration Snakebite |
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List some conditions causing keratocyte/blister cell formation.
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Iron deficiency
DIC/microvascular shearing Liver disease in cats |
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List some conditions causing schistocyte formation.
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DIC
Vascultis Iron deficiency Hemangiosarcoma Caval syndrome Endocarditis |
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What could cause target cell formation?
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Liver disease (if high #)
Polychromatophils with ecxess membrane |
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List some causes of RBC basophilic stippling.
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Regenerative anemia
Lead poisoning |
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List some causes of Howell-Jolly body formation.
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Regenerative anemia
Splenic dysfunction Steroid use |
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List some causes of relative polycythemia.
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Hemoconcentration-dehydration or fluid shift
Redistribution- excitement |
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List some causes of absolute polycythemia.
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Primary: Polycythemia vera
Secondary: Increased EPO |
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List some causes of neutrophilia.
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Excitement (epinephrine)
Stress/corticosteroids Inflammation |
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List some causes of neutropenia.
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Severe inflammation
Sequestration (septicemia) Decreased production |
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List types of toxic changes that may be seen in neutrophils.
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Doehle bodies
Cytoplasmic basophilia Vacuolization Granulation Donut-shaped nucleus "Giant" neutrophil |
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List some causes of lymphocytosis.
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Physiologic (excitement/epinephrine)
Chronic inflammation Lymphoid neoplasia Hypoadrenocorticism |
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List some causes of lymphopenia.
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Atress/corticosteroids
Loss/blocked lymph flow Congenital deficiency Lymphotoxic drugs Impaired lymphopoesis Acute infection (stress) |
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Describe a "leukemoid" response.
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Extreme inflammatory neutrophilia without actual leukemia
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List some causes of monocytosis
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Stress/corticosteroids
Inflammation Compensatory for neutropenia |
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List some causes of eosinophilia.
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Parasitic disease
Hypersensitivity |
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List some causes of eosinopenia
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Stress/corticosteroids
Acute inflammation |
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In the healthy ruminant, which leukocyte is the most plentiful?
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Lymphocyte
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What does an inflammatory leukogram look like int he ruminant?
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Neutropenia
Lymphopenia Hyperfibrinogenemia Inversion of lymphocyte:PMN ratio |
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When PP:fibrinogen is below this level in the bovine, it signifies inflammation.
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Under 10
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When PP:fibrinogen is below this level in the equine, it signifies inflammation.
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Under 15
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When PP:fibrinogen is above this level in the bovine, it signifies dehydration.
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Over 15
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When PP:fibrinogen is above this level in the equine, it signifies dehydration.
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Over 20
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List a negative acute phase protein.
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Albumin
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List two major positive acute phase proteins.
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Fibrinogen
Globulin |
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How does thrombopoetin control platelet production?
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Adsorbs to platelet surface. When fewer platelets are in circulation, free TPO stimulates thrombopoesis by the megakaryocytes.
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List four major causes of thrombocytopenia.
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Destruction
Consumption Decreased production Distribution/sequestration in spleen (?) |
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List two forms of thrombocyte destruction
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Immune
Tick-borne disease |
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List some causes of thrombocyte consumption.
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Hemorrhage
DIC |
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List some causes of decreased thrombopoesis.
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Bone marrow disease
Drugs Megakaryocytic hypoplasia |
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Spontaneous bleeding is possible when platelets fall below...
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25,000/uL
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List three causes of thrombocytosis.
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Physiologic: Epinephrine --> splenic contraction
Primary, neoplastic Secondary, reactive to chronic hemorrhage or iron deficiency |
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List three kinds of thrombopathy.
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Extrinsic congenital disease (like von WIllebrand's Disease)
Intrinsic congenital disease (rare) Acquired disorders (drugs, uremia, DIC, liver disease, infection) |
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Clotting factors of the intrinsic clotting cascade.
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12, 11, 9, 8
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Clotting factors of the extrinsic clotting cascade.
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PF3, 7
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Clotting factors of the common clotting cascade.
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10, 10a, 5, 2 (thrombin)
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2 clotting tests that evaluate the intrinsic and common pathways.
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Partial thrombin time (PTT)
Activated clotting time (ACT) |
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Clotting test that evaluates the extrinsic and common pathways.
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Prothrombin time (PT)
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Clotting test that evaluates the presence of fibrinogen.
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Thrombin time (TT)
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Enzyme that breaks fibrin down into FDP's.
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Plasmin
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What is the significance of prolonged ACT?
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95% loss of intrinsic or common factor
OR Profound thrombocytopenia |
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What is the significance of prolonged PTT?
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70% loss of intrinsic or common factor
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What is the significance of prolonged PT?
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70% loss of extrinsic or common factor
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What is the significance of prolonged TT?
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Hypofibrinogenemia (common system deficiency)
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Anticoagulant causing irreversible Ca++ chelation.
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EDTA
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Anticoagulant causing reversible Ca++ chelation. Good for coagulation studies.
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Citrate
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Anticoagulant that inhibits thrombin and factor 10a.
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Heparin
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The breakdown of fibrin and fibrinogen by plasmin yields...
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FDP's
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The breakdown of crosslinked fibrin alone yields...
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D-dimers
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List two causes of elevated D-dimers.
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DIC
Thrombus |
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This mineral is an important cofactor at multiple levels of the clotting cascade.
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Calcium
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Anticoagulant made by the liver to inhibit thrombin.
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Antithrombin III
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Antithrombin III is the same size as this protein.
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Albumin
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List some situations in which a bone marrow biopsy would be indicated.
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Persistent neutropenia
Nonregenerative anemia Thrombocytopenia Confirming leukemia Determining prognosis |
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Lifespan of a neutrophil in circulation.
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10 hours
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Lifespan of a platelet in circulation.
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7 days
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Lifespan of an erythrocyte in circulation.
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100 days
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In an appropriate erythroid response to anemia, how will the M:E ratio change?
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Decrease with erythroid hyperplasia
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When there is erythroid response to anemia, how will the M:E ratio change?
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Normal or increased, with erythroid hypoplasia
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List two necesities for erythropoesis.
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Iron and EPO
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How will the bone marrow normally respond to peripheral utilization of neutrophils?
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Myeloid hyperplasia
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List some causes of megakaryocytic hyperplasia.
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Peripheral destruction of platelets
Cross-stimulation by EPO |
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Neoplastic proliferation of bone marrow cells
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Leukemia
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Neoplastic proliferation of lymphoid cells in the secondary lymphoid organs.
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Lymphoma
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Which leukocytes are lymphoid in origin?
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Lymphocytes and plasma cells
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List clinical signs of lymphoma.
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Lymphadenopathy
Splenomegaly Hepatomegaly Diarrhea Weight loss |
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Normal lymph node contains this % of mature lymphocytes.
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Over 90%
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In lymphoma, how does the cellular make-up of the lymph nodes appear?
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Mostly (70-90%) immature lymphoblasts
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This leukemia has rapid onset, short survival time, and is marked by immature cells.
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Acute leukemia
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This leukemia has a prolonged course, longer survival time, and is marked by proliferation of mature leukocytes.
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Chronic leukemia
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This leukemia starts in the bone marrow from lymphoid stem cells.
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Lymphoid leukemia
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This leukemia starts in the bone marrow from myeloid and erythroid stem cells.
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Myeloid leukemia
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Myeloid cells include all of the following:
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RBC's
Granulocytes Monocytes Megakaryocytes and platelets |
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Terminally differentiated B cells
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Plasma cells
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List some lymphoproliferative diseases.
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Lymphoma
Lymphoid leukemia Plasma cell myeloma/ multiple myeloma |
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Ar elymphoproliferative or myeloproliferative neoplasms more common?
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Lymphoproliferative
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List a neoplastic and non-neoplastic differential for elevated RBC.
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Non-neoplastic: Relative polycythemia
Neoplastic: Polycythemia vera |
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List a neoplastic and non-neoplastic differential for elevated platelets.
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Non-neoplastic: Reactive thrombocytosis
Neoplastic: Essential thrombocythemia |
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List a neoplastic and non-neoplastic differential for elevated neutrophils.
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Non-neoplastic: Leukemoid response
Neoplastic: Chronic neutrophilic leukemia |
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List three phases of hemostasis.
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Primary hemostasis (platelets)
Coagulation (clotting cascade) Vessels (vascular phase) |
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What proportion of pltelets are normally stored in the spleen?
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1/3
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List some causes of immune-mediated thrombocytopenia.
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Autoimmune disease
Drug reactions |
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These compounds cause a decrease in platelet production.
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Estrogen, bracken fern, chemotherapeutics
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How do tick-borne pathogens affect thrombocyte levels?
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Decrease production and increase destruction
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Where does von Willebrand's factor reside?
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Plasma and blood vessel subendothelium
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How does von Willebrand's factor contribute to clotting?
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When subendothelial collagen of BV is exposed, vWF is exposed and activates platelets, facilitating their adhesion to subendothelial collagen.
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What happens in blood vessel injury when there is a deficiency of von Willebrand's factor?
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Platelets do not adhere to exposed subendothelium, bleeding time gets prolonged.
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This test can evaluate how much von Willebrand's Factor is present.
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vWF antigen test
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Typical signalment for inherited thrombopathias.
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Certain breeds, younger animals
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Buccal mucosal bleeding time will be prolonged in the event of...
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Thrombopathia
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List some clinical signs of a deficiency of primary hemostasis.
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Epistaxis
Petechia and ecchymosis GI hemorrhage Seizures |
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List some clinical signs of factor deficiency associated with secondary hemostasis.
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Hematoma, hemarthroses, intra-cavitary hemorrhage, sudden death
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These clotting factors depend upon Vitamin K to become activated.
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2, 7, 9, 10
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The liver makes all clotting factors except
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Factor 8
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The following should be evaluated to rule out liver disease.
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BUN
Glucose Albumin Cholesterol Coagulation factors |
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List some causes of DIC.
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Severe tissue damage
Inflammation/endotoxemia Neoplasia Heatsrtoke |
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What is an effect seen with decrease of Antithrombin III?
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Clotting
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