Hematology - Levine Regenerative Anemia SG Flashcards Preview

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Flashcards in Hematology - Levine Regenerative Anemia SG Deck (33)
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1

What is the body’s normal response to anemia, and what hormone regulates this?

The bodies normal response to anemia is accelerated erythropoiesis

Erythropoietin (EPO) regulates this

2

EPO release is induced by _______ _______.

renal hypoxia

3

What is the most useful marker of regeneration?

Increased number of reticulocytes

4

What is a reticulocyte?

An immature non-nucleated erythrocytes

5

What two stains can be used to visualize reticulocytes on a blood smear?

New methylene blue

Brilliant cresyl blue

6

What are the two types of cat reticulocytes, and what is the difference between the two?

Cats have aggregate and punctate reticulocytes

Punctate reticulocytes have few basophilic granules and are in circulation for several weeks

7

Which type of feline reticulocyte tells you about an acute anemia and is the one that is reported by the lab?

Aggregate reticulocytes

8

What is the formula to calculate the absolute reticulocyte count?

Absolute reticulocyte count = RBC count x RP 

RP is reticulocyte percentage

9

What else on a CBC can provide evidence of regeneration?

Increased MCV

Increased RDW

Decreased MCHC

Polychromasia

Howell-Jolly bodies

10

What is the canine blood volume in ml/kg?

Canine – 8-10% body weight; 90 ml/kg

11

What is the feline blood volume in ml/kg?

Feline – 6-8% of body weight; 60 ml/kg

12

If you have a 2 kg kitten, what is its blood volume in ml?

120 ml

13

If you can safely sample 10% of an animal’s blood volume for diagnostic testing, how much volume can you sample from a 2kg kitten?

12 mL

14

A dog presents to you with a regenerative anemia.  Which of the following steps are appropriate in determining the cause of his anemia?

a. Evaluate his total protein

b. Evaluate his blood smear for spherocytes

c. Obtain a thorough drug history

d. Perform a bone marrow exam

e. All of the above

f. All of the above except d

f. All of the above except d

15

What happens in the body initially with acute blood loss anemia (protective mechanisms)?

Peripheral vasoconstriction and tachycardia

Regional blood flow to the skin and spleen is curtailed to protect perfusion to the brain, heart, and viscera

16

Why are the PCV and TP initially normal with an acute bleed?

All blood components are lost in similar proportions

Splenic contraction plays a role early in the process, causing a transient increase in PCV

17

How long after an acute bleed do you see a fall in PCV/TP? Why?

2-3 hours after the onset of bleeding, and continuing for 48-72 hours, blood volume replacement occurs by the addition of interstitial fluid

Plasma volume increases, diluting cells, and protein

18

How long after an acute bleed would you expect to see a rise in TP (as long as the bleeding has stopped)?

2-3 days after a bleed

19

After a blood loss event, when is the maximal retic response seen?

3-4 days after the bleed

20

What three clinicopathologic markers are typically present with external blood loss?

Anemia

Hypoproteinemia

Reticulocytosis

21

What are the four main objectives in the management of acute blood loss?

Stop bleeding and prevent further bleeding

Replace lost red cells

Careful volume resuscitation

Treatment of an underlying disorder

22

Why can depletion of RBC mass be difficult to estimate in acute blood loss?

Due to concurrent plasma loss; the HCT decreases only after the total blood volume returns to normal

23

What is the major cause of iron deficiency anemia in cats and dogs?

Chronic external blood loss

24

Where is most iron located in the body?

In RBC's as hemoglobin

25

List some common causes of chronic blood loss in cats and dogs:

Fleas

Hookworms

Bleeding GI neoplasia

Ulcerogenic drugs like NSAIDs and glucocorticoids

Frequent phlebotomy

26

What would you expect the MCHC and MCV to be in severe iron deficiency anemia?

Microcytic and hypochromic or microcytic and normochromic

27

Why does microcytosis occur in iron deficiency anemia?

RBCs continue to divide in order to obtain ideal Hgb concentration per cell

28

What is the normal lifespan of the canine erythrocyte? Feline erythrocyte?

Dog -120 days

Cat – 70 days

29

What is extravascular hemolysis?

RBCs are degraded within macrophages, so no hemoglobin is released from the cytoplasm therefore there is no hemoglobinuria or hemoglobinemia

Also accompanied by bilirubinemia and bilirubinuria

30

What is intravascular hemolysis?

RBCs are lysed within the circulation as a result of membrane permeability changes or cellular fragmentation

Hemoglobin is directly released into the blood

Hemoglobinuria ensues when the amount filtered through the kidney exceeds the limited capacity of the tubule to resorb hemoglobin

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