GP- red blood cells

no, it is a condition

is anemia a disease?

it can be...

a reduction in the total RBC count

a reduction in the packed cell volume

a reduction in hemoglobin concentration

what is anemia?

oxygen carrying capacity and delivery to tissue

the order of consequences are as follows:

1. decrease in PVC, Hb, or RBCs

2. reduced ability to carry O2

3. hypoxia in organs and tissues

4. clinical signs of anemia

anemia causes a decrease in _________

work overload

what is the consequence of anemia on the cardiovascular system?

tachypnea, hypoxia

what is the consequence of anemia on the respiratory system?

hematuria, renal damage (only with hemolytic anemia)

what is the consequence of anemia on the urinary system?

jaundice, tissue hypoxia

what are the systemic consequence of anemia?

weakness

exercise intolerance

pale mucous membranes

tachycardia

what are the main clinical signs of anemia?

jaundice, hematuria, hemoglobinuria

hemolytic anemia will cause what clinical signs?

hemolytic anemia

if a patient is demonstrating these signs:

weakness, exercise intolerance, tachycardia, jaundice, hematuria, and hemolobinuria, what type of anemia can we guess it has?

regenerative

if there is a loss of blood (hemorrhage), is this anemia considered regenerative or non-regenerative?

regenerative

is hemolytic anemia considered regenerative or non regenerative?

non regenerative

is the lack of production of RBCs (bone marrow disease) considered regenerative or non regenerative?

bone marrow disease

what is the cause of a nonregenerative anemia?

primary- unknown cause

secondary- tumor, parasite, bacteria, nutritional, renal failure, inflammation, etc

what is the difference between a primary and a secondary bone marrow disease?

iron deficiency

copper deficiency

vitamin B12/folic acid deficiency

what are the types of nutritional bone marrow disease?

because kidneys produce erythropoietin, which is needed for RBC synthesis

why can chronic renal failure cause anemia?

regenerative

because this means that the body is able to compensate for the lost/destroyed RBCs by making more

in which- regenerative or nonregenerative anemia, do we see a high number of reticulocytes?

high; low

high reticulocytes because the body is regenerating the RBCs that are lost/destroyed

low hemoglobin because there are more reticulocytes, which take up more space in the blood than mature RBCs, but still carry the same amount of Hb

in regenerative anemia, we will have a _______ number of reticulocytes and a ______ % of hemoglobin. (high/low)

reticulocytes are larger, rounder, and have genetic material

how can we differentiate a mature RBC and a reticulocyte on a blood smear?

non regenerative

because all of the RBCs are mature

is this anemia regenerative or non regenerative? why?

regenerative

because there are both mature RBCs and reticulocytes

is this anemia regenerative or non regenerative? why?

regenerative

we see reticulocytes with genetic material (stained basophilically)

is this anemia regenerative or non regenerative? why?

the % of volume taken up by RBCs in the blood

=hematocrit

what is a packed cell volume (PCV)?

the # of RBCs

what is RBC count?

100

Hb concentration is the amount of Hb in ________ml of blood

the Hb content and size of RBCs

in order to specify the TYPE of anemia

RBC indices give us information about...

mean corpuscular volume

the average volume of a RBC

what is MCV?

(Hct/RBC)x10

Hct- hematocrit

how do we calculate mean corpuscular volume?

regenerative

the mean corpuscular volume (MCV) is higher in what type of anemia?

FALSE- bone marrow disease causes non regenerative anemia, which will not have a higher than normal MCV. regenerative anemia has a high MCV because the patient has a higher number of reticulocytes

true or false- if in a blood analysis the MCV is high, we can guess that the anemia is due to a bone marrow disease

the average amount of hemoglobin per RBC

what does the Mean corpuscular hemoglobin (MCH) measure?

(Hb/RBC)x 10

how is the mean corpuscular hemoglobin (MCH) calculated?

iron deficiency anemia

if the mean corpuscular hemoglobin (MCH) is low, what type of anemia does this indicate?

the average concentration of Hb per unit volume of RBCs

what is mean corpuscular hemoglobin concentration (MCHC)?

Regenerative

this is because in regen. anemia, the reticulocytes are larger, so there are less, but they can carry the same amount of Hb as the mature RBCs- if there are less, the total concentration of Hb will be lower

the mean corpuscular hemoglobin concentration (MCHC) is lower in ________anemia

(Hb/Hct)x 100

Hb- hemoglobin

Hct- hematocrit

how is the mean corpuscular hemoglobin concentration (MCHC) calculated?

macrocytic

if there is a high MCV, we call this _______ anemia

normocytic

exceptions:

iron deficiency anemia- micro

vit B12 deficiency anemia- macro

is nonregenerative anemia normocytic, macrocytic, or microcytic?

iron deficiency anemia and copper deficiency anemia

what type of anemia is microcytic (low MCV)?

any regenerative anemias

vitamin B12 deficiency anemia

what type of anemia is macrocytic (high MCV)?

the RBCs are normal size

nonregenerative anemia

what does normocytic mean? what type of anemia does this describe?

they can carry the same

which can carry a greater amount of hemoglobin- mature RBCs or reticulocytes?

regenerative anemia

which type of anemia will we have a low MCHC?

the RBCs have less color

regenerative anemia and iron deficiency anemia

what does hypochromic anemia mean? what type of anemia does this correlate do?

the MCHC is normal

does nonregenerative anemia have a high or low MCHC?

true

(exception- iron deficiency anemia is hypochromic)

true or false- nonregenerative anemia is normochromic

high; low

regenerative anemia has a ________ MCV and a ______ MCHC

normal; normal

(except vit B12 deficiency, which is macrocytic and iron deficiency, which is hypochromic)

nonregenerative anemia has a ________ MCV and a ______ MCHC

regenerative

if a blood analysis shows a high MCV and a low MCHC, can we say it is regenerative or nonregenerative anemia?

nonregenerative:

normocytic- normal sized RBCs (no reticulocytes)

normochromic

nonregenerative or regenerative? why?

regenerative:

macrocytic- bigger cells (reticulocytes)

hypochromic- paler cells

nonregenerative or regenerative? why?

it measures how varied the RBC size is

what does Red blood cell distribution width (RDW) measure?

that the RBCs vary a lot in size

(high RDW)

what does anisocytosis mean?

anisocytosis

if we have a high RDW, we say that the anemia has a high....

(standard deviation of volume/MCV)x 100

how is the red blood cell distribution width (RDW) calculated?

regenerative

what type of anemia has a high anisocytosis?

low

because they have a normal RDW

does nonregenerative anemia have a high or low anisocytosis?

reticulocyte count

the most effective way to measure regeneration in dogs and cats is ______

because they do not have reticulocytes in peripheral blood

why can we not use reticulocyte count to measure regeneration in horses?

3-4 days

+ more days for the peak of the regenerative response

how long does it take after a hemorrhage/loss of blood for the number of reticulocytes to increase?

pre-regenerative anemia

the period in between the hemorrhagic event and the measurable increase of reticulocytes in blood is called....

3-4; several more days

it takes _______ until reticulocytosis is evident on the RBC count, and _____ until the regenerative response peaks

RBC size

color

shape

RBC distribution

RBC inclusions

blood smears provide us with information about...

more color-

reticulocytes have some RNA, which absorb dyes, so regen. anemia can have polychromasia

what is polychromasia?

hemolytic anemia

hemorrhagic anemia

what are the types of regenerative anemia?

a low RBC count because of blood loss

what is hemorrhagic anemia?

low

in hemorrhagic anemia, will we discover a high or low total protein content in the blood analysis?

trauma

digestive- ulcers, neoplasia, parasites

infections

clotting defects

what can be the causes of hemorrhagic anemia?

internal- there is a breakdown of RBCs without the loss of protein and iron; quick regeneration

external- loss of RBCs and proteins (hypoproteinemia); proteins are replaced quicker

what is the difference between internal and external hemorrhagic anemia?

external hemorrhage

hypoproteinemia is caused by...

15-20

with acute hemorrhagic anemia, clinical signs show up when blood loss is ________%

30-40%

with acute hemorrhagic anemia, what percentage of blood needs to be lost in order for it to be life-threatening?

spleen

in horses, 30% of RBCs are stored in the _____

-they do not have reticulocytes in their peripheral blood

-30% of RBCs are stored in the spleen, and sympathetic stimulation (stress, exercise, etc.) induces a false increase in hematocrit

what is important to know about the blood of horses?

horses

greyhounds

in what animals does sympathetic stimulation cause a release of more RBCs, which causes a false increase in hematocrit/PCV?

cats and pregnant animals

what animals have a physiological lower PCV/hematocrit?

hematocrit (PCV)

RBC count

Hb concentration

what 3 tests can give us the information we need to diagnose anemia?

first 24hrs: normal PCV/Hct

after 24hrs: low PCV/Hct, low protein

3 days after: high reticulocytes

7 days after: maximum # of reticulocytes

in a patient with acute hemorrhage, how do test values change over time?

adults- internal bleeding tumors, gastric ulceration

young- parasites, external wounds (rare)

what are the causes of a chronic hemorrhage?

acute

in which- acute or chronic hemorrhagic anemia, do clinical signs appear quicker?

NO

because the body has more time to compensate. for clinical signs to appear, the Hct must be lower than in acute blood loss.

are clinical signs quick to appear in chronic hemorrhagic anemia? why or why not?

chronic

chronic hemorrhage can cause depletion of iron, which will be iron deficiency anemia

in what type of hemorrhagic anemia can it become nonregenerative?

1

which shows acute hemorrhagic anemia?

2

low blood, but high plasma bc the body is compensating

which shows chronic hemorrhagic anemia?

nonregenerative

is iron deficiency anemia regenerative or nonregenerative?

anemia due to premature destruction of RBCs

what is hemolytic anemia?

hemolytic

in which type of anemia- hemolytic or hemorrhagic, is the bone marrow regenerative response higher?

if the hemolysis is slow, hematopoiesis can compensate

why might a patient with hemolytic anemia show normal PCV, RBC count, and Hb?

intracorpuscular/intrinsic causes:

RBC inborn defects- congenital and hereditary disorders (rare)

extracorpuscular/extrinsic causes:

immune mediated hemolytic anemia (autoimmune disorder)

infectious (parasites)

microangiopathic hemolytic anemia- mechanical damage

oxidative stress

what are the possible causes of hemolytic anemia?

intravascular hemolytic anemia

if in the hematocrit, the plasma is darker than usual, what does this indicate?

intravascular- hemolysis occurs in the blood vessels; will produce hemoglobinuria

extravascular- hemolysis occurs in macrophages or spleen; will produce bilirubinuria

what is the difference between intravascular and extravascular hemolysis?

intravascular hemolytic anemia

if the animal has hemoglobinuria, we can suspect what type of anemia?

hemoglobinuria

splenomegaly

bilirubinuria

bulirubinemia (jaundice)

hepatomegaly

weakness, tachycardia, tachypnea, pale mucous membranes

what are the clinical signs that an animal with hemolytic anemia presents?

intravascular hemolytic anemia

bc dark red urine indicates hemoglobinuria

urine this color can indicate ______ anemia

hemolytic anemia

because the destruction of RBCs releases their proteins into the blood

if we have an anemic animal with hyperproteinemia (high total protein in blood), what type of anemia can we guess it has?

extravascular hemolytic anemia

in a urinalysis, we find that an anemic patient has a high bilirubin content. what type of anemia can we diagnose it with?

hemolytic anemia

in what type of anemia is agglutination typical?

hemolytic anemia

in a hematocrit, we find a low PCV. in a blood smear from a sample of the same patient, we find agglutination, lots of reticulocytes, and spherocytes. what is the diagnosis?

agglutination

high reticulocytes

anisocytosis

abnormal shaped RBCs (spherocytes, fragments)

in a blood smear of a patient with hemolytic anemia, what will we see?