Term
| How do you differentiate hemolysis and blood loss anemia? |
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Definition
-Blood loss anemia: normal-low serum protein, common bleeding, negative Coomb's test
-Hemolysis: normal-high protein, rarly bleeds, icterus, hemoglobinemia, spherocytosis, heosiderinuria, occasional autoagglutination, splenomegaly |
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Term
| Is hemolytic anemia more common in dogs or cats? |
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Definition
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Term
| Is hemolytic anemia acute or chronic? |
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Definition
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Term
| What RBC changes are typical of hemolytic anemia? |
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Definition
-macrocytic, hypochromic regen anemia: PCV < 25%
-hyperbilirubinemia (extravascular or intravascular)
+/- hemoglobinemia/hemoglobinuria (INTRAVASCULAR HEMOLYSIS ONLY) |
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Term
| What are the 6 catebories of hemolytic anemia? |
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Definition
1) immune-mediated hemolytic anemia: intravascular vs extravascular or primary vs secondary
2) erythrocyte organisms
3) toxins: oxidative damage
4) microangiopathic or fragmentation anemia
5) inc erythrocyte fragility
6) hemophagocytic syndrome |
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Term
| What RBC organisms are common in dogs? |
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Definition
| -Babesia spp & Mycoplasma hocanis |
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Term
| What RBC roganisms are common in cats? |
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Definition
| -Mycoplasma hemofelic, M. haemominutum, Cytauxzoon felis |
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Term
| How do you diagnose RBC organisms causing hemolytic anemia? |
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Definition
-organism ID on a blood smear
-Blood PCR
-serology for Babesia |
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Term
| What are the signs for toxins causing hemolytic anemia? Common cause? |
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Definition
-oxidative injury= heinz-bodies form = RBC less deformable = inc fragility = hemolysis
-Zinc (dog), onions/garlic, acetominophen |
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Term
| What is microangiopathic or fragmentation anemia? |
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Definition
| -caused by mechanical trauma to RBC secondary to fibrin strands or other |
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Term
| What is the characteristic signs of microangiopathic or fragmentation anemia on a blood smear? |
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Definition
| -schistocytes or keratocytes |
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Term
| What are the 4 common causes of microangiopathic or fragmentaiton anemai? |
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Definition
-DIC
-hemangiosarcoma
-vasculitis
-HW caval syndrome |
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Term
| What sign on the CBC do you often see paired with microangiopathic hemolytic anemia? |
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Definition
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Term
| What is the major cause of increased erythrocyte fragility leading to hemolytic anemia? |
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Definition
| -hypophosphatemia (<1.5): aggressive insulin admin, refeeding syndrome |
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Term
| What is hemophagocytic syndrome causing hemolytic anemia? |
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Definition
-form of malignant histocytosis/ disseminated histiocytic sarcoma
-phagocytic neoplastic histiocytes from spleen and bone marrow lead to RBC destruction |
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Term
| Which dog breeds are prone to hemophagocytic syndrome causing hemolytic anemia? |
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Definition
| -Bernese Mt Dog, Rotties, golden, Lab |
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Term
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Definition
-antibody-mediated premature RBC destruction
-Type II hypersensitivity |
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Term
| What is the major physiologyic difference b/n extravascular and intravascular IMHA? |
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Definition
-extravascular = IgG or IgM
-intravascular = IgM (act complement, membrane attack complex) |
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Term
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Definition
-loss of immunologic tolerance towards self antigen
-alteration in the RBC surface antigen |
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Term
| What are the hallmarks of extravascular hemolysis due to IMHA on a blood smear? |
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Definition
-spherocytosis
-hyperbilirubinemia
-bilirubinuria |
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Term
| What are the hallmarks of intravascular hemolysis due to IMHA on a blood smear? |
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Definition
-hyperbilirubinemia
-hemoblobinemia
-hemoglobinuria
-ghost cells
-worse prognosiss |
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Term
| What are the differences b/n hemolytic aneia and intravascular IMHA? |
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Definition
-IMHA is antibody-mediated
-spherocytes/autoagglutination/ghost cells = IMHA |
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Term
| Is canine IMHA usually primary or secondary? What about feline IMHA? |
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Definition
-canine = primary
-feline = secondary |
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Term
| What causes primary IMHA in dogs? |
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Definition
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Term
| Which breeds/ages/sex of dogs are predisposed to primary IMHA? |
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Definition
-cockers, min schnauzers, poodles, other small breeds
-young/midddle aged: 2-7 y
-females > males |
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Term
| What causes secondary IMHA? |
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Definition
-any disease process that alters the immune system
-neoplasia: LSA, leukemia, histiocytic sarcoma
-ifectious diseases: vector-borne diseases
-drugs: ANY antibiotics
-weak association with vaccines |
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