The flashcards below were created by user
HLW
on FreezingBlue Flashcards.
-
Do puppies/kittens have PCVs lower or higher than adults?
pups usually have lower (hi20s/lo30s)
-
what are 2 breeds with higher than average PCV?
-
what species demonstrates pica as clinical sign for anemia?
cats
-
why is heart murmur associated with anemia?
- incr. sympathetic tone - ejection murmur
- (not viscosity issue)
-
What type of anemia is seen with FeLV?
non regenerative macrocytic anemia
-
If PCV is markedly low but pt not exhibiting clinical signs, what does this indicate?
chronicity - patient adapted to decr. O2
-
will IMHA or GI/iron deficiency bleeds caused mild or severe anemia?
mild
-
Bloodwork results show mild/mod anemia and smear has spherocytes. What is at top of your differential?
IMHA
-
What are characteristics of regeneration?
- incr. MCV/MCHC/RDW
- polychromasia, anisocytosis, spheroctyes
- reticulocytosis
- NRBCs (metarubricytes)
-
what is reticulocyte index?
- patient PVC divided by 45 x retic % = RI
- > 2.5 = regenerative
-
What absolute reticulocyte number indicates regeneration?
>60,000
-
what are two major causes of regenerative anemia?
- hemorrhage (seen after 48-96hr)
- hemolysis
-
What congenital cause of hemolysis is Westie associated with ?
pyruvate kinase deficiency
-
what congenital cause of hemolysis is English Springer Spaniel associated with?
phosphofructokinase deficiency
-
what are 4 causes of acquired hemolysis?
- IMHA (most common)
- hemangiosarcoma - microangiopathic
- infections (babesia, ehrlichiosis, etc)
- hypoP (as w/DKA patient)
-
what drugs are known to cause IMHA?
- sulfas, anticonvulsants
- penicillins, cephalosporins
- methimazole
- zinc (pennies after 1983)
-
What type of immune reaction is IMHA?
type II hypersensitivity (cytotoxic)
-
Are most IMHA's primary or secondary?
most primary (but only know this after r/o secondary)
-
The most common form of IMHA in dog is class III. what immunoglobulin is mediator? intra or extravascular hemolysis?
- IgG mediated
- extravascular
- spherocytes
-
which class of IMHA is mediated by IgM, complement is involved and causes INTRA vascular hemolysis?
class II
-
what are the "cold" classes of IMHA?
- 4: cold agglutination - intravascular
- 5: cold induces extravascular
-
what are 3 causes of primary IMHA?
- idiopathic
- SLE
- unidentified infection
-
when cats get IMHA is it usually primary or secondary?
secondary to drugs like methimazole, neoplasia, vaccines, toxins, infections
-
what signalment and breeds are associated w/IMHA?
- any age/breed but more females, middle aged
- American/English Cocker,
- OESD, GSD,
- irish setter, standard poodle
-
when does IMHA patient present with petechia/ecchymoses?
w/ concurrent ITP (Evan's syndrome)
-
what is leukemoid reaction?
profound left shift neutrophilia (not from infection/inflammation) because bone marrow releases all lines of immature cells
-
Why would liver enzymes be elevated with IMHA?
hypoxia in liver - hepatic injury
-
If slide agglutination test is negative, what is a further test you could run?
Coomb's Test (looks for Antibodies on RBCs - agglutination)
-
Why is bilirubin elevated w/IMHA? Elevations greater than what # are poor prognostic indicator?
- prehepatic - hemolysis
- >10 mg/dL
-
If anemia is nonregenerative, bone marrow can be assessed. What does RBC aplasia mean? what does RBC hyperplasia mean?
- aplasia: maturation arrest; only immatures put in circulation
- hyperplasia indicates regeneration
-
what is antinuclear antibody test looking for?
IgG binding to nuclear components of RBCs
-
how is IMHA treated?
- immunosuppresion: initially Dexamethasone (more potent than pred - pred ok once eating)
- 2mg/kg/day
-
After initiating therapy, when do you expect to see improvement? how long is therapy continued?
- improve markedly in 24-96 hours (1/3 won't respond)
- long term 3-6 mos; slow taper off
-
what are additional drugs reserved for refractory cases?
- cyclosporine
- azathioprine
- leflunomide
- (splenectomy if all else failed)
-
in addition to immunosuppression, what other medication should you start while some diagnostics are pending?
doxycycline (tick born dz) or azithromycin
-
what meds are options to prevent thromboembolism?
- low dose aspirin
- low molecular wt or fractioned heparin
- clopidogrel
-
what is most common cause of nonregenerative anemia in dog/cat?
- anemia of chronic disease
- (mild, no clinical signs; normocytic/normochromic)
-
what are other causes of nonregenerative anemia?
- bone marrow disorder
- anemia of renal disease
- acute blood loss (first 24-96hr)
-
what is the most common cause of semi-regenerative anemia?
iron deficiency (microcytic) from GI blood loss
-
what does semi-regenerative anemia look like on CBC?
- lots of platelets
- high RDW
- mild reticulocytosis
-
which tumors are associated w/semiregenerative anemia?
- leiomyomas/-sarcomas
- LSA
- carcinoma
-
what is most common cause of polycythemia?
relative - hemoconcentration/dehydration (elevated TP)
-
what is TP with absolute polycythemia?
normal TP
-
why is arterial blood gas run in patient with absolute polycythemia?
- look for cardiopulmonary disease as cause
- PaO2 <60
- pulse ox <80%
-
what other diagnostics are run with absolute polycythemia?
- imaging to look for neoplasia
- (excess EPO as paraneoplastic condition or due to renal disease/hypoxia)
-
Although it is difficult to find labs that run EPO levels, what does it mean if CBC shows absolute polycythemia and EPO level is low?
- primary polycythemia (polycythemia rubra vera)
- tx w/hydroxyurea and phlebotomy
|
|