Clin Med - Intro & Bloodwork-3

drraythe's version from 2016-01-28 21:26


Question Answer
ANEMIA IS ___ NOT A ___Clinical sign, Not a dz
Which animal is better at handling anemia, cats or dogs?Cats
How can you identify a reticulocyte? The retic % is out of what?They are larger & darker. For official counts you can stain w/ NMB (new methylene blue). The retic % is out of a 1000 cell count
Which type of retic comes 1st... Aggregate or punctate?Aggregate 1st!! (They go in ABC order)
Describe what an aggregate & punctate retic look like. What are aggregate retics specific to?Aggregate retics have clumps of RNA together in the cell, punctate just has tiny pinpricks of it. Aggregate is specific for a CURRENT BM response, punctate are not bc they can circulate for about 7 days
Anemia of chronic/inflammatory Dz has what blood indices?A normocytic, normochromic non-regenerative anemia
CRF (chronic renal failure) has what blood indices?A normocytic, normochromic non-regenerative anemia
If the cells are MACROCYTIC, but they are NORMOCHROMC, what 4 things might this indicate?Regenerative anemia, post-anemic period in cats, hyperthyroidism in cats, or defective erythropoiesis (delayed nuclear maturation)
If the blood cells are microcytic & hypochromic, what 3 things might cz this?Iron deficiency, copper deficiency, or PSS in puppies (portosystemic shunt)
Is there is a microcytic & normochromic blood cell indices, what 2 situations would you think of?It could be PSS (portosystemic shunt) in an adult, or in healthy Shiba Inus & Akitas.
Explain how a portosystemic shunt (PSS) affects the RBC indices differently in an adult vs a puppy/kittenIf congenital (puppy/kitten) it will be microcytic & hypochromic. But if an adult, it's microcytic & normochromic
Which dogs have naturally tiny RBCs?Shiba Inu & Akita
When do you do a blood smear?For every CBC!!
If you want to know if the sample is agglutination, as opposed to clotting or Rouleaux, what do you do?You do a saline dilution test! Add 1 drop blood to 5 drops saline. Agglutination will stick together, most other stuff wont
Coombs is fairly useless in what situation?If the animal is already agglutinating, don't bother. The endpoint of the coombs test is a positive when there is agglutination...if they are already agglutinating, why bother? (Antiserum directed against Ab bound to RBCs)
What is the most sensitive test you can perform on blood? What is it detecting?Flow cytometry, membrane bound Abs
(Osmotic fragility test is testing what?)↓ surface:volume ratio, or ↓ ability to swell
A hemolytic anemia can be due to a ↓ energy production, as in the case w/... (2)(1) PK deficiency
(2) hypophosphatemia
A hemolytic anemia can be due to an infectious dz, such as... (2)Hemoplasmas, Babesiosis (mainly attacking RBCs so makes sense)
A hemolytic anemia can be due to oxidative damage...2 examples of things which can cz this?Acetaminophen, onion
A hemolytic anemia can be due to fragmentation, which happens in...DIC
Immune mediated RBC lysis is usually due to what 2 things in the body?Ig or C3b (immunoglobulin or compliment factor) & can result in intra or extravascular hemolysis/phagocytosis
IMHA happens when what 2 things (either or) bind to the RBC? What 2 situations cz these things to want to bind in the 1st place?Either Ab or C3b (compliment protein) bind, what they bind to is either an Antigen intrinsic to RBC, OR Foreign antigen on RBC membrane
IHA results in RBCs which... (Look like/act like what? through what process?)The macrophages will remove a portion of the RBC membrane, which leaves them looking spherical (spherocytes), ↓ their deformability (so they cant squeeze through capillaries better) & their osmotic fragility is ↑ (less room to expand, will pop more easily)
Why are neonates so prone to iron deficiency anemias?They have little to no stores of iron, milk is low in iron & they are rapidly expanding their blood volume all the time
Iron deficiency anemia usually happens in adults as a result of...Chronic blood loss (Usually not evident until moderate to severe depletion of iron stores)
Iron Deficiency anemia usually looks like... (Indices? morphology?)Microcytic, hypochromic, often there are poikilocytes & target cells....this is a poorly regenerative anemia
What are the 2 major tests you would use to assess the iron status of a PTx?Serum iron is the MOST common, followed by stainable Fe in the bone marrow (TIBC → total iron binding capacity, % saturation, Serum Ferritin concentration, Reticulocyte Hb content are also used)
Non-Regenerative Anemias due to extramedullary Dz is usually czd by 1 of what 2 things?Either a ↓ in EPO due to kidney problems, or a ↓ in EPO due to inflammation (Just say "cytokines!")
Inflammation/cytokines affect the regenerative abilities of blood in what 3 ways?They ↓ the RBC lifespan, they ↓ EPO production & marrow response & also cytokines will CZ iron sequestration so the RBCs cant use it to get made
Look at slide 131 for the order down the cell line of when immune-mediated anemias affect the cell lineearliest to latest is aplastic anemia → pure red cell aplasia, IMIE, IMHA
What is important to know about the development & CS of anemia?The anemia develops slowly, but most animals are very stoic & will not show CS until they appear abruptly
Relative erythrocytosis is?Appearance of ↑ in RBCs, actually just due to dehydration (loss of fluid) rather than a gain of cells. You will usually see an ↑ of TP in dehydration (ESP albumin)
Primary absolute erythrocytosis is basically ___ (Dz), which is very rare. It is due to a ...Polycythemia rubra Vera, which is a myeloproliferative Dz, which means a ↑ in production of RBC precursors
Secondary erythrocytosis is due to an ↑ in _________. This is usually czd by what 2 situations?↑ in EPO. Can be due to chronic tissue hypoxia (think brachycephalic dogs who can't breathe, or R-L shunt, or high altitude, etc..), OR can be due to Inappropriate EPO production (renal abnormalities/neoplasia, local ischemia, Endocrinopathies—hyperadrenocorticism, hyperthyroidism)
Erythrocytosis leads to many problems, the main 1 (& a few other examples) are?The ↑ viscosity of blood can lead to perfusion problems. The ↑ in volume will also ↑ CO & possibly cz CHF, also Splenomegaly, neurological signs (seizures, ataxia, from the hypoxia), pu/pd, microcytosis....


Question Answer
In simple words, what is 1° coagulation? Secondary?1° has to do w/ platelets, vasculature & is a temp fix. 2° has to do w/ coagulation factors & is a permanent repair
What are the 4 main 1° hemostatic disorders & what is the phrase which sums them up so perfectly?"TINY BLEEDS" so, petechia, ecchymosis, mucosal bleeds & epistaxis
What are the 4 main 2° hemostatic disorders & what is the phrase which sums them up so perfectly?"BIG BLEEDS" so, hemoabdomen, hemothorax, melena, Hematemesis (vomiting blood)
Where are platelets from? (what do they contain?)Fragments of megakaryocytes. But altho they are fragments, they are still quite complex....can contain Proteins & glycoproteins, microtubules, channels, granules
Buccal Mucosal Bleeding Time (BMBT) is testing what part of the coagulation process?It's a platelet test
What's the factor we care about in the extrinsic path?7! (3 is tissue factor so shes not really too concerned)
Whats the factors we care about in the intrinsic path?Think gas station analogy: "it's not 12 dollars, it's 11 98" thats for the intrinsic path.
So: 12, 11, 9, 8
Whats the factors we care about in the common path?5, 10, 2
One Step Prothrombin Time is aka? & tests for what?Aka OSPT or PT, it's testing the EXTRINSIC & common paths (extrinsic=extrovert, O=outgoing)
Activated Partial Thromboplastin Time is aka? & tests for what?Aka APTT, PTT. It's testing the INTRINSIC & common paths
Testing for Fibrinogen/Fibrin Degradation Products FDP has what problem associated w/ it?It can indicate Non specific inflammation AND/OR clot breakdown, not just clot breakdown
Which test is Specific for clot breakdown, 2° fibrinolysisD-dimer
Check out the table on slide 149Useful!