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Red Blood Cells - Coggle Diagram
Red Blood Cells
Anemia
- low RBC
- low hemoglobin
- low hematocrit
Non-regenerative (bone marrow issue)
- decreased red cell production
Primary
- something happening in the bone marrow itself
- pancytopenia
- Examples: hypoplasia/aplasia, myelodysplasia, leukemia
Bone Marrow Aplasia/Hypoplasia
- infectious = FeLV, ehrlichiosis
- Drug/chemical toxicity = estrogen, phenobarbital, cephalosporins, chemo drugs, immune mediated
Myelodysplasia = cells in the bone marrow developing abnormally
- criteria for diagnosis = peripheral blood cytopenias (often pancytopenias), normal to hypercellular bone marrow, dysplastic features
Leukemia
- tumour of developing red cells, white cells or platelets
- can replace normal bone marrow with neoplastic cells
Secondary
- systemic disease suppressing erythropoiesis in the bone marrow
- when there is NOT pancytopenia, the cause is secondary
Chronic Disease/Inflammation
- reason: inflammation (infectious/non-infectious) or neoplasia
- normocytic, normochromic anemia
- inflammatory cells just suppress hematopoiesis, but iron is still available in body and being re-used
Endocrine diseases
- deficiency in: cortisol, androgens, thyroxine or growth hormone
- all of these hormones required for normal hematopoiesis
FeLV related
- normocytic or macrocytic (sometimes cells don't divide as much as they should in marrow, so they are released larger than they should be)
- can cause non-regenerative anemia due to chronic disease, myelophthisis (immature red cells in circulation) and pure red cell aplasia (PRCA)
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Chronic Kidney Disease
- moderate anemia (HCT)
- due to decreased red cell life span, decreased epo production and decreased bone marrow response to epo
Regenerative
- increased red cell loss, but body makes more
- increased polychromatophils/reticulocytes - except for horses
- increased neutrophils and platelets
- increased MCV
- Decreased MCHC (immature RBCs have less hemoglobin
Hemorrhage
- low protein levels in blood (external hemorrhage)
- normal to low protein levels in blood for internal hemorrhage
- anemia
- Hypoproteinemia
- Reticulocytosis
- Hypochromasia (young RBCs)
Single site
- local problem
- trauma, neoplasia
Multiple sites
- platelet and/or clotting factor issue
acute hemorrhage
- trama
- thrombocytopenia (immune mediated, infectious, drug related, DIC)
- coagulation factor deficiency
- neoplasia
Chronic external hemorrhage
- losing red cells outside of body results in inability to recycle hemoglobin and iron -> iron deficient erythropoiesis -> iron deficiency anemia
Hemolysis
- normal or high protein levels in blood
- spherocytes
- ghost cells
- agglutination
- Heinz bodies
Intravascular Hemolysis
- IMHA -> red cells getting destroyed by the body in the vasculature
Extravascular Hemolysis
- Icterus is a clinical sign you will see
Types of Anemia
Iron deficiency anemia
- iron needed to make hemoglobin -> over time there will be delayed expulsion of RBC nucleus and extra mitosis -> hypochromic and microcytic RBCs
- chronic iron deficiency -> not able to keep up with RBC regeneration
- signs:
- poorly regenerative or non regenerative (if iron is not available at all)
- microcytosis
- hypochromasia
- increased anisocytosis or RDW
- red cell fragility (will see weird shapes and fragments) because hemoglobin isn't keeping it held together
- erythropoietin levels should be high bc the body is trying to produce as much RBCs to keep up -> thrombocytosis occurs as well
- lack of marrow iron
Hemolytic anemias
- bacterial
- chemical toxins
- immune mediated
- parasites
- poisonous plants and venoms
- RBC metabolic diseases
- DIC -> fragmentation
Immune Mediated Hemolytic Anemia
- intravascular removal occurs in vessels and extravascular can occur in spleen
- intravascular -> hemoglobinemia in microhematocrit tube
- extravascular -> bilirubinemia in microhematocrit tube
- rapid onset
- splenomegaly
- marked anemia
- reticulocytes in circulation trying to keep up due to high destruction
- spherocytes (RBC ghosts) = intravascular hemolysis
- moderate leukocytosis
- mild left shift
- thrombocytopenia
- autoagglutination
- coombs test vs agglutination
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Polycythemia
- can lead to hypercoaguability
Primary
- VERY RARE
- decreased/normal epi and normal oxygen in blood
Polycythemia vera
- RBC leukemia of mature RBCs
Secondary
- increased epo
- due to: cardiopulmonary disease, increased altitude, hormone excess, renal masses, paraneoplastic syndrome
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