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93 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the 2 forms of relative erythrocytosis commonly seen in horses?
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Splenic contraction
Dehydration |
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What are the 3 major causes of anemia?
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Increased RBC loss
Increased RBC destruction Reduced RBC production |
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Which of the following are always indicative of anemia?
a) reduced PCV b) reduced RBC c) reduced MCHV d) reduced Hb |
b) reduced RBC
d) reduced Hb |
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What is a major cause of anemia in small ruminants?
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Cu toxicity (RBC destruction)
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What are the physical exam findings that are fairly specific to anemia?
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Pale mucous membranes
Tachycardia/tachypnea +/- systolic murmur |
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What is the normal PCV:Hb ratio? How is this interpreted?
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3:1 is normal; if lower = hemolysis
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What is the most common cause of immune-mediated RBC destruction in large animals?
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Drug reaction (penicillin acts as a hapten)
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What are some weird features of the equine erythron?
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Rouleaux
Unstable PCV NO signs of regeneration NORMALLY icteric plasma Howell-Jolly bodies are NORMAL |
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T or F:
Elevated MCV in a horse is indicative of regeneration. |
False!
Maybe more suggestive but you gotta do a bone aspirate to be sure! |
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What are Howell-Jolly bodies?
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Nuclear DNA fragments
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What are the components to iron evaluation in the erythron?
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Serum Fe conc
Total Fe binding capacity (TIBC) Serum ferritin Bone marrow stores |
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With regard to Fe profiles, diagnose what is going on in with the following values in an animal with non-regenerative, hemolytic anemia:
a) normal Fe b) low Fe, normal TIBC, normal ferritin c) low Fe, low TIBC d) low Fe, normal TIBC, low ferritin e) low Fe + high TIBC |
a) normal Fe (bone marrow dysfxn)
b) low Fe, normal TIBC, normal ferritin (chronic dz) c) low Fe, low TIBC (chronic dz) d) low Fe, normal TIBC, low ferritin (Fe deficiency) e) low Fe + high TIBC (Fe deficiency) |
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What are some hemoparasites that may be seen on the equine CBC? White cell parasites?
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White (Anaplasma phagocytophila)
Red (Babesia caballi) |
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What do you see in the regenerative response in ruminants?
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Reticulocytes
Basophilic stippling Polychromasia Anisocytosis |
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If you see Heinz bodies, what should you be thinking?
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Oxidative toxicosis (phenothiazine, red maple, wild onions)
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What is the difference between a Coggin's and a Coomb's test?
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Coggin's (for EIA)
Coomb's (for IMHA; auto-agglutinating) |
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What is normal Myeloid:Erythroid ratio? What do values below this indicate?
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Normal = from 1:2 to 1:1
Values less than 1:2 indicate regeneration (eg: 1:3, 1:4 etc) |
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Choose the coagulation test that samples the following:
- Extrinsic pathway - Intrinsic pathway - Common pathway - Platelets |
PT - Extrinsic pathway
ACT, APTT - Intrinsic pathway ACT, APTT, PT - Common pathway BT - Platelets |
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Choose the coagulation test that samples the following:
- clot removal - factors XII, XI, IX activity - factor VII activity - factor X activity |
FDPs & D dimers - clot removal
ACT, APTT - factors XII, XI, IX activity ACT, PT - factor VII activity ACT, PT, APTT - factor X activity (remember, if you can't get it for $12, you can get it for $11.98 = intrinsic factors) |
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Which of the following are NOT indications for transfusion in an adult horse?
a) Blood loss ~10L or more b) Oxygen extraction ratio (OER) is 20% c) PCV <12-15% d) Coagulopathy e) Lactate >4mmol/mL |
c) PCV <12-15% (this is a GUIDELINE; if chronic and no clinical signs, may not need a transfusion)
e) Lactate >4mmol/mL (I SCHLIPF'D YOU!!! this should be >4mmol/L) (note - blood loss >25% of BW and OER >50% are also indications) |
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What 3 factors contribute to oxygen delivery?
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Hemoglobin concentration
SaO2 Cardiac Output (HRxSV) |
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Which of the following are NOT true regarding blood transfusions?
a) Minor cross match = donor RBC + recipient serum b) Aa and Qa negative are best c) Its OK to skip the cross-match on the first transfusion d) Most horses can donate 8% body weight e) A gelding that has never received blood products makes a good universal donor |
a) Minor cross match = donor RBC + recipient serum (this is MAJOR CROSS MATCH)
d) Most horses can donate 8% body weight (NO - 1.6%) e) A gelding that has never received blood products makes a good universal donor (these make the best donor but there is NO UNIVERSAL DONOR IN THE HORSE) |
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What is your target PCV when transfusing blood?
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15-20%
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How much blood from a patient with a PCV of 35% should be given to a 500kg patient with a PCV of 10% to achieve a PCV of 15%?
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between 5.7 and 7 L (depending on if you assume 0.08 or 0.1 L/kg)
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What are some signs of an adverse reaction to a transfusion?
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Nasal edema
Tachypnia/tachycardia Urticaria Pyrexia Colic Hypotension (shock/collapse) |
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How much ACD do you put into the donor blood?
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100mL ACD per liter donor
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Which of the following are NOT true regarding blood types in large animals?
a) 11 blood groups in cattle b) 2E9 blood types in cattle c) 4E5 blood types in horses d) 8 blood groups in horses e) alloantigens denote blood types |
e) alloantigens denote blood types (FALSE; alloantigens denot blood GROUPS)
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Which of the following is NOT commonly used to prevent transfusion reactions in horses?
a) Steroid premed b) Antihistamines c) NSAID premed d) limit rate to 10ml/kg/hr e) cross-matching |
a) Steroid premed (think about underlying disease; may be used to treat a reaction but not to prevent)
b) Antihistamines (adverse rxns in horses) |
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What are some transfusion issues that cannot be prevented?
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TRALI (transfusion-related acute lung injury)
Theiler's Disease |
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What is TRALI associated with?
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TRALI (transfusion-related acute lung injury) - associated with stored blood and plasma products
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What are some options for most anemic animals that don't need a transfusion? Which is MOST COMMONLY used? Which should NOT be used?
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B12
Cu glycinate Anabolic steroids (this is more often used) Fe supplements (only if Fe deficient) DON'T USE EPO!!!! |
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What are major causes of blood loss via parasitism in horses? Ruminants/camelids?
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Horses (Cyathostomes)
Ruminant/camelid (H. contortus, Ostertagia, Coccidians) |
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What are major causes of coagulopathy in the horse? Ruminant? Which are chronic? Which are acute?
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Drug-induced thrombocytopenia (horse/ruminant - acute)
DIC (horse mostly - acute/chronic) Thrombocytopenia (EIA - chronic) Thrombocytopenia (BVD - chronic) |
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What are causes of equine gastric ulcer syndrome?
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Fasting
High-intensity exercise Gastric SCC NSAIDs |
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Which are NOT true regarding abomasal ulcers?
a) Grade 2 (ulcerating/penetrating) responsible for most anemias b) caused by C. perfringens A c) caused by LSA/BLV d) fecal occult blood can diagnose e) Sucralfate can help |
a) Grade 2 (ulcerating/penetrating) responsible for most anemias (Grade 2 are NON PENETRATING)
d) fecal occult blood can diagnose (NOT VERY SPECIFIC; 66% of type 1 ulcers have occult blood) e) Sucralfate can help (NO - gastric protectants destroyed in the rumen) |
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Which of the following are NOT true regarding dicoumarol coaglopathies?
a) only found in MOLDY clover b) vitamin K agonist c) will affect PT time first d) 10g/kg is toxic level e) Can be treated with vitamin K3 in cattle |
b) vitamin K agonist (ANTAGONIST)
d) 10g/kg is toxic level (yeah this is technically toxic but 10mg/kg is toxic threshold) (note - eventually affects all clot times but PT first since VII has shortest half life; vitamin K1 is best, don't use K3 in horses) |
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Which factors does vitamin K influence? Which of these has the shortest half life?
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II, VII, IX, X
VII has shortest half life |
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How much blood should be transfused with loss of clotting factors?
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Only need 1 L in horses!
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Which of the following is NOT seen with hemophilia A in horses?
a) Sex-linked b) Commonly affects standard/thoroughbreds c) affects intrinsic pathway d) don't breed homozygous females e) affects APTT only |
a) Sex-linked
d) don't breed homozygous females (no such thing in sex-linked...) e) affects APTT only (would also affect ACT) (note: most common in QH; don't breed carrier dams; affects Factor VIII) |
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What is the most common sign of thrombocytopenia?
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Petechial hemorrhage and bruising
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If you see a foal dermatitis and thrombocotypenia, what should you do?
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Nada; it'll outgrow it!
(transient immune-mediated thrombocytopenia/dermatitis syndrome) |
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Thrombocytopenia is diagnosed when platelets are < __________; excessive hemorrhage d/t trauma occurs when platelets < ______________ while spontaneous bleeding occurs <________.
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<100k/uL = thrombocytopenia
<40k/uL = hemorrhage <10k/uL = spontaneous bleeds |
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Predict the following values with thrombocytopenia:
- Bleed time - PT time - aPTT - Fibrinogen - FDPs - bone marrow biopsy |
INCREASED - Bleed time
NORMAL - PT time NORMAL - aPTT NORMAL - Fibrinogen Mild increase - FDPs Megakaryocytosis and erythroid hyperplasia - biopsy |
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How is immune-mediated thrombocytopenia tested? How is this treated?
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Demonstration of Ig on platelet surface (Flow cytometry or Coomb's test)
(Tx underlying dz, immunosuppress, maybe transfusion) |
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Which of the following are NOT true regarding DIC?
a) hypercoagulable state b) never a primary disease c) the end result is poor tissue perfusion and SIRS d) hypocoagulable state e) common in cattle and horses |
c) the end result is poor tissue perfusion and SIRS (NO, end result is MODS - multiple organ dysfxn syndrome)
e) common in cattle and horses (UNCOMMON IN CATTLE) |
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To diagnose DIC, you must have 3 or more of which clinical signs?
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Thrombocytopenia
Prolonged PT and/or PTT Increased FDPs and/or D-dimers Decreased AT-III Low mean platelet component |
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If you have a sick horse with a fibrinogen of 800 yesterday and 200 today, how will you treat it?
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probably in DIC!!!
Tx - underlying dz IV fluids, NSAIDs, Heparin + ATIII, maybe transfusion |
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Which of the following is NOT true regarding Hemorrhagica Purpurea?
a) Caused by S. equi equi b) type II hypersensitivity c) Caused by Equine Influenza d) treat w/steroids |
b) type II hypersensitivity (NO, TYPE III)
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Which of the following are NOT true:
a) acute pyelonephritis can cause massive acute hemorrhage b) Ptaquiloside toxicity often only affects animals with poor forage c) Vena caval syndrome is due to F. necrophorum or A. pyogenes d) Hemorrhagic cystitis develops 2-3 weeks after bracken fern toxicity e) rumen acidosis is a predisposing cause of vena caval syndrome |
a) acute pyelonephritis can cause massive acute hemorrhage (NO, usually chronic)
d) Hemorrhagic cystitis develops 2-3 weeks after bracken fern toxicity (NO, it takes 10-15 mos for cystitis; 1-6 yrs for neoplasia) |
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Which of the following are true regarding hemolytic anemia?
a) spherocytes and schistocytes are signs of intravascular hemolysis b) true intravascular hemolysis is rare c) Hemoglobinuria is an early sign of intravascular hemolysis d) RBCs normally live 120-150d e) jaundice is evidence of extravascular hemolysis |
a) spherocytes and schistocytes are signs of intravascular hemolysis (NO - spherocytes=extravascular; schistocytes = intravascular)
c) Hemoglobinuria is an early sign of intravascular hemolysis (NO, it is a later sign after haptoglobin is overwhelmed) |
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Which of the following is NOT true regarding Heinz body anemias?
a) Methemoglobinemia is common b) Se deficiency, phenothiazines, and toxic plants are causes c) Heinz bodies are only seen with NMB stain d) ferric iron is oxidized to ferrous iron e) may be associated with renal failure |
a) Methemoglobinemia is common (NO - only in red maple toxicity)
d) ferric iron is oxidized to ferrous iron (NO, ferrous Fe2+ oxidized to ferric Fe3+) |
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How is Heinz body anemia treated?
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Antioxidants (Vit C, Vit E)
Activated charcoal/removal of toxin |
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Which of the following is NOT associated with Cu toxicity?
a) Diagnosed via liver biopsy b) Can be due to high Mg in pasture (secondary Cu toxicity) c) usually occurs as outbreaks d) sheep are the most susceptible e) acute is the most common form |
b) Can be due to high Mg in pasture (NO; comparatively low Mg; Cu:Mg >10)
e) acute is the most common form (CHRONIC is most common) |
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Describe the pathogenesis of Cu toxicity?
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Chronic sequesteration of high levels of Cu in liver. Stress triggers Cu release leading to acute hemolytic crisis. See intravascular hemolysis, pigment nephropathy, methemoglobinemia and Heinz bodies
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Which of the following are seen with Cu toxicity?
a) Heinz bodies b) Hemoglobinuria c) Methemoglobinemia d) Biliribinuria e) Hepatic necrosis |
a) Heinz bodies
b) Hemoglobinuria c) Methemoglobinemia e) Hepatic necrosis |
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How is Cu toxicity treated in acute cases? Chronic?
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Acute (remove Cu source; supportive care)
Chronic (D-penicillamine, supportive care, IV tetrathiomolybdate, promote Cu fecal excretion) |
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What are signs of water intoxication of calves? How is it treated?
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Mild anemia
Hemoglobinemia/uria Hypo Na and Cl Hypo-osmolar serum (tx: ELECTROLYTES - restore osmolar gradient) |
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Which of the following are NOT true regarding equine piraplasmosis?
a) Large piroplasms cause mild disease b) Regenerative anemia c) Seen in the crappiest states in the US (hint - Ohio isn't one). d) recovered animals are carriers e) B. caballi are small piroplasms causing severe disease |
e) B. caballi are small piroplasms causing severe disease (Theileria equi are small piroplasms)
(note: B. caballi in TX and FL; tick vector) |
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What are signs of equine piraplasmosis? How is it treated?
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Fever
Neuro signs Nasal/ocular discharge Eyelid edema Intravascular hemolytic anemia signs (tx: imidocarb) |
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Which Lepto serovars are associated with acute hemolytic syndrome?
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L. pomona
L. icterohaemorrhagicae |
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Which of the following are TRUE regarding leptospirosis?
a) anemia is common in horses b) recurrent uveitis in horses c) abortions d) moon blindness e) no good serologic test |
b) recurrent uveitis in horses
c) abortions d) moon blindness = recurrent uveitis (hemolytic anemia more common in calves; good serum Ab titers) |
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Which organisms are responsible for bacillary hemoglobinuria? Which toxins cause this?
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F. hepatica releases Clostridium novyi type D
Produce beta toxin (phospholipase C) causing hemolysis |
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Which organisms are responsible for Yellow Lamb Dz? Which toxins cause this?
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Fluke releases C. perfringens type A which releases alpha toxin
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Which breeds are commonly impacted by neonatal isoerythrolysis?
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Mules, Standardbreds, Thoroughbreds
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How is bacillary hemoglobinuria treated?
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Can't really treat it..only prevent w/fluke control and vaccinations
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T or F:
Mares never have the donkey factor. |
hahahahahahahahahahahahahaha.....its true
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What are signs of post-parturient hemoglobinuria? What causes this?
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Intravascular hemolysis, depression, decreased feed and milk
Probably caused by marked hypophosphatemia (causes RBC lysis) |
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What are the 2 different processes of IMHA? Which is more common? How are they differentiated?
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Autoimmune
Secondary IMHA (more common) Tough to differentiate!! |
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T or F:
Hemoglobinemia is not often found in IMHA. |
True! Don't rule-out IMHA if you don't see hemoglobinemia!
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How is IMHA treated?
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Treat underlying cause or remove causative agent (meds mostly)
Immunosuppress (dexameth is best) Maybe transfuse... |
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Which of the following are NOT true about EIA?
a) affects equids of any breed, age, or sex b) Only licensed labs can run Coggin's tests c) Most commonly transmitted via secretions d) virus replicates in RBCs, causing lysis e) Reportable! |
c) Most commonly transmitted via secretions (NO - biting fly vectors)
d) virus replicates in RBCs, causing lysis (NO - replicates in monocytes/macs; humoral and cell-mediated response causes IMHA) |
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Which of the following are NOT true regarding EIA?
a) Anemia is most often seen acutely b) Infected for LIFE c) Death is often in the subacute to chronic stage d) anemia, icterus, fever, and edema are the classic signs e) Glomerulonephritis, hepatitis, and neuro diseases can be associated |
a) Anemia is most often seen acutely (NO - only fever, depression, anorexia, petechiae)
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Which of the following are NOT true regarding Equine Granulocytic Ehrlichiosis?
a) Oxytetracycline is the preferred treatment b) Caused by Neorickettsia risticii c) Vasculitis causes most clinical signs d) Prevention with vaccination e) Seen in southern OR |
a) Oxytetracycline is the preferred treatment (NO - you can use oxytet or doxy but it is usually self-limiting)
b) Caused by Neorickettsia risticii (NO - Anaplasma phagocytophilium) d) Prevention with vaccination (NO vaccination; only tick control) |
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Choose equine anaplasmosis or ruminant anaplasmosis for each of the following:
- hemoparasite - inclusion bodies in granulocytes - vaccine available - intravascular hemolysis - Oxytetracycline treatment - tick-borne - mild anemia |
RUMINANT - hemoparasite
EQUINE - inclusion bodies in granulocytes RUMINANT - vaccine available RUMINANT - intravascular hemolysis RUMINANT - Oxytetracycline treatment BOTH - tick-borne EQUINE - mild anemia |
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Which anaplasmids induce anemia in ruminants? In horses?
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Ruminants (A. marginale, centrale, caudatum)
Horses (A. phagocytophilum) |
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Choose the organism causing each sign in camelids:
a) mild to subclinical anemia b) Moderate, poorly regenerative anemia c) Tx w/oxytetracycline d) organism within RBCs e) PCR test |
(Eperythozoon) mild to subclinical anemia
(Mycoplasma hemolamae) Moderate, poorly regenerative anemia (BOTH) Tx w/oxytetracycline (Eperythrozoon) organism within RBCs (M. hemolamae) PCR test |
Eperythrozoon or Mycoplasma |
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What is the most common form of anemia in large animals?
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"depression" anemias (maybe obtunded anemias???) - anemias due to reduced RBC production
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What is the most common cause of depression anemia? What are other causes?
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Anemia of chronic disease/chronic inflammation (most common)
Also Cu/Fe/B12 deficiency Renal/Hepatic failure |
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T or F:
Low serum Fe and low TIBC are characteristic of iron deficiency. |
False! TIBC should be high (or normal TIBC w/low ferritin)
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What are causes of suppression anemias?
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Toxins (plants, heavy metals, drugs)
Myelofibrosis Radiation Lymphosarcoma |
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Choose bracken fern or Pb anemia:
- more commonly see neuro dz - typically see neuro/GI signs - more common in ruminants - see basophilic stippling - treated w/chelation |
BOTH - more commonly see neuro dz
Pb - typically see neuro/GI signs Pb - more common in ruminants Pb - see basophilic stippling Pb - treated w/chelation |
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Choose innate, cell-mediated, or humoral immunity for the following:
- Lymphocytes - plasma cells - T-lymphocytes - CD8+ - CD4+ |
Humoral & CMI - Lymphocytes
Humoral - plasma cells CMI - T-lymphocytes CMI - CD8+ (cytotoxic T cells) Regulates Humoral - CD4+ (on T helper cells) |
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Choose innate, cell-mediated, or humoral immunity for the following:
- immediate response - delayed response - physical barriers - direct phagocytosis - memory cells |
Innate - immediate response
Humoral/CMI - delayed response Innate - physical barriers Innate - direct phagocytosis Humoral - memory cells |
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Which equine immunodeficiency describes each of the following?
- NO IgM - Usu seen once maternal antibodies wane - Male foals non-responsive to vaccination - Waning IgM and other globulins in older horses - normal cell-mediated immunity |
SCID, Fell Pony - NO IgM
Transient Hypogammaglobulinemia - Usu seen once maternal antibodies wane Agammagloblulinemia - Male foals non-responsive to vaccination Common Variable Immunodeficiency - Waning IgM and other globulins in older horses Agammaglobulinemia, FPT, Selective IgM deficiency - normal cell-mediated immunity |
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Which equine immunodeficiency describes each of the following?
- NO IgM - No B lymphocytes - only low IgM - Low IgG, M, and A - no treatment; dead foals! |
Transient Hypo - Eventually produces antibodies
Agammaglob - No B lymphocytes Selective IgM deficiency - only low IgM Transient hypo and Common Variable - Low IgG, M, and A SCID, Fell pony - no treatment; dead foals! |
Choose from: SCID Fell Pony Syndrome Transient Hypogammaglobulinemia Equine Agammaglobulinemia Selective IgM Deficiency of Horses Common Variable Immunodeficiency of Horses |
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Which immunodeficiency has:
- NO B or T cells - Low to no B cells, normal Ts - No T cells, normal Bs - Normal B and T cells - abnormal B cells w/aging |
SCID - NO B or T cells
Fell Ponys; Agamaglobs, Common variable ID - Low to no B cells NO DISEASE - No T cells, normal Bs Selective IgM def - Normal B and T cells Common variable immunodeficiency - Abnormal B cells with aging |
Choose from: SCID Fell Pony Syndrome Transient Hypogammaglobulinemia Equine Agammaglobulinemia Selective IgM Deficiency of Horses Common Variable Immunodeficiency of Horses |
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What is the signalment for BLAD? What is the pathogenesis?
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Holstein cattle; CD18 issue w/leukocytes that can't adhere
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Choose Juvenile, Thymic, or Cutaneous bovine LSA:
- >3yo - respiratory signs - can spread to other organs - young animals - decreased venous return |
Cutaneous - >3yo
Thymic - respiratory signs Cutaneous - can spread to other organs Juvenile - young animals Thymic - decreased venous return |
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Which of the following are NOT true regarding enzootic LSA?
a) all animals w/enzootic LSA have BLV b) Commonly found in uterus, R-heart, abomasum, liver c) All cattle with BLV will get enzootic LSA d) must find neoplastic cells for diagnosis e) Persistent lymphocytosis |
b) Commonly found in uterus, R-heart, abomasum, liver (SPLEEN, also kidney, spinal cord, etc and not liver)
c) All cattle with BLV will get enzootic LSA (NO; only 5% of infected will) |
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Which structure is likely affected in a cow with exopthalmus?
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Retrobulbar lymph node due to Enzootic LSA
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Which are NOT true regarding equine LSA?
a) Multicentric form often affects GI b) Clin path signs include: leukemia, anemia, hypercalcemia c) good prognosis d) can be young or old e) weight loss is the most frequent sign |
b) Clin path signs include: leukemia, anemia, hypercalcemia (Leukemia and hypo Ca are rare; sometimes anemia)
c) good prognosis (BAD unless cutaneous form) |
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How is equine LSA treated?
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Bust a CAP in it!
Cyclophosphamide, Arabinoside, Prednisolone (maybe Vincristine too) |
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If you see pectoral edema in a horse, what should you be thinking?
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Something in the chest! Maybe Thymic LSA!!
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