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PATHOLOGY > 11. Leukocyte Responses in Disease > Flashcards

11. Leukocyte Responses in Disease Flashcards

1
Q

What is leukemia?

A

neoplastic cells in the blood and/or bone marrow

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2
Q

What is leukemoid response or reaction

A

can easily be mistaken for leukemia
Characterised by marked leukocytosis (>50.0x10^9WBC/L)
usually due to an inflam response

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3
Q

What is pancytopenia

A

refers to a dec in the number of all blood cell types

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4
Q

What is a left shift?

A

inc numbers of immature neutrophils in the blood

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5
Q

What is a degenerative left shift?

A

normal to dec #’s of mature neutrophils w/ equal or higher #’s of immature neutrophils BAD

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6
Q

What is leukopenia?

A

a dec in white blood cell numbers
leukopenia may be balanced with a dec in the # of all cellular elements, or it may be confined to one
nursing care and great nutrition are important to prevent 2nd infections & bone marrow function

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7
Q

What are common causes of leukopenia?

A
  1. viral infections
  2. Overwhelming bacterial infections
  3. anaphylactic shock and endotoxin shock
  4. Certain antibiotics
  5. Chemotherapeutic drugs
  6. Some analgesics
  7. Lead, mercury, antihistamines, & cortisone products
  8. A cachetic state (usually bc anorexia)
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8
Q

What is leukocytosis?

A

an inc in white blood cells
usually due to a rise in the number of circulating neutrophils
commonly occurs due to a physiological cause (As opposed to a pathological one)

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9
Q

What are some physiological cause of leukocytosis?

A

Exercise (more common in cats/eq)
Stress (common in dogs)
trauma, steroid therapy
chronic illness
DUe to an in in other cell types

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10
Q

What might happen to WBC’s with a stress response?

A

WBC changes that occur in response to stress, chronic illness, exercise or steroid supplementation
Absense of stress response in an animal that is sick is significant

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11
Q

What WBC stress response will you see in cats and dogs?

A

you’ll see a mature neutrophilia, monocytosis, lymphopenia, and possible eosinopenia**

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12
Q

What WBC stress response will you see in cattle?

A

reversal of neutrophil to lymphocyte ratio even if both are still within reference limits**

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13
Q

What WBC stress response will you see in horses

A

mature neutrophilia and lymphopenia**

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14
Q

What are the pathological causes of leukocytosis?

A
  1. systemic or localized infections - can cause marked neutrophilia (in dogs also monocytosis) with a possible left shift (Mastitis, peritonitis, metritis)
  2. Inflam, 3. acute hemorrhage (especially if its into body cavity*)
  3. Sudden lyses of erythrocytes*
  4. Some toxins,* 6. neoplasia
  5. Leukemia - may prod an inc in bizarre, atypical cell types and a severe left shift
    *these cases usually = in neutrophilia with NO left shift, may be followed by monocytosis
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15
Q

What is leukocytosis?

A

the total leuckocyte response in an individual is directly related to the patient’s susceptibility to an infection, it’s immune status, and it’s general health
debilitated animals may fail to show the expected response - bone marrow may be affected by underlying condition

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16
Q

What is a left shift? WHat might you see?

A

refers to an increased conc of immature neutrophils in the peripheral blood
Band neutrophils are the first immature cells to appear
Metamyelocytes or earlier immature forms may also be seen

17
Q

Which one indicates a more severe condition, neutrophilia or neutropenia?

A

Neutropenia
Orderly classification - there should be fewer immature cells than mature neutrophils

18
Q

How are left shifts described?

A

Described to the degree of the shift
Termed slight or mild if shifted to the band neutrophil stage
Moderate if shifted to metamyelocyte stage
marked or severe if shifted to myelocyte or promyelocyte stage

19
Q

What are regenerative left shift?

A

a leukocytosis due to a neutrophilia and appearance of immature neutrophils DO NOT out-number the mature neutrophils > bone marrow is responding to inflam stimulus
EX: seg N. - 45
Band - 15
Metamyelocyte - 6
myelocyte - 1
A marked regenerative left shift

20
Q

Describe this left shift
Seg. N - 48, band N. - 11, metamyelocyte - 3

A

Moderate regenerative left shift

21
Q

What are degenerative left shifts and what is an example of them?

A

Total WBC count often normal, but it can be above/below normal range
The immature neutrophils out-number mature ones > bone marrow no longer keeping up to the demands of the body - indicates poor px
Ex. Seg N - 8, Band - 25, metamyelocytes - 20, myelocytes - 1

22
Q

Can animals go from a regenerative to a degenerative left shift?

A

Yes, but it will take some time to go from a regenerative to a degenerative shift
At first the body will be able to maintain a leukocytosis
In time, total WBC count will fall & a leukopenia will develops

23
Q

What is the bone marrows ability to respond measured by? How is the intensity of the response measured by?

A

Bone marrow’s ability to respond is measured by total leukocyte count
Intensity of response measured by extent of left shift

24
Q

What is a leukemoid response/reaction?

A

Characterized by severe leukocytosis (more than 50-100 x10^9wbc/L), most are mature Neutro\s, marked left shift myelocytes and metamyelocytes
cells show toxic granulation, dohle bodies and increased vacuoles

25
Q

What is different/similar in leukomoid response/reaction than with leukemia?

A

Only differentiated via bone marrow exam
Both show peripheral blood shows an inc total count w/ severe left shift

26
Q

What is a leukemoid response normally associated with? Is it treatable?

A

Usually associated w/ severe inflam & infecction such as pyometra, hepatic abscesses
Usually treatable, but leukemia has grave px

27
Q

What is the function of bone marrow?

A

in young animals, bone marrow is very hematopoietically active
as animal matures, marrow activity decreases & fat cells take up more marrow volume
There are two types of marrow, they differ histologically - active marrow is RED marrow, other is yellow

28
Q

How long does it take yellow marrow to convert to red marrow after sudden massive blood loss and hemolytic destruction of red cells?

A

It’ll take about 48 hours for yellow marrow to begin converting to red marrow - it then becomes very active to replace lost cells
during chronic blood loss, conversion more slowly

29
Q

Why might we evaluate bone marrow?

A

to dx conditions or provide a prognosis for a condition
findings on blood smear analysis used to determine whether or not a bone marrow eval is req
persistent unexplained pancytopenia, neutropenia or thrombocytopenia, and non-regen anemia
abnormal circulating cells
unexplained presence or immature cells on a smear

30
Q

When might we not do a bone marrow evaluation?

A

contraindicated in patients with clotting factors
It’s painful! Patient needs to be anesthetizes or heavily sedated w/ local anesthetic at a minimum
Requires aseptic technique because risk of infection is high

31
Q

Where is bone marrow aspirated/biopsied in dogs, cats, horses and cattle?

A

Dogs: proximal end of femur @ end of trochanteric fossa, the iliac crest or proximal humerus
Cats: trochanteric fossa or proximal humerus
Horses& cattle: sternum, ribs or ilium

32
Q

Why should we always review a bone marrow slide?

A

To make sure it is of diagnostic quality before it is submitted to the lab, ensures it is present and intact
Bone marrow evaluation must be accompanied w/ CBC

33
Q

How is bone marrow evaluated?

A

Evaluated on low-power (10x) to eval adequacy of the smear and degree of cellularity
in juveniles or young animals, should have 75% nucleated cells to 25% fat
Adults should have 50:50
Geriatic should have 25:75

34
Q

What cells will we see in the bone marrow?

A

immature + mature RBC’s
immature granulocytes
mature neutros, eosinos, basos
Immature platelets
macrophages, lymphos, plasma cells, mast cells, osteoblasts and clasts

35
Q

What microorganisms might we find on bone marrow aspirates?

A

Bacteria very rare finding
more likely to see histoplasma capsulatum
toxoplasma gondii
leishmania donovani
ehrlichia spp
mycoplasma haemofelis
babesia spp

PATHOLOGY (19 decks)

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