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Lymphoreticular > Abnormal Leukon: Neutropenia (Balasz) > Flashcards

Abnormal Leukon: Neutropenia (Balasz) Flashcards

1
Q

How are leukocytes measured using machines?

A

> impedence/optical
- RBC lysed
- nucleated cells streamed through channel where electrical impedence or optical deflection noted (NB. if RBC nucleated this will mess up value)
- most accurate for total numbers
quantitative buff ycoat (QBC)
- problems with abnormal cells/platelt enumeration
- ddx provided poor

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2
Q

How are leucocytes measured manually?

A
  • chamber couunt/unopette system for birds/exotics

- blood smear estimate (count in a 100x field, divide by 4 ~= WBCx10e9: average at least 10 fields

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3
Q

What does the total white blood cell conc comprise?

A
  • neutrophils
  • lymphocytes
  • monocytes
  • eosinophils
  • basophils (most difficult to count)
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4
Q

T1/2 of a neutrophils?

A

6 hours

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5
Q

What factos affect total leucocyte numbers?

A
  • position of the leukocyte within the vessel (marginated v circulating) and availability for sampling
  • balance between supply and demand
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6
Q

What are lecuocyte differentials? ECHO

A
  • count 100 consequtive cells?
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7
Q

Percentage v absolute concentration neutrophils? ECHO

A

-

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8
Q

Outline stages of neutrophil poduction and kinetics

A
  • proliferating
  • maturating
  • circulating
  • tissue
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9
Q

What is the neutrophils stem cell?

A
  • CFU-G (colony forming unit-granulocyte)
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10
Q

What stages exist within the proliferation pool? What is the proliferative pool and how long does it take for a neutrophil to pass thorugh this stage?

A
  • Mb (myeloblast)
  • Pg (progranulocyte)
  • Me (Myelocyte)
    > mitotic pool, stimulated by IL-1, 3, 6, GM-CSF, G-CSF
    > apoptosis at myelocyte stage to limit production in health
  • 3d
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11
Q

What stages exist within the maturation pool? What is this pool and what measurements of it can be made?

A
  • Mmc (metamyelocyte)
  • B (Band neutrophil)
  • S (segmeneted neutrophil)
    > post mitotic pool
  • 2-3d in this pool
  • MatNP:ProNP ratio should be 4-6
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12
Q

What is SNP/

A
  • storage neutrophil pool
  • subpool of matNP
  • ready to be released to marrow sinusoids
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13
Q

What may be seen in bone marrow around developing neutrophils?

A

nRBC

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14
Q

Which pool is sampled during blood collection?

A

CNP (circulating neutrophil pool)

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15
Q

What is the MNP?

A
  • marginated neutrophil pool

- ready to exit circulation and migrate to TNP

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16
Q

Wha is the CNP:MNP ratio? What should it be?

A
  • CNP:TNP ~1

- cats ~3!

17
Q

How long is the lag between ^ demand for neutrophils and hem entering the circulating pool?

A

~3d prolfierative, ~3d maturation (~6d)

18
Q

How do toxic changes manifest in neutrophils?

A
  • cytoplasmic foaminess and basophilia
  • DOhle bodies (blue bits in cytoplasm)
  • Giant neutrophils
  • Vacuolatoon
  • TOxic granules
19
Q

Are “toxic changes” related to toxicity?

A

NO!!!

- can be with anything eg. IMHA etc. with rapid turnover

20
Q

How do band neutrophils appear? Do they continue developing in the circulation?

A
  • banded, not segmented (thinnest point not less than 2/3 thickest part)
21
Q

WWhat is the difference between toxic and degenerate/lytic neutrophils?

A 
> toxic
- in peripheral blood
- indicates accelerated production 
- no need for toxins
> degenerate/lytic
- in tissues (fluids) 
- fighting with bacteria
- bacterial toxins
22
Q

How can left shift be classified?

A 
> regenerative 
- neutrophilia 
- segmented > bands
> degenerative
- neutropenia
- bands > segmented
23
Q

Which species have the greatest storage pool of neutrophils?

A
  • cats and dogs
24
Q

How does left shift classification differ between large and small animals?

A 
> large animals no storage pool 
- numbers will drop rapidly
- will recover when BM kicks in 
> smallies large storage pool
- if you see a degenerative left shift this is BAAAD!! stores used up
25
Q

What is right shift?

A
  • hypersegmentation >5 lobes
  • been in the circulation too long!
    > something preventing adherence to walls of vessels
26
Q

What is endotoxin neutropenia?

A

endotoxaemia - > neutrophils stick to the vessel walls

-^ marginated pool

27
Q

What is the neutrophil equivalent of IMHA?

A
  • macrophage destruction in tissues -> peripheral-destruction neutropenia
28
Q

What 2 types of neutropenia result from incorrect production?

A

> granulocytic-hypoplasia neutropenia

> ineffective-production neutropenia

29
Q

Causes of neutropenia d/t increasedd demand?

A
  • peracute bacterial infeections (peritonitis, pyothorax)
  • endotoxaemia
  • immune mediated (alongside v neutrophil survival time)
30
Q

Causees of neutropenia d/t redistribution?

A
  • response to endotoxaemia, anaphylactic shock

- neutrophils ^ margination to vessel walls so fewer free to sample

31
Q

Causes of neutropenia d/t decreased production?

A

> BM Disorders usually

  • Infectious causes eg. parvo, FIV, FeLV, Ehrlichia
  • Toxicity commonly iatrogenic eg. azathioprine, cyclophosphamide, idiosyncratic reactions
  • Ineffective production: myelodysplasa often FeLV related
  • change in BM environment (myelofibrosis, myelopthisis [crowding out by neoplasia]
  • congential abnormalities: cyclical neutropenia of grey collies, CHediak-Higashi syndrome (neutropenia in cats)
32
Q

What non-pathological factors affect neutropenia?

A 
> Breed differences
- greyhounds normally neutropenic! 
- referecne ranges not different 
> individual differnecess 
- if mild, track over time
33
Q

What cut off level to give BS prophylaxis Abx exists for neutrophils?

A

different for different clinicians

- usually

34
Q

Where are leukocytes produced? What else is required?

A
  • BM (all cell lines)
  • spleen and liver maintain potential to produce all lines
  • thymes, spleen, LNs, bursa of Fabricus (birds): mostly involved in differentiation of lymphoid
  • complex interplay of growth factors
35
Q

Neutrophil t1/2 in blood?

A

5-10hrs

Lymphoreticular (31 decks)

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