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Lymphoreticular and haematopoetic > Abnormalities of the Leukon > Flashcards

Abnormalities of the Leukon Flashcards

1
Q

What are the two methods of measuring leukocytes through a machine?

A

Impedance/optical

Quantitative buffy coat

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2
Q

How does an impedence/optical machine calculate WBC numbers?

A

Lyse RBC and stream nucleated cells through a channel where electrical impedance or optical deflection is noted

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3
Q

What are the pros and cons of using impedence/optical machines to measure WBCs?

A

Accurate for total numbers

If there is regenerative anaemia present not accurate as nucleated RBCs are counted as well

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4
Q

How is a quantitative buffy coat used to measure WBC numbers?

A

Scans a spun down large PCV tube and related fractions to where cell types settle

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5
Q

In what order from bottom to top do WBCs settle in the buffy coat?

A

Basophils, mast cells, eosinophils, monocytes, lymphocytes, platelets

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6
Q

What are the disadvantages of using quantitative buffy coat analysis to calculate WBC numbers?

A

Problems with abnormal cells/platelet enumeration

Differentials poorly performed

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7
Q

What are some manual methods used to calculated WBC numbers?

A

Chamber counts/unopette systems used for exotics

Blood smear estimates from a monolayer assuming there is no clotting or clumping

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8
Q

How is a blood smear estimate of WBC numbers calculated?

A

Number of leukocytes in the monolayer of a 100x field counted then divided by four which correlates roughly to WBC x10^9/L
Average at least 10 fields to minimise variation across smear

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9
Q

What does total WBC concentration include?

A

All neutrophils, lymphocytes, monocytes, eosinophils and basophils

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10
Q

How are specific leukocyte numbers calculated?

A

Count 100 cells per 10x10^9/L total WBCs then times percentage of cells by concentration of WBCs to get absolute concentration

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11
Q

How do you compare specific numbers to absolute concentration of WBCs?

A

Percentage of specific leukocytes can be compared directly but absolute concentration needs to be compared to WBC concentration for context

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12
Q

What factors influence total leukocyte numbers?

A

Dynamic equilibrium
Balance between peripheral demand and the ability of bone marrow to supply adequate replacements
Position of the leukocyte (marginated/circulating)
Availability for sampling

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13
Q

What are the kinetics of neutrophils in a healthy animal?

A

Each stage of production of a neutrophil takes about a da and remain in the blood for between 30 minutes-6hours

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14
Q

What is the self-renewal stem cell for neutrophils

A

CFU-G

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15
Q

What cells make up the ProNP?

A

Myeloblasts, progranulocytes and myelocytes

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16
Q

What stimulates the mitotic pool?

A

IL-1, IL-3, IL-6, GM-CSF, G-CSF

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17
Q

When does apoptosis occur in health to prevent overproduction?

A

Myelocyte stage

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18
Q

Which cells make up the MatNP?

A

metamyelocytes, band neutrophils and segmented neutrophils

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19
Q

What is the ratio of MatNP to ProNP?

A

4-6

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20
Q

What is the SNP?

A

Storage neutrophil pool made up of sub-pool of MatNP with cells ready to be released into marrow sinusoids

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21
Q

What species differences are there in SNP?

A

Dogs and cats have good storage but horses don’t

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22
Q

What is the CNP?

A

Circulating neutrophil pool that is samples in blood collection

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23
Q

What is the MNP?

A

Marginated neutrophil pool which are the cells ready to exit the circulation and migrate into the tissues

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24
Q

What is the TNP?

A

Tissue neutrophil pool

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25
What is the CNP:MNP ratio?
Near 1 but can be 3 in cats
26
What changes occur in left shift of neutrophils?
More band neutrophils, may see toxic changes, cytoplasmic foaminess and basophilia, Dohle bodies, giant neutrophils, vaculolation and toxic granules
27
What causes changes see in left shift of neutrophils?
Accelerated production
28
What is regenerative left shift of neutrophils?
Production meets demand and more resulting in neutrophilia and more segmented cells than band
29
What is a degenerative left shift of neutrophils?
Production doesn't keep up with demand resulting in neutropenia and bands in the circulation in greater numbers than segmented
30
Why are large animals more prone to degenerative left shift?
They have less storage
31
What changes are seen in right shift of neutrophils? Why does it happen?
Hypersegmentation | If neutrophil can't adhere so keeps circulating
32
What is neutropenia?
Lack of neutrophils
33
What causes neutropenia due to increased demand?
Peracute bacterial infections, endotoxaemia or immune-mediated disease
34
What causes a redistributive neutropenia?
Endotoxaemia or anaphylactic shock
35
What causes neutropenia due to decreased production?
Bone marrow disorder - myelodysplasia, myelofibrosis or myelophthisis Parvovirus, FeLV, FIV and Ehrilichia Iatrogenic due to azathioprine/cyclophosphamide Cyclic neutropenia of grey collies or Chediak-Higashi syndrome in cats
36
What is important to keep in mind with neutropenia?
Breed differences and individual differences Broad spectrum ABs if below 2.0x10^9/L Relate clinical signs to blood count when interpreting results
37
What is neutrophilia?
Increased numbers of WBCs
38
What causes neutrophilia due to increased production due to increased demand?
Infections, immune-mediated diseases, secondary to neoplasia, haemorrhage, haemolysis, necrosis or thrombosis
39
What causes neutrophilia due to increased production independent of demand?
Well differentiated neutrophils transformed = chronic granulocytic leukaemia Poorly differentiated with early precursors transformed = acute myeloid leukaemia
40
What causes neutrophilia due to increased persistence in the circulation?
Part of stress/steroid response and look for accompanied monocytosis/lymphopenia Hypersegmented = can't marginate
41
What causes neutrophilia due to redistribution?
Stress or excitement increases blood pressure causes marginated neutrophils to be swept into circulation which in cats can increase numbers by 200%
42
What are the similarities and differences between B and T cells?
Look the same but B cells mostly short lived apart from memory cells and T cells are long lived
43
How are lymphocytes produced?
Formed in bone marrow from lymphoid stem cell but production and clonal proliferation occurs in thymus, spleen and LNs
44
What is the kinetics of lymphocytes?
Can recirculated from blood into tissues back via lymphatics, in and out of lymphoid tissue and back into blood
45
What causes changes in plasma or Motts cell?
Reaction to any antigenic stimulation
46
What is lymphopenia?
Reduction in the number of lymphocytes
47
What causes lymphopenia due to increased demand?
Some protein losing enteropathies as cells are lost in chyle or through recruitment and emigration into tissue
48
What causes lymphopenia due to redistribution?
Influence of steroids causing redistribution to bone marrow, tissue and trapping in lymph nodes
49
What causes lymphopenia due to decreased production?
Infection with canine distemper, parvovirus, panleukopenia virsu, FeLV and FIV Lympholytic drugs such as cyclophophamide/azothioprine and long term corticosteroids Congenital immunodeficiencies such as those found in Basset Hounds where B and T cells are affected
50
What is lymphocytosis?
Increased numbers of lymphocytes
51
What causes lymphocytosis due to increased demand?
Persistent antigenic stimulation, post vaccination or in young animals
52
What causes lymphocytosis independent of demand?
Chronic lymphocytic leukaemia (well differentiated) Acute lymphocytic leukaemia (poorly differentiated) Stage V lymphoma involves bone marrow and release of neoplastic lymphocytes into circulation
53
What causes lymphocytosis due to redistribution?
Physiological lymphocytosis is wehre there is inhibition of recirculation and release of thoracic duct due to adrenaline or in 11-20% of hypoadrenocorticism patients
54
What is the general appearance of monocytes?
Larger blue grey cytoplasm | Can have vacuoles and nucleus and can look like anything with less slumping of chromatin
55
How are monocytes produced?
Monoblasts->monocytes in 6 days in bone marrow but no storage pool but there is a circulating pool and marginated pool
56
How long do monocytes persist in the circulation?
Varies but shortens with inflammation
57
What happens when monocytes leave the circulation?
Differentiate into macrophages with inflammatory cytokines
58
What is moncytosis?
Increased numbers of monocytes
59
What causes monocytosis with increased demand?
Bacterial/fungal/protozoal infection Immune-mediated disease such as IMHA, meningitis or polyarthritis Necrosis/burns/trauma Neoplasia
60
What causes monocytosis independent of demand?
Secondary to immune neutropenia due to CFU-GM being a common precursor cell Myelomonocytic leukaemia (acute and chronic) Acute monocytic leukaemia with or without maturation
61
What causes redistributive monocytosis?
Steroids as moved out of marginated pool
62
What is the general appearance of eosinophils?
Larger, segmented nucleus, granules, vacuole looking holes are granules that haven't stained Species differences in appearance
63
How long does is take eosinophils to differentiate and mature?
2-6 days depending on species with variable persistence in circulation
64
What are the kinetics of eosinophils?
Random entry into skin, respiratory and Gi tract but directional entry under the influence of chemokines/inflammatory mediators
65
What causes eosinopenia?
Mechanisms unclear but can occur due to corticosteroids and catecholamines
66
What causes eosinophilia due to increased demand?
Sensitised T cells/Mast cells cause IL-5 release | Parasite antigen, allergic disease or inflammation of mast cell rich tissue
67
What causes eosinophilia independent of demand?
Paraneoplastic due to lymphoma, mast cell tumours or other tumour where IL-5 is elaborated Hypereosinophilic syndrome where numbers increase in circulation or tissue without obvious cause Eosinophilic leukaemia is rare
68
What is the general appearance of basophils?
Larger ribbon shaped segmented nucleus with lavendar granules
69
How long does maturation and release of basophils take?
2-5 days and persist in circulation for 6 hours
70
What is the role of basophils?
Type 1 hypersensitivities such as anaphylaxis, rhinitis, asthma, GI sensitivities and parasites
71
Why can basopenia not be detected?
Reference interval begins at 0 but possible occurs with anaphylactic, inflammatory and steroid responses
72
What causes basophilia due to increased demand?
Immediate or delayed hypersensitivities Parasitism especially Dirofilaria but also Gi parasites, fleas and ticks Other inflammatory responses
73
What causes basophilia independent of demand?
Paraneoplastic | Rarely basophilic leukaemia
74
What is a stress leukogram?
Response to corticosteroid either endogenously as cortisol or exogenously such as prednisolone Mild to moderate mature neutrophilia, lymphopenia, monocytosis and eosinopenia Addisons can cause it to occur
75
What is an acute inflammatory leukogram?
Neutrophilia without left shift, lymphopenia, monocytosis and +/- eosinopenia
76
What is a chronic inflammatory leukogram?
Neutrophilia without left shift, lymphocytosis and monocytosis
77
What does adrenaline response have on leukocytes?
Neutrophilia and lymphocytosis

Lymphoreticular and haematopoetic (12 decks)

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