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Lymphoreticular and Haemopoietic > Abnormalities of the Leukon > Flashcards

Abnormalities of the Leukon Flashcards

1
Q

Where are leukocytes produced?

A

Bone marrow - all cell lines
Spleen and liver - maintain potential to produced all leukocyte lines
Thymus, spleen and LNs - differentiation of lymphoid

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2
Q

What makes up total WBC concentration?

A 
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
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3
Q

What influences total leukocyte numbers?

A

Dynamic equilibrium
Balance between peripheral demand and ability of bone marrow to supply replacements
Position of leukocyte within blood vessel

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4
Q

How can you identify neutrophils on smear?

A

Segmented nuclei and fine cytoplasmic granules

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5
Q

What are the different neutrophil pools?

A
  1. Proliferation pool
  2. Maturation pool
  3. Storage pool
  4. Circulating pool
  5. Marginating pool
  6. Tissue pool
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6
Q

Describe the maturation of neutrophils

A
  1. Myeloblast
  2. Myelocyte
  3. Metamyelocyte
  4. Band neutrophil
  5. Segmented neutrophil
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7
Q

What pool of neutrophils are you sampling when you sample neutrophils? What is the neutrophil half life in blood?

A

Circulating pool

5-10 hours

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8
Q

What is the circulating:marginated neutrophil ratio like in dogs? What does this mean?

A

Near 1
At any given time up to half are not circulating but in tissue
When adrenaline increases, tissue pool can double back into circulation
Can appear as significant neutrophilia

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9
Q

What is left shift?

A

If demand is high more immature neutrophils are released

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10
Q

Describe the toxic changes to neutrophils…

A

In peripheral blood
Accelerated production
Cytoplasmic foaminess
Dohle bodies, giant neutrophils, vacuolation, toxic granules

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11
Q

Describe degenerative/lytic change to neutrophils…

A

In tissues
Bacterial toxins
If you have septicaemia you may have degenerative neutrophils in the circulation

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12
Q

What is regenerative left shit? What does it indicate?

A

Neutrophilia
Segmented > bands
Big demand but marrow producing lots of neutrophils to cope - this is good.

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13
Q

What is degenerative left shift? What does it indicate?

A

Neutropenia
Bands > segmented
Other than horses, bands > segmented is v rare.
If you have bands but no neutrophils you are in trouble.

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14
Q

What is right shift?

A

> 5 lobes to a neutrophil
Keep segmenting
e.g. steroids down regulate adhesion molecules

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15
Q

What are the different types of neutropenia?

A
  1. Inflammatory neutropenia
  2. Endotoxin neutropenia
  3. Peripheral destruction neutropenia
  4. Granulocytic hypoplasia neutropenia
  5. Infective production neutropenia
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16
Q

What is inflammatory neutropenia?

A

Kicks out storage pool

More into tissue than marrow can produce

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17
Q

What is endotoxaemia neutropenia?

A

Marrow ok

Sudden increase in maturation means they go from circulating to marginating pool

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18
Q

What is peripheral destruction neutropenia?

A

Marrow producing more but being destroyed in the periphery

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19
Q

What is granulocytic hypoplasia neutropenia?

A

Marrow not producing enough

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20
Q

What is ineffective neutropenia?

A

Dysplasia so cells not viable and don’t enter circulation

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21
Q

Describe neutrophilia in terms of increased production and increased demand…

A

Inflammatory neutrophilia - increased marrow production and storage release.

  • Infections - bacterial, viral, protozoal
  • Immune mediated diseases - IMHA, polyarthritis
  • Secondary to neoplasia
  • Haemolysis, haemorrhage, necrosis, thrombosis
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22
Q

Describe neutrophilia in terms of increased production independent of demand…

A

Well differentiated neutrophils transformed: chronic granulocyctic leukaemia
Poorly differentiated transformed: acute myeloid leukaemia

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23
Q

Describe neutrophilia in terms of increased persistence in circulation

A

Stress/steroid response
Hypersegmented
Accompanied by monocytosis and lymphopenia

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24
Q

Describe neutrophilia in term of redistribution…

A

Stress/excitement increased blood pressure
Marginated neutrophils swept into circulation
May increase WBC number up to 200% in cats
Lymphocytes prevented from leaving circulation = number increased

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25
Treatments for neutrophil abnormalities...
Treat underlying causes Chronic granulocytic leukaemia = good short term prognosis Acute myeloid leukaemia = no successful treatment
26
How can you identify lymphocytes on smear?
Large nucleus with small amount of blue cytoplasm
27
How long do B cells last? | How long do T cells last?
B cells = days to weeks Memory B cells = longer lived T cells = months to years
28
Describe production and circulation of lymphocytes...
Formed in bone marrow Production and clonal proliferation in thymus, spleen and LNs Recirculate from blood into tissues and lymphatics
29
Describe the reactive changes you may see in lymphocytes...
Antigenic stimulation = nucleus becomes larger with a bit more cytoplasm Strong antigenic stimulation = may pick up plasma cells
30
Describe lymphopenia in terms of increased demand...
Some protein losing enteropathies Chylothorax Recruitment and emigration into tissue with some antigens
31
Describe lymphopenia in terms of redistribution...
Steroid/stress - redistribution to bone marrow, tissues, trapping LNs Trapping in lymph rich fluid e.g. chylothorax
32
Describe lymphopenia in terms of decreased production...
Infectious causes Lympholytic drugs e.g. chemo Congenital immunodeficiencies where B and T cells affected
33
Decribe lymphocytosis in terms of increased numbers and increased demand...
Persistent antigenic stimulation (funal, protozoal, FeLV, leishmania, brucellosis) Post vaccination Young animals
34
Describe lymphocytosis in terms of increased numbers independent of demand..
Chronic lymphocytic leukaemia = well differentiated slowly progressing Acute lymphoblastic leukaemia = more poorly differentiated (poor prognosis) Stage V lymphoma = bone marrow involvement and release of neoplastic lymphocytes into circulation
35
Describe lymphocytosis in terms of redistribution..
Physiological leukocytosis = adrenaline increases, high BP, wash back into circulating pool from marginating pool Hypoadrenocorticism = no steriods
36
How can you identify monocytes on smear?
Largest cell Neutrophils have darker denser nucleus Monocyte has blue-grey cytoplasm Hard to differentiate monocyte and degenerative neutrophils
37
Describe the different pools of monocytes...
No storage pool | Do have marginated and circulating pools
38
Describe circulation of monocytes
Persistence in circulation varies, shortens with inflammation Leaves circulation to tissues Differentiaties in macrophages with inflammatory cytokines
39
Describe monocytosis in terms of increased numbers with increased demand
Infectious causes IMHA, meningitis, polyarthritis Necrosis, trauma, burns Neoplasia
40
Describe monocytosis in terms of increased number independent of demand
Secondary to immune neutropenia Myelomonocytic leukaemia - acute and chronic Acute monocytic leukaemia
41
Describe monocytosis in terms of redistribution
Steroids may move them out of marginated pools
42
Treatment for monocytosis?
Treat underlying cause | Chronic myelomonocytic much the same as chronic granulocytic leukaemia
43
How can you identify eosinophils on smear?
Segmented nucleus Granules in cytoplasm Orange granules Looks like they have vacuoles
44
Species differences in eosinophils?
Greyhound = look like very vacuolated neutrophils Cat = very orange and clear neutrophils Horse = looks like mulberry
45
How long does it take eosinophils to differentiate and mature?
2-6 days
46
Describe circulation of eosinophiles..
Random entry into tissues, skin, resp, GI | Directional with chemokines and immatory mediators
47
What can cause eosinopenia?
Mechanisms unclear - Corticosteroids via apoptosis - Catecholamines
48
Describe eosinophilia in terms of increased demand
Parasitic antigen Allergic disease - atophy, drug allergy, asthma, pulmonary infiltrate with eosinophils Inflammation of mast cell rich tissues (GI, skin, lungs, uterus)
49
How is T cell lymphoma associated with eosinophilia?
T cells produce IL-5 which is specific for eosinophils
50
Describe eosinophilia in terms of increased numbers independent of demand...
Paraneoplastic (IL5) Hypereosinophilic syndrome Eosinophilic leukemia
51
How can you identify basophils on smear?
Rarely seen them as so few in circulation Huge cells Segmented nucleus that looks like ribbon Dark purple granules in dog, lilac in cats
52
Describe circulation of basophils
Persistent in circulation for 6hrs | Role in type 1 hypersensitivites
53
Describe basophilia in terms of increased numbers due to increased demand...
Immediate or delayed hypersensitivies | Parasitism
54
Describe basophilia in terms of increased numbers independent of demand..
Paraneoplastic | Basophilic leukaemia
55
What does a stress leukogram look like?
Neutrophilia Lymphopenia Monocytosis Eosinopenia
56
What does Addison's leukogram look like?
Reverse stress leukogram Neutrophils and monocytes usually normal Lymphocytosis Eosinophilia
57
What does an acute inflammatory leukogram look like?
``` Neutrophilia with or without left shift Lymphopenia Monocytosis Eosinopenia Looks similar to stress leukogram, but wouldn't expect toxic changes and left shift with steroids ```
58
What does a chronic inflammatory leukogram look like?
Neutrophilia with or without left shift Lymphocytosis Monocytosis
59
What leukocyte response would you see with adrenaline?
Neutrophilia Lymphocytosis Looks similar to chronic inflammation. However, adrenaline response very transient - repeat test
60
What does normal haemogram look like for young animals?
Higher numbers of WBS Lower haematocrit Changes are usually mild - normalised around 3months

Lymphoreticular and Haemopoietic (14 decks)

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