Ashleys Leukocytic 8pm on a Saturday deck of Awesome Flashcards
What is a granular lymphocyte?
cytotoxic T cell
What does a reactive lymphocyte look like?
bluish black cytoplasm
Which immune cells are innate and adaptive
innate - NK
adaptive - T, B
Most common leukocyte
nuetrophil (most species)
2nd most common leukocyte?
lymphocyte (predominate in ruminants, swine, rodents, some reptiles)
T cells live?
B cells live?
blood
lymph
Which leukocytes have round nuclei?
Mast cells and lymphocytes
Which leukocytes have blue granules?
Basophils - segmented nuclei
Mast cells - round nuclei
Bacterial infection assassins?
Neutrophils
Other infection (viral, fungal, protozoal, helminth) assassins
Monocytes/Macrophages
Who presents Ags to T-cells?
monocytes
function in immune modulation/cytokine production?
monocytes
Equine eosinophil
lotsa pink waterballoons
rod shaped granules
feline eosinophils
Where are eosinophils found?
GI!!, respiratory, urogenital mucosa and skin
Which leukocytes attack CERTAIN tissue phases of a few parasites (heartworm, paragonimus)
eosinophils
which two cells typically increase parallel to each other?
eosinophils and basophils
time to mature from myeloblast to a segmented neutrophil
1 week
Livespan in blood of:
erythrocytes?
leukocytes?
platelets?
WBC - 10 hours
Plat - 10 days
RBC - 100days
Entire neutrophil population replaced ____ times a day?
2.5
time to release seg neutrophils from storage pool is quick! (few hours)
PMNs?
neutrophils usually
Who has bigger storage pools and can thus respond more readily to inc. tissue demand for neutrophils?
dog > Cat»_space; Horse > Bovine
Who has a weird (non-50:50) ratio of circulating:marginating neutrophils?
cAtS! o.O
30:70
neutrophils mature ________ vs. lymphocytes can ________.
unidirectionally
recirculate
What can cause the marginating pool to decrease (and inc. the circulating pool)
Steroids (or Cushings)
When there’s an increased demand for neutrophils, inflammation, it can take ______ days to move from marrow pools to the blood.
2-5 days
The time a neutrophil spends in circulation is solely dependent on
Tissue demand
Causes of Eosinophilia?
NAACP PINK Neoplasia Allergy/Hypersensitivity Addisons Parasites
Clinically important leukocytopenias?
Neutropenia
Lymphopenia
Eosinopenia
Causes of Left Shift?
Inflammation (Infectious or non)
Hereditary (Pelger Huet)
Neoplasia (CML)
Types of Left shift?
Regenerative: Neutrophilia, mature predominates
Degenerative: normal/neutropenia, immature dominate
Which left shift is worse?
Degenerative!!
Bovines almost always present with a _______ Left Shift, so?
Degenerative, so its not a good prognostic indicator
toxic changes in neutrophils?
Is neutrophil function affected by these changes?
cytoplasmic basophilia dohle bodies foamy vacuolatioin giantism toxic granulation donut nuclei (nope)
hypersegmentation
hypercortisolemia or old blood
more common in inflamed tissues
not a toxic change!!
(right shift)
affect of necrosis of tissues on neutrophils
degeneration
exploded looking nuclei
leukergy occurs due to coating of WBCs with _____.
happens?
protein of Ig
in the tube after sample collection
infectious bacterial agents (ehrlichia, anaplasma) can be seen as _____ within neutrophils
morulae
Pelger-Huet Anomaly
AUSTRALIAN SHEPARDS (or chronic infections or certain drugs) banded (hyposegmentation) with normal cytoplasm
healthy foals
normally have granules in neutrophils
Stress Leukogram (glucocorticoids)
SMiLEd
segs, monos increase
Lymphocytes, eosinophils decrease
(Leukocytosis with a L shift Neutrophilia)
Most common cause of nonregenerative anemia
inflammation
Epinephrine “Excitement Response” Leukogram
Increased
Neutrophils and Lymphocytes
(Q demarginates neutrophils, flushes out lymphocytes from lymphoid organs)
Excitement Response is most easily seen in?
Will return to normal in?
cats and horses
returns to normal in an hour
What happens when the Maturation and Storing pools release their reserves in response to stress/excitement?
storage pool -> neutrophilia
maturing cells -> left shift
When tissue demand is _____ than marrow production -> _______
greater; neutropenia
lesser; neutrophilia
more mature segmented neutrophils than immature
Regenerative Left Shift
How to know animal is on the ‘down-swing’ and possibly about to become neutropenic
more immature cells than mature segmented (Degenerative Left Shift)
leukemoid
common in dogs
When WBCs get super high, especially during chronic inflammation
(common in dogs)
Interpretation of Neutropenia in different species?
In Dogs and Cats will indicate a very severe lesion vs. probably severe in horses and a usual finding in bovine, regardless of severity
Increases with active inflammation.
Response is more pronounced in ?
fibrinogen
Large Animals, will even preceed neutrophilia
How do we estimate fibrinogen?
Measure TP before and after heating hematocrit tube, the difference is estimated fibrinogen (heat precipitated proteins)
Which inflammation will be worse ‘more inflamed’ ? Closed or Open?
Closed
ex. leukemoid response in canine pyometra, closed cavity lesions with extensive necrosis and inflammaiton
Different causes of neutrophilia?
Inflam & Steroid - L shifted neutrophilia
Steroid - Neutrophilia and Lymphopenia
Excitement - Neutrophilia and normal/lymphocytosis
Normal Lymphocytes vs. Reactive vs. Neoplastic?
normal (small, intermediate, or granualar)
Reactive (Bluish/Black cytoplasm)
Neoplastic (larger, inc. in number, abnormal predominant cell type, lymphoblasts)
Prolonged antigenic stimulation can lead to?
examples
lymphocytosis
hypersensitivity and autoimmune diseases
Bovines can get persistent lymphocytosis due to ______. Then they can’t be exported to certain countries.
BLV (Bovine Leukemia Virus)
inflammation and specifically hyperglobinemia can lead to smear changes including?
Reuleaux
Causes of Neutropenia?
decreased
Canine Parvovirus is a common cause of?
severe reversible stem cell injury. (neutropenia)
and Mast cells in circulation
which cells are the first to be affected by bone marrow injury?
neutrophils
Neutropenia with (nonregenerative anemia, thrombocytopenia, neoplasm)
chronic marrow injury
L shifted neutropenia without anemia
acute inflammation
Non-Left-shifted neutropenia without anemia
acute viral infection or acute marrow injury
example of a loss of lymphocyte-rich fluid as an effusion
chylothorax
In horses, a stress leukogram will only have a _______
low end of normal lymphocyte count
What to do with a monocytopenia?
nothing, its normal
Parasites with ____________ cause eosinophilia
tissue migration phases
Mast cells can be seen in circulation with?
Parvovirus, skin/GI/Resp diseases
Marrow is totally dead when
pancytopenia
How does marrow normally respond to anemia and thrombocytopenia
Erythroid hyperplasia (reticulocytosis) and Megakaryocytic hyperplasia
pancytopenia doesn’t include
lymphocytes and monocytes
If you see Nucleated RBCs without polychromasia you should probably
check out the marrow
hyperproteinemia
MM, Lymphoid neoplasia, Leishmaniasis, histoplasmosis…. Do I have to know this??
hypercalcemia of malignancy…
lymphoid or metastatic neoplasms, or MM
What metastisizes to the marrow?
Lymphoma, Mast Cell tumor, carcinoma/sarcomas
typically use _____ for bone marrow aspirates in small animals
humerus
stains for iron
prussian blue
Its ok for the M:E ratio to be off when?
the marrow is responding
Why do we care if there’s iron in the marrow?
When sequestered in the marrow - anemia of inflammation
When low in marrow - Fe deficiency anemia
causes of reversible marrow injuries?
infection, drugs, chemo, immune-mediated
______ (from Endogenous Sertoli cell tumors or ferrets) , phenylbutazone, albendazole are all chemicals toxic to marrow stem cells
estrogen
FeLV
CHRONIC marrow injury (irreversible, MYELODYSPLASIA)
Causes of irreversible marrow injury?
myelophthisis, myelodysplasia (FeLV), Radiation, Benzene chemicals
occurs due to several types of marrow injuries? and predisposed if central IMHA
myelofibrosis
any agent directly toxic to marrow, hemolytic anemias, radiation, idiopathic
myelofibrosis
myelodyspasia may progress to?
myeloproliferative disease
How to identify dysplastic
maturation asynchrony
3 types of neoplastic proliferative lymphocytic diseases?
leukemia
lymphoma
MM
What kind of marrow injury does leukemia cause?
chronic
Leukemia arises from uncontrolled growth of cells that are either mature (______ Leukemia) or immature/blastic (______ Leukemia)
chronic; acute
_____ Leukemia may turn into _____.
Chronic -> Acute
Which (cell type) leukemia is more rapidly progressive and has a worse prognosis?
Myeloid
Which leukemia has the best prognosis? Which leukemia has the best prognosis?
chronic lymphoid
Which leukemia has the worst prognosis?
acute myeloid
Lymphoma and Multiple Myeloma are both
lymphoproliferative diseases of lymphoid origin
centripetal spread vs. centrifugal spread?
lymphoma vs. leukemia
hyperglobulinemia due to monoclonal gammopathy
multiple myeloma
Neoplasm of plasma cells that usually begins in the marrow
multiple myeloma
In MM, Plasma cells produce an excessive amount of _______, that can ___________ causing _____.
Bence Jones proteins (Ig light chains) that can leak into the urine causing proteinuria.
Must exhibit 2 of these to confirm Multiple Myeloma.
Plasma cells infiltrate in marrow, monoclonal gammopathy, bence jones proteinuria, osteolytic lesions
Crossmatching?
not necessary on FIRST canine-canine transfusion. Ideally done before all transfusions.
