Bone Marrow

Question 1

Hypoplasia

Answer 1

Decreased cell formation

Question 2

Hyperplasia

Answer 2

Increased cell formation

Question 3

Aplasia

Answer 3

Lack of cell formation

Question 4

Dysplasia

Answer 4

Abnormal cell formation

Question 5

Dysmyelopoiesis

Answer 5

abnormal haematopoiesis resulting in cytopenias and dysplastic cells

Question 6

Dyserythropoiesis

Answer 6

Abnormal erythrocyte production -> cytopenias and dysplastic cells

Question 7

Dysgranulopoiesis

Answer 7

abnormal granulocyte production -> cytopenias and dyplastic cells

Question 8

Myelofibrosis

Answer 8

fibrosis of marrow

Question 9

Myelophthisis

Answer 9

displacement of haematopoietic tissue by other tissue (fibrosis, inflammation, tumour)

Question 10

Pancytopenia

Answer 10

concurrent anaemia, thrombocytopenia and leukopenia

Question 11

Myelodysplasia

Answer 11

abnormal haematopoiesis

Question 12

Mtylodysplastic syndrome (MDS)

Answer 12

neoplastic disorder resulting in clonal dysplastic cells

Question 13

Aplastic anaemia

Answer 13

lack of formation of all cell lines causing pancytopenia

Question 14

Pure red cell aplasia

Answer 14

lack of formation of erythroid cell only

Question 15

What clinical situation is a bone marrow aspirate indicated in

Answer 15

when haematologic abnormalities are not readily explained by a good history, physical examination and thorough evaluation of clinical pathology data has taken place.

Question 16

What are indications for bone marrow collection?

Answer 16

Persistent cytopenias
Persistent cytosis
Atypical or immature cells on blood smears
Unexplained Hyperproteinaemia
Hypercalcaemia of unexplained aetiology
Staging malignant neoplasia
Evaluation of iron stores and determination of iron sequestration

Question 17

Features of acute myeloid leukaemia

Answer 17

• Excess blasts +/- differentiated cells
• can be myeloid, erythroid or megakaryocytic origin
• hypercellular marrow with excess blasts
• Aggressive disease with poor prognosis

Question 18

Features of chronic myeloid leukaemia

Answer 18

• Excess production of mature cells
• Any cell line
• Hypercellular marrow with low numbers of blasts and ofter marked leukocytosis
• May show dysplasia

Question 19

Primary Myelodysplasia

Answer 19

neoplastic disorder -> abnormal cell production -> poor pronosis

Question 20

Secondary myelodysplasia

Answer 20

secondary to drugs, viruses or toxins -> variable prognosis

Question 21

Causes of myelofibrosis

Answer 21

primary (neoplastic) or secondary (IMHA, drugs, marrow injury)

Question 22

Causes of myelophthisis

Answer 22

metastatic neoplasia, inflammatory cells

Question 23

Causes of myelonecrosis

Answer 23

Serous atrophy with starvation, toxins

Question 24

Causes of persistent cytopenias

Answer 24

Infectious (parvovirus, FeLV, FIV)
Toxins (Bracken, chemotherapy)
Immune mediated disease
Endocrine disease (hypoT, hyperA)
Neoplasia

Question 25

Evidence of dysplasia

Answer 25

- inappropriate release of immature cells | - abnormal morphology

Question 26

Causes of marked hyperglobulinaemia

Answer 26

- Inflammation | - Lymphoid neoplasia

Question 27

Differentials for hypercalcaemia

Answer 27

- H yperparathydroidism - A ddisons (dogs) - R enal failure (horses) - D vitamin D toxicosis - I diopathic (cats) - O steolysis - N eoplasia - S purious

Question 28

Marrow diseases that cause hypercalcaemia

Answer 28

- Lymphoma (usually T cell) - Multiple Myeloma (plasma cell tumour) - Oseolysis - osteomyelitis - osteosarcoma - Metastatic neoplasia

Question 29

Bone marrow collection sites

Answer 29

Pelvis - iliac crest; med/large dogs Proximal femur - trochanteric fossa; cats and small dogs Proximal humerus - obese animals Sternum - horses

Question 30

When not to do bone marrow biopsy

Answer 30

``` Coagulopathy -Warfarin toxicity -DIC -Hepatic disease Caustion if marked thrombocytopenia ```