Bone Marrow and The Leukon

Question 1

What are the ways of classifying acute myeloid leukaemias?

Answer 1

M0 = undifferentiated
M1/M2 = acute myeloblastic (+/- maturation)
M3 = acute promyelocytic
M4 = acute myelomonocytic
M5 = acute monoblastic/ monocytic
M6 = Erythemic myelosis or erythroleukaemia
M7 = acute megakaryoblastic/-cytic

Question 2

What classification/type of acute myeloid leukemia is most common?

Answer 2

M4 - acute myelomonocytic leukemia

Question 3

What are the rarest acute myeloid leukemias?

Answer 3

M5 (acute monoblastic/monocytic)
M7 (acute megakaryoblastic/-cytic)

Question 4

M6, aka erythemic myelosis or erythroleukemia, occurs in what species?

Answer 4

Cats and humans only

Question 5

What cell is this?

Answer 5

Megakaryoblast

Question 6

What type of cell is this?

Answer 6

Megakaryocyte

Question 7

What might major shifts in the M:e ratio indicate?

Answer 7

absolute or relative changes in proportion of myeloid & erythroid cells

Question 8

What is the m:e ratio for -blasts?

Answer 8

1:1

Question 9

What is the m:e ratio for pro-?

Answer 9

2:2

Question 10

What is the m:e ratio for -cytes?

Answer 10

5:27

Question 11

What is the m:e ratio for meta-?

Answer 11

7:13

Question 12

What is the maturation index?

Answer 12

proportions of proliferating vs non-proliferating cells estimated or counted for calculation

Question 13

What are the 3 types of maturation indices?

Answer 13

• erythroid maturation index
• myeloid maturation index
• overall maturation index

Question 14

Maturation indices are useful for…

Answer 14

semi-quantifying left or right shifts in maturation

Question 15

Late asynchrony in the erythroid cell lines occurs in what two conditions? What would it show on a graph?

Answer 15

lead poisoning
IDA
Shows right shift in maturation

Question 16

What is the production time for RBC & platelets?

Answer 16

4 days

Question 17

What is the production time neutrophils?

Answer 17

5.5 days

Question 18

erythroid precursors of the horse have heavy…

Answer 18

nuclear condensation

Question 19

What is unique about the bone marrow of horses in regards to reticulocytes?

Answer 19

it does not release many reticulocytes

Question 20

If the bone marrow in a horse has >5% reticulocytes, this means the horse has…

Answer 20

responsive anemia

Question 21

in the dog, the marrow granulocyte reserve in the bone marrow is approximately what percentage?

Answer 21

20%

Question 22

Myelocytes can undergo how many divisions? How many can myeloblasts and promyelocytes undergo?

Answer 22

Myelocytes: 3-4 divisions
Myeloblasts & promyelocytes: 1 division

Question 23

These cells are commonly present in what AML?

Answer 23

M1

Question 24

What changes may occur with chloramphenicol toxicity?

Answer 24

BM hypocellular
Leukopenia w/i 2-3 weeks
Increased m:e w/ giant metas & vacuolated neut precursors suggesting defective maturation

Question 25

What are the most serious side effects of estrogen therapy?

Answer 25

BM suppression & toxicity progressing to fatal aplastic anemia

Question 26

What animals are especially sensitive to estrogen toxicity?

Answer 26

dogs, cats, ferrets

Question 27

What would you see within 1 week of an estrogen toxicity?

Answer 27

neutrophilic leukocytosis Thrombocytopenia

Question 28

What would you see within 3 weeks of estrogen toxicity?

Answer 28

BM depression w/ non-responsive anemia, thrombocytopenia, leukopenia

Question 29

What drugs can cause myelotoxicities?

Answer 29

Question 30

Aside from drugs, what are some things that can cause myelotoxicities?

Answer 30

Bracken fern Lead Benzene, trichloroethylene Irradiation

Question 31

What is this?

Answer 31

Erythroleukemia

Question 32

What condition might be present here? How do you know?

Answer 32

Anemia w/ chronic inflammation Increased m:e, granulocytic hyperplasia, erythroid hypoplasia which increased plasma cells and Fe

Question 33

Does lymphocyte production mainly occur in the bone marrow?

Answer 33

No, but it is possible to occur in the bone marrow

Question 34

What percentage of lymphocytes is present in cats normally? In dogs?

Answer 34

cats:16% Dogs: 1-2%

Question 35

What is the normal occurrence of plasma cells in cats? dogs?

Answer 35

cats: 1% dogs: 5%

Question 36

Plasma cells have what characteristics that allow them to be differentiated from lymphocytes?

Answer 36

- larger - lower N/C - Greater cytoplasmic basophilia

Question 37

What are Russell bodies?

Answer 37

Plasma cells w/ a dilated ER w/ immunoglobulin

Question 38

What are Mott cells?

Answer 38

Plasma cells filled w/ Russell bodies

Question 39

Flame cells are...

Answer 39

plasma cells w/ reddish staining, especially at the periphery

Question 40

What condition is shown here?

Answer 40

Multiple Myeloma

Question 41

What neoplasia is this?

Answer 41

Lymphoma

Question 42

Increased numbers of macrophages may indicate...

Answer 42

BM inflammation, necrosis, or increased phagocytic activity

Question 43

Bone marrow is an important site for ____ storage for use in...

Answer 43

Fe; Hemoglobin synthesis

Question 44

Storage Fe is usually visible in ___, but not in ___

Answer 44

dogs; cats

Question 45

What stain can be used to eval the quantity of storage Fe?

Answer 45

Prussian Blue

Question 46

What condition is present here?

Answer 46

Hemophagocytic Histiocytic Sarcoma seen in bone marrow

Question 47

What is this an image of?

Answer 47

Leishmania donovani - Leishmaniasis

Question 48

How does chronic systemic Leishmaniasis appear in a dog?

Answer 48

anorexia, weight loss Somnolence & decreased endurance Locomotion disturbance Polydipsia Lymphadenomegaly Symmetric alopecia Thin haircoat excessive scaling

Question 49

What are some clinical pathological findings that may be present in Leishmaniasis?

Answer 49

- Hyperglobulinemia producing hyperproteinemia despite hypoalbuminemia & proteinuria - Weak + Coomb's test - High ALP & ALT - Thrombocytopenia

Question 50

Leishmaniasis is...

Answer 50

zoonotic