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Clinical Haematology Flashcards

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1
Q

what are the erythrocyte (RBC) parameters shown on a haemogram?

A 
manual reticulocyte count
haemaglobin
haematocrit
number of RBC
mean cell volume 
mean cell heamoglobin
mean cell heamoglobin concentration
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2
Q

what value on a haemogram is most often wrong?

A

platelets

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3
Q

what are the main leukocyte (WBC) parameters on a haemogram?

A 
total WBC
neutrophils
lymphocytes
monocytes
eosinophils
basophils
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4
Q

what is the best tube to used for haematology?

A

EDTA blood tube

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5
Q

what does EDTA do to blood in the tube?

A

chelates (binds) calcium in the blood. This is required for clotting so EDTA prevents clotting.

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6
Q

when may heparin tubes be used?

A

in some exotic species as EDTA can cause lysis

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7
Q

what is essential when filling tubes for haematology?

A

respect the amount of blood required in the tube - only fill to the line

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8
Q

what must you do to haematology tubes to ensure good mixing of blood with anti-coagulate?

A

gently invert the tube 10-20 times and roll

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9
Q

how should blood smears be stored?

A

once dry - in slide containers

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10
Q

why should blood smears not be stored in the fridge?

A

condenses the cells and leads to water artefact

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11
Q

where should haematology samples be stored?

A

in the fridge until submission to the lab or running sample

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12
Q

why should haematology samples not be stored in the freezer?

A

causes cell rupture

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13
Q

how should haematology samples be packaged?

A

not right next to the ice pack as this may freeze them

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14
Q

what parameters evaluate RBC?

A

haematocrit
packed cell volume
RBC count

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15
Q

what parameters show average makeup of RBC/indexes?

A

mean corpuscular volume
mean corpuscular haemoglobin
mean corpuscular haemoglobin concentration

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16
Q

what test is used to assess RBC morphology?

A

peripheral blood smear exam

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17
Q

what parameters are directly measured by haematology analyser?

A

haemoglobin
red blood cell count
mean cell volume

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18
Q

what does the mean cell volume show?

A

average size of RBC

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19
Q

what can be calculated from parameters measured by haematology machine?

A

haematocrit
mean corpuscular haemoglobin
mean corpuscular haemoglobin concentration

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20
Q

how can haematocrit be calculated?

A

mean cell volume x red blood cell count

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21
Q

how can mean corpuscular haemoglobin be calculated?

A

Haemoglobin x 10/red blood cell count

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22
Q

how can mean corpuscular haemoglobin concentration be calculated?

A

Haemoglobin / haematocrit

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23
Q

what are the two types of haematology analysers?

A

flow cytometry

impedance

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24
Q

how do flow cytometry haematology analysers work?

A

individual cells pass through a laser beam absorbing and scattering light. Interruptions in light count cells and light scatter is used to determine size of cell and the internal complexity. Produces differential count

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25
Q

How is cell size measured by flow cytometry?

A

Interruptions in light count cells

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26
Q

how is cell size and complexity measured by haematology analyser?

A

light scatter

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27
Q

how do impedance haematology analysers work?

A

individual cells pass an isotonic solution between two electrodes. Cells are poor electrical conductors so when passed between electrodes they produce a change in electrical impedance that is proportional to the size of the cell

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28
Q

what form of haematology analyser is preferable?

A

flow cytometry can produce a differential count

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29
Q

what are the 9 common sample artefacts which interfere with automated CBCs?

A 
clots of any size
platelet clumps (may be read as a cell duce to lack of nucleus in mammalian RBC)
macroplatelets
RBC agglutination (RBC with nucleus)
nRBC
Heinz bodies
Lipaemia
leukocyte agglutination
delay in sample handling (increased haemolysis)
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30
Q

what is packed cell volume?

A

PCV: percentage of RBC in a volume of blood

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31
Q

How is PCV read?

A

after centrifugation, the percentage of RBC in column of the capillary tube

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32
Q

what else can be assessed during PCV test?

A

buffy coat assessment - number of WBC
Plasma colour
total proteins

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33
Q

what does the buffy coat on a PCV test show?

A

WBC and platelets, should be small

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34
Q

what does plasma colour indicate?

A

straw/clear = normal
bright yellow = icteric
pink = haemolysed
milky and turbid = lipaemia

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35
Q

why is a blood smear so important?

A

morphology changes are not picked up by any analysers
will show discrepancies/errors in any analyser (QA)
help with quick clinical decisions
PCV+Blood smear are a low cost option when no machines available

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36
Q

what are the minimum levels of patients that should have their blood smear reviewed?

A

all critically ill patients

CBCs with unusual or suspicious results

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37
Q

what would indicate the need for performing a blood smear?

A

presence of:
nucleated RBC (indicating reduced RBC or high need for RBC)
neutrophil left shift (immature neutrophils)
unclassified or unidentified cells
automated WBC count that may not be accurate

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38
Q

what background would trigger a blood smear review?

A

unusual background matrix
unusual background colour
organisms or suspected organisms

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39
Q

what RBC parameters would trigger at blood smear review?

A

moderate to marked poikilocytosis of any kind (abnormally shaped RBC)
moderate to sever anaemias
any Heinz bodies in non-feline species (>10% in cats)
inclusions (organisms or suspected organisms)
Howell-Jolly bodies
abnormal MCV

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40
Q

what is poikilocyotsis?

A

strange shaped cells

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41
Q

what WBC parameters would trigger blood smear review?

A 
left shift (marked or degenerative)
leukopenia
leukocytosis
lymphocytosis
unclassified cells
organisms (or suspected)
presence of granules in non-monocytes and abnormal granulation of any leukocyte
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42
Q

what is leukopenia?

A

decrease in number of WBC (<3,000 WBC)

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43
Q

what is leukocytosis?

A

Increase in total WBC count (>30,000 WBC)

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44
Q

what is lymphocytosis?

A

elevation of lymphocytes (>10,000 cells)

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45
Q

what platelet parameters would trigger blood smear review?

A

> 900,000 platelet count
thrombocytopenia
abnormal MPV
suspected inclusions or abnormal granulation

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46
Q

what is thrombocytopenia?

A

low platelets (<100,000 cells)

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47
Q

what are the 3 main parts of a blood smear?

A

base/head
monolayer
feathered edge

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48
Q

what are the measured areas of a blood smear?

A

monolayer and feathered edge

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49
Q

how do RBC appear in the monolayer of the blood smear?

A

side by side, not overlapping

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50
Q

how should you start looking at a blood smear?

A

small - low magnification and at the feathered edge of the smear

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51
Q

what is the systemic approach to a blood smear exam?

A

start small at low magnification from the feathered end
go 2-3 fields back to the body of the smear in the monolayer
increase to oil and evaluate morphology
finish at the side, count 100 leukocytes into types looking for abnormal forms as you go

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52
Q

what do you look at regarding RBC in a blood smear?

A

numbers (does it loo anaemic)
do RBC look normal
is there evidence of regeneration

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53
Q

what do you look at regarding WBC in a blood smear?

A

number
type present
morphology

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54
Q

what do you look at regarding platelets in a blood smear?

A

number (estimate)

morphology (size)

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55
Q

what is the function of RBC?

A

oxygen carrying to tissues

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56
Q

how do RBC appear in dogs?

A

central pallor taking 1/3 of cell

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57
Q

how do RBC appear in cats?

A

small
no central pallor
all cells same size/colour

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58
Q

what is the role of neutrophils?

A

defence against invading microorganisms especially bacteria

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59
Q

when do neutrophils increase?

A

in inflammation and infection. Stress due to adrenaline and corticosteroids

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60
Q

what do neutrophils look like under a microscope?

A

ribbon shaped, segmented nucleus

pale cytoplasm

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61
Q

what do eosinophils do?

A

defence against parasites

allergic response

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62
Q

what do basophils do?

A

defence against parasites

allergic response as contian histemine

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63
Q

what do basophils do?

A

defence against parasites

allergic response as contain histamine

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64
Q

what are granulocytes?

A

collective name for neutrophils, basophils and eosinophils

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65
Q

how do eosinophils and basophils differ under a microscope?

A

basophils are blue toned. Eosinophils have pink granules with purple nucleus

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66
Q

what are lymphocytes involved in?

A

immunity both adaptive/cell mediated (T cell-) and humoral (b cells - antibody production)

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67
Q

how do lymphocytes appear under a microscope?

A

round cells with a large round nucleus

very little cytoplasm

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68
Q

what are monocytes?

A

precursor of macrophages

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69
Q

what are monocytes involved in?

A

phagocytosis
antigen presentation to T cells
immunomodulation

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70
Q

how do monocytes appear under a microscope?

A

have vacuoles

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71
Q

how do platelets appear under a microscope?

A

small
no nucleus
some granulation

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72
Q

what are platelets involved with?

A

haemostasis
formation of platelet plug
accelerating coagulation
inhibition of antithrombin III

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73
Q

in haematology what does the suffix philia or cytosis mean?

A

increase in number

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74
Q

in haematology what does the suffix penia mean?

A

decrease in number

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75
Q

what is thrombocytopenia?

A

reduction in number of platelets

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76
Q

what type of cells is the suffix philia used for?

A

granulocytes only

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77
Q

what is cytosis used for?

A

all other cells (apart from granulocytes)

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78
Q

in what species is the neutrophil the dominant cell type?

A

healthy cats, dogs, horses and camilids

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79
Q

in what species is lymphocyte the dominant cell type?

A

healthy cattle and rodents

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80
Q

what is WBC morphology like in rabbits and birds?

A

neutrophils are known as heterophils - have shiny pink granules like an eosinophil

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81
Q

in what species is the azurophil found?

A

reptiles and amphibions (monocyte with pinky/blue staining)

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82
Q

how do RBC appear in birds, reptiles, amphibians and fish?

A

nucleated
thrombocyte (platelet) is also nucleated - may look like a lymphocyte
counting is not performed by analysers due to presence of nucleus (cannot differentiate between RBC, thrombocyte or WBC)

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83
Q

what is used instead of a change in leukogram in horses, cattle and sheep?

A

haematology and measurement of serum acute phase proteins to detect inflammation

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84
Q

what can be diagnosed through blood smear?

A 
thrombocytopenia
regenerative vs non-regenerative anemia
rouleux vs agglutination 
check machine WBC differentials/ manual differential WBC count
normal and abnormal morphology
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85
Q

what can happen during automated counts of platelets in whole blood in EDTA?

A

done by analysers
commonly leads to artefactual (false) thrombocytopenia due to platelet clumping and macroplatelets
overlap in size between RBC and platelets often leads to false automated counts

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86
Q

under what circumstances should platelet numbers from blood in EDTA be checked by blood smear?

A

any animal with low automated counts

every animal with clinical signs of haemorrhage

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87
Q

what do platelet estimates on blood smears assume?

A

no platelet clumps on feather edge

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88
Q

how is platelet estimate carried out on blood smears?

A 
10 fields - oil immersion in monolayer
count number of platelets
do average
multiply by 15 or 20 (depending on practice)
estimated number x10^9/L
89
Q

what can macroplatelets lead to?

A

false thrombocytopenia

regeneration / increased platelet production

90
Q

in what breed are macroplatelets normally seen?

A

Caviler King Charles

91
Q

how will non-regenerative and regenerative anemia present under a microscope?

A

non - regenerative: bone marrow producing no new RBC so they appear normal
regenerative - many different RBC shapes

92
Q

what do agglutination vs rouleux show?

A

cell interaction with each other

93
Q

how does agglutination appear under a microscope?

A

bunch of grapes
large 3D clusters
interference with machine

94
Q

how does rouleux appear under a microscope?

A

stack of coins

no interference with machine

95
Q

where is the leukogram taken from?

A

edge of smear within monolayer

96
Q

what does a leukogram count?

A

number of WBC and the types present (in 100 cells)

97
Q

what does anaemia reflect?

A

reduced oxygen carrying capacity

98
Q

what is reduced red blood cell mass noted by?

A

reduced RBC
reduced haemoglobin concentration
reduced PCV and haematocrit

99
Q

what intra-individual variables can affect RBC mass?

A

breeds bred for athleticism (greyhounds/thoroughbreds)

age - young animals have reduced RBC mass until 4-6 months of age

100
Q

what are the clinical signs of anaemia?

A 
mucous membrane pallor (pale)
lethargy
exercise intollerence
tachycardia
tachypnoea
heart murmur
collapse
icterus
melaena/haematuria/haemoglobinuria
pica
101
Q

what are the 3 areas anaemia is classified by?

A

RBC indexes
regenerative vs non-regenerative
severity of anaemia

102
Q

what are the 3 main RBC indexes for anaemia?

A

macrocytic
normocytic
microcytic

103
Q

what do macrocytic and microcytic RBC indexes mean?

A

macrocytic - large RBC

microcytic - small RBC

104
Q

what is the difference between regenerative and non-regenerative anaemia measured by?

A

reticulocyte counts

105
Q

what is severity of anaemia based on?

A

how low haematocrit is

106
Q

do cats or dogs compensate for anaemia better?

A

cats

107
Q

what are the tests used for investigation of anaemia?

A 
PCV/HCT and haemoglobin concentration
RBC indexes: MCV, MCHC/MCH
reticulocyte count
blood smear for morphology
auxiliary tests are available
108
Q

what are normocytic erythrocytes?

A

erythrocytes of normal size

109
Q

what are microcytic (low MCV) erythrocytes?

A

smaller RBC

110
Q

what can microcytic (low MCV) erythrocytes be caused by?

A

iron deficiency allows an extra cell division which is usually prevented by normal haemoglobin concentration.

111
Q

what are macrocytic (high MCV)artic RBC?

A

larger than normal RBC

112
Q

what causes macrocytic RBC?

A

immature RBC

113
Q

what dog breeds show naturally higher RBC?

A

poodles

114
Q

what can cause artificial macrocytic RBC?

A

artefact in stored/old blood samples

115
Q

what is hypochromic/ low MCHC/MCH?

A

presence of immature RBC (not fully haemaglobinised)

116
Q

what is hyperchromic/high MCHC/MCH?

A

not physically possible (cannot fill RBC with extra haemaglobin) down to artefact

117
Q

what would macrocytic and hypochromic results suggest?

A

regenerative anaemia: haemorrhage or haemolysis

118
Q

what would normocytic and normochromic results suggest?

A

normal. Non- regenerative anaemia or following acute blood loss before regeneration (pre-regenerative)

119
Q

what would microcytic and hypochromic results suggest?

A

iron deficiency anaemia due to chronic external blood, or secondary to liver disease, portosystemic shunt

120
Q

what are the 2 key types of anaemia?

A

regenerative and non regenerative

121
Q

what can non-regenerative anaemia be divided into?

A

bone marrow related

systemic disease

122
Q

what are the two divisions of regenerative anaemia?

A

haemorrhage

haemolysis

123
Q

what are the 2 types of haemorrhage that may cause anaemia?

A

internal and external

124
Q

what are the two types of haemolysis?

A

intravascular

extravascular

125
Q

what is regeneration the bodies response to?

A

fall in oxygenation - kidneys release EPO

126
Q

what is regeneration determined by in dogs and cats?

A

reticulocyte concentration

127
Q

what length of time is required before there is significant blood reticulocytosis?

A

about 3-5 days

128
Q

how may the regenerative response be seen in anaemia?

A

presence of polychromatophils (immature RBC - has lost nucleus)

129
Q

what are reticulocytes?

A

precursors of RBC

130
Q

how can reticulocytes be counted?

A

manually or by some of the newer haematology analysers

131
Q

what are the 2 types of reticulocytes in cats?

A

aggregates

punctate

132
Q

what are aggregate reticulocytes?

A

immature reticulocytes, appear like canine reticulocytes

133
Q

where are aggregate reticulocytes formed?

A

in the bone marrow in response to anaemia

134
Q

how do aggregate reticulocytes become punctate?

A

mature after 12-24 hours in circulation

135
Q

what are punctate reticulocytes?

A

have only small amount of reticulum (mRNA) and have undergone a degree of maturation

136
Q

how long can punctate reticulocytes remain in the blood stream?

A

up to 4 weeks after the anaemia has resolved

137
Q

describe the stages of a manual reticulocyte count

A

mix an equal amount of blood and vital stain
incubate at room temperature
do a normal blood smear with the mixture
evaluate 500-1000 stained RBC to determine % of reticulocytes
use % reticulocytes and RBC to determine absolute value

138
Q

what are the two types of stain used for manual reticulocyte counts?

A

new methylene blue

brilliant cresyl violet

139
Q

how long should blood and stain be incubated for during a manual reticulocyte count?

A

new methylene blue - 10 mins

brilliant cresyl violet - 15 mins

140
Q

what are RBC evaluated for on a blood smear for anaemia?

A

RBC density
RBC regeneration
RBC morphology (clues as to causes of anaemia)

141
Q

what are 4 of the most common morphological changes seen in RBC?

A

anisocytosis
polychromasia
hypochromasia
spherocytes/ghost cells

142
Q

what is anisocytosis?

A

different cell sizes

143
Q

what3 questions must be asked when presented with anisocytosis?

A

is there macrocytosis (large RBC)
is there microcytosis (small RBC)
is there poly chromasia?

144
Q

the presence of what red blood cell morphology in anaemic patients suggests RBC regeneration?

A

anisocytosis and polychromasia

145
Q

what does polychromasia indicate?

A

regeneration

146
Q

what are polychromatophils?

A

younger RBC - reticulocytes

147
Q

what do polychromatophils look like?

A

more purple in colour - have lost nucleus

148
Q

what is hypochromasia?

A

not enough haemoglobin

149
Q

what do hypochromatic RBC look like?

A

larger pallor in the middle of the RBC (>1/3 of cell)

150
Q

when is hypochromasia seen?

A

alongside microcytosis (reduced cell size) in iron deficiency anaemia

151
Q

in what disease are spherocytes and ghost cells seen?

A

IMHA

152
Q

what do spherocytes look like?

A

round, smaller and darker than RBC and have no central pallor

153
Q

what are ghost cells formed of?

A

only outer RBC membrane with no internal structures

154
Q

when are spherocytes often seen in low numbers?

A

concurrently with evidence of shear damage injury

155
Q

what is polycythaemia?

A

increased red cell mass

156
Q

what indicates polycythaemia?

A 
increased:
haemoglobin
packed cell volume (PCV)
haematocrit (HCT)
red blood cell count (RBC)
157
Q

what are the 2 types of polycythaemia?

A

relative

absolute

158
Q

what is relative polycythaemia due to?

A

loss of plasma volume/dehydration

159
Q

what is relative polycythaemia known as?

A

erythrocytosis

160
Q

what is absolute polycythaemia due to?

A

red cell mass is increased

161
Q

what is absolute polycythaemia known as?

A

true polycythaemia

162
Q

what are the clinical signs of polycythaemia?

A

elevated PCV (70-85%)
hyperaemic mucous membranes (dark red or blueish)
sneezing
nosebleeds
neurological signs (hyper viscosity) - seizure, blindness, ataxia, behavioral changes

163
Q

what must be checked first in polycythaemia?

A

whether it is persistent or the patient is dehydrated

164
Q

what are the 6 steps to rule out secondary causes of polycythaemia?

A

haematology, biochemistry and urinalysis
check reticulocyte count
assess for signs of cyanosis
check blood gas (hypoxia)
abdominal ultrasound to identify neoplasia or renal disease
thoracic rads to detect respiratory or cardiac abnormalities

165
Q

what is increased EPO (erythropoetin) level diagnostic for?

A

secondary polycythaemia (can be 50x normal)

166
Q

what is thrombocytopenia?

A

low platelet numbers

167
Q

when does spontaneous haemorrhage occur?

A

very low platelet counts (<50x10 to the 9/L)

168
Q

what are the clinical signs of thrombocytopenia?

A 
petechiae - tiny haemorrhages
ecchymosis - bruising
melaena
epistaxis
haematuria
169
Q

how can you check for true thrombocytopenia?

A

check the blood smear for estimate of platelets
check for clinical signs (could be due to poor collection/artefact)
repeat haematology to check for persistence if no clinical signs

170
Q

what are additional tests for thrombocytopenia?

A

other haemostasis tests
testing for infectious diseases
bone marrow analysis

171
Q

what are the common leukogram changes associated with normal or increased WBC?

A 
stress leukogram
inflammatory leukogram
adrenaline (white coat) leukogram
inverted "stress" leukogram 
neoplasia
172
Q

what is a stress leukogram due to?

A

chronic disease

exogenous steroids

173
Q

what do you need to know when looking at inflammatory leukogram changes?

A

which leukocytes are increased

174
Q

what is an inverted “stress” leukogram caused by?

A

Addisons disease

175
Q

what neoplasia can be indicated by a leukogram?

A

leukaemias
stage V lymphoma
mast cell disease

176
Q

describe the leukogram pattern of physiological (white coat) leukogram

A

increased: total WBC count, segmented neutrophils, lymphocytes
variable: monocytes

177
Q

describe the leukogram pattern of a steroid/stress leukogram

A

increased: total WBC count, non-segmented neutrophils (mild), segmented neutrophils, monocytes
decreased: lymphocytes, eosinophils
(roller coaster)

178
Q

describe the leukogram pattern of an acute inflammatory leukogram

A

increased: total WBC count, non-segmented neutrophils (mild), segmented neutrophils, monocytes
reduced: lymphocytes
variable: eosinophils

179
Q

describe the leukogram pattern of a chronic inflammatory leukogram

A

increased: total WBC count, segmented neutrophils,
variable: non-segmented neutrophils, lymphocytes, monocytes

180
Q

describe the leukogram pattern of a leukaemia leukogram

A

hugely increased total WBC count - cell types vary

181
Q

where should WBC differential counts be taken from?

A

edge of monolayer

182
Q

what is leukopenia?

A

no leukocytes

183
Q

what is calculated during WBC differential counts?

A

percentage of different leukocyte types

184
Q

what is neutrophilia?

A

increased neutrophils

185
Q

when does neutrophilia occur?

A

inflammation/infection
part of stress leukogram
physiological leukogram
independent of demand due to neoplasia

186
Q

why does neutrophilia increase with inflammation/infection?

A

due to cytokine release (can be seen with or without left shift or toxic change)

187
Q

why does neutrophilia increase with physiological leukogram?

A

due to adrenaline release

188
Q

what will neutrophilia be seen alongside in a physiological leukogram?

A

mild lymphocytosis

189
Q

why does neutrophilia increase with stress leukogram?

A

due to endogenous or exogenous steroids

190
Q

what will neutrophilia be seen alongside in a stress leukogram?

A

lymphopenia
monocytosis
eosinopenia

191
Q

what neoplasia causes neutrophillia?

A

paraneoplastic (outside of BM)

neoplasia of BM

192
Q

what are signs of increased demand on neutrophils?

A

band neutrophil - U or S shaped nucleus with parallel sides (minimal indentation or segmentation)
signs of toxicity - Dohle bodies, foamy cytoplasm, blueish cytoplasm, toxic granules

193
Q

what is neutrophil left shift?

A

release of earlier granulocyte precursors from BM

194
Q

what does neutrophil left shift indicate?

A

indication of increased neutrophil demand/consumption

inflammation/infection

195
Q

what are neutrophil toxic changes?

A

in response to overwhelming demand immature neutrophils are seen. Organelles that are normally removed from the neutrophil in the BM, persist when the neutrophil is in circulation

196
Q

what are toxic changes often seen with?

A

alongside left shift

197
Q

what is seen during toxic changes?

A 
cytoplasmic basophillia
Doehle bodies
cytoplasmic vacuolation
persistent primary granules (toxic granulation)
ring form nuclei
giant forms
198
Q

when may neutropenia be seen in normal animals?

A 
breed variations (greyhounds)
cats sit on low end of reference interval
199
Q

what may lead to neutropenia?

A

secondary to decreased production with marrow disease/suppression
increased utilisation through marked inflammation or immune mediated destruction

200
Q

what does complete marrow destruction or suppression cause the destruction of first?

A

neutrophils

201
Q

what can marked neutropenia indicate?

A

predisposition to infection and sepsis

202
Q

what is lymphocytosis?

A

increased lymphocyte count

203
Q

is lymphocytosis “true” in young animals?

A

no as they are constantly immune stimulated

204
Q

what can lead to lymphocytosis?

A

adrenaline release
mobilisation of cells (hypoadrenocorticism)
increased numbers to increased demand (immune stimulaton)
increased numbers independent of demand (lymphoproliferative disease)

205
Q

how does normal lymphocytes appear?

A

around 2 RBC in size, little cytoplasm

206
Q

how does a reactive lymphocyte appear?

A

lots of cytoplasm

207
Q

how does a lymphoblast appear?

A

larger than 3 RBC

208
Q

what is lymphopenia?

A

loss of lymphocytes

209
Q

what can lymphopenia be caused by?

A

loss of chylous fluid
decreased production - viral infections, lympholytic drugs (chemo), immunodeficiency
redistribution - chronic stress, trapped in lymph nodes, lymphocytolysis, move from circulation into bone marrow and tissues

210
Q

what is monocytosis (increased monocytes) caused by?

A

increased demand for macrophages - chronic inflammation, transient monocytosis
redistribution (part of stress leukogram) - increased glucocorticoid levels
increased production independent of demand - leukaemia

211
Q

what is eosinophilia caused by?

A

increased demand - usually parasitism, can be allergy or inflammation of mast cell rich tissues
paraneoplastic
hypoadrenocorticism
eosinophilic leukaemia

212
Q

is eosinopenia of clinical significance?

A

no

213
Q

what leukogram findings indicate poor prognosis?

A 
degenerative left shift
leukopenia
leukemoid reation
toxic neutrophils
severe or persistent lymphopenia
214
Q

what is the reason for poor prognosis in degenerative left shift?

A

overwhelming tissue demands (exceeds BM production)

215
Q

what is the reason for poor prognosis in leukopenia?

A

overwhelming tissue demands (exceeds BM production) or BM disease

216
Q

what is the reason for poor prognosis in leukemoid reation?

A

excessive neutrophils due to marked inflammatory stimulus

217
Q

what is the reason for poor prognosis in toxic neutrophils?

A

due to accelerated production. Associated with longer hospitalization, higher costs of treatment and increased morbility

218
Q

what is the reason for poor prognosis in severe or persisttant lymphopenia?

A

indicates severe and persistent stress

X Pre Clinical Science (17 decks)

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