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3. Sys Path > CO1 Hemolymphatic > Flashcards

CO1 Hemolymphatic Flashcards

1
Q

Hemolymphatic System: What is it?

A
  1. Hematopoietic cells
  2. Where they are derived & where they develop
  3. Routes they travel & sites they work
  • Myeloid tissues = bone marrow & the circulating cells derived there (RBCs, neutrophils, eosinophils, basophils, mast cells, platelets)
  • Lymphoid tissues = lymph nodes, spleen, thymus, circulating lymphocytes, Bursa of Fabricius
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2
Q

hematopoietic cell lines

A

pluripotent stem cell becomes:
1. myeloid stem cell
> macrophage
> neutrophil
> eosinophil
> basophil
> mast cell
> platelets
> erythrocyte
2. lymphoid stem cell
- T lymphocyte
- B lymphocyte
> plasma cell

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3
Q

primary lymphoid organs

A
  • Bone Marrow
  • Thymus
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4
Q

secondary lymphoid organs

A
  • Lymph nodes
  • Tonsils
  • Spleen
  • Mucosa-associated lymphoid tissue (MALT)
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5
Q

bone marrow function

A

= Major hematopoietic organ in adults
= Major site for B-cell development throughout life

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6
Q

Where does hematopoiesis occur?

A

Yolk-sac
– Embryo: shifts to liver & spleen in fetus

Liver & Spleen
– Fetus: shifts to bone marrow prior to birth
– Mature: Extramedullary hematopoiesis (EMH)

Bone Marrow
– Young: all marrow spaces
– Mature: marrow spaces of the axial bones, proximal humerus and femur

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7
Q

reasons for bone marrow hyperplasia

A

Increased demand

– Loss of RBCs/platelets
> Hemorrhage, Hemolytic anemia etc.

– Inflammatory stimulus
> Liver abscess, Pneumonia etc.

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8
Q

when do we see myelopthisis

A

(bone marrow replacement)
– Myelofibrosis, Chronic Leukemia etc.

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9
Q

when do we see serous atrophy of fat in bone marrow

A

– Cachexia, Starvation
* Fat is metabolized, bone marrow reticular cells produce a mucoid substance

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10
Q

gross pathology of bone neoplasia vs osteomyelitis? what about bone marrow activiation?

A

osteomyelitis - craters with pus
<><>
neoplasia / osteosarcoma - lack of support / weakness, new bone added to outside
> activated endosteal bone marrow to clean necrosis

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11
Q

what is the structure and function of the thymus?

A
  • Differentiation, selection, & maturation of T-cells
    – T-cell receptor (TCR) rearrangement
    – Positive selection (MHC binding)
    – Negative selection (self-reactive)
    <><>
  • 3 Zones:
    1. Subcapsular: T-cells from bone marrow enter thymus
    2. Cortex: positive/negative selection + TCR rearrangement
    3. Medulla: negative selection
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12
Q
  • What % of T-cells exit the Thymus?
A

2%

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13
Q

Two main cell types of the thymus:

A
  1. Lymphocytes
  2. Epithelial cells (Hassall’s corpuscles)
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14
Q

thymus location and appearance

A
  • intrathoracic mediastinum, cranial to the heart and ventral to the trachea
  • pink, lobulated
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15
Q

What is the term used to describe the normal physiologic change in the thymus with age?

A

thymic involution (replacement of thymus with adipocytes)
- begins after puberty / sexual maturity

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16
Q

reasons for a smaller thymus

A
  • Involution (physiological NOT pathological)
  • Inadequate Nutrition
  • Stress (glucocorticoids)
  • Infectious Agents (viruses)
  • Intoxicants (lead, mercury)
  • Medical Tx (radiation, chemotherapy)
  • Aplasia (SCID)
17
Q

reasons for a large thymus (diffuse and focal)

A

Diffuse:
- variation (physiological NOT pathological)
- Hyperplasia (repeated immunization)

Focal/Localized:
- Cysts (persist during involution or acquired)
- Neoplasia (thymoma*) > associated with paraneoplastic syndromes

18
Q

Thymic Hemorrhage
* Important features of signalment/history? (3)

A
  • age
  • access, eg. to anticoagulants
  • automobile??
19
Q

Ddx for thymic hemorrhage

A

I. Idiopathic hemorrhage
II. Anticoagulant toxicity (rodenticide)
III. Traumatic hemorrhage

20
Q

ante and post mortem diagnostic tests for thymic hemorrhage

A
  1. Antemortem (CBC, clotting times)
  2. Postmortem (stomach content…freeze it)
21
Q

Signalment: canine, 11 mos, CM
Spontaneous Idiopathic Thymic Hemorrhage
– Proposed pathogenesis:
– This is a diagnosis of:

A
  • Thymic involution → thin walled vessels no longer have structural support from adjacent parenchyma → (minor trauma?, sudden increase in BP?) → hemorrhage
    – This is a diagnosis of: exclusion
22
Q

prepubescent dog with thymic hemorrhage - histologic findings?

A

– absence of evidence of thymic involution (pre-onset of sexual maturation)
– extensive hemorrhage

23
Q

pathogenesis of rodenticide toxicity causing thymic hemorrhage

A
  • Ingestion of anticoagulant rodenticide → vitamin K deficiency → clotting factors consumed without replacement → hemorrhage
24
Q

Spontaneous Idiopathic Thymic Hemorrhage
- Rule outs? how? requires what?

A

R/O: Trauma, anticoagulant rodenticide
– History
– Physical examination
– Clotting times
– Examination of ingesta
– Toxicological screening for anticoagulant rodenticides
<><>
* Required: Currently undergoing thymic involution
– Signalment: begins at 6-12 mos depending on the breed

25
Q

thymic neoplasia
- is it common
- diffuse or localized? types?
- paraneoplastic syndromes?

A
  • Uncommon
  • Thymoma (& thymic carcinoma) = localized
  • lymphoma = diffuse
    <><>
    dogs: myasthenia gravis
    cats: exfoliative dermatitis
26
Q

Myasthenia Gravis 2° to Thymoma
- pathogenesis

A

– Thymoma → develop autoantibodies against thymic myoid cells (which have acetylcholine receptors=AChR) → antibodies in systemic circulation → bind to AChRs on postsynaptic membrane at the neuromuscular junctions → preventing ACh binding ∴ preventing muscle contraction → muscle weakness
<><>
> look at eyes, esophagus - first places to seeit

27
Q

cell types in the stroma of the spleen

A

1) Endothelium
2) Smooth muscle cells
3) Fibroblasts

28
Q

cell types in the white pulp of the spleen? function?

A

Cell types:
1) Lymphocytes
2) Histiocytes (Dendritic Cells)

Function:
1) Adaptive immune function

29
Q

cell types in the red pulp of the spleen? function?

A

Cell types:
1) Erythrocytes
2) Histiocytes (Macrophages)

Function:
1) Innate immune function
2) Storage
3) EMH

30
Q

what can cause bloody nodules in the spleen?

A
  • neoplasia
  • hematoma
  • nodular hyperplasia
  • infarct
31
Q

what causes not-bloody nodules in the spleen?

A
  • Neoplasia
  • Abscess/Granuloma
  • Nodular Hyperplasia
  • Infarct
  • Siderotic Plaques
32
Q

what could cause extra / multiple normal spleens?

A
  • Ectopic
  • Fracture
  • Splenosis
33
Q

what could cause a congested spleen?

A
  • Acute Septicemia
  • Barbiturates
  • Volvulus/Torsion
  • Infectious Disease
  • Acute IMHA
34
Q

what could cause a meaty spleen?

A
  • Neoplasia
  • Phagocytosis
  • Storage Material
  • Bacteremia/Abscess
  • Granuloma, EMH
35
Q

what colour is nodular hyperplasia?

A

red, white, or both

3. Sys Path (28 decks)

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