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Year 1/2 > Defense & Barriers 2: Hematolymphoid Pathology > Flashcards

Defense & Barriers 2: Hematolymphoid Pathology Flashcards

1
Q

what 5 cells are included in LYMPHOID lineage?

& SHOW PROGRESSION

A
  1. MULTIPOTENT STEM CELL
  2. COMMON LYMPHOID PROGENITOR
  3. NATURAL KILLER CELL or SMALL LYMPHOCYTE
  4. from SMALL LYMPHOCYTE –> T or B LYMPHOCYTE
  5. from B LYMPHOCYTE –> PLASMA CELL
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2
Q

a MYELOBLAST produces what 4 main cells?

A
  1. Basophil
  2. Neutrophil
  3. Eosinophil
  4. Monocyte
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3
Q

a MONOCYTE makes what 2 kinds of cells?

A
  1. DENDRITIC cels
  2. MACROPHAGE
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4
Q

MAJORITY of cells in the bone marrow are of the ______ lineage

A

MYELOID

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5
Q

GRANULOPOIESIS is stimulated by ____

ERYTHROPOIESIS is stimulated by ____

A

INFLAMMATION

HYPOXIA

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6
Q

megakaryopoiesis…
how are MORE platelets stimulated to be made?
what hormone regulates this process/what organ is it made by?

A

how are MORE platelets stimulated to be made?
= PLATELETS are CELL FRAGMENTS that HOLD ONTO THROMBOPOIETIN, and if NOT ENOUGH PLATELETS then TPO CAUSES MATURATION OF IMMATURE PLATELETS

regulated by THROMBOPOIETIN which is MADE BY THE LIVER

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7
Q

proportion of cells in bone marrow…
LYMPHOCYTES?
PLASMA CELLS?
OSTEOBLASTS/CLASTS?

A

LYMPHOCYTES = 1-10%

PLASMA CELLS = <1%

OSTEOBLASTS/CLASTS = RARE

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8
Q

where are CYTOLOGICAL samples taken from the bone marrow? (2)

A
  1. PROXIMAL HUMERUS
  2. or ILIAL WING
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9
Q

HISTOPATHOLOGY of bone marrow allows for WHAT 2 things?

A

allows for DEFINITIVE DETERMINATION OF CELLULARITY and FIBROSIS

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10
Q

DISEASES of the bone marrow should affect what 3 types of cells?

A
  1. RBCs
  2. WBCs
  3. PLATELETS
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11
Q

pathologic causes for…

HYPERCALCEMIA?
HYPERGLOBULINEMIA?

both can involve disease of WHAT?

A

HYPERCALCEMIA = NEOPLASIA of BONE MARROW

HYPERGLOBULINEMIA = MULTIPLE MYELOMA/MONOCLONAL GAMMOPATHY

both involve disease of BONE MARROW

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12
Q

if bone marrow is DYSFUNCTIONAL, what controls NUMBER OF CELLS that can be produced?

A

MARROW FUNCTION

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13
Q

FEVER OF UNKNOWN ORIGIN…
can be the result of WHAT 3 diseases?
usually due to WHAT ORGAN’S issue?

A
  1. NEOPLASTIC
  2. IMMUNE-MEDIATED
  3. INFECTIOUS

BONE MARROW

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14
Q

bone marrow sample must come with… (2)

A
  1. FULL CBC DRAWN WITHIN 24 HOURS!!
  2. if not possible, send BLOOD SMEAR
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15
Q

If you have an UNSUCCESSFUL/DRY ASPIRATION trying to do BONE MARROW CYTOLOGY, concerns are… (2)

A
  1. DECREASED MARROW CELLULARITY
  2. MYELOFIBROSIS
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16
Q

PARTICLE in bone marrow evaluation…
= made of?
tells us..?
in OLDER dogs…

A

= A BLOB OF CELLS W/ FAT ADMIXED

tells us..?
–> How CELLULAR is this particle?
–> GOOD CELLULARITY = HYPERPLASTIC/FUNCTION

In OLDER DOGS, likely to see MORE FAT

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17
Q

BONE MARROW EVALUATION (5 parameters, include something about second one with cell age & cat-specific fact)

A
  1. determine CELLULARITY of PARTICLES/how much fat
  2. determine if CELLS LOOK NORMAL for their AGE by examining 3 MOST PREVALENT CELL LINES IN BONE MARROW
    –> MYELOID (granulocytes, neutrophils)
    –> ERYTHROID
    –> MEGAKARYOCYTIC
  3. CELL TYPES THAT SHOULD NOT BE IN MARROW = PATHOLOGIC
  4. IRON DEFICIENCY (DOGS ONLY, CATS DO NOT STORE IRON IN MARROW)
  5. MYELOID:ERYTHROID RATIO
18
Q

MYELOID:ERYTHROID RATIO…
1. what cells are counted?
2. what should we NOT count?
3. how MANY cells do we count/division?
4. 2 NORMAL values?

A
  1. COUNT NEUTROPHIL SERIES:ERYTHROCYTE SERIES
  2. ** DO NOT COUNT MATURE RBCs or POLYCHROMATOPHILS because they COME FROM PERIPHERAL BLOOD
  3. Usually count 300-500 cells and DIVIDE RATIO (myeloid/erythrocyte)
  4. Normal = 1:1 or 2:1 (MYELOID > ERYTHROCYTE)
19
Q

MYELITIS = ??

DYSPLASIA can be PRE-___

A

MYELITIS = DYING OFF TISSUE

DYSPLASIA can be PRE-NEOPLASTIC

20
Q

4 EVENTS that cascade to INCREASE RBCs?

A
  1. LOSS OF Hb
  2. HYPOXIA
  3. LOW RENAL PERFUSION causes EPO RELEASE
  4. INCREASED RBC PRODUCTION
21
Q

4 reasons for NO REGENERATION from MARROW?

A
  1. PRE-REGENERATIVE = give it time
  2. IMMUNE-MEDIATED DISEASE attacking MARROW
  3. DYSPLASIA = RBCs CANNOT LEAVE MARROW bc they LOOK WEIRD
  4. NUTRITIONAL deficiency = Fe, Cu, COBALAMIN
22
Q

How can we have MYELOID HYPERPLASIA in response to ERYTHROID HYPERPLASIA?

A
  1. decrease in Hb from loss of RBCs
  2. OXYGEN DEPLETION in tissues (erythroid hyperplasia must occur)
  3. TISSUE NECROSIS from lack of perfusion
  4. INFLAMMATION is caused & MYELOID HYPERPLASIA
23
Q

MYELOID hyperplasia…
= EXPECTED response to _____
cascade? (4)
overall result?

A

o EXPECTED response to INCREASED NEED FOR GRANULOCYTES or MONOCYTES

cascade?
1. ANTIGENIC stimulation
2. cytokines
3. cytokines stimulate BONE MARROW via INFLAMMATION
4. MYELOID HYPERPLASIA

OVERALL result? = INCREASED NEUTROPHILS IN PERIPHERAL BLOOD

24
Q

MEGAKARYOCYTIC hyperplasia…
= EXPECTED response to ____
due to what 2 major things? (3 for first, 1 for second)

A

= EXPECTED response to NEED FOR PLATELETS

due to…
1. CONSUMPTION
–> DIC
–> VASCULITIS
–> SEVERE ACUTE HEMORRHAGE

  1. DESTRUCTION
    –> IMMUNE-MEDIATED
25
changes in what 4 OTHER cells can occur in marrow? for what 4 reasons does this happen?
4 other cells? 1. MAST CELLS 2. PLASMA CELLS 3. LYMPHOCYTES 4. HISTIOCYTES 4 reasons? 1. ANTIGENIC STIMULATION 2. CHRONIC INFECTION 3. NEOPLASIA 4. TOXINS
26
bone marrow HYPOPLASIA... = definition 2 ways it can manifest? 3 examples?
= DECREASED production in the bone marrow causing a cytopenia 2 ways to manifest? 1. MEASURABLE hypoplasia measured via M:E because of DECREASE/ABSENCE of a PARTICULAR CELL LINE 2. FAILURE TO RESPOND WITH APPROPRIATE HYPERPLASIA despite PERIPHERAL CYTOPENIA 3 examples? 1. ANEMIA OF CHRONIC DZ or INFLAMMATION --> SUPPRESSES HYPERPLASIA 2. IMMUNE-MEDIATED 3. RENAL FAILURE --> CANNOT MAKE EPO
27
Myelitis/Necrosis can be better visualized on ____ than ____ because it can cause ____ _____
HISTOPATHOLOGY, CYTOLOGY, FOCAL INFLAMMATION
28
MYELOFIBROSIS 1. generally primary/secondary? 2. often seen with what disease? 3. is it hard to aspirate? 4. how is it diagnosed? 5. staining?
1. GENERALLY REACTIVE/SECONDARY 2. Often seen with PIMA 3. DIFFICULT TO ASPIRATE 4. HISTOLOGIC DIAGNOSIS 5. Fibers can be SPECIFICALLY STAINED
29
MYELODYSPLASTIC SYNDROME = what defines it? MOST COMMON in cats with ___
= Marrow profile indicates HYPERPLASIA OF ONE OR MORE CELL LINE with PERSISTENT CYTOPENIA MOST COMMON IN CATS WITH FeLV
30
LEUKEMIA definition
= MALIGNANT HEMATOPOEITIC NEOPLASM originating in the BONE MARROW, typically with MANY NEOPLASTIC CELLS IN BLOOD
31
ACUTE myeloid leukemia 1. what do you see on blood smear? 2. most commonly seen in ____, but also ____ 3. prognosis? CHRONIC myeloid leukemia? what do we see on BLOODWORK?
ACUTE MYELOID LEUKEMIA 1. SEE IMMATURE BLOOD CELLS on PERIPHERAL BLOOD SMEAR 2. Most commonly seen in FeLV+ cats, but also YOUNG DOGS 3. POOR PROGNOSIS CHRONIC MYELOID LEUKEMIA --> VERY HIGH PERIPHERAL CELL COUNTS of MATURE CELLS
32
If I’m not sure WHAT lineage it is, and I’m not sure if it originated in the marrow, WHAT TERMINOLOGY for JUST IMMATURE CELLS?
ACUTE HEMATOPOIETIC LEUKEMIA
33
what 4 organs are a part of both IMMUNE and LYMPHOID systems? 3 PRIMARY lymphoid organs? 4 SECONDARY lymphoid organs?
BOTH systems? 1. THYMUS 2. SPLEEN 3. LNs 4. LYMPH NODULES PRIMARY lymphoid organs? 1. THYMUS 2. BONE MARROW 3. BURSA SECONDARY lymphoid organs? 1. SPLEEN 2. LNs 3. Mucosal-Associated Lymphoid Tissue (MALT) in GUT/CONJUNCTIVA 4. TONSILS
34
in the THYMUS, T cells are...
UNDERGOING POSITIVE & NEGATIVE SELECTION
35
the thymus is a ____ organ the MOST common lesion in the THYMUS? 2 presentations?
LYMPHOEPITHELIAL NEOPLASIA is most common lesion! THYMOMA = EPITHELIAL component LYMPHOMA = LYMPHOID component
36
THYMIC LYMPHOMAS ARE NOT ___ ____ because we ____ AGAINST ____, which used to cause them
THYMIC LYMPHOMAS ARE NOT VERY COMMON because we VACCINATE AGAINST FeLV, which used to cause them
37
4 differentials of ENLARGED LNs?
1. Reactive Hyperplasia 2. Lymphadenitis: bacterial, viral, fungal, protozoal 3. Metastatic neoplasia 4. Primary neoplasia
38
6 steps of REACTIVE hyperplasia?
(1) ANTIGEN COMES IN (2) T CELLS PRESENTED WITH ANTIGEN by APCs (3) T cells TALK TO B CELLS (4) B cells --> MARGINAL ZONE CELLS --> PLASMA CELLS (5) Plasma cells go to MEDULLARY SINUSES of LNs and DUMP IgGs (6) IgGs travel out to PERIPHERY to FIND ANTIGEN
39
SPLENOMEGALY differentials... if BLOODY/LARGE? (3 W/ REASONS) if MEATY/LARGE? (what part of spleen is reactive, 3 DDxs)
BLOODY/LARGE 1. CONGESTION --> Torsion --> Barbiturate euthanasia 2. SEPTICEMIA --> Blood rushes through VASCULATURE and SEQUESTERS IN SPLEEN --> ANTRHAX 3. ACUTE HEMOLYTIC ANEMIA --> RBCs getting sequestered EARLY ON in spleen MEATY/LARGE = The WHITE PULP IS REACTIVE 1. CHRONIC INFECTIOUS DZ --> Prolonged bacteremia/septicemia 2. NEOPLASIA --> ROUND CELL TUMORS (Histiocytic, Lymphocytic (MOST COMMON!), TVT, Mast cell, Plasma cell) 3. EXTRAMEDULLARY HEMATOPOIESIS --> IMHA so NEED TO MAKE MORE RBCs
40
what NEOPLASIA is MOST COMMON in MEATY, LARGE SPLEEN?
LYMPHOCYTIC!
41
NODULAR spleen (NOT ENLARGED) differentials...
BLOODY/NODULAR 1. HEMATOMA --> Occurs when WHITE PULP DISRUPTS BLOOD FLOW IN RED PULP --> Benign, but RUPTURE COULD CAUSE HYPOVOLEMIC SHOCK 2. HEMANGIOSARCOMA = Neoplasm of ENDOTHELIAL/VESSEL cells 3. INCOMPLETE/IRREGULAR CONTRACTION of the spleen 4. ACUTE SPLENIC INFARCT --> Look for TRIANGLE --> As they mature, TAN/FIRM MEATY/NODULAR 1. FOCAL NODULAR HYPERPLASIA 2. GRANULOMA or ABSCESS 3. NEOPLASIA --> PRIMARY = LYMPHOSARCOMA, HISTIOCYTIC SARCOMA, SPLENIC STROMAL SARCOMAS (fibrosarcomas, leiomyosarcomas) --> METASTATIC DZ POSSIBLE

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