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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
Q

changes in what 4 OTHER cells can occur in marrow?

for what 4 reasons does this happen?

A

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
Q

bone marrow HYPOPLASIA…
= definition
2 ways it can manifest?
3 examples?

A

= 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
Q

Myelitis/Necrosis can be better visualized on ____ than ____ because it can cause ____ _____

A

HISTOPATHOLOGY, CYTOLOGY, FOCAL INFLAMMATION

28
Q

MYELOFIBROSIS
1. generally primary/secondary?
2. often seen with what disease?
3. is it hard to aspirate?
4. how is it diagnosed?
5. staining?

A
  1. GENERALLY REACTIVE/SECONDARY
  2. Often seen with PIMA
  3. DIFFICULT TO ASPIRATE
  4. HISTOLOGIC DIAGNOSIS
  5. Fibers can be SPECIFICALLY STAINED
29
Q

MYELODYSPLASTIC SYNDROME
= what defines it?
MOST COMMON in cats with ___

A

= Marrow profile indicates HYPERPLASIA OF ONE OR MORE CELL LINE with PERSISTENT CYTOPENIA

MOST COMMON IN CATS WITH FeLV

30
Q

LEUKEMIA definition

A

= MALIGNANT HEMATOPOEITIC NEOPLASM originating in the BONE MARROW, typically with MANY NEOPLASTIC CELLS IN BLOOD

31
Q

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?

A

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
Q

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?

A

ACUTE HEMATOPOIETIC LEUKEMIA

33
Q

what 4 organs are a part of both IMMUNE and LYMPHOID systems?
3 PRIMARY lymphoid organs?
4 SECONDARY lymphoid organs?

A

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
Q

in the THYMUS, T cells are…

A

UNDERGOING POSITIVE & NEGATIVE SELECTION

35
Q

the thymus is a ____ organ

the MOST common lesion in the THYMUS? 2 presentations?

A

LYMPHOEPITHELIAL

NEOPLASIA is most common lesion!
THYMOMA = EPITHELIAL component
LYMPHOMA = LYMPHOID component

36
Q

THYMIC LYMPHOMAS ARE NOT ___ ____ because we ____ AGAINST ____, which used to cause them

A

THYMIC LYMPHOMAS ARE NOT VERY COMMON because we VACCINATE AGAINST FeLV, which used to cause them

37
Q

4 differentials of ENLARGED LNs?

A
  1. Reactive Hyperplasia
  2. Lymphadenitis: bacterial, viral, fungal, protozoal
  3. Metastatic neoplasia
  4. Primary neoplasia
38
Q

6 steps of REACTIVE hyperplasia?

A

(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
Q

SPLENOMEGALY differentials…

if BLOODY/LARGE? (3 W/ REASONS)
if MEATY/LARGE? (what part of spleen is reactive, 3 DDxs)

A

BLOODY/LARGE
1. CONGESTION
–> Torsion
–> Barbiturate euthanasia

  1. SEPTICEMIA
    –> Blood rushes through VASCULATURE and SEQUESTERS IN SPLEEN
    –> ANTRHAX
  2. 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
Q

what NEOPLASIA is MOST COMMON in MEATY, LARGE SPLEEN?

A

LYMPHOCYTIC!

41
Q

NODULAR spleen (NOT ENLARGED) differentials…

A

BLOODY/NODULAR
1. HEMATOMA
–> Occurs when WHITE PULP DISRUPTS BLOOD FLOW IN RED PULP
–> Benign, but RUPTURE COULD CAUSE HYPOVOLEMIC SHOCK

  1. HEMANGIOSARCOMA
    = Neoplasm of ENDOTHELIAL/VESSEL cells
  2. INCOMPLETE/IRREGULAR CONTRACTION of the spleen
  3. ACUTE SPLENIC INFARCT
    –> Look for TRIANGLE
    –> As they mature, TAN/FIRM

MEATY/NODULAR
1. FOCAL NODULAR HYPERPLASIA

  1. GRANULOMA or ABSCESS
  2. NEOPLASIA
    –> PRIMARY = LYMPHOSARCOMA, HISTIOCYTIC SARCOMA, SPLENIC STROMAL SARCOMAS (fibrosarcomas, leiomyosarcomas)
    –> METASTATIC DZ POSSIBLE

Year 1/2 (139 decks)

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