exam 2

Question 1

what is polycythemia?

Answer 1

increased PCV. A better term would have been erythrocytosis.

Question 2

relative polycythemia

Answer 2

hemoconcentration: It looks like its increased, but really the fluids is increased. Dehydration is the most common cause Fluid shifts (this can happen fairly suickly eg. Colitis) Redistribution Excitement and exercise (splenic contration)

Question 3

absolute polycythemia

Answer 3

increased Epo that is either appropriate or inappropriate

Question 4

appropriate increase

Answer 4

Chronic hypoxia, lung disease, heart disease

Question 5

inappropriate

Answer 5

EPO secretion renal cysts, tumors (this one is not very common)- fooling the cells into thinking that they are hypoxic.

Question 6

primary polycythmia

Answer 6

is a myeloproliferative disorder where all cell lines are affective

Question 7

what is leukemia

Answer 7

presence of neoplastic cells in peripheral blood and/or bone marrow or spleen.

Question 8

aleukemic leukemia

Answer 8

no white cells

Question 9

subleukemic leukemia

Answer 9

normal white cells

Question 10

leukemic leukemia

Answer 10

drastically high white cells

Question 11

what is the difference bt acute and chronic leukemia

Answer 11

acute tends to have a lower degree of maturation, and therefore the prognosis is very poor with survival times being low (20% more more blast cells in the marrow) chronic leukemia tends to be characterized by mature white cells and the survival time is longer

Question 12

lymphoproliferative disorders are

Answer 12

lymphocytes and plasma cells

Question 13

myeloproliferative disorders

Answer 13

are cells of the bone marrow stem cells: neutrophils, erythrocytes, rarely eosinophils and basophils

Question 14

>35000 is >15000 and erlichia negative

Answer 14

is leukemia!!!!!!

Question 15

acute lymphoblastic leukemia (ALL)

Answer 15

Differentiate from stage V lymphoma Lots of dogs presenting with multicentric lymphoma are leukemia 50% of dogs with ALL will have lymphadenopathy

Question 16

CBC associated with acute lymphoblastic leukemia

Answer 16

• Thrombocytopenia - Lymphocytosis (usually) - lymphoblasts in the blood Prognosis is poor, course is rapid and progressive and respond poorly to therapy Cats are usually younger and FeLV positive.

Question 17

Chronic lymphocytic leukemia

Answer 17

Cells are small and appear well differentiated Most common in dogs, but can be in other species. Way more common in dogs than cats. Differentiate from other causes of lymphocytosis If >35,000 its leukemia, but it can be lower and still be leukemia

Question 18

two ddxs for chronic lymphocytic leukemia

Answer 18

stress in cats cat scratch fever

Question 19

clinical signs of chronic lymphocytic leukemia

Answer 19

can either be asymptomatic, ill, lethargic, anorexia, pale mucosal membranes, lymphadenopathy, splenomegaly, hepatomegaly

Question 20

lab findings chronic lymphocytic leukemia

Answer 20

Lymphocytosis (slightly greater to above 300,000 Maybe anemia, thrombocytopenia Increased small lymphs in the bone marrow Rarely monoclonal gammopathy Cats are usually Fe-LV negative

Question 21

you see this slide, what are you thinking?

Answer 22

chronic lymphocytic leukemia

Question 23

CD 8

Answer 23

T cell

Question 24

CD21

Answer 24

Bcell

Question 25

CD 4-8-5

Answer 25

abberant T cells

Question 26

CD34+

Answer 26

proginator cells

Question 28

Multiple myeloma

Answer 28

Proliferation of plasma cells at various sites of the bone marrow and eventually other tissues
Release into the peripheral blood happens, but its in small numbers. If a leukemia is lumped on, then survival time is very low

On the left you see flame cells, they have an eccentric nucleus, and the immunoglobulin is not released. This accounts for the pink color

Question 29

signs of multiple myeloma

Answer 29

Depends on where the neoplastic plasma cells are.
Also related to the immunoglobulins produced which result in hyperviscosisty of the blood. This can manifest as neurological signs. Also depends on the Ig. IgG there is not as much viscosity as IgM.

Question 30

you see

More than 20% plasma cells in the bone marrow, but this can also happen in antigenic stimulation, so you should differentiate from this.
Monoclonal or biclonal gammopathy (igG and IgA) and this is referred to as a paraprotein
Bence jones proteins in the urine (the remanants of the light chains when Igs break up). These proteins cannot be picked up by dip sticks. Maybe send in fpr protein electrophoresis.
Light chain disease (when the cells just produce the light chains). When this happens, you can miss a multiple myeloma because everything is going into the urine.
Thrombocytopenia ( and the platelets will also fail to work), maybe. Depends on what is happeneing in the bone marrow

Answer 30

multiple myeloma