Exam 2: Bone marrow indications, leukocytes, leukograms

Question 1

When do you do a bone marrow evaluation?

Answer 1

Used to evaluate hematologic abnormalities that cannot be explained by PE, chemistry, CBC, history (neutropenia, anemia, thrombocytopenia, abnormal cell morphologies or cell populations/reactions.. etc)

Question 2

define leukogram

Answer 2

Numeric data + morphologic abnormalities = leukogram

Question 3

How do you distinguish between bands and neutrophils?

Answer 3

the end of bands are roughly parallel to each other.

Question 4

What is the most numerous cell in most all species?

Answer 4

neutrophils

Question 5

When would you expect to see more monos than metas on a blood slide?

Answer 5

during inflammation

Question 6

Do lymphocytes participate in the peripherl blood inflammatory response?

Answer 6

No, they traffic and proliferate to the lymphoid tissues.

Question 7

What is pyknosis? What does it indicate?

Answer 7

The nuclear shrinks. It represents death.

Question 8

What does degeneration of nucleus look like? what does it indicate?

Answer 8

unwound. it getting used up.

Question 9

what does hypersegmentation of a neutrophil mean?

Answer 9

It is getting old.

Question 10

Define and describe “left shift”

When do you see left shift? what is it usually accompanied with?

Answer 10

Increased concentration of immature neutrophils in the blood (usually band neutrophils, may include metamyelocytes).

Left shifts can occur with neutrophilia, normal concentration of neutrophils, or neutropenia. If with neutropenia, it is a more severe inflammatory response.

Question 11

When can you see fibrinogenemia?

Answer 11

seen during inflammation (especially in large animals)

Question 12

What should you expect to see in a stress response?

Answer 12

with stress response EXPECT TO SEE LYMPHOPENIA. You MAY OR MAY NOT see neutrophilia. See monocytosis even less. EOSINOPHILS ALSO VERY SENSITIVE. If neutrophilia is present but no lymphopenia – NOT stress response.

Question 13

what is gammopathy?

Answer 13

high (gamma?) globulins

Question 14

What is the “doctor” word for decreased neutrophils, lymphocytes, monocytes, eosinophils?

Answer 14

“Cytopenia”
includes neutropenia, lymphopenia, monocytopenia, eosinopenia

Question 15

what is the “doctor” word for increased neutrophils, lymphocytes, monocytes, eosinophils?

Answer 15

“philia” or “cytosis”
Leukocytosis

neutrophilia, lymphocytosis, monocytosis, eosinophilia, (basophilia)

Question 16

Bone Marrow Indcations Lecture

How do you prepare a proper bone marrow slide?

Answer 16

15‐18ga 1‐2 inch bone marrow aspiration needle (Jamshidi,etc.)
10‐12mL syringe
clean slides
2‐3% EDTA/saline sterile solution (optional – If not putting marrow into EDTA, slides made w/in 30 seconds!)

Sites: Illiac crest, Tronchanter Fossa of Proximal Femur, Proximal humerus, Rib, Sternum

Making slides:
Direct and squash preps
Flow cytometry, PCR, ICC, Cytochemistry – call your diagnostic lab

avoid hemodilution

Question 17

Bone Marrow Indcations Lecture

Myeloid to Erythroid ratios normal and not

Answer 17

normal 1:1 or 2:1
can have myeloid hyper (3:1) or hypoplasia (1:3). Can have erythroid hyper (1:3) or hypoplasia.

Question 18

When basophils are high on a leukogram, what could this be pointing to?

Answer 18

a parasitic infection

Question 19

Segsare high, lyphs are low, what kind of leukogram is this?

Answer 19

Stress

Question 20

You see that segs are low on a leukogram, can you immediately rule out inflammation?

Answer 20

no, segs can be working in the tissues, marginated, or being destroyed/or not produced…

Question 21

everything is normal or should be pointing to stress but lymphs are high… what should you be worried about?

Answer 21

Hypoadrenocorticism, steroids are not being made to lower lymphocytes

Question 22

A cat comes in with a hacking cough, despite being stressed, it has lymphocytosis… why?

Answer 22

Excited cats can present with lymphocytosis