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Clinical Pathology > Interpretation of Leukograms (14) > Flashcards

Interpretation of Leukograms (14) Flashcards

1
Q

What is the difference between relative and absolute counts?

A

relative: %
absolute: #/microL of blood

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2
Q

Is relative or absolute leukocyte count better? Why?

A

absolute - percentage can be misleading

each leukocyte has its own kinetics - rather know amount than percentage relative to their site

each leukocyte has its own functions

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3
Q

What predominates in the blood of carnivores?

A

neutrophils

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4
Q

What predominates in the blood of ruminants?

A

lymphocytes

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5
Q

Neutrophils predominate in which species?

A

dog

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6
Q

Lymphocytes predominate in which species?

A

ruminants

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7
Q

Why can leukograms vary in normal animals?

A
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8
Q

Are there more immature or mature neutrophils in the bone marrow?

A

mature

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9
Q

What is a left shift?

A

increased immature neutrophils in the blood

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10
Q

What causes left shifts?

A

inflammation - infectious, noninfectious

Neoplasia (CML, AML)

hereditary (Pelger Huet)

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11
Q

What is a regenerative left shift?

A

neutrophilia with left shift
mature neutrophils predominate

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12
Q

What is a degenerative left shift?

A

normal neutrophil count of neutropenia
immature neutrophils predominate

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13
Q

What are toxic left shifts caused by?

A

strong inflammatory conditions, with severe bacterial infections

LESS predominate with immune-mediated, neoplastic, or hereditary disorders

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14
Q

What does this show?

A

toxic left shift - feline

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15
Q

What are causes of neutrophilia?

A

epinephrine - excitement

glucocorticoids

inflammation

chemical and drug poisonings

hemorrhage and hemolysis

malignancy, including leukemia

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16
Q

What is the pathophysiology of neutrophilia?

A

increased neutrophil production and release from bone marrow

decreased movement of neutrophils from blood to tissues

shift of neutrophils from the marginal to circulating

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17
Q

What is physiologic neutrophilia?

A

epinephrine-induced neutrophilia

no neutrophil toxicity or left shift

short duration - about 30 minutes

lymphocytosis

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18
Q

What happens in pseudo-neutrophilia?

A

epinephrine or marked exercise

shift from large marginal neutrophil pool to circulating

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19
Q

T/F: Epinephrine results in a toxic left shift

A

FALSE

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20
Q

What happens in glucocorticoid-induced neutrophilia?

A

neutrophilia without left shift

lymphopenia

eosinopenia

monoctyosis (dogs)

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21
Q

Explain the glucorticoid response in the marrow

A

decrease movement of neutrophils into tissue

releasing stored mature neutrophil from bone marrow

dumping out mature neutrophils from the storage pool

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22
Q

Contrast epinephrine and glucocorticoid neutrophilia

A

epinephrine: lymphocytosis, instantaneous

corticoid: lymphoPENIA with eosinopenia and monocytosis, 4-8 hours

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23
Q

Over time, how does increased blood glucocorticoid concentration alter leukograms?

A

neutrophilia can go away but lymphopenia and eosinopenia remain

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24
Q

What happens in lymphopenia?

A

glucocorticoid result in sequestration of lymphocytes in lymphoid organs - prevent migration

long-term glucocorticoid administration results in lysis of certain lymphocyte type or stages

25
Q

What is eosinopenia?

A

glucocorticoids inhibit release of eosinophils from bone marrow

26
Q

How does acute inflammation affect neutrophils?

A

left shift - release of cells from marrow to circulation and tissue

bone marrow keeps up with demand: high neutrophil count

27
Q

How does established inflammation affect neutrophils?

A

a lot more cells in marrow being produced becoming neutrophils

28
Q

What is a “leukemoid” neutrophilia?

A

marked left shift to include myelocytes

infectious processes such as prothorax, pyelonephritis, septic peritonitis, pyometra, abscess, and pneumonia

29
Q

What happens with chronic inflammation?

A

marrow proliferation

NOT much of a L shift

high M:E ratio

30
Q

Which species have more dramatic magnitude of inflammatory leukocytosis?

A

dogs and cats

31
Q

How does inflammation differ in cattle, sheep, and manatees?

A

sometimes minimal leukogram changes

increased acute phase proteins including SAA, fibrinogen, and haptoglobin

32
Q

What are inherited neutrophil defects with neutrophilia?

A

leukocyte adhesion deficiency I
leukocyte adhesion deficiency III

33
Q

What is leukocyte adhesion deficiency I?

A

defect in CD18 (B subunit of B2-integrin adhesion molecule) in Irish setter dogs and Holstein cattle

marked neutrophilia

adhesion molecules needed for neutrophils to bind to activate endothelial into tissues

34
Q

What is leukocyte adhesion deficiency III?

A

kindlin-3 protein deficiency in German Shepherds

lack of activation of leukocyte and platelet integrals

marked neutrophilia, platelet defect

35
Q

How is LAD I and LAD III different?

A

LAD III: includes platelet defect also

36
Q

Why do leukocyte adhesion deficiencies results in neutrophilia?

A

neutrophils can’t get out in tissues but stay in the blood

37
Q

What is neutropenia patholophysiology?

A

decreased marrow production

increased exit from the blood

shift from circulating to marginal pool

38
Q

What is pseudoneutropenia?

A

shift from circulating to marginal

39
Q

What happens with reduced granulopoiesis in the bone marrow?

A

decreased production = less in the blood

40
Q

What things cause neutropenia (decreased marrow progenitor cells) in the blood?

A

idiosyncratic drug reactions

estrogen toxicity in dogs and ferrets

cytotoxic chemotherapy drugs, colchicine toxicity

41
Q

What is myelophthisis?

A

form of bone marrow failure that results from the destruction of bone marrow precursor cells and their stroma

things that occupy space in marrow interfere with normal microenvironment

42
Q

What are examples of myelophthisis?

A

lymphoid leukemia (primarily ALL)
multiple myeloma
myelofibrosis
osteosclerosis
metastasis of lymphomas, carcinomas, and mast cell tumors

43
Q

What happens with dysgranulopoiesis?

A

neutropenia - not maturing out normally

high mitotic precursors and low mature

44
Q

What are examples of neutropenia regarding dysgranulopoiesis?

A

myelodysplastic syndrome (MDS)

acute myelogenous leukemia (AML)

inherited cobalamin deficiency

45
Q

What is this an example of?

A

dysgranulopoiesis

46
Q

What is acute myeloid leukemia?

A

leads to the production of vast numbers of immature blood cells that ultimately crowd out the other normal cells in the blood

causes neutropenia

47
Q

What happens with excess tissue demand - increased utilization or destruction?

A
48
Q

What happens with shock?

A

pseudoneutropenia - shift from circulating to marginating

49
Q

What are some inherited neutropenias?

A

cyclic hematopoiesis in gray collies

trapped neutrophil syndrom in border collies

50
Q

What does (purulent) neutrophilic inflammation result in?

A
51
Q

What causes lymphocytosis?

A
52
Q

What causes neoplastic lymphocytes?

A

ALL
CLL
lymphoma

53
Q

What is chronic lymphocytic leukemia?

A

high lymphocyte count

54
Q

What causes lymphopenia?

A

corticosteroid induced
acute systemic infections
immunosuppressive drugs and radiation

55
Q

What causes monocytosis?

A

often occurs in association with neutrophilia

acute and chronic inflammation

glucocorticoids in dogs

56
Q

Is it normal to see monocytopenia?

A

not clinically significant

57
Q

What causes eosinophilia?

A

parasitic diseases (especially nematodes and flukes)

allergic hypersensitivities

eosinophilic granulomas

58
Q

What causes basophilia?

A

IgE-mediated disorders

usually accompanies eosinophilia

may be associated with mast cell neoplasia

59
Q

What causes mastocytemia?

A

mast cell neoplasia

dogs: inflammatory diseases, regenerative anemia, tissue injury, neoplasia other than mast cell tumors, and necrosis

cats: especially with splenic mast cell tumors

Clinical Pathology (11 decks)

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