klinisk patologi 03 hæmatologi

Question 1

Neutrophilia with left shift

Answer 1

Time dependant response:In 1-6 hours
Release of band and segmented from the bone marrow
umodne stadier til stede, knoglemarven kan ikke helt følge med.
Increased presence of (especially band) neutrophils in
the blood:
– Typical more than 0,5 mia/L
– Especially seen in acute inflammatory reactions

Question 2

Increased granulopoiesis

Answer 2

Time dependant response
In 3-4 days
Increased granulopoiesis - Mature neutrophilia

Question 3

Toxic Neutrophils

toxiske forandringer, hvad er det`?

Answer 3

Ikke kun toxicitet der kan forårsage det.
Accelereret produktion af neutrofile.
Deres cytoplasma er mere basofilt (blåt), dølelegeer (blå-grå inklusioner i cytoplasma).

Often cytoplasmic changes:
Basophilia
Vacuolation
Döhle bodies (blue/grey bodies in the cytoplasm; RER)
– Normal finding in cats (should be other changes as well)

Traditionally: Endotoxins, bacterial infection, exotoxins
Severe inflammatory states
Normal function - fungerer ligeså fint som andre neutrofile

Question 4

Neutrophilia

- hvad kan forårsage?

Answer 4

 Excitement
 Stress, Cushing
 Inflammation, paraneoplastic
 Hemolysis
 Myeloid leukemia

Question 5

Neutropenia

- hvad kan forårsage?

Answer 5

Peracute inflammation

Virusinfection, bone marrow suppression

Question 6

neutrophilia betyder?

Answer 6

describes a high number of neutrophil granulocytes in blood

Question 7

Neutropenia betyder?

Answer 7

abnormally low level of neutrophils

Question 8

Monopoiesis

Answer 8

Udviklingen af monocytter

Question 9

Monocytter

udseende

Answer 9

 Big irregular cells
 Released as immature
 Irregular nucleus
 Can look like the nucleus in promyelocytes, myelocytes, bands
 Cytoplasm
 Abundant
 Vacuolation
 Bluish, slight foamy

Question 10

Monocytosis

hvad er det?

Answer 10

(> 1.2 mia/L): højt monocyttal

ofte ved kroniske infektioner pga behov for phagocytose ude i væv.

Question 11

Monocytosis

kan skyldes

Answer 11

 Stress, Cushing
 Chronic inflammation, paraneoplastic
– Demand for phagocytosis (necrosis)
 Hemolysis
 Myeloid leukemia
 Severe: > 4.0 mia./L

Question 12

Monocytopenia

Answer 12

for få monocytter (ikke signifikant for noget)

Question 13

Lymphocytes in the blood:

udseende

Answer 13

Smooth cytoplasm, rarely vacuoles
– Often a little white ring around the nucleus
– The nucleus is often round
– High Nucleus: Cytoplasm (N/C) ratio (the nucleus
preoccupies the majority of the cell)
– Large activated lymphocytes can be hard to differentiate from monocytes (reaktive. højt antal kan være skidt).

Question 14

Lymphocytosis

kan skyldes:

Answer 14

(For mange lymfocytter)
 Young animals
 Excitement, fear (adrenalin)
 Mb. Addisonii 
 (Chronic inflammation)
 Leukemia

Question 15

Lymphopenia

Answer 15

Between 0,5 og 1,5 mia/L (for få):
– Cushing, disease stress, acute viral infection
– Often found in acute inflammation Below 0,5 mia/L:
– Could be leukemia

Question 16

Eosinophilia

Answer 16

(> 1.2 mia/L):
Hypersensitivity reactions (allergy)
Parasitic infection with tissue migration
Mb. Addisonii
Hyper-eosinophilic syndromes
– Eosinophilic granuloma, gastritis, panosteitis, myositis,

Question 17

Eosinopenia:

Answer 17

Not significant

Question 18

Basophilia

Answer 18

  (> 0.1 mia/L):
 Often seen with eosinophilia
 Hypersensitivity reactions (allergy)
 Parasitic infections
 Drug reaction
 Neoplasia

Question 19

Basopenia:

Answer 19

Not significant

Question 20

Leukocytic Changes

Typical patterns in leukocyte changes (kasser):

Answer 20

Leukopenia
Physiologic leukocytosis (adrenalin)
Stress/steroid-induced leukogram (steroid induceret)
Inflammatory leukogram
– Peracute, acute, chronic, extreme neutrophilic leukocytosis

Leukemia

Question 21

Leukopenia

Rule of thumb:

Answer 21

Generally with infection
Overwhelming the bone marrow response
– Leukopenia 2-6 hours duration then WBC rises

Poor prognostic findings
 Persistant inceasing leukopenia
 Degenerative left shift
– Normal number of neutrophils or neutropenia
– Bands > Segmented

Question 22

Physiologic Leukocytosis

Answer 22

 Epinephrine-induced:
 Excitement, fear
– Transient
 Happens within few minutes
 Decreases within ½ hour when the animal has calmed down

Question 23

Mild mature neutrophilia and lymphocytosis

Answer 23

– Often lymphocytosis in cats: often more lymphocytes than neutrophils
– Monocytes and eosinophils are normal, perhaps slightly increased

Question 24

Stress Leukogram

Answer 24

Steroid-induced
Cushing, steroid treatment, trauma, disease stress
– Longer lasting
Starts ~ 4 hours after steroid administration
Can last up till 4-6 days after steroid administration
Mild to moderate leukocytosis
Mature neutrophilia
Lymphopenia (and eosinopenia)
Monocytosis (especially dogs)

Question 25

Hvad kan bånd-neotrofile i blodet være tegn på?

Answer 25

Akut inflammation

- venstre forskydning

Question 26

Hvis der er flere bånd-neutrofile end segmenterede neutrofile. Hvad kaldes det så?

Answer 26

Degenerativ venstreforskydning.
kan ses ved Svær inflammation. Kroppen svarer ikke korrekt.
Patient daglig undersøgelse af blod.

Question 27

Promyelocyter og metamyelocyter i blodet kan være tegn på?

Answer 27

neoplasi i knoglemarven

Question 28

Neutrofile overlever hvor længe i hhv. blodet og ude i vævet?

Answer 28

Neutrofile overlever 10 timer i blodet og 1-4 dage i vævet

Question 29

Leukocytose kan ses ved

Answer 29

• Inflammation
• Ophidselse (adrenalin)
• Stress, cushings (steroid)
• Malign neoplasi
• Leukæmi

Question 30

Lymfocytose:

ses ved

Answer 30

Kronisk inflammation
Fysiologisk (adrenalin)
Neoplasi (lymfom, leukæmi, FeLV)
Hypoadrenocorticisme
Unge dyr der stadig udvikler immunsystemet

Question 31

Lymfopeni kan ses ved:

Answer 31

Akut inflammation – hjem til lymfeorganer.
Glucocoticoider: inflammationsmediator
Lymfoid hypoplasi, aplasi
lymfom

Question 32

Monocytose

- kan skyldes

Answer 32

• Inflammation (infektion, necrose)
• Flucocorticoid associeret
• Neoplasi

Question 33

Eosinofili

- kan skyldes

Answer 33

• Hypersensitivitet
• Parasitter
• Idiopatisk
• Mast celle degeneration eg inflammation
• Hypoadrenocorticisme
• Neoplastisk esosinofili