L11 BONE MARROW Flashcards

1
Q

define aplasia

A

lack of cell formation

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2
Q

define hypoplasia

A

decreased cell formation

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3
Q

define hyperplasia

A

increased cell formation

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4
Q

define dysplasia

A

abnormal cell formation

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5
Q

define dysmyelopoesis

A

abnormal haematopoesis

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6
Q

define dyserythropoesis

A

abnormal eryhrocyte prod

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7
Q

define dtysgranulopooesis

A

abnormal granulate production

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8
Q

define myelophthisis

A

displacement of haematopoietic tissue by other tissue ie/ fibrosis, inflammatory cells or neoplasia

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9
Q

define pancytopenia

A

concurrent anaemia, thrombocytopenia and leukopenia

everything decreased

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10
Q

define aplastic anaemia

A

lack of formation of a cell line causing pancytopenia

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11
Q

define pure red cell aplasia

A

lack of formation of erythroids only

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12
Q

LIST some key disease off marrow

A
  • myeloid leukaemia
  • myelodysplasia
  • myelofibroris
  • myelophthisis
  • myelonecrosis
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13
Q

compare and contrast acute myeloid leukaemia with chronic myeloid leukaemia

A
ACUTE: 
- excessive blasts
- myeloid, erythroid or megakaryocytic origin
- hypercellular marrow 
agressive, poor prognosis 

CHRONIC

  • excessive prod of mature cells of any cell line
  • hypercell marrow w/ little blasts
  • often w/ leukocytosis
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14
Q

what is primary myelodysplasia (MDS), name some secondary causes

A

primary - neoplastic disorder causing abnormal cell production,
can also be secondary to toxins, drugs, viruses

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15
Q

what is myelofibrosis

A

replacement of marrow by fibrous tissue
primary = neoplastic
secondary = IMHA

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16
Q

what is myelonecrosis

A

necrosis of bone marrow, usually serous atrophy due to starvation.

17
Q

WHEN SHOULD YOU SUSPECT BONE MARROW DISEASE

A

PERSISTENT AND UNEXPLAINED

  • CYTOPENIA
  • CTYOSIS
  • ABNORMAL CELL MORPHOLOGY
  • HYPERGLOBULINAEMIA
  • FEVER OF UNKNOWN ORIGIN
  • HYPERCALCAEMIA
  • LYTIC BONE DISEASE
  • INFECTIOUS DX SCREENING - LESHIMANIASIS
18
Q

What are the three persistent cytopenia cell lines we should worry about? which ones should we not worry about and why

A

worry about persistent:
thrombocytopenia, neutropenia and non-regenerative anaemia
dont worry about basopenia, eosionopenia or monocytopenia because we see them so low in health

19
Q

what are some causes of persistent cytopenias

A
bone marrow neoplasia 
infectious dx - parvo, FIV, FeLV 
toxins - oestrogen (dogs), bracken fern (ruminants) chemotherapy 
IMHA 
endocrine - hypothyroidism, hypoadrenoc.
20
Q

what are the persistent cytosis that we should be worried about

A
  • leukocytosis
  • erythrocytosis
  • thrombocytosis
21
Q

what are some bone marrow diseases resulting in leukocytosis, what must you rule out first?

A

need to rule out inflam or infection , paraneoplastic syndrome
could be :
- AML/ CML
- lymphoproliferative dx

22
Q

what are some bone marrow diseases resulting in erythrocytosis, what must you rule out first?

A

rule out dehydration, splenic contraction, hypoxia

causes: renal mass , polycythaemia vera

23
Q

what are some bone marrow diseases resulting in thrombocytosis, what must you rule out first?

A

rule out: inflammation, hypercortisolemia, splenic contraction, iron deficiency, paraneoplastic syndrome
could be:
- essential thrombocytopenia

24
Q

what kinds of abnormal cell morphology would suggest bone marrow dx?

A
  • inappropriate release of immature cells
  • disorderly left shit
  • cytomegaly: giant neutrophil, macro platelets
  • abnormal nuclear morph: abnormal segmentation of nucleus
  • abnormal cytoplasm; inclusions, toxic change
25
Q

what are some causes of hyperglobulinaemia

A

inflammation: infection w/ leishmanaiais

lymphoid neoplasia: lymphoma, lymphoid leukamia, multiple myeloma, plasmocytoma

26
Q

what are the differentiates for hypercalcaemia

A
HARDIONS
h - hyperparathyroidism 
a - addison (dogs)
r - renal failure (horses)
d - vitamin d toxicity 
i - idiopathic (cats)
o - osteolysis
n - neoplasia 
s - spurious
27
Q

what is multiple myeloma, what is the diagnostic criteria for it

A

plasma cell neoplasia
must have two of the following to diagnose
- neoplastic plasma cell in bone marrow
- osteolytic lesions
- monoclonal gammopathy (1 protein made)
- light chain proteinuria

28
Q

what are the sites for bone marrow collection?

A
  • pelvis; ileac crest
  • proximal femur
  • proximal humerus
  • sternum
29
Q

when would yo take a core biopsy?

A
  • pancytopenia
  • RBR morph suggests myelofibrosis ie/ ovalocytes
  • no spicule evident in aspirate
30
Q

when would you NOT do bone marrow aspirate

A

coagulopathy

  • DIC
  • warfarin tox
  • hepatic dx
    • caution w/ thrombocytopenia - might not be able to clot