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Pathology II > LEC 10 - Hemo-lymphatic System > Flashcards

LEC 10 - Hemo-lymphatic System Flashcards

1
Q

What are the two major defense mechanisms within the erythrocytes?

A

Glycolytic pathway + Pentose shunt pathway

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2
Q

What does the glycolytic pathway do?

A

Produce NADH - helps in the conversion of methemoglobin to hemoglobin

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3
Q

What does the pentose pathway do?

A

Produce NADPH - maintains glutathione in the reduced state

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4
Q

What are the eight responses to injury that bone marrow can undergo?

A

Hyper/hypoplasia + Dysplasia + Myelopthisis + Aplasia + Neoplasia + Myelofibrosis + Inflammation/Necrosis

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5
Q

What are the causes of hyperplasia in bone marrow?

A

Response to stimulus

Secondary phenomenon to a stimulus

Idiopathic

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6
Q

Term: Hypoplasia of bone marrow

A

Decrease in bone marrow hematopoietic tissue

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7
Q

Term: Dysplasia of Bone Marrow

A

Abnormally large size of hemopoietic tissue

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8
Q

Term: Myelophthisis

A

Replacement of mematopoietic tissue in bone marrow by another tissue

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9
Q

What are the possible causes of decrease in the concentration of blood cells?

A

Decrease production

Increase destruction

Blood loss

Altered distribution

Consumption

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10
Q

What are the possible reasons for increase in the concentration of blood cells?

A

Increase in production

Paraneoplastic syndromes

Neoplasia

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11
Q

Term: Anemia

A

Subnormal RBC mass

– or –

Hemoglobin concentration

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12
Q

What are the clinical signs of anemia?

A

Pallor of mucous membrans

Lethargy, weakness

Elevated liver enzymes

Heart murmur

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13
Q

Why is there elevated liver enzymes with anemia?

A

Hypoia-induced damage to hepatocytes

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14
Q

Why do you hear heart murmurs with anemia?

A

Blood thinning

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15
Q

What can cause regenerative anemia?

A

hemorrhage

– or –

Hemolysis

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16
Q

What is seen on blood work if there is a strong regerneative response?

A

Increase MCV

Decrease MCHC

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17
Q

What is the hallmark of regenerative anemia?

A

reticulocytosis

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18
Q

What does reticulocytosis indicate?

A

Increase bone marrow erythropoiesis

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19
Q

How do horses present with regenerative anemia?

A

Increase MCV

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20
Q

How are reticulocytes distinguided?

A

Polychormasia

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21
Q

What two things are needed to determine regenerative anemia is occurring in horses?

A

Bone marrow examination

– and –

Sequential CBC

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22
Q

What is the hallmark of regenerative anemia in a horse’s bone marrow?

A

Erythroid hyperplasia

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23
Q

What is a classic sequlae of hemolytic anemia?

A

Hypernilirubinemia

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24
Q

What is seen clinically with hyperbilirubinemia?

A

Icterus

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25
Q

What are the two types of hemolytic anemias?

A

Extravascular

– and –

Intravascular

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26
Q

What does extravascular hemolytic anemia result in? Why?

A

Splenomegaly

Increase destruction of RBC’s by splenic macrophages

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27
Q

What does intravascular hemoysis result in?

A

Hemoglobinemia

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28
Q

What causes hemoglobinuria? What does it lead to?

A

Free HgB pass through renal glomeruli into urine

Can lead to renal tubular necrosis

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29
Q

What are two other differietials for hemoglobinuria?

A

Hematuria

– or –

Myoglobinuria

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30
Q

What is seen in the blood of a patient with IMHA?

A

Spherocytosis

– and –

Autoaggluintation

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31
Q

What bacteria can cause spelnomegaly in a pig, caused by hemolytic anemia?

A

Mycoplasma suis

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32
Q

What feature is seen histologically of spherocytes?

A

Howell-Joly bodies

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33
Q

How does oxidative damage occur to erythrocytes?

A

Normal antioxidant pathways that make NADH + NADPH are compromised/overwhelmed

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34
Q

What evidence of oxidative damage on a blood smear?

A

Heinz bodies

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35
Q

Term: Heinz Bodies

A

Foci of denatured globin that interact with erthrocyte membrane

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36
Q

What can oxidative insult cause to the hemoglobin?

A

HgB can convert to methemoglobin which are inable to bind to oxygen

Blood becomes chocolate colored

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37
Q

How is nonregenerative anemia characterized?

A

Lack of reticulocytosis on CBC

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38
Q

What is the most common form of nonregenerative anemia?

A

Anemia of inflammation or Anemia of chronic disease

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39
Q

Why does anemia of chornic disease tend to cause nonregenerative anemia?

A

Increased iron stores in bone marrow

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40
Q

Term: Hepcidin

A

Acute phase protein

Limit iron avalibility

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41
Q

What happens to levels of hepcidin when there is inflammation?

A

Increases

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42
Q

What is the end result of increased hepcidin?

A

Functional iron deficiency by:

inhibiting absorption of dietary iron in GI

Blocking export of iron from marcophages/hepatocytes

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43
Q

What is true iron defiency most commonly caused by?

A

Chronic blood loss

sometimes nutritional deficiency

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44
Q

What is the hematologic appearance of iron deficiency?

A

Microcytic

Hypochromic

Low MVC + MCHC

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45
Q

What are the four major reasons for neutropenia?

A

Decreased production

Increased destruction

Increased demand

Altered distribution

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46
Q

What can cause neuropenia due to increased demand?

A

Margination between inflammatory stimulus + reserve of postmitotic neutrophils in bone marrow

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47
Q

What can cause neuropenia due to increased destruction?

A

Occurs before they leave the bone marrow

Immune mediated

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48
Q

What is the increased destruction of neutrophils knowns as?

A

Granulopoiesis

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49
Q

What can cause neuropenia due to decreased production?

A

Chemical

Radiation

Neoplaisa

infection

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50
Q

If eosinopenia/basopenia is detectable what is it suspected to be a part of?

A

Stress leukogram

Mediated by glucocorticoids

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51
Q

What can cause thrombocytopenia due to increased destruction?

A

Immune mediated thrombocytopenia

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52
Q

What can cause thrombocytopenia due to increase consumption?

A

Hallmark of DIC

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53
Q

Term: Erythrocytosis

A

Increase in RBC mass

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54
Q

What causes primary erythrocytosis?

A

Dehydration

– and –

Epinephrine mediated splenic contraction

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55
Q

What are the causes of secondary erythrocytosis?

A

true EPO-mediated increase in RBC mass

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56
Q

What are the five mechanisms for neutrophilia?

A

Increase release if marrow storage pool cells

Demargination of neutrophils

Decreased extravasation into tissue

Expansion of marrow precursor pool

Congenital

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57
Q

What might cause increased release of marrow storage pool cells?

A

Endotoxemia

Acute infection

Hypoxia

Glucocorticosteroids

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58
Q

What can cause demargination of neutrophils?

A

Acute infection

Excercise

EPI release

Glucocorticosteroids

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59
Q

What could be the cause of expansion of marrow precursor pool?

A

Chronic infection

Tumors

Rebound from neutropenia

Myeloproliferative disorders

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60
Q

What is a congenital cause of neutrophilia?

A

Leukocyte adhesion defiency

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61
Q

When is lymphocytosis normal?

A

Young animals

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62
Q

What can cause lymphocytosis in cats? What does it occur with?

A

Epinephrine mediated physiological leukocytosis

Marked with neutrophilia

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63
Q

What virus can cause lymphocytosis in cattle?

A

BLV

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64
Q

What condition is caused by BLV that leads to lymphocytosis in cattle?

A

Persistent leukocytosis

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65
Q

What defines an animal with persistent leukocytosis?

A

Lymphocytosis for at least 3 months

Non-neoplastic proliferation of B-lymphocytes

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66
Q

Term: Anaplastic anemia

A

Severe hypoplasia of all hematopoietic lineages in bone marrow

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67
Q

What is another name for anaplastic anaemia?

A

Aplastic pancytopenia

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68
Q

What is the cause of anaplastic anemia?

A

Destruction of hematopoietic stem cells caused by

Chemical agents

Infectious agents

Idiopathic

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69
Q

What infectious agents in dogs and cats cause anaplastic anemia?

A

Erlichiosis

– and –

Parvovirus

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70
Q

What infectious agents cause anaplastic anemia in cats?

A

FeLV

– and –

FIV

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71
Q

What infectious agents cause anaplastic anemia in horses?

A

Equine infectious anemia

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72
Q

Term: Erythropoietic porphyrias

A

Defect of enzymes in synthesis of porphyrins and other heme proteins

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73
Q

What is prphyrins?

A

Precursors of HgB

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74
Q

What are three common types of erythropoietic porphyrias?

A

Congentical erythropoietic porphria

Bovine erythropoietic protoporphyria

Congenital prophyria of Siamese and DSH cats

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75
Q

What animals are at risk for getting congenital erythropoietic porphyria?

A

Holstein cattle

– and –

Shorthorn cattle

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76
Q

What are the characteristics of congenital erythropoietic porphyria?

A

Red-brown discoloration of teeth + bones + urine

Photodynamic porphyrins in circulation

Anemia

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77
Q

What animals tend to be at risk for Bovine erythropoietic protoporphyria?

A

Limousin cattle

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78
Q

What are the characteristics of bovine erthropietic protoporphyria?

A

No discoloration of teeth or bones

Accumulation of protoporphyrins in tissues + erytrocytes

Photosensitivity only clinical manifestation

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79
Q

What is causing bovine erythropoietic protoporphyria?

A

Inherited disorder of heme synthase

Accumulation of prorotporphrins in tissues and erythrocutes

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80
Q

How is pyruvate kinase deficiency characterized?

A

Moderate to severe extravascular hemolytic anemia

Strongly regenerative

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81
Q

What is the genetic characteristic of pyruvate kinase deficiency?

A

Inherited autosomal recessive

Dogs + cats

82
Q

What is seen clinically with Chediak-Higashi syndrome?

A

Pyogenic infections

Bleeding tendencies

Ocular/cutaneous hypopigmentation

83
Q

What causes chediak-higashi syndrome to occur?

A

Mutation in the gene for LYST

Causes severely impaired cellular innate immunity due to neutropenia

impaired chemotaxis

respiratory burst

84
Q

What causes Glazmann thrombasthenia?

A

Defective expression of integrin GPIIb-IIIa

Fibrin receptor for normal platelet aggregation

85
Q

What is clinically seen with glazmann thrombasthenia?

A

Severely impaired clot retraction

86
Q

What breeds of dogs are found to have Glazmann thrombasthenia?

A

Great pyrenees

– and –

Otterhound dogs

87
Q

What are the oxidative agents that cause toxicoses in horses?

A

Red maple

Phenotiazine

Onions/garlic

88
Q

What are the oxidative agents that cause toxicoses in ruminants?

A

Brassica/Rye grass

Copper toxicity

Onions/Garlic

89
Q

What are the oxidative agents that cause toxicoses in Dogs?

A

Acetaminophen

Naphthalene

Benzocaine

Phenylhydrazine

Vitamin K1 and K3

Zinc toxicity

90
Q

What are the oxidative agents that cause toxicoses in Cats?

A

Acetaminophen

Benzocaine

Methionine

Napthalene

Propofol

Propylen glycol

91
Q

What are the post mortem findings in animals with toxicoses due to oxidative agents?

A

Icterus

Hemoglobinuric nephrosis

Brown discoloration of liver/kidney

Splenomegaly

92
Q

Describe the organism that causes babesiosis?

A

Babesia spp.

Intraerythrocytic protozoal organism

93
Q

How is babesiosis transmitted?

A

Arthropods

94
Q

What are the four species affected by babesiosis?

A

Horses

Cattle

Dogs

Cats

95
Q

Babesia spp. : Horse

A

Equi

Caballi

96
Q

Babesia spp. : Cattle

A

Bovis

Bigemina

97
Q

Babesia spp. : Dogs

A

Canis

98
Q

Babesia spp. : Cats

A

Cati

Herpailuri

Pantherae

99
Q

What is the mechanism of hemolysis in an animal infected with babesiosis?

A

direct damage of the membranes due to:

Protozoal proteases

Oxidative damage

Immune mediated destruction

100
Q

What is seen in a necropsy of an animal that died from babesiosis?

A

Splenomegaly

Icterus

Hemoglobinuria

Swollen, HgB stained kidneys

101
Q

What is seen upon histological examination of blood from a babesiosis infected animal?

A

Parasitized erythrocytes

Kidney + Brain + Skeletal muscle

102
Q

What is the organism responsible for the transmission of theileriosis?

A

Ticks

103
Q

What animals are infected by therileria spp.

A

Cattle

104
Q

What species of Theileria affect cattle?

A

Parva

Annulata

Buffeli

105
Q

What is the mechanism by which Theileria causes anemia in infected cattle?

A

Splenic hemosiderosis

Edema of lymph nodes/subcutis

Thoracic + Peritoneal effusions

106
Q

What are the histological features of theileriosis?

A

Schizonts - interlymphocytic

Merozoites/trophozoites - Intraerthrocytic

107
Q

What are the vectors for Trypanosomiasis?

A

Arthropods

108
Q

What animals are infected by typanosomiasis?

A

Horses

Cattle

Pigs

109
Q

Trypanosoma spp. : Horse

A

Brucei

Evansi

110
Q

Trypanosoma spp. : Cattle

A

Congolense

Vivax

111
Q

Trypanosoma spp. : Pigs

A

Simiae

112
Q

What is the mechanism that Trypanosoma causes hemolysis?

A

Immune-mediated

113
Q

What is found in a necropsy of an animal infected with trypanosomiasis?

A

Cachexia

Generalized edema with increased fluid in body cavities

Generalized lymphadenomegaly

Splenomegaly

114
Q

What is the vector for anaplasma?

A

Arthropods

Contaminated needles

115
Q

What is the vector for Ehrlichia?

A

Tick

116
Q

What animals are infected by anaplasma?

A

Cattle

Sheep/goat

117
Q

Anaplasma spp. : Cattle

A

Centrale

Marginale

118
Q

Anaplasma spp. : Sheep/Goat

A

Ovis

119
Q

What animals are infected by ehrlichia?

A

Horses

Dogs

120
Q

Ehrlichia: Horses

A

Phagocytophilum

Risticii

121
Q

Ehrlichia: Dogs

A

Canis

Phagocytophilum

122
Q

What is the mechanism by which anaplasma is able to cause hemolysis?

A

Immune-mediated extravascular hemolysis

123
Q

What is the mechanism by which ehrlichia causes hemolysis?

A

Infects granulocytes

Monocytes - dogs/horses

Enterocytes - horses

124
Q

What is seen in a necropse of an animal that died of ehrlichosis or anaplasmosis?

A

Pallor

Petechia/Ecchymoses

Splenomegaly

Lymphadenomegaly

125
Q

What organs should a cytology be taken from when anaplasmosis or ehrlichiosis is in question?

A

Liver

Lung

Spleen

LN

126
Q

What animals are infected by clostridial diseases?

A

Cattle

Lambs

127
Q

Clostridial spp.: Cattle

A

Hemolyticum

Novyi Type D

128
Q

Clostridial spp.: Lambs/calves

A

perfringens type A

129
Q

What causes bacillary hemogloburia?

A

Hemolyticum

Novyi type D

130
Q

What causes yellow lamb disease?

A

Perfringens type A

131
Q

What is the mechanism for hemolysis in yellow lamb disease?

A

Bacteria is normally found in GI

Some diets might cause abnormal proliferation within the GI tract

132
Q

What is the mechanism for hemolysis in bacillary hemoglobinuria?

A

Spores found in kupffer cells

Flukes migrate liver parenchyma

Leads to necrosis + anaerobis conditions

Spores activated and toxins degrade cell membranes

133
Q

What bacterial toxins degrade the cell membranes in bacillary hemoglobinuria?

A

Phospholipase

Lecithinases

134
Q

What is found in necropsy of an animal who died of clostridium?

A

Icterus

Hemoglobinuria

Hemoglobinuric nephrosis

135
Q

What is the mechanism of anemia caused by mycoplasma?

A

Extravascualr hemolysis

136
Q

What is found upon necropsy of an animal who has died of hemotropic mycoplasmosis?

A

Pallor

Icterus

Splenomegaly

137
Q

What is seen in the cytology from an animal infected with hemotropic mycoplasmosis?

A

Short, branching chains

Found in extracellular spaces

Attache to the surface of the RBC’s

138
Q

How is IMHA described?

A

Increased destruction of erythrocytes due to binding of immunoglobulines to cell surface antigens

139
Q

What is the reactive antibody in IMHA?

A

IgG

140
Q

What is the target of IMHA?

A

Mature erthrocytes

will have a marked regenerative response

141
Q

What are common clinical findings of IMHA?

A

Hyperbilirubinemia

Splenomegaly

Pyrexia

Inflammatory neutrophilia

142
Q

What is found post mortem in animals that have died of IMHA?

A

Ischemic necrosis of;

Liver

Kidney

Lung

heart

Spleen

143
Q

Describe: Neonatal isoerthrolysis

A

New born has colostrum-derived maternal antibodies

React against owh erythrocytes

144
Q

What species is most commonly affected by NI?

A

Horses

but seen in cattle and cats

145
Q

What are the clinical signs in a foal suffering from NI?

A

Become weak 8 to 10 hours after brith

Pale to icteric mucous membranes

Hemobloginuria

146
Q

Descirbe: Pure Red Cell Aplasia

A

Rare bone marrow disorder

Absense of erthropoiesis

Severe nonregenerative anemia

147
Q

What causes primary PRCA?

A

Immune mediated destruction of erythroid progenitor cells

148
Q

What causes secondary PRCA in cats?

A

FeLV

149
Q

What causes secondary PRCA in dogs?

A

Parvoviral infections

150
Q

What are the classes of hematopoietic neoplasias?

A

Lymphoproliferative

Myeloproliferative

151
Q

What are the lymphoproliferative neoplasia?

A

Lymphoma/Lymphosarcoma

Lymphoid leukemia

Plasma cell tumors

152
Q

What are the myeloproliderative neoplasitic disorders?

A

Myeloid leukemia

Myelodysplastic syndrome

Histiocytic neoplasia

Mast cell tumors

153
Q

What are the techiques for diagnosing neoplastic disorders?

A

Immunophenotyping

Clonality assay

154
Q

What is a clonality assay?

A

PCR test

ID’s neoplastic lymphoid proliferations

155
Q

Immunophenotyping: Histological sections

A

Immunohistochemistry

156
Q

Immunophenotyping: Cytologic

A

Immunocytochemistry

157
Q

What is immunophenotyping?

A

The use of antibodies recognizing specific molecules expressed on different cell types to ID cell populations

158
Q

Describe: Leukemia

A

Malignant hematopoietic neoplasms

Originate in bone marrow

159
Q

What are the classifications for leukemias?

A

Lymphocytic or Myeloid

Acute or Chronic

160
Q

What determines acute or chronic leukemia?

A

Degree of cell differentiation

and

Biological behavior

161
Q

What are then four major types of leukemia?

A

CLL

CML

ALL

AML

162
Q

Term: CLL

A

Chronic lymphocytic leukemia

Middle age to older dogs

T-lymphocytes

163
Q

Term: CML

A

Chronic myeloid leukemia

Dogs and Cats

Chronic granulocytic leukemia of:

neutrophils

eosinophils

basophils

164
Q

Term: ALL

A

Acute lymphocytic leukemia

Horses + Cattle

165
Q

Describe: AML

A

Acute myeloid leukemia

Dogs + Cats

166
Q

What can myelodyspalstic syndrome transform into?

A

AML

167
Q

What is myelodysplastic syndrome?

A

Ineffective hematopoiesis

168
Q

What is needed to diagnose myelodysplastic syndrome?

A

less than 30% blasts in the marrow

cytopenias of more that one cell linage

Morphological evidence of dyshematopoiesis

169
Q

Describe: Lymphoma

A

neoplasia arising from lymphoid tissue outside of the bone marrow

170
Q

What clinical finiding is commonly seen with lymphoma?

A

Orangomegaly

171
Q

What is immunophenotyping used for in lymphoma?

A

If it is B or T cell in origin

Distinguish lymphoma from lymphoid leukemia

172
Q

What marker is used to see acute leukemias?

A

CD34

173
Q

What hematological findings are seen with lymphoma?

A

Nonregenerative anemia

Hypercalcemia

174
Q

Why is hypercalcemia sometimes seen with lymphoma?

A

Production of parathyroid hormone related protein by neoplastic cells

175
Q

What are the necropsy findings in an animal that died from lymphoma in the case of multicentric?

A

Enlarged LN with buldge on cut surface

White-gray discoloration

176
Q

What are the necropsy findings in an animal that died from lymphoma in the case of alimentary?

A

GI tract by be thickened to nodular

Enlarged mesenteric LN

177
Q

What are the necropsy findings in an animal that died from lymphoma in the case of thymic?

A

Enlarged, white to gray and nodular masses

Cranial mediastinum

178
Q

What are the necropsy findings in an animal that died from lymphoma in the case of renal?

A

Bilateral enlargement and pallor

179
Q

What are the two forms of plasma cells neoplasia?

A

Multiple myeloma

Plasmocytoma

180
Q

What are the characteristics of plasmocytoma?

A

Cuteanous or mucous membrane solid tumors

Single or multiple

Usually benign

181
Q

What kind of plasmocytoma is malignant?

A

Extramedullary plasmocytoma (EMP)

182
Q

Where is EMP found most commonly?

A

GI

183
Q

What is associated with EMP?

A

Monocolonal gammopathy

Amyloidosis

184
Q

Describe: Multiple myeloma

A

Arises from bone marrous

Secretes larges amounts of Ig

No blood involvement

185
Q

What is the hallmark of Multiple myeloma?

A

Hyperglobulinemia

186
Q

What is needed to make the diagnosis of multiple myeloma?

A

Increase in plasma cells in bone marrow

monoclonal gammopathy demonstrated by serum protein

Osteolysis

Light chain proteinuria

187
Q

What pathological findings are seen with MM?

A

Hypercalcemia

Cytopenias

188
Q

Where does multiple myeloma tend to metastasize?

A

Spleen

Liver

Lymph node

Kidneys

189
Q

What is seen upon histological examination of MM?

A

Pink tinged cytoplasm

Due to high concentration of immunoglobulin

190
Q

What is seen upon histological examination of plasmacytoma?

A

Well differentiated plasma cells

Small clusters serperated by a fibrovascular stroma

191
Q

What is the origin of histiocytic neoplasia?

A

Macrophage

Dendritic cells

192
Q

What breeds are predisposed to histiocytic sarcoma?

A

Rottweiler

Bernese Mountain

193
Q

What is seen upon histological examination of histiocytic neoplasia?

A

Large, roung to spindle shaped cells

Well differentiated histocytic morphology

194
Q

What are the two types of histocytic sarcomas?

A

Solitary

Diffuse

195
Q

Describe: Solitary histiocytic sarcoma

A

Solid/single masses

Spleen

Lung

LN

Bone Marrow

Skin

SQ

Joints

Brain

196
Q

Describe: Diffuse histiiocytic sarcoma

A

Rapid/Aggressive clinical course

Spleen

Lung

LN

Bone Marrow

Skin
SQ

197
Q

What is the source of cutaneous histiocytoma?

A

Benign neoplasm of epidermal Langerhans cells

regress on its own

Appears in young dogs

198
Q

What is the histiocytic sarcoma histological morphology?

A

Gray cytoplasm

199
Q

Describe: Bloody spleen

A

Uniform splenomegaly with blood consistency

200
Q

Describe: Meaty spleen

A

Uniform splenomegaly with firm consistency

201
Q

What normally causes meaty spleen?

A

Proliferation of cells (most commonly macrophages)

and increased phagocytosis in:

Septicemia

Bacteremia

Hemolytic disease

202
Q
A

Pathology II (20 decks)

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