LEC 10 - Hemo-lymphatic System Flashcards
1
Q
What are the two major defense mechanisms within the erythrocytes?
A
Glycolytic pathway + Pentose shunt pathway
2
Q
What does the glycolytic pathway do?
A
Produce NADH - helps in the conversion of methemoglobin to hemoglobin
3
Q
What does the pentose pathway do?
A
Produce NADPH - maintains glutathione in the reduced state
4
Q
What are the eight responses to injury that bone marrow can undergo?
A
Hyper/hypoplasia + Dysplasia + Myelopthisis + Aplasia + Neoplasia + Myelofibrosis + Inflammation/Necrosis
5
Q
What are the causes of hyperplasia in bone marrow?
A
Response to stimulus
Secondary phenomenon to a stimulus
Idiopathic
6
Q
Term: Hypoplasia of bone marrow
A
Decrease in bone marrow hematopoietic tissue
7
Q
Term: Dysplasia of Bone Marrow
A
Abnormally large size of hemopoietic tissue
8
Q
Term: Myelophthisis
A
Replacement of mematopoietic tissue in bone marrow by another tissue
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
10
Q
What are the possible reasons for increase in the concentration of blood cells?
A
Increase in production
Paraneoplastic syndromes
Neoplasia
11
Q
Term: Anemia
A
Subnormal RBC mass
– or –
Hemoglobin concentration
12
Q
What are the clinical signs of anemia?
A
Pallor of mucous membrans
Lethargy, weakness
Elevated liver enzymes
Heart murmur
13
Q
Why is there elevated liver enzymes with anemia?
A
Hypoia-induced damage to hepatocytes
14
Q
Why do you hear heart murmurs with anemia?
A
Blood thinning
15
Q
What can cause regenerative anemia?
A
hemorrhage
– or –
Hemolysis
16
Q
What is seen on blood work if there is a strong regerneative response?
A
Increase MCV
Decrease MCHC
17
Q
What is the hallmark of regenerative anemia?
A
reticulocytosis
18
Q
What does reticulocytosis indicate?
A
Increase bone marrow erythropoiesis
19
Q
How do horses present with regenerative anemia?
A
Increase MCV
20
Q
How are reticulocytes distinguided?
A
Polychormasia
21
Q
What two things are needed to determine regenerative anemia is occurring in horses?
A
Bone marrow examination
– and –
Sequential CBC
22
Q
What is the hallmark of regenerative anemia in a horse’s bone marrow?
A
Erythroid hyperplasia
23
Q
What is a classic sequlae of hemolytic anemia?
A
Hypernilirubinemia
24
Q
What is seen clinically with hyperbilirubinemia?
A
Icterus
25
What are the two types of hemolytic anemias?
Extravascular
-- and --
Intravascular
26
What does extravascular hemolytic anemia result in? Why?
Splenomegaly
Increase destruction of RBC's by splenic macrophages
27
What does intravascular hemoysis result in?
Hemoglobinemia
28
What causes hemoglobinuria? What does it lead to?
Free HgB pass through renal glomeruli into urine
Can lead to renal tubular necrosis
29
What are two other differietials for hemoglobinuria?
Hematuria
-- or --
Myoglobinuria
30
What is seen in the blood of a patient with IMHA?
Spherocytosis
-- and --
Autoaggluintation
31
What bacteria can cause spelnomegaly in a pig, caused by hemolytic anemia?
Mycoplasma suis
32
What feature is seen histologically of spherocytes?
Howell-Joly bodies
33
How does oxidative damage occur to erythrocytes?
Normal antioxidant pathways that make NADH + NADPH are compromised/overwhelmed
34
What evidence of oxidative damage on a blood smear?
Heinz bodies
35
Term: Heinz Bodies
Foci of denatured globin that interact with erthrocyte membrane
36
What can oxidative insult cause to the hemoglobin?
HgB can convert to methemoglobin which are inable to bind to oxygen
Blood becomes chocolate colored
37
How is nonregenerative anemia characterized?
Lack of reticulocytosis on CBC
38
What is the most common form of nonregenerative anemia?
Anemia of inflammation or Anemia of chronic disease
39
Why does anemia of chornic disease tend to cause nonregenerative anemia?
Increased iron stores in bone marrow
40
Term: Hepcidin
Acute phase protein
Limit iron avalibility
41
What happens to levels of hepcidin when there is inflammation?
Increases
42
What is the end result of increased hepcidin?
Functional iron deficiency by:
inhibiting absorption of dietary iron in GI
Blocking export of iron from marcophages/hepatocytes
43
What is true iron defiency most commonly caused by?
Chronic blood loss
sometimes nutritional deficiency
44
What is the hematologic appearance of iron deficiency?
Microcytic
Hypochromic
Low MVC + MCHC
45
What are the four major reasons for neutropenia?
Decreased production
Increased destruction
Increased demand
Altered distribution
46
What can cause neuropenia due to increased demand?
Margination between inflammatory stimulus + reserve of postmitotic neutrophils in bone marrow
47
What can cause neuropenia due to increased destruction?
Occurs before they leave the bone marrow
Immune mediated
48
What is the increased destruction of neutrophils knowns as?
Granulopoiesis
49
What can cause neuropenia due to decreased production?
Chemical
Radiation
Neoplaisa
infection
50
If eosinopenia/basopenia is detectable what is it suspected to be a part of?
Stress leukogram
Mediated by glucocorticoids
51
What can cause thrombocytopenia due to increased destruction?
Immune mediated thrombocytopenia
52
What can cause thrombocytopenia due to increase consumption?
Hallmark of DIC
53
Term: Erythrocytosis
Increase in RBC mass
54
What causes primary erythrocytosis?
Dehydration
-- and --
Epinephrine mediated splenic contraction
55
What are the causes of secondary erythrocytosis?
true EPO-mediated increase in RBC mass
56
What are the five mechanisms for neutrophilia?
Increase release if marrow storage pool cells
Demargination of neutrophils
Decreased extravasation into tissue
Expansion of marrow precursor pool
Congenital
57
What might cause increased release of marrow storage pool cells?
Endotoxemia
Acute infection
Hypoxia
Glucocorticosteroids
58
What can cause demargination of neutrophils?
Acute infection
Excercise
EPI release
Glucocorticosteroids
59
What could be the cause of expansion of marrow precursor pool?
Chronic infection
Tumors
Rebound from neutropenia
Myeloproliferative disorders
60
What is a congenital cause of neutrophilia?
Leukocyte adhesion defiency
61
When is lymphocytosis normal?
Young animals
62
What can cause lymphocytosis in cats? What does it occur with?
Epinephrine mediated physiological leukocytosis
Marked with neutrophilia
63
What virus can cause lymphocytosis in cattle?
BLV
64
What condition is caused by BLV that leads to lymphocytosis in cattle?
Persistent leukocytosis
65
What defines an animal with persistent leukocytosis?
Lymphocytosis for at least 3 months
Non-neoplastic proliferation of B-lymphocytes
66
Term: Anaplastic anemia
Severe hypoplasia of all hematopoietic lineages in bone marrow
67
What is another name for anaplastic anaemia?
Aplastic pancytopenia
68
What is the cause of anaplastic anemia?
Destruction of hematopoietic stem cells caused by
Chemical agents
Infectious agents
Idiopathic
69
What infectious agents in dogs and cats cause anaplastic anemia?
Erlichiosis
-- and --
Parvovirus
70
What infectious agents cause anaplastic anemia in cats?
FeLV
-- and --
FIV
71
What infectious agents cause anaplastic anemia in horses?
Equine infectious anemia
72
Term: Erythropoietic porphyrias
Defect of enzymes in synthesis of porphyrins and other heme proteins
73
What is prphyrins?
Precursors of HgB
74
What are three common types of erythropoietic porphyrias?
Congentical erythropoietic porphria
Bovine erythropoietic protoporphyria
Congenital prophyria of Siamese and DSH cats
75
What animals are at risk for getting congenital erythropoietic porphyria?
Holstein cattle
-- and --
Shorthorn cattle
76
What are the characteristics of congenital erythropoietic porphyria?
Red-brown discoloration of teeth + bones + urine
Photodynamic porphyrins in circulation
Anemia
77
What animals tend to be at risk for Bovine erythropoietic protoporphyria?
Limousin cattle
78
What are the characteristics of bovine erthropietic protoporphyria?
No discoloration of teeth or bones
Accumulation of protoporphyrins in tissues + erytrocytes
Photosensitivity only clinical manifestation
79
What is causing bovine erythropoietic protoporphyria?
Inherited disorder of heme synthase
Accumulation of prorotporphrins in tissues and erythrocutes
80
How is pyruvate kinase deficiency characterized?
Moderate to severe extravascular hemolytic anemia
Strongly regenerative
81
What is the genetic characteristic of pyruvate kinase deficiency?
Inherited autosomal recessive
Dogs + cats
82
What is seen clinically with Chediak-Higashi syndrome?
Pyogenic infections
Bleeding tendencies
Ocular/cutaneous hypopigmentation
83
What causes chediak-higashi syndrome to occur?
Mutation in the gene for LYST
Causes severely impaired cellular innate immunity due to neutropenia
impaired chemotaxis
respiratory burst
84
What causes Glazmann thrombasthenia?
Defective expression of integrin GPIIb-IIIa
Fibrin receptor for normal platelet aggregation
85
What is clinically seen with glazmann thrombasthenia?
Severely impaired clot retraction
86
What breeds of dogs are found to have Glazmann thrombasthenia?
Great pyrenees
-- and --
Otterhound dogs
87
What are the oxidative agents that cause toxicoses in horses?
Red maple
Phenotiazine
Onions/garlic
88
What are the oxidative agents that cause toxicoses in ruminants?
Brassica/Rye grass
Copper toxicity
Onions/Garlic
89
What are the oxidative agents that cause toxicoses in Dogs?
Acetaminophen
Naphthalene
Benzocaine
Phenylhydrazine
Vitamin K1 and K3
Zinc toxicity
90
What are the oxidative agents that cause toxicoses in Cats?
Acetaminophen
Benzocaine
Methionine
Napthalene
Propofol
Propylen glycol
91
What are the post mortem findings in animals with toxicoses due to oxidative agents?
Icterus
Hemoglobinuric nephrosis
Brown discoloration of liver/kidney
Splenomegaly
92
Describe the organism that causes babesiosis?
Babesia spp.
Intraerythrocytic protozoal organism
93
How is babesiosis transmitted?
Arthropods
94
What are the four species affected by babesiosis?
Horses
Cattle
Dogs
Cats
95
Babesia spp. : Horse
Equi
Caballi
96
Babesia spp. : Cattle
Bovis
Bigemina
97
Babesia spp. : Dogs
Canis
98
Babesia spp. : Cats
Cati
Herpailuri
Pantherae
99
What is the mechanism of hemolysis in an animal infected with babesiosis?
direct damage of the membranes due to:
Protozoal proteases
Oxidative damage
Immune mediated destruction
100
What is seen in a necropsy of an animal that died from babesiosis?
Splenomegaly
Icterus
Hemoglobinuria
Swollen, HgB stained kidneys
101
What is seen upon histological examination of blood from a babesiosis infected animal?
Parasitized erythrocytes
Kidney + Brain + Skeletal muscle
102
What is the organism responsible for the transmission of theileriosis?
Ticks
103
What animals are infected by therileria spp.
Cattle
104
What species of Theileria affect cattle?
Parva
Annulata
Buffeli
105
What is the mechanism by which Theileria causes anemia in infected cattle?
Splenic hemosiderosis
Edema of lymph nodes/subcutis
Thoracic + Peritoneal effusions
106
What are the histological features of theileriosis?
Schizonts - interlymphocytic
Merozoites/trophozoites - Intraerthrocytic
107
What are the vectors for Trypanosomiasis?
Arthropods
108
What animals are infected by typanosomiasis?
Horses
Cattle
Pigs
109
Trypanosoma spp. : Horse
Brucei
Evansi
110
Trypanosoma spp. : Cattle
Congolense
Vivax
111
Trypanosoma spp. : Pigs
Simiae
112
What is the mechanism that Trypanosoma causes hemolysis?
Immune-mediated
113
What is found in a necropsy of an animal infected with trypanosomiasis?
Cachexia
Generalized edema with increased fluid in body cavities
Generalized lymphadenomegaly
Splenomegaly
114
What is the vector for anaplasma?
Arthropods
Contaminated needles
115
What is the vector for Ehrlichia?
Tick
116
What animals are infected by anaplasma?
Cattle
Sheep/goat
117
Anaplasma spp. : Cattle
Centrale
Marginale
118
Anaplasma spp. : Sheep/Goat
Ovis
119
What animals are infected by ehrlichia?
Horses
Dogs
120
Ehrlichia: Horses
Phagocytophilum
Risticii
121
Ehrlichia: Dogs
Canis
Phagocytophilum
122
What is the mechanism by which anaplasma is able to cause hemolysis?
Immune-mediated extravascular hemolysis
123
What is the mechanism by which ehrlichia causes hemolysis?
Infects granulocytes
Monocytes - dogs/horses
Enterocytes - horses
124
What is seen in a necropse of an animal that died of ehrlichosis or anaplasmosis?
Pallor
Petechia/Ecchymoses
Splenomegaly
Lymphadenomegaly
125
What organs should a cytology be taken from when anaplasmosis or ehrlichiosis is in question?
Liver
Lung
Spleen
LN
126
What animals are infected by clostridial diseases?
Cattle
Lambs
127
Clostridial spp.: Cattle
Hemolyticum
Novyi Type D
128
Clostridial spp.: Lambs/calves
perfringens type A
129
What causes bacillary hemogloburia?
Hemolyticum
Novyi type D
130
What causes yellow lamb disease?
Perfringens type A
131
What is the mechanism for hemolysis in yellow lamb disease?
Bacteria is normally found in GI
Some diets might cause abnormal proliferation within the GI tract
132
What is the mechanism for hemolysis in bacillary hemoglobinuria?
Spores found in kupffer cells
Flukes migrate liver parenchyma
Leads to necrosis + anaerobis conditions
Spores activated and toxins degrade cell membranes
133
What bacterial toxins degrade the cell membranes in bacillary hemoglobinuria?
Phospholipase
Lecithinases
134
What is found in necropsy of an animal who died of clostridium?
Icterus
Hemoglobinuria
Hemoglobinuric nephrosis
135
What is the mechanism of anemia caused by mycoplasma?
Extravascualr hemolysis
136
What is found upon necropsy of an animal who has died of hemotropic mycoplasmosis?
Pallor
Icterus
Splenomegaly
137
What is seen in the cytology from an animal infected with hemotropic mycoplasmosis?
Short, branching chains
Found in extracellular spaces
Attache to the surface of the RBC's
138
How is IMHA described?
Increased destruction of erythrocytes due to binding of immunoglobulines to cell surface antigens
139
What is the reactive antibody in IMHA?
IgG
140
What is the target of IMHA?
Mature erthrocytes
will have a marked regenerative response
141
What are common clinical findings of IMHA?
Hyperbilirubinemia
Splenomegaly
Pyrexia
Inflammatory neutrophilia
142
What is found post mortem in animals that have died of IMHA?
Ischemic necrosis of;
Liver
Kidney
Lung
heart
Spleen
143
Describe: Neonatal isoerthrolysis
New born has colostrum-derived maternal antibodies
React against owh erythrocytes
144
What species is most commonly affected by NI?
Horses
but seen in cattle and cats
145
What are the clinical signs in a foal suffering from NI?
Become weak 8 to 10 hours after brith
Pale to icteric mucous membranes
Hemobloginuria
146
Descirbe: Pure Red Cell Aplasia
Rare bone marrow disorder
Absense of erthropoiesis
Severe nonregenerative anemia
147
What causes primary PRCA?
Immune mediated destruction of erythroid progenitor cells
148
What causes secondary PRCA in cats?
FeLV
149
What causes secondary PRCA in dogs?
Parvoviral infections
150
What are the classes of hematopoietic neoplasias?
Lymphoproliferative
Myeloproliferative
151
What are the lymphoproliferative neoplasia?
Lymphoma/Lymphosarcoma
Lymphoid leukemia
Plasma cell tumors
152
What are the myeloproliderative neoplasitic disorders?
Myeloid leukemia
Myelodysplastic syndrome
Histiocytic neoplasia
Mast cell tumors
153
What are the techiques for diagnosing neoplastic disorders?
Immunophenotyping
Clonality assay
154
What is a clonality assay?
PCR test
ID's neoplastic lymphoid proliferations
155
Immunophenotyping: Histological sections
Immunohistochemistry
156
Immunophenotyping: Cytologic
Immunocytochemistry
157
What is immunophenotyping?
The use of antibodies recognizing specific molecules expressed on different cell types to ID cell populations
158
Describe: Leukemia
Malignant hematopoietic neoplasms
Originate in bone marrow
159
What are the classifications for leukemias?
Lymphocytic or Myeloid
Acute or Chronic
160
What determines acute or chronic leukemia?
Degree of cell differentiation
and
Biological behavior
161
What are then four major types of leukemia?
CLL
CML
ALL
AML
162
Term: CLL
Chronic lymphocytic leukemia
Middle age to older dogs
T-lymphocytes
163
Term: CML
Chronic myeloid leukemia
Dogs and Cats
Chronic granulocytic leukemia of:
neutrophils
eosinophils
basophils
164
Term: ALL
Acute lymphocytic leukemia
Horses + Cattle
165
Describe: AML
Acute myeloid leukemia
Dogs + Cats
166
What can myelodyspalstic syndrome transform into?
AML
167
What is myelodysplastic syndrome?
Ineffective hematopoiesis
168
What is needed to diagnose myelodysplastic syndrome?
less than 30% blasts in the marrow
cytopenias of more that one cell linage
Morphological evidence of dyshematopoiesis
169
Describe: Lymphoma
neoplasia arising from lymphoid tissue outside of the bone marrow
170
What clinical finiding is commonly seen with lymphoma?
Orangomegaly
171
What is immunophenotyping used for in lymphoma?
If it is B or T cell in origin
Distinguish lymphoma from lymphoid leukemia
172
What marker is used to see acute leukemias?
CD34
173
What hematological findings are seen with lymphoma?
Nonregenerative anemia
Hypercalcemia
174
Why is hypercalcemia sometimes seen with lymphoma?
Production of parathyroid hormone related protein by neoplastic cells
175
What are the necropsy findings in an animal that died from lymphoma in the case of multicentric?
Enlarged LN with buldge on cut surface
White-gray discoloration
176
What are the necropsy findings in an animal that died from lymphoma in the case of alimentary?
GI tract by be thickened to nodular
Enlarged mesenteric LN
177
What are the necropsy findings in an animal that died from lymphoma in the case of thymic?
Enlarged, white to gray and nodular masses
Cranial mediastinum
178
What are the necropsy findings in an animal that died from lymphoma in the case of renal?
Bilateral enlargement and pallor
179
What are the two forms of plasma cells neoplasia?
Multiple myeloma
Plasmocytoma
180
What are the characteristics of plasmocytoma?
Cuteanous or mucous membrane solid tumors
Single or multiple
Usually benign
181
What kind of plasmocytoma is malignant?
Extramedullary plasmocytoma (EMP)
182
Where is EMP found most commonly?
GI
183
What is associated with EMP?
Monocolonal gammopathy
Amyloidosis
184
Describe: Multiple myeloma
Arises from bone marrous
Secretes larges amounts of Ig
No blood involvement
185
What is the hallmark of Multiple myeloma?
Hyperglobulinemia
186
What is needed to make the diagnosis of multiple myeloma?
Increase in plasma cells in bone marrow
monoclonal gammopathy demonstrated by serum protein
Osteolysis
Light chain proteinuria
187
What pathological findings are seen with MM?
Hypercalcemia
Cytopenias
188
Where does multiple myeloma tend to metastasize?
Spleen
Liver
Lymph node
Kidneys
189
What is seen upon histological examination of MM?
Pink tinged cytoplasm
Due to high concentration of immunoglobulin
190
What is seen upon histological examination of plasmacytoma?
Well differentiated plasma cells
Small clusters serperated by a fibrovascular stroma
191
What is the origin of histiocytic neoplasia?
Macrophage
Dendritic cells
192
What breeds are predisposed to histiocytic sarcoma?
Rottweiler
Bernese Mountain
193
What is seen upon histological examination of histiocytic neoplasia?
Large, roung to spindle shaped cells
Well differentiated histocytic morphology
194
What are the two types of histocytic sarcomas?
Solitary
Diffuse
195
Describe: Solitary histiocytic sarcoma
Solid/single masses
Spleen
Lung
LN
Bone Marrow
Skin
SQ
Joints
Brain
196
Describe: Diffuse histiiocytic sarcoma
Rapid/Aggressive clinical course
Spleen
Lung
LN
Bone Marrow
Skin
SQ
197
What is the source of cutaneous histiocytoma?
Benign neoplasm of epidermal Langerhans cells
regress on its own
Appears in young dogs
198
What is the histiocytic sarcoma histological morphology?
Gray cytoplasm
199
Describe: Bloody spleen
Uniform splenomegaly with blood consistency
200
Describe: Meaty spleen
Uniform splenomegaly with firm consistency
201
What normally causes meaty spleen?
Proliferation of cells (most commonly macrophages)
and increased phagocytosis in:
Septicemia
Bacteremia
Hemolytic disease
202
