Lecture 26 - WBC Interpretation 1 Flashcards
T/F: WBC counts are not reliable in avian/exotics since RBCs are nucleated
TRUE
List the Leukogram-related terms for increase
-cytosis, -philia
List the Leukogram-related terms for decrease
-penia
What are the 3 steps to interpreting a leukogram
- describe the overall change
- characterize shifts or morphology
- interpret
Inflammation leukograms would have
neutrophilia +/- monocytosis
neutropenia
+/- band neutrophils, toxic change
Physiologic/epinephrine-related leukograms would have
neutrophilia, lymphocytosis
Stress/corticosteroid-related leukograms would have
lymphopenia, mature neutrophilia, monocytosis, eosinophilia
what species is physiologic leukocytosis common in
healthy cats and foals
Physiologic leukocytosis is caused by…
fear, excitement, exercise
stress response/corticosteroid leukocytosis is caused by…
steroid treatment, Cushing’s (hyper),, trauma/illness
Characterize the Bloodwork:
RBC 1.95 (5-11)
Hgb 2.9 (8-15)
Hct 9.2 (25-45)
MCHC 29 (30-36)
RDW 22.4 (13-17)
PLT 143 (200-500)
Neut. 13.6 (2.7-6.9)
Lymph .151 (.415-4.996)
Mono. 1.3 (.07-.8)
morphology - clumped platelets, anisocytosis, polychromasia
Erythrogram: marked normocytic hypochromic anemia
Leukogram: mild neutrophilia, mild monophilia, moderate lympopenia
T/F: a stress response leukogram occurs independently
FALSE - concurrently w inflammatory leukogram
left degenerative shift indicates
band neutrophils > mature neutrophils
What would you diagnose if a dog had no stress leukogram but was presenting as sick
Addison’s (hypo)
Left shift indicates
banded neutrophil presence
What is the predominant leukocyte in health for dogs, cats, and horses
Neutrophils
In non-mammalian species, what are neutrophils called
heterophils
Where is the neutrophil storage pool
bone marrow
what species has the largest storage pool? smallest storage pool?
dogs; ruminants
circulating neutrophil pool
free flowing in the blood
marginating neutrophil pool
adhered to endothelial cells
Neutrophil count on CBC is affected by what 3 factors?
- rate of bone marrow production and release
- rate of migration into tissues
- shifts between marginating and circulating pools
What are 4 examples of cytoplasmic toxic changes
- dohle bodies
- cytoplasmic basophilia
- cytoplasmic vacuolization
- toxic granulation
Toxic change in neutrophils is seen by
retention of immature features
What are the 4 patterns of inflammation
- classic inflammation
- extreme neutrophilia
- overwhelming inflammation
- inflammation w concurrent stress response
increased neutrophils is consistent with what inflammation pattern
classical
decreased neutrophils is consistent with what inflammation pattern
overwhelming
Describe classical inflammation
- neutrophilia +/- left shift and toxic change
- bone marrow production outpaces tissue consumption
Describe extreme neutrophilia
- “leukemia-like”
- big bone marrow stimulus
- the Ps
What are the 5 Ps of inflammation
pyometra
pyelonephritis
pyothorax
pancreatitis
pus-pockets
neutropenia in ruminants indicates what inflammation
significant acute
What are examples of agents that cause overwhelming inflammation
gram - bacterial infection
canine parvovirus
FPV
bone marrow damage
leukemia
leukemia
cancer of blood cells
myelophthisis
neoplastic infiltration of bone marrow
Characterize the bloodwork:
WBC 31.5 (4.4-11.6)
Hct 7.4 (39.2-55.9)
MCV 98.5 (64-75.2)
MCHC 26.2 (34.5-36.6)
PCV 9 (39-58)
Reticulo. 189225 (8040-93730)
Neutro. 25.8 (2.8-9.1)
Bands 1.3
lymph 0.63 (.59-3.3)
mono. 3.7 (.075-.85)
morphology - polychromasia, spherocytes, agglutination
Erythrogram - marked macrocytic hypochromic regenerative anemia w spherocytes and agglutination (IMHA)
Leukogram - moderate leukocytosis, moderate neutrophilia w/ left shift, moderate monocytosis (classical)
Characterize the bloodwork:
Hct 36 (39.2-55.9)
PLT 480 (190-468)
PCV 35 (39-58)
neutro. 1.9 (2.8-9.1)
bands 1.7
lymph .32 (.59-3.3)
morphology - 2+ toxic change
Erythrogram - normocytic normochromic non-regenerative anemia
Leukogram - moderate neutropenia w/ degenerative left shift and toxic change
moderate lymphopenia and eosinopenia (overwhelming)
Physiologic leukogram patterns
increased neutrophils, lymphocytes
Corticosteroid leukogram patterns
increased neutrophils, monocytes
decreased lymphocytes, eosinophils
Classic inflammation leukogram patterns
increased neutrophils, maybe monocytes
maybe decreased lymphocytes, eosinophils
+/- left shift and toxic change
Overwhelming inflammation leukogram patterns
decreased neutrophils
+ Left shift and toxic change
Inflammation + stress leukogram patterns
increased neutrophils, monocytes
decreased lymphocytes, eosinophils
+/- left shift and toxic change
