Lecture 26 - WBC Interpretation 1

Question 1

T/F: WBC counts are not reliable in avian/exotics since RBCs are nucleated

Answer 1

TRUE

Question 2

List the Leukogram-related terms for increase

Answer 2

-cytosis, -philia

Question 3

List the Leukogram-related terms for decrease

Answer 3

-penia

Question 3

What are the 3 steps to interpreting a leukogram

Answer 3

1. describe the overall change
2. characterize shifts or morphology
3. interpret

Question 4

Inflammation leukograms would have

Answer 4

neutrophilia +/- monocytosis
neutropenia
+/- band neutrophils, toxic change

Question 4

Physiologic/epinephrine-related leukograms would have

Answer 4

neutrophilia, lymphocytosis

Question 4

Stress/corticosteroid-related leukograms would have

Answer 4

lymphopenia, mature neutrophilia, monocytosis, eosinophilia

Question 5

what species is physiologic leukocytosis common in

Answer 5

healthy cats and foals

Question 6

Physiologic leukocytosis is caused by…

Answer 6

fear, excitement, exercise

Question 7

stress response/corticosteroid leukocytosis is caused by…

Answer 7

steroid treatment, Cushing’s (hyper),, trauma/illness

Question 8

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

Answer 8

Erythrogram: marked normocytic hypochromic anemia

Leukogram: mild neutrophilia, mild monophilia, moderate lympopenia

Question 9

T/F: a stress response leukogram occurs independently

Answer 9

FALSE - concurrently w inflammatory leukogram

Question 10

left degenerative shift indicates

Answer 10

band neutrophils > mature neutrophils

Question 10

What would you diagnose if a dog had no stress leukogram but was presenting as sick

Answer 10

Addison’s (hypo)

Question 11

Left shift indicates

Answer 11

banded neutrophil presence

Question 12

What is the predominant leukocyte in health for dogs, cats, and horses

Answer 12

Neutrophils

Question 12

In non-mammalian species, what are neutrophils called

Answer 12

heterophils

Question 13

Where is the neutrophil storage pool

Answer 13

bone marrow

Question 14

what species has the largest storage pool? smallest storage pool?

Answer 14

dogs; ruminants

Question 15

circulating neutrophil pool

Answer 15

free flowing in the blood

Question 16

marginating neutrophil pool

Answer 16

adhered to endothelial cells

Question 17

Neutrophil count on CBC is affected by what 3 factors?

Answer 17

1. rate of bone marrow production and release
2. rate of migration into tissues
3. shifts between marginating and circulating pools

Question 18

What are 4 examples of cytoplasmic toxic changes

Answer 18

1. dohle bodies
2. cytoplasmic basophilia
3. cytoplasmic vacuolization
4. toxic granulation

Question 19

Toxic change in neutrophils is seen by

Answer 19

retention of immature features

Question 20

What are the 4 patterns of inflammation

Answer 20

1. classic inflammation 2. extreme neutrophilia 3. overwhelming inflammation 4. inflammation w concurrent stress response

Question 21

increased neutrophils is consistent with what inflammation pattern

Answer 21

classical

Question 22

decreased neutrophils is consistent with what inflammation pattern

Answer 22

overwhelming

Question 23

Describe classical inflammation

Answer 23

- neutrophilia +/- left shift and toxic change - bone marrow production outpaces tissue consumption

Question 24

Describe extreme neutrophilia

Answer 24

- "leukemia-like" - big bone marrow stimulus - the Ps

Question 25

What are the 5 Ps of inflammation

Answer 25

pyometra pyelonephritis pyothorax pancreatitis pus-pockets

Question 26

neutropenia in ruminants indicates what inflammation

Answer 26

significant acute

Question 27

What are examples of agents that cause overwhelming inflammation

Answer 27

gram - bacterial infection canine parvovirus FPV bone marrow damage leukemia

Question 28

leukemia

Answer 28

cancer of blood cells

Question 29

myelophthisis

Answer 29

neoplastic infiltration of bone marrow

Question 30

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

Answer 30

Erythrogram - marked macrocytic hypochromic regenerative anemia w spherocytes and agglutination (IMHA) Leukogram - moderate leukocytosis, moderate neutrophilia w/ left shift, moderate monocytosis (classical)

Question 31

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

Answer 31

Erythrogram - normocytic normochromic non-regenerative anemia Leukogram - moderate neutropenia w/ degenerative left shift and toxic change moderate lymphopenia and eosinopenia (overwhelming)

Question 32

Physiologic leukogram patterns

Answer 32

increased neutrophils, lymphocytes

Question 33

Corticosteroid leukogram patterns

Answer 33

increased neutrophils, monocytes decreased lymphocytes, eosinophils

Question 34

Classic inflammation leukogram patterns

Answer 34

increased neutrophils, maybe monocytes maybe decreased lymphocytes, eosinophils +/- left shift and toxic change

Question 35

Overwhelming inflammation leukogram patterns

Answer 35

decreased neutrophils + Left shift and toxic change

Question 36

Inflammation + stress leukogram patterns

Answer 36

increased neutrophils, monocytes decreased lymphocytes, eosinophils +/- left shift and toxic change