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Hemic-Lymphatic and Clin Path > Leukogram Interpretation > Flashcards

Leukogram Interpretation Flashcards

1
Q

when evaluating leukocyte numbers, should you use the absolute cell count or the percentage?

A

absolute cell count

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2
Q

what are the two neutrophil responses?

A

neutrophilia
neutropenia

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3
Q

what can cause neutropenia?

A

increased loss
increased margination
decreased production

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4
Q

what can cause neutrophilia?

A

increased neutrophil production or release
demargination of neutrophils

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5
Q

what is mature neutrophilia?

A

neutrophilia with no left shift
only mature neutrophils (segs)

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6
Q

what can cause shifting of neutrophils from marginal to circulating pool?

A

corticosteroids
catecholamines/epinephrine

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7
Q

what can cause decreased production of neutrophils leading to neutropenia?

A

bone marrow disease

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8
Q

what can cause neutrophil destruction?

A

immune-mediated neutropenia
hemophagocytic syndrome

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9
Q

what are some infectious causes of neutropenia?

A

viral diseases: parvovirus, panleukopenia, FeLV, FIV, equine herpesvirus-1
ehrlichiosis/anaplasmosis

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10
Q

what do cytotoxic drugs do?

A

damage all bone marrow cell lines

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11
Q

what does immune-mediated neutropenia result in?

A

destruction of mature cells or precursors

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12
Q

what are some causes of immune-mediated neutropenia?

A

idiopathic
response to infectious organisms
drug reactions: may have immune-mediated component

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13
Q

when do ruminants exhibit a neutropenia?

A

often with acute inflammation

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14
Q

what are the options for lymphocyte responses?

A

lymphocytosis
lymphopenia

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15
Q

what are some causes of lymphocytosis?

A

epinephrine release
antigenic stimulation: sometimes seen in chronic inflammatory conditions in general
infections
hypoadrenocorticism sometimes
lymphoid neoplasia
non-lymphoid neoplasia

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16
Q

what infections can cause lymphocytosis?

A

some viral diseases
Ehrlichia canis
leishmaniasis
trypanosomiasis

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17
Q

what are some causes of lymphopenia?

A

increased corticosteroid levels
acute inflammation/infection or endotoxemia
loss of lymph
immunosuppression or hereditary immunodeficiency

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18
Q

is monocytosis a specific finding?

A

no
can occur in most of same situations as neutrophilia

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19
Q

can monocytosis occur in acute and chronic inflammation?

A

yes

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20
Q

is monocytopenia often clinically irrelevent?

A

yes

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21
Q

what are some causes of eosinophilia?

A

parasitic disease
allergic disease/hypersensitivity
eosinophilic infiltrative or proliferative diseases
paraneoplastic
hypoadrenocorticism
hyperthyroidism treated with methimazole

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22
Q

why is eosinopenia difficult to diagnose?

A

may not be possible: some reference intervals go down to 0 cells/microliter

23
Q

when might eosinopenia be seen?

A

increased corticosteroid levels
acute infections
epinephrine: cattle

24
Q

when might basophilia/basocytophilia be seen?

A

parasitic disease
allergic disease
neoplasia
inflammation in reptiles

25
Q

does basopenia occur?

A

not really

26
Q

what are the common types of leukograms?

A

inflammatory
stress/corticosteroid
physiologic leukocytosis
decreased production/pancytopenia
leukemic

27
Q

what do the classic inflammatory CBC findings include?

A

neutrophilia
left shifting in neutrophil line
toxic change in neutrophils
monocytosis
lymphocytes may be normal, increased, or decreased
all of the above may not be present

28
Q

what inflammation can cause neutropenia?

A

acute, severe inflammation

29
Q

what is the evidence of inflammation with normal or decreased neutrophil count?

A

left shift
toxic neutrophils
increased acute phase proteins
direct evidence of inflammation (lesions, fever)

30
Q

who is neutropenia with acute/severe inflammation most common in?

A

ruminants
horses

31
Q

what are acute phase proteins?

A

blood proteins that tend to increase in patients with inflammation

32
Q

what are some commonly evaluated acute phase proteins?

A

fibrinogen: large animals
C-reactive protein: dogs
serum amyloid A: cats and horses

33
Q

what are negative acute phase proteins?

A

blood proteins that tend to decrease with inflammation

34
Q

when may corticosteroid-induced leukocytosis be seen?

A

pain
chronic stress
corticosteroid therapy
hyperadrenocorticism

35
Q

in what species is corticosteroid-induced leukocytosis most common in?

A

dogs

36
Q

when may epinephrine responses occur?

A

acute stress
fear
“fight or flight” responses

37
Q

what is the typical pattern with corticosteroid-induced/stress leukocytosis?

A

lymphopenia
neutrophilia
monocytosis maybe
eosinopenia, though difficult to detect

38
Q

why is neutrophilia seen with corticosteroid-induced leukocytosis?

A

corticosteroids cause neutrophil demargination

39
Q

how many of the neutrophils in the body are usually transiently adhered to endothelium?

A

about half

40
Q

what is the most typical feature of a stress leukogram?

A

lymphopenia

41
Q

what are some findings that would suggest inflammation but not a stress leukogram?

A

severe neutrophilia
left shift
toxic change in neutrophils
increased fibrinogen or other acute phase proteins
clinical signs of inflammatory disease
combinations of inflammation and stress/corticosteroids may occur

42
Q

what is epinephrine leukocytosis caused by?

A

epinephrine release: “fight or flight”

43
Q

who is epinephrine leukocytosis most common in?

A

cats
horses

44
Q

what are the typical findings of physiologic/epinephrine leukocytosis?

A

neutrophilia
lymphocytosis
leukocytosis is short-lived: 30 minutes

45
Q

what is pancytopenia?

A

decrease in all three major cell types in blood

46
Q

what does pancytopenia usually indicate?

A

bone marrow suppression or aplasia

47
Q

what are some potential causes of pancytopenia?

A

myelophthisis
toxins or hormones
infectious agents
immune-mediated destruction of hematopoietic stem cells
combined effects of multiple non-marrow conditions

48
Q

what is myelophthisis?

A

replacement of normal bone marrow tissue by abnormal cells or tissue

49
Q

what does a normal erythrocyte morphology with anemia suggest (no polychromasia)?

A

anemia is nonregenerative

50
Q

what is leukemia?

A

neoplastic proliferation of a hematopoietic cell line

51
Q

how are leukemias typically categorized?

A

lymphocytic or myeloid
immature vs mature cells

52
Q

how are leukemic leukograms typically characterized?

A

very high blood cell counts
some can have few circulating neoplastic cells or no circulating cells

53
Q

what is a leukemoid leukogram?

A

CBC with very high neutrophil count and marked left shifting due to inflammation
like leukemia but is not

54
Q

what is seen in pancytopenia?

A

anemia
thrombocytopenia
leukopenia/neutropenia

Hemic-Lymphatic and Clin Path (33 decks)

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