Leukogram Interpretation

Question 1

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

Answer 1

absolute cell count

Question 2

what are the two neutrophil responses?

Answer 2

neutrophilia
neutropenia

Question 3

what can cause neutropenia?

Answer 3

increased loss
increased margination
decreased production

Question 4

what can cause neutrophilia?

Answer 4

increased neutrophil production or release
demargination of neutrophils

Question 5

what is mature neutrophilia?

Answer 5

neutrophilia with no left shift
only mature neutrophils (segs)

Question 6

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

Answer 6

corticosteroids
catecholamines/epinephrine

Question 7

what can cause decreased production of neutrophils leading to neutropenia?

Answer 7

bone marrow disease

Question 8

what can cause neutrophil destruction?

Answer 8

immune-mediated neutropenia
hemophagocytic syndrome

Question 9

what are some infectious causes of neutropenia?

Answer 9

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

Question 10

what do cytotoxic drugs do?

Answer 10

damage all bone marrow cell lines

Question 11

what does immune-mediated neutropenia result in?

Answer 11

destruction of mature cells or precursors

Question 12

what are some causes of immune-mediated neutropenia?

Answer 12

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

Question 13

when do ruminants exhibit a neutropenia?

Answer 13

often with acute inflammation

Question 14

what are the options for lymphocyte responses?

Answer 14

lymphocytosis
lymphopenia

Question 15

what are some causes of lymphocytosis?

Answer 15

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

Question 16

what infections can cause lymphocytosis?

Answer 16

some viral diseases
Ehrlichia canis
leishmaniasis
trypanosomiasis

Question 17

what are some causes of lymphopenia?

Answer 17

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

Question 18

is monocytosis a specific finding?

Answer 18

no
can occur in most of same situations as neutrophilia

Question 19

can monocytosis occur in acute and chronic inflammation?

Answer 19

yes

Question 20

is monocytopenia often clinically irrelevent?

Answer 20

yes

Question 21

what are some causes of eosinophilia?

Answer 21

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

Question 22

why is eosinopenia difficult to diagnose?

Answer 22

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

Question 23

when might eosinopenia be seen?

Answer 23

increased corticosteroid levels
acute infections
epinephrine: cattle

Question 24

when might basophilia/basocytophilia be seen?

Answer 24

parasitic disease
allergic disease
neoplasia
inflammation in reptiles

Question 25

does basopenia occur?

Answer 25

not really

Question 26

what are the common types of leukograms?

Answer 26

inflammatory stress/corticosteroid physiologic leukocytosis decreased production/pancytopenia leukemic

Question 27

what do the classic inflammatory CBC findings include?

Answer 27

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

Question 28

what inflammation can cause neutropenia?

Answer 28

acute, severe inflammation

Question 29

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

Answer 29

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

Question 30

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

Answer 30

ruminants horses

Question 31

what are acute phase proteins?

Answer 31

blood proteins that tend to increase in patients with inflammation

Question 32

what are some commonly evaluated acute phase proteins?

Answer 32

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

Question 33

what are negative acute phase proteins?

Answer 33

blood proteins that tend to decrease with inflammation

Question 34

when may corticosteroid-induced leukocytosis be seen?

Answer 34

pain chronic stress corticosteroid therapy hyperadrenocorticism

Question 35

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

Answer 35

dogs

Question 36

when may epinephrine responses occur?

Answer 36

acute stress fear "fight or flight" responses

Question 37

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

Answer 37

lymphopenia neutrophilia monocytosis maybe eosinopenia, though difficult to detect

Question 38

why is neutrophilia seen with corticosteroid-induced leukocytosis?

Answer 38

corticosteroids cause neutrophil demargination

Question 39

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

Answer 39

about half

Question 40

what is the most typical feature of a stress leukogram?

Answer 40

lymphopenia

Question 41

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

Answer 41

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

Question 42

what is epinephrine leukocytosis caused by?

Answer 42

epinephrine release: "fight or flight"

Question 43

who is epinephrine leukocytosis most common in?

Answer 43

cats horses

Question 44

what are the typical findings of physiologic/epinephrine leukocytosis?

Answer 44

neutrophilia lymphocytosis leukocytosis is short-lived: 30 minutes

Question 45

what is pancytopenia?

Answer 45

decrease in all three major cell types in blood

Question 46

what does pancytopenia usually indicate?

Answer 46

bone marrow suppression or aplasia

Question 47

what are some potential causes of pancytopenia?

Answer 47

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

Question 48

what is myelophthisis?

Answer 48

replacement of normal bone marrow tissue by abnormal cells or tissue

Question 49

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

Answer 49

anemia is nonregenerative

Question 50

what is leukemia?

Answer 50

neoplastic proliferation of a hematopoietic cell line

Question 51

how are leukemias typically categorized?

Answer 51

lymphocytic or myeloid immature vs mature cells

Question 52

how are leukemic leukograms typically characterized?

Answer 52

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

Question 53

what is a leukemoid leukogram?

Answer 53

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

Question 54

what is seen in pancytopenia?

Answer 54

anemia thrombocytopenia leukopenia/neutropenia