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vet med 4 > Lympho > Flashcards

Lympho Flashcards

1
Q

Describe the function of the spleen

A
  • blood reserve (injury or exercise can release 10-20% BV)
  • RBC metabolism
  • hematopoesis (if BM fails can make RBC and WBC)
  • immune function (macrophage pathogens and make antibodies)
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2
Q

What are the indications for a splenectomy

A
  • trauma
  • neoplasia (ie haemangiosarcoma)
  • splenic torsion
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3
Q

What clinical signs may you see with hemangiosarcoma

A
  • anaemia
  • haemoabdomen
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4
Q

Is isolated splenic injury common?

A

No

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5
Q

Neoplasia in the spleen- total or partial splenectomy?

A

Total splenectomy

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6
Q

On US of the spleen you see a snow globe effect - what may has happened to the spleen?

A

Splenic torsion

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7
Q

What are the 2 main perioperative risks of splenectomy?

A
  • DIC
  • Increased risk of cardiac arrhythmis
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8
Q

Focal or benigh disease of the spleen- would you do a partial or total splenectomy?

A

Partial splenectomy

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9
Q

What are the 2 suture patterns used during a partial splenectomy?

A

2 rows of continuous overlappig mattress sutures followed by continuous suture / linear staple

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10
Q

What complications can be seen with splenectomy?

A
  • Hemmorhage (due to technical failure)
  • increased risk of infection
  • cardiac arrhythmmias
  • gastritis and pancreatitis (if you have compromised the left limb of pancreas’s blood supply)
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11
Q

What is the most common cause of thrombocytopenia?

A

Immune mediated thrombocytopenia

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12
Q

List causes of severe thrombocytopenia

A
  • DIC
  • immune mediated
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13
Q

List causes of mild thrombocytopenia

A
  • hemmorhage
  • splenic sequestration
  • cavitated mass
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14
Q

Absence of all Vwf multimers- what type of Vwf disease is this?

A

Type 3

puppies usually die

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15
Q

Qualitative abnormalities in VwF structure and function. Decrease in large VwF multimers- what type of Vwf disease is this?

A

Type 2

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16
Q

All VwF multimers present but at decreased concentration- what type of Vwf disease is this?

A

Type 1

commonly seen in Dobermans

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17
Q

How to we test for VwF disease?

A
  • Elisa (measure antibodies for VwF)
  • immunoelectrophoresis
  • genetic tests for carriers
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18
Q

Treatment for VwF disease

A
  • cryoprecipitate
  • desmopressin (prior to operations)
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19
Q

What clinical signs may you see with VwF disease?

A
  • NO PETECHIA
  • epistaxis
  • mucosal bleeding
  • bleeding may be absent
  • PTT may be prolonger (factor 8)
  • ## prolonged buccal mucosal time
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20
Q

If a patient has VwF disease will clotting times be normal or abnormal?

A

Normal

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21
Q

What part of the pathway does PTT measure?

A

intrinsic and common

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22
Q

What part of the pathway does ACT measure?

A

Intrinsic and common

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23
Q

What part of the pathway does PT measure?

A

extrinsic and common

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24
Q

what increases FDP?

A
  • DIC
  • hemmorhage
  • jugular venous thrombosis
  • liver disease
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25
Q

What are the Vit K dependent clotting factors

A

2
7
9
10

to heaven, knives them

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26
Q

In VwF are there petechia

A

No

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27
Q

In Vit K deficiency which increases first PT or PTT?

A

PT (as factor 7 is the first to be lost )

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28
Q

if PT and PTT both increased which disease processes can be considered?

A
  • liver disease
  • DIC
  • Vit K deficiency
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29
Q

Hemophilia A is a deficiency in with factor?

A

8

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30
Q

Hemophilia B is a deficiency in with factor?

A

9

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31
Q

DIC can be defined as a mix hemostatic defect caused by…leading to…

A

excessive COAGULATION

HEMMORHAGE

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32
Q

What may you see with DIC? (what increases and decreases?)

A
  • increase in FDP
  • increase in PT and PTT
  • decrease in fibrinogen
  • decrease in ATIII
  • decrease in PLATELETs
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33
Q

IMHA- usually regenerative or non regenerative?

A

usually STRONGLY regenerative

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34
Q

plasma is pink- intravascular or extravascular hemolysis?

A

intravascular

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35
Q

plasma is yellow- intravascular or extravascular hemolysis?

A

extravascular

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36
Q

presence of spherocytes- intravascular or extravascular hemolysis?

A

extravascular

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37
Q

presence of ghost cells - intravascular or extravascular hemolysis?

A

intravascular

(complement pokes holes in Red blood cells- Hg leaks out!!)

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38
Q

In saline agglutination test is positive- what does it mean?

A

Could mean IMHA-

check under microscope for rouleaux or whether true agglutination

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39
Q

What are common features of IMHA?

A
  • positive agglutination test
  • Coombs test positive
  • billirubinemia (usually due to extravascular hemolysis)
  • increased neutrophils and monocytes
  • ghost cells
  • spherocytes
  • myelofibrosis
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40
Q

What is the most common cause of a non-regen anemia?

A

chronic inflammation

(downregulation of iron is an evolutionary adaptation as bacteria require iron–> this leads to RBCs having a shorter lifespan)

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41
Q

List causes of non-regenerative anemia

A
  • chronic inflammation
  • renal disease (lack of EPO)
  • endocrine (hypoT4 or hypo AC lead to mild non regen)
  • myelodysplasia
  • myelophtisis
  • FeLV
  • Aplastic anema causes by destruction of the BM
  • myelofibrosis (seem in IMHA)
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42
Q

What are 2nd causes of erythrocytosis

A

chronic hypoxia
EPO increase
tumour seceting EPO

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43
Q

What are the primary causes of erythrocytosis

A
  • myeloproliferative disorder of the erythroid stem cell (EPO and O2 are normal)
44
Q

What are the 2 causes of regenerative anemia?

A
  • hemorrhage (internal or external)
  • hemolysis (intravascular or extravascular)
45
Q

If a hemmorhage is internal what happens to TP and iron?

A

it stays the same

46
Q

if a hemmorhage is external what happens to TP and iron?

A

they decrease

47
Q

Give examples of external hemmorage

A

melaena
epistaxis
blood in urine

48
Q

Neutrophils are in the blood for how long?

A

5-6h

can also be 30min!

49
Q

granulocytes all have…

A
  • segmented nucleus
  • granules
50
Q

If you have an increased demand in neutrophils what may you see?

A
  • Left shift: band neutrophils or earlier
  • Toxic changes:
  • basophilia, Dohle bodies, vacuolation, foamy cytoplasm, toxic granules)
51
Q

Toxic changes seen in neutrophils are associated with…

A

an accelerated production!

They have to be made quicker by the BM so they are not perfect

52
Q

What do endotoxins do to neutrophils?

A

they marginate them so decreased circulating neutrophils

53
Q

What do glucocorticoids do to neutrophils?

A

they prevent them from marginating —> increased circulating neutrophil pool—> R shift (hypersegmentation)

54
Q

What is this showing?

A

degenerate neutrophils (kamikaze explosions)

55
Q

What are these?

A

reactive lymphocytes- become almost twice the size of a RBC

56
Q

What is this?

A

a Russell body

constipated PC, cannot release its immunoglobulins

57
Q

What are the 2 most common cause of lymphopenia?

A

1) glucocorticoids/ STRESS
2) Acute inflammation

58
Q

Long term use of corticosteroid can be …. to lymphocytes

A

lymphotoxic

59
Q

What are these cells? the big ones

A

monocytes ( the largest granulocytes in circulation)

60
Q

IMHA will increase or decrease monocytes?

A

increase

61
Q

immune mediated neutropenia—> leads to an increase or decrease in monocytes?

A
  • Increase!
  • as they have the same precursor cell, neutropenia stimulates the precursor to make more cells
62
Q

What do steroids do to monocytes?

A

increase circulating monocytes

63
Q

What is this picture showing? What agent causes this?

A

thymic lymphoma is the cat

FeLV

64
Q

If you took a sample of the pleural effusion in a cat with thymic lymphoma what may you see?

A

malignant lymphocytes

65
Q

What is this showing?

A

thymoma causing paraneoplastic effects of myasthenia gravis (immune mediated disease).

—> focal myasthenia gravis —-> MEGAESOPHAGUS

66
Q

If you have lymphadenopathy- what are the 2 possible causes ?

A
  • Infection
  • Neoplasia (1ry or metastatic)
67
Q

Chylothorax (ie perforation or erosion of the thoracic duct) will have what effect on lymphocytes?

A

lymphopenia

68
Q

How is this LN?

A

It is reactive, it has increased cellularity and is responding to the presence of an antigen and mounting an immunological response.

heterogenous population

This is a healthy response

69
Q

What is occuring in the LN?

A

Lymphadenitis

Like reactive but the pathogen has invaded the LN!

Note the areas of necrosis

there are 3 types of lymphadenitis

70
Q

What type of Lymphadenitis is this?

A

Suppurative

  • presence of pus

This occurs In Strep Equi (strangles)

71
Q

What type of Lymphadenitis is this?

A

Caseous lymphadenitis

( ie. Corynebacterium)

72
Q

What type of Lymphadenitis is this?

A

granulomatous adenitis (ie Mycobacterium)

73
Q

What are these pictures showing?

A

Different tumours like to metastasise to LN

i.e. melanoma, MCT, soft tissue sarcomas

74
Q

What is a common cancer that can cause generalised lymphadenopathy?

A

Multicentric lymphoma

75
Q

Give some ddx for nodular splenomegaly

A
76
Q

Give some examples of diffuse splenomegaly

A
  • amyloidosis
  • lymphoid hyperplasia
  • lymphoma/ multiple myeloma
  • venous congestion
77
Q

Sudden death of sheep or cow- what is the suspected notifiable disease?

A

Bacillus anthracis

can cause hemmorages from orifices, splenomegaly

DO NOT POST MORTEM

78
Q

Classic swine fever (notifiable disease) - How does it affect the spleen?

A

Splenic infarcts

79
Q

Why should you never interpret understained areas of lymph node aspirates?

A

they always look like lymphoma!

80
Q

An aspirate is taken from a LN- what is the classification?

A

presence of many neutrophils, or eosinophils or macrophages is abnormal

Lymphadenitis

81
Q

What does a normal lymph node smear look like?

A

90% small lymphocytes
5-10% medium to large (2-3X RBC)

82
Q

What does a reactive lymph node look like?

A

similar to normal lymph node

increase in medium to large lymphocytes but must be <50%

83
Q

How can you tell if a lymph node has lymphoma?

A

NOT THE APPEARANCE BUT THE NUMBERS!!

> 50% immature LARGE lymphocytes

very few small lymphocytes

84
Q

Smear from lymph node, what does this show?

A

metastatic neoplasia

85
Q

If a patient has meleana what could be the causes?

A
  • systemic bleeding disorder
  • primary GI disease
86
Q

If a patient has icteric membranes and a low PCV - what could the disease process be ?

A

hemolytic anemia

87
Q

When investigating an anemic patient- what clues can be given on a manual Hct tube?

A
  • plasma colour (intravascular vs extravascular hemolysis?)
  • TP via refractometer
  • PCV
    Buffy coat- is there an inflammatory response?
88
Q

Dohle bodies can be seen in…

A

Toxic neutrophils

89
Q

What is this?

A

Mycoplasma hemofelis

90
Q

What is this showing? What does it tell us?

A

Schistocyte

Mechanical destruction is occurring

ie hemangiosarcoma, tortous vessels…

these are rapidly cleared up so if seen has happened acutely

91
Q

What are these?

A

Spherocytes

Round red blood cells that lack an area of central pallor. Cells often appear darker and smaller than a normocytic red blood cell

sign of extravascular hemolysis

92
Q

How do you treat IMHA?

A
  • blood transfusion
  • clopidogrel
  • Immunosuppressive corticosteroids
  • adjunct immunosup (Chlorambucil, azathioprine)
93
Q

IMHA dogs commonly die of…

A

Pulmonary Thromboembolism

94
Q

FIV SNAP test- are we testing for antibody or antigen?

A

antibody

95
Q

FeLV SNAP test- are we testing for antibody or antigen?

A

antigen

96
Q

My cat was bitten by an FIV positive cat when can i test?

A

2 months

97
Q

FIV test - what is the specificity and sensitivity?

A

High specificity
High sensitivity

98
Q

FeLV test- what is the specificity and sensitivity?

A

High sensitivity
Low specificity

99
Q

How long can an FIV positive cat live for?

A

as long as any other cat

100
Q

If you are testing for absence of disease in a herd- which animals do you test?

A

Just a few- if negative assume the whole herd is negative

101
Q

If the presence of is disease is high, PPV is

A

high

102
Q

If the presence of disease is low, the PPV is

A

low

103
Q

Clues for poor management on a farm

A
  • invoices for:
    dry cow mastitis tube
    mastitis cow tube use
    preventative tx with Calocur (crypto)
104
Q

What is lepto virus vaccine for in cow?

A

to reduce shedding

105
Q

What is BVD vaccine for in cow?

A

to prevent (re-)introduction

vet med 4 (11 decks)

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