Test 4: 5: lymphoid Flashcards

1
Q

— regulated the production of RBC

A

erythropoietin (Epo)

released during hypoxia by kidneys promotes RBC proliferation and inhibits apoptosis

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2
Q

erythropoiesis is the formation of ___

A

red blood cells

regulated by Epo- which is made by kidneys

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3
Q

Granulopoiesis is the formation of —

A

myeloid series

Inflammatory mediators (ILs and TNF-α) stimulate fibroblasts, macrophages, and endothelial cells to produce cytokines (G-CSF and GM-CSF) that increase granulopoiesis and monocytopoiesis.

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4
Q

Granulocytic and monocytic cells are referred to collectively as —

A

myeloid cells

In the context of hematology, “myeloid” is also
sometimes used to mean a hematopoietic cell of nonlymphoid origin; in neuroanatomy, the prefixes “myelo-” or “myel-” can refer to the spinal cord or myelin.)

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5
Q

Thrombopoietin (Tpo), synthesized primarily in the —, regulates thrombopoiesis.

A

liver

always/ constitutively produced

makes megakaryocytes → platelets

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6
Q

Megakaryocytes arise from a progenitor cell → endomitosis to become — →extend cytoplasmic processes bone marrow venous sinusoids →shed cytoplasmic fragments (—) into circulation.

A

polyploid
platelets

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7
Q
A

neutrophil

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8
Q
A

eosinophil

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9
Q
A

basophil

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10
Q
A

monocyte

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11
Q
A

lymphocyte

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12
Q

— tissue (red marrow) regresses and is replaced with nonhematopoietic tissue, mainly fat (yellow marrow).

A

Hematopoietic

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13
Q

what is a cytology how is it different from biopsy

A

Aspirates = Cytologic preparations are collections of cells expressed or “smeared” on a slide, stained and examined microscopically. Most aspects of a ‘marrow evaluation’ can be done cytologically

Core biopsies = Histologic preparations are sections of tissue that have been fixed with formalin, embedded in paraffin or plastic, sectioned, stained, and coverslipped.

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14
Q

why do you submit a CBC with a bone marrow sample

A

need to compare to each other, they change rapidly in response to each other

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15
Q

M:E ratio is for —

A

THIS ONLY INCLUDES ERYTHROID AND MYELOID - NOT MEGAKARYOCYTES!

Normal M:E in healthy animals: Companion animals M:E=1:1 – 2:1, Livestock
& horses M:E = 0.5:1.

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16
Q

when to do core biopsy

A

if bone changes
FNA showed abnormal cellularity
focal lesion
FNA unsuccessful- dry tap

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17
Q

what cells for the M:E ration

A

myeloid : neutrophil, eosinophil, basophil

erythroid: red blood cell

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18
Q

deep blue ?
purple?

A

deep blue: erythroid
purple: myeloid

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19
Q

what is a band cell

A

immature neutrophil

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20
Q

— is an Increase in response to peripheral demand for a specific cell type

A

hyperplasia

predictable

21
Q

2 causes of erythroid hyperplasia?

A

Hemorrhage
– Trauma
– Coagulopathies
– Neoplasia

Hemolysis
– IMHA
– Toxin
– Infectious
– Oxidant injury
– Enzyme deficiencies
– Hypophosphatemia

22
Q

this causes — in the bone marrow

A

liver failure- ↓ red blood cells
low hemoglobin = hypoxemia= Epo production by kidneys which triggers bone marrow to make more red blood cells

Erythroid hyperplasia

23
Q

what happens to M:E if there is erthroid hyperplasia

A

decreases because E increases

there will be immature RBC in the blood (polychromatophilic RBC (bluish)and Reticulocytes(stained with methylene blue))

leads to regenerative anemia

24
Q

With persistence of blood loss (e.g., refractory immune-mediated thrombocytopenia, or
chronic urinary or GI losses), there is depletion of —. This blunts the regenerative response and
eventually results in a — anemia, secondary to iron depletion. Erythroid hyperplasia may not be evident.

A

iron

non-regenerative

25
Q

how can prolonged blood loss cause increase in myeloid cells

A

sudden loss of blood = loss of hemoglobin/oxygen= cell death which recruits myeloid cells. This recruitment causes ↑ production of myeloid cells in the bone marrow

M:E will be equal but both increased

26
Q

which is false in respect to erythroid hyperplasia

A

increased M:E

it will cause a decrease because E gets bigger

27
Q

what happens to M:E with myeloid hyperplasia

A

increase

caused by need for more granulocytes or monocytes

infection

28
Q

what is a left shift in maturation?

A

there is such a need for cells that
myeloid cells are moved into blood before fully mature

will see band cells

29
Q

three causes of megakaryocytic hyperplasia

A
  • Destruction
  • Loss
  • Consumption

platelets

30
Q

three causes of megakaryocytic hyperplasia

A

Peripheral destruction (immune-mediated thrombocytopenia, ITP)

Loss (hemorrhage)

Consumption (disseminated intravascular coagulation, DIC)

    • The marrow will respond by increasing megakaryocytes.

platelets

31
Q

what is the marrow response in a dog with immune mediated thrombocytopenia

A

megakaryocytic hyperplasia

(produce platelets)

32
Q

2 manifestations of bone marrow hypoplasia

A
  • Measurable hypoplasia (change in M:E);
    decrease/absence of a particular cell line
  • Failure to respond with appropriate hyperplasia despite peripheral cytopenia (thus, marrow may appear normal)→ body tells marrow it needs something but marrow says nope
33
Q

high or low thyroid will cause bone marrow hypolasia

A

low

causes mild to moderate erythroid hypoplasia

34
Q

high or low estrogen will cause bone marrow hypoplasia

A

high

can be severe generalized marrow hypoplasia/aplastic anemia

35
Q

how does anemia cause bone marrow hypoplasia

A

non-regenerative anemia

Hepcidin:
-Acute phase protein synthesized in the liver; expression increases with inflammation, infection, or iron overload and decreases with anemia or hypoxia -Limits iron availability, causing functional iron deficiency: Binds to and causes the degradation of the cell surface iron efflux molecule, ferroportin, thus inhibiting both absorption of dietary iron from the GI and export of iron from macrophages and hepatocytes into the plasma.

Inflammatory cytokines (e.g. TNF & IL-1):
-Inhibit erythropoiesis by oxidative damage and trigger apoptosis of developing erythroid cells
-Decrease expression of Epo, Epo receptors, and stem-cell factor

35
Q

how does anemia of chronic disease cause bone marrow hypoplasia

A

non-regenerative anemia

Hepcidin:
-Acute phase protein synthesized in the liver; expression increases with inflammation, infection, or iron overload and decreases with anemia or hypoxia -Limits iron availability, causing functional iron deficiency: Binds to and causes the degradation of the cell surface iron efflux molecule, ferroportin, thus inhibiting both absorption of dietary iron from the GI and export of iron from macrophages and hepatocytes into the plasma.

Inflammatory cytokines (e.g. TNF & IL-1):
-Inhibit erythropoiesis by oxidative damage and trigger apoptosis of developing erythroid cells
-Decrease expression of Epo, Epo receptors, and stem-cell factor

36
Q

— is the most common cause of nonregenerative anemia and causes a lack of compensatory —. This process is controlled by — which limits iron availability.

A

Anemia of chronic disease
erythropoiesis
hepcidin

leads to bone marrow hypoplasia

37
Q

IMHA

A

Immune-Mediated Hemolytic Anemia

body attacks red blood cells

38
Q

how to tell acute bone marrow inflammation

A

fibrinous / neutrophils in higher amounts

can be hard to measure cause cells are supposed to be there or inflammation can be focal

if you see necrosis good way to know that something is going wrong

39
Q

how to tell chronic bone marrow inflammation

A

granulomatous inflammation
necrosis

40
Q

Myelodysplastic Syndrome

A

group of clonal myeloid proliferative disorders characterized by ineffective hematopoiesis, resulting in a peripheral cytopenia of the affected cell population(s).

can lead to acute myeloid leukemia

marrow profile indicates hyperplasia of one or more cell lines with no improvement in the peripheral cell count and abnormal cell morphology

Rare in veterinary medicine, occurring most frequently in cats infected with FeLV.

41
Q

when can you see MYELODYSPLASTIC SYNDROME (MDS)

A

Rare in veterinary medicine, occurring most frequently in cats infected with FeLV.

Refers to a group of clonal myeloid proliferative disorders characterized by ineffective hematopoiesis, resulting in a peripheral cytopenia of the affected cell population(s).

42
Q

AML vs CML

A

acute myloid leukemia: blood smear show blast cells, >20% of cells will be of myloid origin, seen in FELV + cats, poor prognosis

chronic myelogenous leukemia: high cell counts, very rare, marrow hyperplasia of the affected cell line; normal morphology and therefore diagnosis is made by process of elimination

43
Q

compare ALL or CLL

A

acute lymphoid leukemia immature lymphocytes, may efface the marrow, young animals

chronic lymphoid leukemia well differentiated lymphocytes, does NOT efface the marrow, older animals

44
Q

what are bence-jones proteins

A

light chains that break off antibodies and secreted in the urine

seen in multiple myeloma (plasma cell neoplasm)

45
Q

— are plasma cell neoplasm in the medullary marrow

A

multiple myeloma

46
Q

how to detect multiple myeloma

A
  • Plasma cell neoplasm in the
    marrow (medullary)

Specific diagnostic criteria
* Marrow plasma cells greater
than 30%

* Monoclonal protein (M-spike)- single type of immunoglobulin(antibody)
* Bence-Jones protein in the
urine (light chain that fell off antibody)
* Lytic bone lesions- oval shaped lesion on bone

47
Q

myelofibrosis

A

when bone marrow scars in reaction to injury,neoplasia, and inflammation

Fibrosis impedes marrow collection by aspiration and therefore best diagnosed histologically