UNIT 1 - Lecture 8: Neutrophils 1

Question 1

CBCs are a point in _____ and reflect cells, including NPs, at that _____.

Answer 1

time

Question 2

_____ are the first line of defense against bacterial and fungal pathogens.

Answer 2

PMNs

Question 3

What can a CBC be used for regarding WBCs?

Answer 3

To determine the status between the marrow, peripheral blood, and tissue demands

Question 4

What do we call an increase in NP above the RI?

Answer 4

neutrophilia

Question 5

What do we call a decrease in NPs below the RI?

Answer 5

neutropenia

Question 6

NPs are effector cells of _____ immunity.

Answer 6

innate

Question 7

NPs are highly mobile _____.

Answer 7

phagocytes

Question 8

What are the 3 main functions of neutrophils, specifically?

Answer 8

1. Degranulation
2. Phagocytosis
3. NETosis

Question 9

How are NPs involved in a negative feedback loop?

Answer 9

They secrete cytokines to regulate constant balance between bone marrow demand, blood, and tissue

Question 10

What is CNP? MNP?

Answer 10

CNP = circulating NP pool

MNP = marginating NP pool

Question 11

In what spp does MNP = CNP?

Answer 11

dog, horse, cow

Question 12

What is the relationship between MNP and CNP in cats?

Answer 12

MNP = 2-3x CNP

(have a larger marginating pool)

Question 13

What is the transit time of NPs?

Answer 13

~5-10 hours

Question 14

How long is the NP’s life in tissues?

Answer 14

~24-48 hours

Question 15

What drug can get NPs out of the MNP and into the CNP?

Answer 15

epinephrine

Question 16

What are the 5 roles of inflammatory mediators in the context of NP migration to tissues?

Answer 16

1. Stimulate release of NPs from marrow
2. Promote margination and adhesion
3. Stimulate emigration into tissues
4. Move via chemotaxis
5. Enhanced phagocytosis and killing

Question 17

What are positive effects of NETosis?

Answer 17

Extracellular killing;

Trapping bacteria, viruses, fungal organisms

Question 18

What are adverse effects of NETosis?

Answer 18

Augment tissue damage, autoimmune-mediated disease (EX: AIHA, RA), thrombosis

Question 19

Into what types of blood cells will multipotential stem cells differentiate?

Answer 19

Lymphoid stem cells, myeloid stem cells

Question 20

What is neutropoiesis induced by?

Answer 20

Colony Stimulating Factors (CSFs) and cytokines

Question 21

How do CSFs work?

Answer 21

They increase cell proliferation and cell differentiation;

They also induce and enhance cell function

Question 22

Immature NPs have a _____ nucleus and more _____ staining cytoplasm.

Answer 22

non-segmented, basophilic

Question 23

What is the size of immature NPs compared to mature NPs?

Answer 23

They are slightly larger than mature NPs

Question 24

Chromatin of immature NPs is _____ than that of mature NPs.

Answer 24

less dense

Question 25

What NP stages are part of the proliferation pool (ProNP)?

Answer 25

Myeloblast, promyelocyte, myelocyte

Question 26

What NP stages are part of the maturation storage pool (MatNP)?

Answer 26

Metamyelocyte, band form, segmented PMNs

Question 27

How many days are NPs in the proliferation/mitotic pool and how many divisions do they undergo?

Answer 27

~3-4 days; 4-5 divisions

Question 28

How many days are NPs in the maturation/storage pools?

Answer 28

2-3 days

Question 29

Most NPs are in the _____ pool/compartment.

Answer 29

maturation/storage

Question 30

What NP type exits from the marrow first?

Answer 30

The most mature

Question 31

What are 4 ways by which NPs respond to increased peripheral tissue demand?

Answer 31

1. Increased stem cell recruitment 2. Increased granulopoiesis 3. Shortened maturation time/released faster 4. Earlier stages released

Question 32

What is released when there is a "left shift"?

Answer 32

Increase in non-segmented NPs in the peripheral blood due to increased peripheral demand

Question 33

What NP types are seen in a left shift? What type of disease are we looking for here?

Answer 33

Myelocyte, metamyelocyte, bands; look for these with inflammatory disease

Question 34

What NP types are seen in a right shift? What can cause this to occur?

Answer 34

Segmented PMNs and **hypersegmented PMNs**; These occur if NPs are in circulation for a longer time than usual (EX: glucocorticoid usage)

Question 35

Hypersegmented NPs represent _____ NPs.

Answer 35

"old"

Question 36

\_\_\_\_\_ can cause presence of hypersegmented NPs via downregulation of adherence to the vessel wall and delayed exit into tissues.

Answer 36

Glucocorticoids

Question 37

What spp has idiopathic but NORMAL amounts of hypersegmented NPs in circulation?

Answer 37

horses

Question 38

When do left shifts occur?

Answer 38

When there is increased tissue demand for NPs (inflammation, tissue damage)

Question 39

What are considered the "hallmark of acute inflammation"?

Answer 39

segmented NPs in circulation

Question 40

What two things determine the severity of a left shift?

Answer 40

1. Magnitude of immature NPs 2. Stage/type of immature NPs

Question 41

What constitutes a mild, moderate, and severe left shift by level of immaturity?

Answer 41

Mild = bands only Moderate = bands and metamyelocytes Severe = bands, metamyelocytes, myelocytes

Question 42

What constitutes a mild, moderate, and marked left shift by means of magnitude (for dogs and cats)?

Answer 42

Mild = \<1,000 / µL Moderate = 1,000 - 10,000 / µL Marked = \>10,000 / µL

Question 43

What is a degenerative left shift?

Answer 43

A severe left shift where immature NPs \> segmented NPs

Question 44

In a degenerative shift, the _____ and the _____ in circulation and tissues is abnormal, compromised, and lagging = not meeting demand.

Answer 44

balance of bone marrow production, ability to meet the need

Question 45

T/F: A degenerative shift means that the patient is in immediate danger.

Answer 45

True

Question 46

When would presence fo a degenerative left shift point to a poor prognosis?

Answer 46

If toxic changes are present

Question 47

When would presence of a degenerative left shift point to a grave prognosis?

Answer 47

When toxic changes are present, neutropenia is present, and neutropenia is not recovering/resolving

Question 48

What can cause a toxic color change of the NP cytoplasm?

Answer 48

Changes in phagosome, granules, or cytoplasmic pH

Question 49

What does cytoplasm color change of a NP indicate?

Answer 49

Intense stimulation of NP production, often due to markedly increased tissue demand during marked inflammation.

Question 50

What are some examples of toxic changes in NPs?

Answer 50

1. Cytoplasmic basophilia 2. Döhle bodies 3. Toxic granules 4. Foamy cytoplasm 5. Less mature chromatin

Question 51

What is significant about cats and Döhle bodies?

Answer 51

Healthy cats can have a few NPs with Döhle bodies

Question 52

Toxic NPs can be confused with \_\_\_\_\_.

Answer 52

monocytes

Question 53

What is the goal of reporting toxic changes in NPs?

Answer 53

To correlate severity of NP changes with clinical disease and prognosis

Question 54

What causes cytoplasmic basophilia of NPs?

Answer 54

RER and polyribosomes

Question 55

What are Döhle bodies?

Answer 55

Irregular, blue cytoplasmic inclusions; Aggregates of RER that contain RNA

Question 56

In what spp. with severe infections can Döhle bodies be seen? What is an example?

Answer 56

Horses; EX: Salmonellosis

Question 57

What causes a foamy cytoplasm in NPs?

Answer 57

Cytoplasmic clearning due to dispersed organelles

Question 58

What are toxic granules?

Answer 58

Pink-purple granules in cytoplasm that are a persistence of primary granule staining; Observed less frequently than other toxic changes

Question 59

What does it signify when there are "donut" or "ring" NP nuclei present? What spp is this occasionally seen in?

Answer 59

It is failure of the band and segmented NPs to have "pinched" lobes due to marked rapid recruitment of NPs in inflammation; Occ. seen in horses