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Clinical Pathology > UNIT 1 - Lecture 9: Neutrophils 2 > Flashcards

UNIT 1 - Lecture 9: Neutrophils 2 Flashcards

1
Q

What are 2 reasons why NPs may shift from MNP to CNP?

A
  1. Physiologic (epinephrine)
  2. Corticosteroids
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2
Q

What are 4 mechanisms for neutrophilia?

A
  1. Shift from MNP to CNP
  2. Increased release from marrow
  3. Increased production
  4. Decreased migration into tissues
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3
Q

What are 2 reasons why there may be an increased NP release from marrow?

A
  1. Inflammation
  2. Corticosteroids
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4
Q

How long does it take for a neutrophilia to be caused by increased production of NPs?

A

3-6 days

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5
Q

What 2 things might decrease NP migration into the tissues?

A
  1. Leukocyte adhesion deficiency
  2. Corticosteroids
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6
Q

When may we see physiologic neutrophilia during health? What is it due to?

A

During fear/excitement due to release of epinephrine

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7
Q

How long after stress/excitement is over do we see NP count return to RI in healthy animals?

A

within ~1 hour

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8
Q

Other than NPs, what cell type would we see an increase in due to fear/excitement?

A

lymphocytes

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9
Q

What spp do we most often recognize physiological neutrophilia in?

A

cats

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10
Q

Physiologic leukocytosis in horses (young foals) is due to _____ and _____.

A

neutrophilia, lymphocytosis

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11
Q

When do we see physiologic neutrophilia in healthy cattle? What might they also have?

A

Parturition, exercise, transport, chutes;

Eosinopenia

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12
Q

In what spp is physiologic neutrophilia uncommon?

A

dogs

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13
Q

When might we see physiologic neutrophilia in pigs? What else might we see?

A

Lactation, post-prandial;

Lymphocytosis

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14
Q

In a physiologic leukogram, total WBC count is _____.

A

increased

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15
Q

In a physiologic leukogram, segmented NPs are _____.

A

increased

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16
Q

In a physiologic leukogram, non-segmented neutrophils are _____.

A

WRI

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17
Q

T/F: In a physiologic leukogram, there are several WBC morphology changes.

A

False;

there are none

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18
Q

In a physiologic leukogram, lymphocytes are _____.

A

increased

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19
Q

In a physiologic leukogram, monocytes are _____ to _____.

A

WRI to increased

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20
Q

In a physiologic leukogram, eosinophils are _____.

A

WRI

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21
Q

In an inflammatory leukogram, what are the mediators and key cell type?

A

Mediators = inflammatory, cytokines

Key cell = NPs

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22
Q

In an inflammatory leukogram with neutrophilia, what are the mediators and what is the key cell type?

A

Mediators = Inflammtory, cytokines

Key cell = increased NPs

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23
Q

In an inflammatory leukogram with neutropenia, what are the mediators and what is the key cell type?

A

Mediators = unmet high demand/toxins

Key cell = decreased neutrophils

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24
Q

In a leukogram with a left shift, what are the mediators and key cell type?

A

Mediators = inflammatory, cytokines

Key cell = increased band NPs (can have myelocytes and metamyelocytes as well)

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25
Q

In a fright/flight leukogram, what is the mediator and key cell types?

A

Mediator = epinephrine

Key cells = increased NPs & increased lymphocytes

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26
Q

In a “stress” leukogram, what is the mediator and key cell types?

A

Mediator = cortisol

Key cells = increased NPs, decreased lymphocytes

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27
Q

What are the 2 types of stress neutrophilia due to cortisol?

A

Endogenous and exogenous

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28
Q

Where are glucocorticoids produced?

A

In the zona fasciculata of the adrenal cortex

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29
Q

Cortisol, a major _____, is a _____ derived from _____.

A

glucocorticoid, steroid hormone, cholesterol

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30
Q

Where are mineralcorticoids synthesized?

A

zona glomerulosa

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31
Q

What 2 mechanisms cause a stress neutrophilia from cortisol/clucocorticoid release?

A
  1. Increased marrow release of NPs
  2. Decreased adhesion molecules
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32
Q

What happens when adhesion molecules are decreased?

A
  1. Shift from MNP to CNP
  2. Decreased migration into tissues
  3. NPs circulate longer; increase T1/2 –> hypersegmented
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33
Q

What spp has the highest corticosteroid-induced neutrophilia?

A

dogs

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34
Q

What are characteristic findings on a corticosteroid leukogram?

A
  1. Mature neutrophilia (little to no left shift)
  2. Lymphopenia
  3. Monocytosis (dogs mostly)
  4. Eosinopenia
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35
Q

Presence of a corticosteroid leukogram in birds depends on what?

A

If heterophils of lymphocytes are predominant in that particular spp

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36
Q

In general, what would be characteristics of a corticosteroid leukogram in birds?

A

Heterophilia and lymphopenia

37
Q

In a corticosteroid leukogram, total WBC would be _____.

A

increased

38
Q

In a corticosteroid leukogram, segmented neutrophils would be _____.

A

increased

39
Q

In a corticosteroid leukogram, non-segmented NPs would be _____ to _____.

A

WRI to minimally increased

40
Q

In a corticosteroid leukogram, what WBC morphology changes would occur?

A

+/- hypersegmented PMNs

41
Q

In a corticosteroid leukogram, lymphocytes would be _____.

A

decreased

42
Q

In a corticosteroid leukogram, monocytes would be _____.

A

increased

43
Q

In a corticosteroid leukogram, eosinophils would be _____.

A

decreased

44
Q

What changes would be seen in a leukogram when there is lack of cortisol due to hypoadrenocorticism?

A

Segmented NPs = Decreased to WRI

Lymphocytes = WRI to increased

Eosinophils = WRI to increased

45
Q

What NP changes indicate inflammation (acute, strong NP demand)?

A
  1. Significant left shift
  2. Toxic changes
46
Q

What changes would one expect to see with lymphocytes, monocytes, and eosinophils when there is acute inflammation?

A

Lymphocytes = increased (WRI if cortisol also involved)

Monocytes = increased

Eosinophils = increased

47
Q

At what point is inflammation considered chronic?

A

>7-10 days

48
Q

In chronic inflammation, marrow catches up with demand and will have granulocyte _____.

A

hyperplasia

49
Q

In chronic inflammation, there will typically be a _____ neutrophilia.

A

moderate

50
Q

What are characteristics of chronic inflammation that can be seen on a leukogram?

A
  1. +/- lymphocytosis
  2. Monocytosis
  3. Eosinophilia and basophilia (dep on cause)
  4. +/- left shift, +/- toxic NPs
51
Q

Why does a left shift typically diminish or resolve over time in chronic inflammation?

A

Marrow becomes hyperplastic and NP supply can now keep up with demand

52
Q

In a chronic inflammatory leukogram, total WBCs are _____.

A

increased

53
Q

In a chronic inflammatory leukogram, segmented NPs are _____.

A

increased

54
Q

In a chronic inflammatory leukogram, non-segmented NPs are _____ to _____.

A

WRI to increased

55
Q

In a chronic inflammatory leukogram, what WBC morphology changes might we expect?

A

+/- toxic changes, +/- reactive lymphocytes

56
Q

In a chronic inflammatory leukogram, lymphocytes are _____.

A

WRI to increased

57
Q

In a chronic inflammatory leukogram, monocytes are _____.

A

WRI increased

58
Q

In a chronic inflammatory leukogram, eosinophils are _____.

A

WRI

59
Q

What conditions can cause extreme neutrophilia in dogs?

A

Pyometra, pyothorax, hepatozoonosis, AIHA, canine leukocyte adhesion deficiency (CLAD), paraneoplastic syndrome (CSF release)

60
Q

How is cat neutrophilia compared to dogs?

A

Similar response but not as robust (rarely gets to 75,000/µL when dogs can get >100,000/µL)

61
Q

Regarding cattle neutrophilia: Cattle have a smaller marrow _____.

A

maturing storage pool

62
Q

How long can neutrophilia take to show in cattle?

A

3-6 days

63
Q

What is associated with cattle neutrophilia and how long does it take before it is apparent?

A

Increased fibrinogen - takes ~48 hours before you can see an increase

64
Q

What is significant about calves and NP count?

A

Newborns have more PMNs than lymphocytes;

Increasing LC counts happen @ 6-8 weeks of age;

Within 3 months LCs drop to adult intervals

65
Q

What is the cattle ratio of NP to LC?

A

NP : LC = 1 : 2

66
Q

What might one see in acute inflammation in cattle?

A
  1. Leukopenia due to neutropenia and pymphopenia
  2. Severe left shift
67
Q

What might one see in chronic inflammation in cattle?

A
  1. NP counts up to 10,000/µL
  2. NPs predominate instead of lymphocytes
68
Q

What is the horse neutrophilia response like?

A

NP response to inflammation is moderate

69
Q

In cattle and horses, what is a more reliable indicator of inflammation than a leukogram?

A

hyperfibrinogenemia

70
Q

What methods can be used to assess inflammatory disease in cattle and horses and which one is not very reliable?

A
  1. Plasma protein : fibrinogen ratio - not reliable
  2. Serum amyloid A (SAA)
  3. Haptoglobin
71
Q

What is happening if cattle plasma protein : fibrinogen ratio is >15? <10? 10-15?

A

>15 = dehydration

<10 = true increase in fibrinogen –> inflammation

10-15 = either/both

72
Q

What is happening if horse plasma protein : fibrinogen ratio is >20? <15? 15-20?

A

>20 = dehydration

<15 = true increase in fibrinogen –> inflammation

15-20 = either/both

73
Q

What diseases are of concern when an avian has an inflammatory leukogram?

A

Salmonellosis, Mycobacteriosis, Aspergillosis, Chlamydiosis

74
Q

What is the cause of leukocyte adhesion deficiency?

A

Inherited lack of ß2 integrins CD18 for adhesion;

NPs cannot migrate to tissues due to this

75
Q

What spp can have leukocyte adhesion deficiency?

A

bovine (Holstein), canine (Irish Setter)

76
Q

What are 3 features of leukocyte adhesion deficiency?

A
  1. Extreme neutrophilia - marrow makes more NPs due to infection in tissues but cannot adhere to vessels to exit into tissues
  2. Infections with lack of suppuration
  3. Animals fail to thrive
77
Q

What are 4 mechanisms for neutropenia?

A
  1. Shift from CNP to MNP
  2. Increased peripheral destruction
  3. Decreased production
  4. Migration into tissues (increased inflammation)
78
Q

What are some causes of neutropenia?

A
  1. Inflammation (endotoxemia)
  2. Peripheral destruction
  3. Ineffective production
  4. Cyclic hematopoiesis
  5. Granylocytic hypoplasia
79
Q

Inflammatory neutropenia can be caused by _____ or severe _____ inflammation.

A

overwhelming, acute

80
Q

In what spp. is inflammatory neutropenia common and in what conditions?

A

Adult cattle;

Mastitis and pneumonia

81
Q

What is the effect of an endotoxic neutropenia on PMNs?

A

Rapid shift from circulating PMN pool to marginating PMN pool.

82
Q

What 2 things are common in endotoxic neutropenia?

A
  1. NP toxic change
  2. Lymphopenia
83
Q

In an acute overwhelming inflammatory endotoxemia leukogram, total WBC are _____.

A

decreased

84
Q

In an acute overwhelming inflammatory endotoxemia leukogram, segmented NPs are ____.

A

decreased

85
Q

In an acute overwhelming inflammatory endotoxemia leukogram, nonsegmented NPs are _____.

A

increased

86
Q

In an acute overwhelming inflammatory endotoxemia leukogram, what WBC morphology changes might we see?

A

toxic changes

87
Q

In an acute overwhelming inflammatory endotoxemia leukogram, lymphocytes are _____.

A

decreased

88
Q

What is a common infectious cause for neutropenia?

A

Anaplasma phagocytophilum

89
Q

What are some RARE causes of peripheral or marrow destruction neutropenia?

A

Immune-mediated, hemophagocytic syndrome

Clinical Pathology (22 decks)

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