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1
Q

what is leukocytosis?

A

increase in total WBC count

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2
Q

what is leukopenia?

A

a decrease in total WBC count

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3
Q

what iis neutrophilia?

A

increase in neutrophils

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4
Q

what is lymphocytosis

A

increase in lymphocytes

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5
Q

what is monocytosis?

A

increase in monocytes

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6
Q

what is eosinophilia?

A

increase in eosinophils

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7
Q

what is basophilia?

A

increase in basophils

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8
Q

what is neutopenia?

A

decrease in neutrophils

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9
Q

what are the three granulocytes with segmented neucli?

A

neutrophils, eosinophils, basophils

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10
Q

what is lymphopenia?

A

decrease in lymphocytes

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11
Q

what is monocytopenia?

A

decrease in monocytes

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12
Q

what is eosinopenia?

A

decrease in eosinophils

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13
Q

what are the two pools of neutrophils?

A

circulating pool and marginal pool
- in cats the marginal pool is 50-75%
- in the dog the marginal pool is 50%

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14
Q

what are the factors/compounds that cause the neutrophils to shift from the marginal pool to the circulating pool?

A
  • epinephrine
  • glucocorticoids
  • infection
  • stress
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15
Q

what does a more than double in neurophil concentration on a blood test mean?

A

if the neutrophil conc is just double this can be accounted for as a stress response and the marginal pool entering the circulation pool
however if more than double then there must be an increase in the number of neutrophils being made by the bone marrow

however if the inflammation is sever enough then the tissue consumtion could be utilising the neutrophils quicker than they are being made

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16
Q

what are the inflammatory causes of neutrophilia?

A
  • Infections (bacterial, viral, fungal, protozoal)
  • Immune mediated anaemia
  • Necrosis (including haemolysis, sterile inflammation and FB’s)
    *
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17
Q

what are the steroid causes of neutrophilia?

A

Stress
Steroid therapy
Hyperadrenocorticism

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18
Q

what are physiological causes of neutrophilia?

A
  • Epinephrine
  • Fight or flight (excitement, fear, pain, exercise)
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19
Q

what are the other (non inflammatory/steroid/physiological) reasons for neutrophilia?

A

Chronic neutrophil leukaemia
Paraneoplastic (rectal polyp, renal tubular carcinoma, metastatic fibrosarcoma)
Other E.g. Leukocyte Adhesion factor Deficiency (inherited)

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20
Q

what are the 4 mechanisms of neutrophilia?

A
  • increased release of marrow storage pool cells
  • demarginiation of neutrophils
  • decreased extravasation into tissues
  • expansion of marrow precursor pool
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21
Q

what is left shift of neutrophils?

A

segmented neutrophils are mature and are at the end of the ‘line’ of neutrophil development, the banded stage comes before them, when we see lots of baned neurophils this means that immature neutrophils are being released into the circulation and we call this left shift

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22
Q

what is a right shift of neutrophils?

A

hyper mature cells (very segmented)

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23
Q

what is a regenerative left shift?

A

when there are band neutrophils present but there are more segmented neutrophils present than banded neutrophils - therefore the neutrophil number is going up

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24
Q

what is a degenerative left shift?

A

when there are more immature (banded) neutrophils inthe circulation than segmented, this can cause the number of neutrophils to stay the same or to decrease
a poor prognostic sign

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25
what two mechanisms cause left shift to occur?
significant inflamatory demand will cause: - increased release of marrow storage pool cells - expansion of marrow precursor pool
26
what mechanism will cause right shift?
decreased extravascularisation into tissues
27
what is neutrophil toxic change?
rapid neutropoiesis - formation of neutrophils **morphologic abnormalities** acquired during maturation under conditions that intensely stimulate neutrophil production and shorten the maturation time in marrow. ## Footnote (if you use the army ananalysis left shift is sendign younger people to battle, and toxic change is giving them less time in boot camp, not full maturation process)
28
what are the causes of neutrophil toxic change?
* Usually severe bacterial infection * but Not always - can induce by injecting Granulocyte-Colony Stimulating Factor * Other example assocations: Parvo, IMHA, ARF, DIC, neoplasia Prognostic indicator
29
on a blood smear how do you recognise neutrophil toxic change?
* Foamy cytoplasm * Diffuse cytoplasmic basophilia Persistent of cytoplasmic RNA Incl segmented neutrophils * Döhle bodies Focal blue-grey cytoplasmic structures (RER/RNA) (Isolated finding in some healthy cats) * Asynchronus nuclear maturation - Finely granular nuclear chromatin but in “segments”
30
what type of cell is this?
normal mature neutrophil
31
what type of cell is this?
toxic neutrophil
32
what type of cell is this?
normal band (immature) neutrophil
33
what type of cell is this?
toxic band neutrophil
34
what bacterial inculsions can be seen in neutrophils?
ehrlichia, anaplasma
35
what viral inculsions can be seen in neutrophils?
canine distemper
36
what protozoa inculsions can be seen in neutrophils?
toxoplasma, hepatozoon
37
what fungi inculsions can be seen in neutrophils?
histoplasma
38
what hereditary/metabolic things can cause inculsions to be seen in neutrophils?
* chediak-higashi * birman cat anomaly * mucopolysidosis
39
what is the functionally equivalent cell of neutrophils in rebbitas and reptiles , what colour to the granules inthe cytoplasm stain?
heterophils - stain red
40
what are the inflammatory causes of neutropenia?
Per-acute/overwhelming bacterial infections Canine and feline parvo-virus
41
what are the decreased production causes of neutropenia?
damage to bone marrow * Infections: parvovirus, FeLV, toxoplasma * Toxicity: chemotherapy, oestrogen, chloramphenicol (cats) * Neoplasia: leukaemia, myelodysplastic, metastatic * Marrow necrosis * Myelofibrosis
42
relating to the marrow reserve and regenertion capacity of neutrophils in dogs and cats what is the interpretation of neutropenia in acute inflammation?
high marrow reserve and rapid regeneration therefore very servere lesion
43
relating to the marrow reserve and regenertion capacity of neutrophils in horses what is the interpretation of neutropenia in acute inflammation?
intermediate reserve and regeneration so probable servere lesion
44
relating to the marrow reserve and regenertion capacity of neutrophils in cows what is the interpretation of neutropenia in acute inflammation?
low reserve and slow regeneration therefore neutropenia typical in inflammation regardless of severity
45
due to the half life of the blood cells when the re is a marrow disruption, what is the order in which the cells with disappear?
neutrophils (hours), then platelets (days), RBC (months) ## Footnote when neutrophils leave the circulation they die - there is no recirculation
46
what tissues and organs do lymphocytes ciculate through?
spleen, heart, tissues, lymph nodes via blood and lymphatic vessels
47
what are reactive lymphocytes?
immunocytes, plasmacytoid lymphocytes (look like plasma cells, have white area nect to golgi apparatus) seen with inflammation in young animals
48
what are the apperance of reactive lymphocytes?
stimulated T or B cells * increased cytoplasm * increased cytoplasmic basophilia * prominent golgi zone * cleaved nucleus (dented)
49
what are the physiological reasons for lymphocytosis?
Catecholamine mediated via splenic contraction (especially cats)
50
what are the inflammation causes of lymphocytosis?
chronic inflammation: - although normally inflammatory conditions are stressful enough that you see lymphopenia * Chronic antigenic stimulation * May include reactive lymphocytes * Usu with neutrophilia and/or monocytosis (±eosinophilia)
51
what are the non physiologicla reasons for lymphocytosis?
* Young animals and recent vaccination * Lymphoproliferative disorder (incl FeLV, BLV) - May be lymphopenia in lymphoma - **tumuor**
52
what endocrine disease can cause lymphocytosis?
Hypoadrenocorticism - addison's there is a decrease in glucocorticoids therefore there is a loss of normal level of lymphocyte inhibition that would be caused by glucocorticoids lymphocytes are normaly very sensitive to glucocorticoids - this is why we use glucocorticoids as immunosuppressive
53
what are the 7 general causes of lymphopenia?
- **stress/steroid** - acute inflammation - loss of lymph - cytotoxic drugs, raddiation - immunodeficiency syndrome - lymphoma
54
why does lymphopenia occur with stres/steroids?
Endogenous or exogenous glucocorticoid - shifts lymphocytes out of circulation & lymphocytolysis
55
what does acute inflammation cause lymphopenia?
* Bacterial, viral or endotoxaemia * Migration to inflamed tissue and homing to LN’s * Often with neutrophilia or neutropenia * Correction of lymphopenia → better prognosis
56
what conditions can cause loss of lymph?
chylothorax (drainage), or lymphangiactasia ## Footnote dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein-losing enteropathy
57
what is lymphangiectasia?
dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein-losing enteropathy
58
what does lymphoma cause lyphopenia?
LN pathology and disrupted circulation
59
what is the difference between monocytes and macrophages?
monocytes are within blood and macrophages are are what they differentiate into when they enter the tissues they are responsible for phagocytosis and result inthe release of immune mediators (cytokines)
60
when does monocytosis occur?
* **Inflammation** May imply “chronic” Bacterial, fungal, protozoal Necrosis: haemolysis, haemorrhage, neoplasia, infarction, trauma Inconsistent finding (chronic but also acute inflammation) * **Steroid/Stress** * Monocytic/myelomonocytic leukaemia ## Footnote Monocytopenia not recognised a clinically significant entity
61
what endocrine condition can cause monocytosis?
Hyperadrenocorticism
62
what are the causes of eosinophilia? | (6)
* Hypersensitivity * Parasitism * Hypoadrenocorticism * Paraneoplastic (esp Mast cell but also others) * Idiopathic eosinophilic syndromes: E.g., canine eosinophilic bronchopneumopathy, myositis, feline eosinophilic granuloma etc * Eosinophilic leukaemia (v rare)
63
what 3 things cause eosinopenia?
glucocorticoids, stress, inflammation - many reference intervals include '0'
64
what WBC is a rare finding on a blood smear in SA?
basophil
65
what are these?
basophils
66
what are these?
eosinophils
67
what are these?
monocytes
68
what is this?
reactive lymphocyte
69
why are nucleated red cells problematic?
Manual and automated counting methods for total WBCC that count nuclei in lysed samples, will need WBCC correcting for nRBC’s
70
what are the causes of nucleated red cells?
* Can be present in moderate numbers in regenerative anaemias, lead toxicity * the spleen can generate RBCs and therefore splenic contraction and damaged marrow can cause increase due to the filter not being as good in these situations and therefore the nucleated cells can escape * Present in inappropriately high numbers in erythroleukaemia (erythemic myelosis; cats)
71
what is shown here?
the top and bottom cells are nucleated red cells and the middle are lymphocyte
72
what is shown here?
big, unclassified neoplastic cells, acute leukaemia
73
what will steroids/ stress cause withing the blood?
1. eosinopenia 2. lymphopenia 3. mature neutrophilia 4. +/- monocytosis
74
what WBC result should you see with suspected hyperadrenocorticism?
eosinopenia - if not reconsider dx
75
if a very sick patient does not have what **blood result** what **endocrine** disorder do you need to consider?
if the patient does not have eosinopenia you need to consider hypoadrenocorticism
76
what substance is present in excitement and fear (fight or flight)?
Catecholamine * Travel, capture, chutes * Handling
77
what blood results will you see with fight or flight response (excitment and fear)?
* Mature neutrophilia * Lymphocytosis - esp. cats Resolves within hours or less

E - Haem (9 decks)

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