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clinical pathology > WBCs > Flashcards

WBCs Flashcards

1
Q

sequence of neutrophil production

A

myeloblast–>progranulocyte–>myelocyte–>metamyelocyte–>band neutrophil–>segmented neutrophil

become smaller, chromatin condenses and nuclei become progressively more elongated and segmented

6-7 days in health

increased stimulation and demand-2-5 days

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2
Q

Neutrophil pools in bone marrow

A

proliferation pool-myeloblasts, progranulocytes and myelocyts, mitotically active

maturation and storage pools-metamyelocytes, bands and segs

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3
Q

neutrophil pools in blood

A

circulating pool-freely flowing in vasculature, meausred on CBC

marginated pool-“rolling” along and loosely adhered to endothelial surfaces via selectins

dynamic

marginated:circulating is 1:1 (except cats, 3:1)

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4
Q

neutrophil pool in tissue

A

migrated into tissues and do not return to circulation

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5
Q

what size is the maturation/storage pool?

A

largest in dog

intermediate in cats and horses

smallest in ruminants

dogs have more capacity to respond to an increased peripheral demand for neutrophils compared to ruminants

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6
Q

where do neutrophils go?

A

migrate to sites of infl

apoptosis

transmucosal migration

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7
Q

left shift

A

increased numbers of bands

result of depletion of seg PMN within BM

significant inflammatory stimulus

hallmark of acute inflammation (acute/ongoing demand)

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8
Q

regenerative left shift

A

segs>bands

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9
Q

degenerative left shift

A

seg<bands></bands>

<p>
worse px</p>

<p>
interpretation different in SAM vs LAM</p>

</bands>

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10
Q

neutrophilia mechanisms

A

shift from marginated pool to circulating pool (min/hr)

increased release from maturation/storage pools in BM (hr)

increased pdn by BM (d)

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11
Q

causes of neutrophilia

A

inflammation

steroid neutrophilia

epinephrine neutrophilia

neoplasia

paraneoplasitc

leukocyte adhesion deficiency

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12
Q

inflammation neutrophilia

A

numerous underlying causes

left shift often present

Mechanism: increased release from BM, increased production by precursors in BM

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13
Q

steroid neutrophilia

A

results from increased glucocorticoids-stress, Cushing’s, Glucocorticoid therapy

mature neutrophilia

mechanism: shift from marginated to circulating pool, increased release from marrow

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14
Q

epinephrine neutrophilia

A

due to effects of catecholamines (fear, strenuous exercise, excitement)

transient

cats and young horses!

mature

mechanism: shift from marginated to circulating pool

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15
Q

neoplasia neutrophilia

A

chronic granulocytic leukemia

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16
Q

paraneoplastic neutrophilia

A

tumor pdn of G-CSF

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17
Q

Leukocyte adhesion deficiency neutrophilia

A

defective integrin molecule (CD18)

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18
Q

mechanisms for neutropenia

A

shift from circulating to marginated pool

decreased pdn within BM

overwhelming tissue demand

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19
Q

inflammatory neutropenia

A

LA (esp cattle) with acute infl

left shift often present

mechanism: overwhelming tissue demand

difficult to differentiate from endotoxemia neutropenia

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20
Q

endotoxemia neutropenia

A

infection with gram-negative bacteria (LPS)

mechanism: shift from circulating to marginated pool

difficult to differentiate from inflammatory neutropenia

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21
Q

decreased pdn neutropenia

A

damage to precursors or BM microenvironment

Parvo, FeLV, Erlichia

mechanism: decreased pdn within BM

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22
Q

toxic change

A

cytoplasmia vacuolization, basophilia, Dohle bodies

giant PMN-rare

toxic granulation-rare

associated with inflammatory conditions

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23
Q

Which animal has small numbers of Dohle bodies in health?

A

Cats!

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24
Q

peripheral destruction neutropenia

A

rare

immune mediated neutropenia

autoimmune dz char by presence of anti-neutrophil abs

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25
Q

infectious agents in neutrophils

A

bacteria-morulae or Anaplasma & Ehrlichia

Histoplasma capsulatum-yeast

distemper inclusions

Protozoa-Hepatozoon sp, Toxoplasma sp

26
Q

Pelget-Huet Anomaly

A

inherited

occurs in several breeds of dogs, DSH cats and Arabian horses

hyposegmented nuclei in PMN, Eos, Baso

nuclei-band to oval shaped with mature appearing chromatic pattern

normal function

27
Q

Chediak Higashi syndrome

A

rare

cats (perian), cattle and other mammals (mink, whale)

large eosinophilic cytoplasmic inclusions

neutrophil fcn somewhat abn

animals usually healthy but slight tendency to bleed due to abn platelet fcn

28
Q

Birman cat neutrophil granulation

A

rare

fine eosinophilic cytoplasmic granules within neutrophils

fcn normal, cats are healthy

29
Q

lymphocyte pdn

A

not solely dependent on BM pdn

produced in lymphoid tissues-LN, spleen

30
Q

lymphoid tissue pool

A

consists of lymphocytes wihtin LNs, spleen, etc

31
Q

tissue lymphocyte pool

A

lymphocytes that have migrated into tissues

can return into circulation via lymphatics

32
Q

reactive lymphocytes

A

due to infl/antigenic stimulation

increased cytoplasmic basophilia

perinuclear clear zone

increased size

increased amount of cytoplasm

nuclear atypia

33
Q

lymphoblasts

A

not normally found in circulation

char by large size, presence of nucleoli & immature chromatic pattern

neoplasm vs reactive lymphocytes?

34
Q

epinephrine lymphocytosis

A

due to effects of catecholamines (fear, strenuous exercise, excitement)

transient

cats, young horses

mechanism: shift from marginated pool to circulating pool

35
Q

granular lymphocytes

A

CD8, NK cells

small numbers of fine, pink, cytoplasmic granules

low numbers in healthy animals

increased numbers with reactive conditions

36
Q

Chronic inflammation leukocytosis

A

due to chronic antigenic stimulation

lymphoid hyperplasia

esp Ehrlichia/Anaplasma sp

may see reactive lymphocytes

vaccination

37
Q

lymphoproliferative disorder lymphocytosis

A

lymphoid leukemia/lymphoma

persistent lymphocytosis of cattle (BLV inf), of cats (FeLV)

38
Q

hypoadrenocorticism lymphocytosis

A

due to absence of glucocorticoid effects

39
Q

Steroid lymphopenia

A

sequestration of lymphocytes within lymphoid tissues, decreased lymphopoiesis

most consistent feature of steroid leukogram

40
Q

acute bacterial/viral infection lymphopenia

A

due to increased margination in the vasculature and migration of lymphocytes to lymphoid nodes and inflamed tissues

41
Q

depletion/loss lymphopenia

A

GI loss (eg PLE, GI lymphoma, lympangectasia)

chylothorax

42
Q

congenital lymphopenia

A

due to lymphoid hypoplasia

eg combined immunodeficiency syndrome of Arabian foals

43
Q

lymphopenia associated with lymphoma

A

result of damage to lymph tissue and/or altered lymphocyte circulation

44
Q

causes of monocytosis

A

inflammation

steroids

neoplasia-monocytic leukemia

45
Q

inflammation monocytosis

A

infectious, immune-mediated disease, necrosis, hemorrhage, trauma

46
Q

steroid monocytosis

A

increase endogenous/exogenous glucocorticoids in dogs & occasinoally cats

47
Q

eosinophilia

A

parasitism

hypersensitivity reaction

Mast cell degranulation

paraneoplastic

idiopathic eosinophilic conditions

neoplasia

can have significant tissue eosinophilia while having normal eos conc in peripheral blood

48
Q

eosinopenia

A

steroid leukogram

marrow hypoplasia

49
Q

basophilia

A

parasitism

allergic/hypersensitivity reactions

neoplasia

50
Q

mastocytemia

A

inflammation/allergic rxn

mast cell neoplasia

51
Q

epinephrine leukogram

A

Mature neutrophilia-up to 2x URL for most spp (3x for cats)

normal neutrophils

lymphocytosis

cats and horses

transient change

52
Q

steroid leukogram

A

mature neutrophilia-up to 2-3x URL

neutrophils normal or hypersegmented

lymphopenia

+/-monocytosis-dog

+/-eosinopenia-dog

53
Q

classic inflammatory leukogram

A

neutrophilia +/- toxic change, left shift

+/- monocytosis

with chronicity, left shift and degree of toxic change may decrease or disappear as pdn of neutrophils in BM cataches up with peripheral demand

54
Q

inflammatory leukogram (overwhelming tissue demand)

A

neutropenia +/- left shift, toxic change

poor px factor in SAM

pattern is anticipated in LAM (esp ruminants) because they have small marrow storage pools and slower marrow response times

55
Q

endotoxemia leukogram

A

early-neutropenia due shift from circulating pool to marginated pool

rebound-neutrophilia or WRI

56
Q

marrow suppression leukogram

A

neutropenia

lymphocytes WRI

+/- anemia and thrombocytopenia-delay in these cytopenia due to longer life span

57
Q

Dog WBC special facts

A

neutrophil is predominated circulating leukocyte

monocytosis due to steroids most often seen in dog

lymphocytes are small

relatively large neutrophil storage pool and proliferative capacity

58
Q

Cat WBC special facts

A

neutrophil is predominate circulating leukocyte

healthy cats can have a small amount of Dohle bodies within neutrophils

epinephrine leukogram-more often seen

lymphocytes are small

59
Q

Cattle WBC special facts

A

Neutrophils>lymphocytes at birth

lymphocytes may be > neutrophils after 1 week

with significant infl, neutropenia or degenerative left shift-due to relatively small bone marrow reserve pool and proliferative capacity

lymphocyte morphology variable with small, medium and large lymphocytes

BLV (persistent lymphocytosis and leukemia)

increased fibrinogen concentration may be an early indicator of infl

60
Q

horse WBC special facts

A

Neutrophils>lymphocytes at birth (N:L ~3)

Neutrophils>lymphocytes in adults (N:L ~1-2)

epinephrine leukogram seen more often (esp young horses)

increased fibrinogen concentration early indicatory of infl

may develop neutropenia/degenerative left shift with acute infl

clinical pathology (8 decks)

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