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L - S Haem & Onco > White Blood Cells > Flashcards

White Blood Cells Flashcards

1
Q

Define leukocytosis

A

Increase in white cell count

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2
Q

Define neutrophilia

A

Increase in neutrophil count

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3
Q

Define lymphocytosis

A

increase in lymphocyte count

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4
Q

Define monocytosis

A

Increase in monocyte count

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5
Q

Define eosinophilia

A

Increase in eosinophil count

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6
Q

Define basophilia

A

Increase in basophil count

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7
Q

Define leukopenia

A

Decrease in white blood cells

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8
Q

Define neutropenia

A

decrease in neutrophils

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9
Q

Define lymphopenia

A

decrease in lymphocytes

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10
Q

Define monocytopenia

A

Decrease in monocytes

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11
Q

Define eosinopenia

A

decrease in eosinophils

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12
Q

How do white blood cells leave blood vessels in an immune response?

A

marginal pool of WBCs on the outskirts of the capillary lumen so they can get out if needed

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13
Q

What can be a trigger for a shift from the maginal to circulating pool?

A
  • Epinephrine
  • Glucocorticoids
  • Infection
  • Stress
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14
Q

What is the proportion of WBCs in the circulating pool of the cat?

A

25-50%

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15
Q

What is the proportion of WBCs in the circulating pool of the dog?

A

50%

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16
Q

What is the proportion of WBCs in the marginal pool of the cat?

A

50-75%

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17
Q

What is the proportion of WBCs in the marginal pool of the dog?

A

50%

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18
Q

What does the neutrophil count in blood depend on?

A

Balance between neutrophils going out of the blood to fight infection vs the speed at which they are being replaced by the bone marrow

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19
Q

What are possible causes of neutrophilia?

A

Inflammation
Infections (bacterial, viral, fungal, protozoal)
Immune mediated anaemia
Necrosis (including haemolysis, sterile inflammation and FB’s)
(Inflammatory mediators must be able to get from lesion to circulation to reach marrow – think about superficial skin, LUTD, CNS)

Steroid
Stress
Steroid therapy
Hyperadrenocorticism

Physiological
Epinephrine
Fight or flight (excitement, fear, pain, exercise)

Chronic neutrophil leukaemia

Paraneoplastic
(rectal polyp, renal tubular carcinoma, metastatic fibrosarcoma)

Other
E.g. LAD

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20
Q

How does the location of neutrophils change during different situations?

A
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21
Q

What does a left shift in neutrophils?

A

Presence of immature cells

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22
Q

What is a regenerative left shift?

A
  • segmented (mature) > immature
  • increased neutrophils
23
Q

What is a degenerative left shift?

A
  • immature > segmented
  • decreased neutrophil count
24
Q

What are possible causes of left shift neutrophilia?

A

significiant inflammatory demand will pull immature (banded) cells out

25
What does a right shift in neutrophils mean?
Neutrophils are made to stay in the circulation rather than go off to be recycled - means they are hypersegmenting (how they mature)
26
What is neutrophil toxic change?
* Rapid neutropoiesis - not going thorugh whole maturation cycle * Usually severe bacterial infection * Other example assocations (Parvo, IMHA, ARF, DIC, neoplasia) * Prognostic indicator
27
What is the only way to see toxic change?
Through blood smear
28
How can we recognise toxic change in cytology?
**Foamy cytoplasm** Dispersed organelles (not discrete –EDTA) **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”
29
Which one of these is the toxic neutrophil?
C - normal band neutrophil D - toxic band neutrophil
30
Which one of these is the toxic neutrophil?
A - normal mature neutrophil B - toxic neutrophil
31
What are possible neutrophil inclusions?
* Bacterial (Ehrlichia, Anaplasma) * Viral (Canine distemper) * Protozoa (Toxoplasma, Hepatozoon) * Fungi (Histoplasma) * Hereditary/metabolic (Chediak-Higashi, Birman cat anomaly, mucopolysidosis)
32
What are heterophils?
Functionally equivalent cell to neutrophils with red coloured granules In rabbits, reptiles and birds
33
What are possible neutropenia causes?
- Inflammation - Decreased production
34
What can cause decreased production of neutrophils?
* Infections: parvovirus, FeLV, toxoplasma * Toxicity: chemotherapy, oestrogen, chloramphenicol (cats) * Neoplasia: leukaemia, myelodysplastic, metastatic * Marrow necrosis * Myelofibrosis
35
How does neutrophil marrow reserve vary by species?
Dog - relatively high Cat - intermediate Horse - intermediate Cow - relatively low
36
How does the neutrophil regeneration capacity vary by species?
Dog - rapid Cat - intermediate Horse - intermediate Cow - slow
37
Which cells disapear first in cytopenia? Why?
When there is marrow disruption, lineage kinetics result in disappearance of neutrophils first, then platelets then RBC’s Because it takes hours for bone marrow to produce neutrophils, days for platelets and months for RBCs.
38
How is neutrophil circulation different from lymphocyte circulation?
Neutrophils have a one way life from bone marrow to being destroyed Lymphocytes circulate around the body - for defence memory (long lived)
39
What are reactive lymphocytes?
* Immunocytes, plasmacytoid lymphocytes * Stimulated T or B * Inflammation (esp chronic) * Young animals * ↑ cytoplasm * ↑ cytoplasmic basophilia * Perinuclear halo * Prominent Golgi zone * ↑, eccentric, cleaved nucleus * More medium and large (i.e., vs peripheral blood “small”)
40
What are these lymphocytes?
Reactive lymphocytes
41
What causes lymphocytosis?
**Physiological** - Catecholamine mediated via splenic contraction (especially cats) **Chronic Inflammation** Chronic antigenic stimulation May include reactive lymphocytes Usu with neutrophilia and/or monocytosis (±eosinophilia) **Young animals and recent vaccination** **Lymphoproliferative disorder** (incl FeLV, BLV) May be lymphopenia in lymphoma **Hypoadrenocorticism** Loss of normal level of lymphocyte inhibition by glucocorticoids
42
What causes lymphopenia?
**Stress/steroid** Endogenous or exogenous glucocorticoid shifts lymphocytes out of circulation & lymphocytolysis **Acute inflammation ** Bacterial, viral or endotoxaemia Migration to inflamed tissue and homing to LN’s Often with neutrophilia or neutropenia Correction of lymphopenia → better prognosis **Loss of lymph** - Chylothorax (drainage) or lymphangiectasia **Cytotoxic drugs, radiation** **Immunodeficiency syndrome** **Lymphoma** - LN pathology and disrupted circulation
43
How are monocytes and macrophages linked?
Monocytes are blood resident Differentiate into macrophages when they enter tissues
44
What are these cells?
Monocytes
45
What does the presence of monocytes trigger?
Results in release of immune mediators (cytokines)
46
What causes monocytosis?
**Inflammation** May imply “chronic” Bacterial, fungal, protozoal Necrosis: haemolysis, haemorrhage, neoplasia, infarction, trauma Inconsistent finding (chronic but also acute inflammation) **Steroid/Stress** Stress Glucocorticoids (occ ACTH) Hyperadrenocorticism **Monocytic/myelomonocytic leukaemia** Monocytopenia not recognised a clinically significant entity
47
What causes eosinophilia?
* 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)
48
What causes eosinopenia?
* Glucocorticoids, stress, inflammation * Many reference intervals include “0”
49
What are these cells?
Eosinophils
50
What are these cells?
Basophils
51
When do we see nucleated red cells?
* Can be present in moderate numbers in regenerative anaemias, lead toxicity * EMH and splenic contraction, damaged marrow * Present in inappropriately high numbers in erythroleukaemia (erythemic myelosis; cats)
52
What are these cells?
Neoplastic undefined cells
53
What can glucocorticoid stress cause on WBC count?
* Mature neutrophilia (3) * Lymphopenia (2) * Eosinopenia (1) * ± Monocytosis (4)
54
WHat does catecholamine mediated excitement cause on WBC count?
Triggered during travel, capture, chutes & handling Mature neutrophilia Lymphocytosis - esp. cats Resolves within hours or less

L - S Haem & Onco (13 decks)

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