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L - S Haem > 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
Q

What does a right shift in neutrophils mean?

A

Neutrophils are made to stay in the circulation rather than go off to be recycled - means they are hypersegmenting (how they mature)

26
Q

What is neutrophil toxic change?

A
  • Rapid neutropoiesis - not going thorugh whole maturation cycle
  • Usually severe bacterial infection
  • Other example assocations (Parvo, IMHA, ARF, DIC, neoplasia)
  • Prognostic indicator
27
Q

What is the only way to see toxic change?

A

Through blood smear

28
Q

How can we recognise toxic change in cytology?

A

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
Q

Which one of these is the toxic neutrophil?

A

C - normal band neutrophil
D - toxic band neutrophil

30
Q

Which one of these is the toxic neutrophil?

A

A - normal mature neutrophil
B - toxic neutrophil

31
Q

What are possible neutrophil inclusions?

A
  • Bacterial (Ehrlichia, Anaplasma)
  • Viral (Canine distemper)
  • Protozoa (Toxoplasma, Hepatozoon)
  • Fungi (Histoplasma)
  • Hereditary/metabolic (Chediak-Higashi, Birman cat anomaly, mucopolysidosis)
32
Q

What are heterophils?

A

Functionally equivalent cell to neutrophils with red coloured granules
In rabbits, reptiles and birds

33
Q

What are possible neutropenia causes?

A
  • Inflammation
  • Decreased production
34
Q

What can cause decreased production of neutrophils?

A
  • Infections: parvovirus, FeLV, toxoplasma
  • Toxicity: chemotherapy, oestrogen, chloramphenicol (cats)
  • Neoplasia: leukaemia, myelodysplastic, metastatic
  • Marrow necrosis
  • Myelofibrosis
35
Q

How does neutrophil marrow reserve vary by species?

A

Dog - relatively high
Cat - intermediate
Horse - intermediate
Cow - relatively low

36
Q

How does the neutrophil regeneration capacity vary by species?

A

Dog - rapid
Cat - intermediate
Horse - intermediate
Cow - slow

37
Q

Which cells disapear first in cytopenia? Why?

A

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
Q

How is neutrophil circulation different from lymphocyte circulation?

A

Neutrophils have a one way life from bone marrow to being destroyed
Lymphocytes circulate around the body - for defence memory (long lived)

39
Q

What are reactive lymphocytes?

A
  • 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
Q

What are these lymphocytes?

A

Reactive lymphocytes

41
Q

What causes lymphocytosis?

A

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
Q

What causes lymphopenia?

A

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
Q

How are monocytes and macrophages linked?

A

Monocytes are blood resident
Differentiate into macrophages when they enter tissues

44
Q

What are these cells?

A

Monocytes

45
Q

What does the presence of monocytes trigger?

A

Results in release of immune mediators (cytokines)

46
Q

What causes monocytosis?

A

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
Q

What causes eosinophilia?

A
  • 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
Q

What causes eosinopenia?

A
  • Glucocorticoids, stress, inflammation
  • Many reference intervals include “0”
49
Q

What are these cells?

A

Eosinophils

50
Q

What are these cells?

A

Basophils

51
Q

When do we see nucleated red cells?

A
  • 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
Q

What are these cells?

A

Neoplastic undefined cells

53
Q

What can glucocorticoid stress cause on WBC count?

A
  • Mature neutrophilia (3)
  • Lymphopenia (2)
  • Eosinopenia (1)
  • ± Monocytosis (4)
54
Q

WHat does catecholamine mediated excitement cause on WBC count?

A

Triggered during travel, capture, chutes & handling
Mature neutrophilia
Lymphocytosis - esp. cats

Resolves within hours or less

L - S Haem (9 decks)

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