Test 4: 5: lymphoid

Question 1

— regulated the production of RBC

Answer 1

erythropoietin (Epo)

released during hypoxia by kidneys promotes RBC proliferation and inhibits apoptosis

Question 2

erythropoiesis is the formation of ___

Answer 2

red blood cells

regulated by Epo- which is made by kidneys

Question 3

Granulopoiesis is the formation of —

Answer 3

myeloid series

Inflammatory mediators (ILs and TNF-α) stimulate fibroblasts, macrophages, and endothelial cells to produce cytokines (G-CSF and GM-CSF) that increase granulopoiesis and monocytopoiesis.

Question 4

Granulocytic and monocytic cells are referred to collectively as —

Answer 4

myeloid cells

In the context of hematology, “myeloid” is also
sometimes used to mean a hematopoietic cell of nonlymphoid origin; in neuroanatomy, the prefixes “myelo-” or “myel-” can refer to the spinal cord or myelin.)

Question 5

Thrombopoietin (Tpo), synthesized primarily in the —, regulates thrombopoiesis.

Answer 5

liver

always/ constitutively produced

makes megakaryocytes → platelets

Question 6

Megakaryocytes arise from a progenitor cell → endomitosis to become — →extend cytoplasmic processes bone marrow venous sinusoids →shed cytoplasmic fragments (—) into circulation.

Answer 6

polyploid
platelets

Question 7

Answer 7

neutrophil

Question 8

Answer 8

eosinophil

Question 9

Answer 9

basophil

Question 10

Answer 10

monocyte

Question 11

Answer 11

lymphocyte

Question 12

— tissue (red marrow) regresses and is replaced with nonhematopoietic tissue, mainly fat (yellow marrow).

Answer 12

Hematopoietic

Question 13

what is a cytology how is it different from biopsy

Answer 13

Aspirates = Cytologic preparations are collections of cells expressed or “smeared” on a slide, stained and examined microscopically. Most aspects of a ‘marrow evaluation’ can be done cytologically

Core biopsies = Histologic preparations are sections of tissue that have been fixed with formalin, embedded in paraffin or plastic, sectioned, stained, and coverslipped.

Question 14

why do you submit a CBC with a bone marrow sample

Answer 14

need to compare to each other, they change rapidly in response to each other

Question 15

M:E ratio is for —

Answer 15

THIS ONLY INCLUDES ERYTHROID AND MYELOID - NOT MEGAKARYOCYTES!

Normal M:E in healthy animals: Companion animals M:E=1:1 – 2:1, Livestock
& horses M:E = 0.5:1.

Question 16

when to do core biopsy

Answer 16

if bone changes
FNA showed abnormal cellularity
focal lesion
FNA unsuccessful- dry tap

Question 17

what cells for the M:E ration

Answer 17

myeloid : neutrophil, eosinophil, basophil

erythroid: red blood cell

Question 18

deep blue ?
purple?

Answer 18

deep blue: erythroid
purple: myeloid

Question 19

what is a band cell

Answer 19

immature neutrophil

Question 20

— is an Increase in response to peripheral demand for a specific cell type

Answer 20

hyperplasia

predictable

Question 21

2 causes of erythroid hyperplasia?

Answer 21

Hemorrhage
– Trauma
– Coagulopathies
– Neoplasia

Hemolysis
– IMHA
– Toxin
– Infectious
– Oxidant injury
– Enzyme deficiencies
– Hypophosphatemia

Question 22

this causes — in the bone marrow

Answer 22

liver failure- ↓ red blood cells
low hemoglobin = hypoxemia= Epo production by kidneys which triggers bone marrow to make more red blood cells

Erythroid hyperplasia

Question 23

what happens to M:E if there is erthroid hyperplasia

Answer 23

decreases because E increases

there will be immature RBC in the blood (polychromatophilic RBC (bluish)and Reticulocytes(stained with methylene blue))

leads to regenerative anemia

Question 24

With persistence of blood loss (e.g., refractory immune-mediated thrombocytopenia, or
chronic urinary or GI losses), there is depletion of —. This blunts the regenerative response and
eventually results in a — anemia, secondary to iron depletion. Erythroid hyperplasia may not be evident.

Answer 24

iron

non-regenerative

Question 25

how can prolonged blood loss cause increase in myeloid cells

Answer 25

sudden loss of blood = loss of hemoglobin/oxygen= cell death which recruits myeloid cells. This recruitment causes ↑ production of myeloid cells in the bone marrow

M:E will be equal but both increased

Question 26

which is false in respect to erythroid hyperplasia

Answer 26

increased M:E

it will cause a decrease because E gets bigger

Question 27

what happens to M:E with myeloid hyperplasia

Answer 27

increase

caused by need for more granulocytes or monocytes

infection

Question 28

what is a left shift in maturation?

Answer 28

there is such a need for cells that
myeloid cells are moved into blood before fully mature

will see band cells

Question 29

three causes of megakaryocytic hyperplasia

Answer 29

• Destruction
• Loss
• Consumption

platelets

Question 30

three causes of megakaryocytic hyperplasia

Answer 30

Peripheral destruction (immune-mediated thrombocytopenia, ITP)

Loss (hemorrhage)

Consumption (disseminated intravascular coagulation, DIC)

• • The marrow will respond by increasing megakaryocytes.

platelets

Question 31

what is the marrow response in a dog with immune mediated thrombocytopenia

Answer 31

megakaryocytic hyperplasia

(produce platelets)

Question 32

2 manifestations of bone marrow hypoplasia

Answer 32

• Measurable hypoplasia (change in M:E);
  decrease/absence of a particular cell line
• Failure to respond with appropriate hyperplasia despite peripheral cytopenia (thus, marrow may appear normal)→ body tells marrow it needs something but marrow says nope

Question 33

high or low thyroid will cause bone marrow hypolasia

Answer 33

low

causes mild to moderate erythroid hypoplasia

Question 34

high or low estrogen will cause bone marrow hypoplasia

Answer 34

high

can be severe generalized marrow hypoplasia/aplastic anemia

Question 35

how does anemia cause bone marrow hypoplasia

Answer 35

non-regenerative anemia

Hepcidin:
-Acute phase protein synthesized in the liver; expression increases with inflammation, infection, or iron overload and decreases with anemia or hypoxia -Limits iron availability, causing functional iron deficiency: Binds to and causes the degradation of the cell surface iron efflux molecule, ferroportin, thus inhibiting both absorption of dietary iron from the GI and export of iron from macrophages and hepatocytes into the plasma.

Inflammatory cytokines (e.g. TNF & IL-1):
-Inhibit erythropoiesis by oxidative damage and trigger apoptosis of developing erythroid cells
-Decrease expression of Epo, Epo receptors, and stem-cell factor

Question 35

how does anemia of chronic disease cause bone marrow hypoplasia

Answer 35

non-regenerative anemia

Hepcidin:
-Acute phase protein synthesized in the liver; expression increases with inflammation, infection, or iron overload and decreases with anemia or hypoxia -Limits iron availability, causing functional iron deficiency: Binds to and causes the degradation of the cell surface iron efflux molecule, ferroportin, thus inhibiting both absorption of dietary iron from the GI and export of iron from macrophages and hepatocytes into the plasma.

Inflammatory cytokines (e.g. TNF & IL-1):
-Inhibit erythropoiesis by oxidative damage and trigger apoptosis of developing erythroid cells
-Decrease expression of Epo, Epo receptors, and stem-cell factor

Question 36

— is the most common cause of nonregenerative anemia and causes a lack of compensatory —. This process is controlled by — which limits iron availability.

Answer 36

Anemia of chronic disease
erythropoiesis
hepcidin

leads to bone marrow hypoplasia

Question 37

IMHA

Answer 37

Immune-Mediated Hemolytic Anemia

body attacks red blood cells

Question 38

how to tell acute bone marrow inflammation

Answer 38

fibrinous / neutrophils in higher amounts

can be hard to measure cause cells are supposed to be there or inflammation can be focal

if you see necrosis good way to know that something is going wrong

Question 39

how to tell chronic bone marrow inflammation

Answer 39

granulomatous inflammation
necrosis

Question 40

Myelodysplastic Syndrome

Answer 40

group of clonal myeloid proliferative disorders characterized by ineffective hematopoiesis, resulting in a peripheral cytopenia of the affected cell population(s).

can lead to acute myeloid leukemia

marrow profile indicates hyperplasia of one or more cell lines with no improvement in the peripheral cell count and abnormal cell morphology

Rare in veterinary medicine, occurring most frequently in cats infected with FeLV.

Question 41

when can you see MYELODYSPLASTIC SYNDROME (MDS)

Answer 41

Rare in veterinary medicine, occurring most frequently in cats infected with FeLV.

Refers to a group of clonal myeloid proliferative disorders characterized by ineffective hematopoiesis, resulting in a peripheral cytopenia of the affected cell population(s).

Question 42

AML vs CML

Answer 42

acute myloid leukemia: blood smear show blast cells, >20% of cells will be of myloid origin, seen in FELV + cats, poor prognosis

chronic myelogenous leukemia: high cell counts, very rare, marrow hyperplasia of the affected cell line; normal morphology and therefore diagnosis is made by process of elimination

Question 43

compare ALL or CLL

Answer 43

acute lymphoid leukemia immature lymphocytes, may efface the marrow, young animals

chronic lymphoid leukemia well differentiated lymphocytes, does NOT efface the marrow, older animals

Question 44

what are bence-jones proteins

Answer 44

light chains that break off antibodies and secreted in the urine

seen in multiple myeloma (plasma cell neoplasm)

Question 45

— are plasma cell neoplasm in the medullary marrow

Answer 45

multiple myeloma

Question 46

how to detect multiple myeloma

Answer 46

• Plasma cell neoplasm in the
  marrow (medullary)

Specific diagnostic criteria
* Marrow plasma cells greater
than 30%
* Monoclonal protein (M-spike)- single type of immunoglobulin(antibody)
* Bence-Jones protein in the
urine (light chain that fell off antibody)
* Lytic bone lesions- oval shaped lesion on bone

Question 47

myelofibrosis

Answer 47

when bone marrow scars in reaction to injury,neoplasia, and inflammation

Fibrosis impedes marrow collection by aspiration and therefore best diagnosed histologically