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Lymphoreticular and haematopoetic > Abnormalities of the Leukon > Flashcards

Abnormalities of the Leukon Flashcards

1
Q

What are the two methods of measuring leukocytes through a machine?

A

Impedance/optical

Quantitative buffy coat

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2
Q

How does an impedence/optical machine calculate WBC numbers?

A

Lyse RBC and stream nucleated cells through a channel where electrical impedance or optical deflection is noted

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3
Q

What are the pros and cons of using impedence/optical machines to measure WBCs?

A

Accurate for total numbers

If there is regenerative anaemia present not accurate as nucleated RBCs are counted as well

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4
Q

How is a quantitative buffy coat used to measure WBC numbers?

A

Scans a spun down large PCV tube and related fractions to where cell types settle

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5
Q

In what order from bottom to top do WBCs settle in the buffy coat?

A

Basophils, mast cells, eosinophils, monocytes, lymphocytes, platelets

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6
Q

What are the disadvantages of using quantitative buffy coat analysis to calculate WBC numbers?

A

Problems with abnormal cells/platelet enumeration

Differentials poorly performed

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7
Q

What are some manual methods used to calculated WBC numbers?

A

Chamber counts/unopette systems used for exotics

Blood smear estimates from a monolayer assuming there is no clotting or clumping

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8
Q

How is a blood smear estimate of WBC numbers calculated?

A

Number of leukocytes in the monolayer of a 100x field counted then divided by four which correlates roughly to WBC x10^9/L
Average at least 10 fields to minimise variation across smear

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9
Q

What does total WBC concentration include?

A

All neutrophils, lymphocytes, monocytes, eosinophils and basophils

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10
Q

How are specific leukocyte numbers calculated?

A

Count 100 cells per 10x10^9/L total WBCs then times percentage of cells by concentration of WBCs to get absolute concentration

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11
Q

How do you compare specific numbers to absolute concentration of WBCs?

A

Percentage of specific leukocytes can be compared directly but absolute concentration needs to be compared to WBC concentration for context

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12
Q

What factors influence total leukocyte numbers?

A

Dynamic equilibrium
Balance between peripheral demand and the ability of bone marrow to supply adequate replacements
Position of the leukocyte (marginated/circulating)
Availability for sampling

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13
Q

What are the kinetics of neutrophils in a healthy animal?

A

Each stage of production of a neutrophil takes about a da and remain in the blood for between 30 minutes-6hours

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14
Q

What is the self-renewal stem cell for neutrophils

A

CFU-G

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15
Q

What cells make up the ProNP?

A

Myeloblasts, progranulocytes and myelocytes

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16
Q

What stimulates the mitotic pool?

A

IL-1, IL-3, IL-6, GM-CSF, G-CSF

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17
Q

When does apoptosis occur in health to prevent overproduction?

A

Myelocyte stage

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18
Q

Which cells make up the MatNP?

A

metamyelocytes, band neutrophils and segmented neutrophils

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19
Q

What is the ratio of MatNP to ProNP?

A

4-6

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20
Q

What is the SNP?

A

Storage neutrophil pool made up of sub-pool of MatNP with cells ready to be released into marrow sinusoids

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21
Q

What species differences are there in SNP?

A

Dogs and cats have good storage but horses don’t

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22
Q

What is the CNP?

A

Circulating neutrophil pool that is samples in blood collection

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23
Q

What is the MNP?

A

Marginated neutrophil pool which are the cells ready to exit the circulation and migrate into the tissues

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24
Q

What is the TNP?

A

Tissue neutrophil pool

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25
Q

What is the CNP:MNP ratio?

A

Near 1 but can be 3 in cats

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26
Q

What changes occur in left shift of neutrophils?

A

More band neutrophils, may see toxic changes, cytoplasmic foaminess and basophilia, Dohle bodies, giant neutrophils, vaculolation and toxic granules

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27
Q

What causes changes see in left shift of neutrophils?

A

Accelerated production

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28
Q

What is regenerative left shift of neutrophils?

A

Production meets demand and more resulting in neutrophilia and more segmented cells than band

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29
Q

What is a degenerative left shift of neutrophils?

A

Production doesn’t keep up with demand resulting in neutropenia and bands in the circulation in greater numbers than segmented

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30
Q

Why are large animals more prone to degenerative left shift?

A

They have less storage

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31
Q

What changes are seen in right shift of neutrophils? Why does it happen?

A

Hypersegmentation

If neutrophil can’t adhere so keeps circulating

32
Q

What is neutropenia?

A

Lack of neutrophils

33
Q

What causes neutropenia due to increased demand?

A

Peracute bacterial infections, endotoxaemia or immune-mediated disease

34
Q

What causes a redistributive neutropenia?

A

Endotoxaemia or anaphylactic shock

35
Q

What causes neutropenia due to decreased production?

A

Bone marrow disorder - myelodysplasia, myelofibrosis or myelophthisis
Parvovirus, FeLV, FIV and Ehrilichia
Iatrogenic due to azathioprine/cyclophosphamide
Cyclic neutropenia of grey collies or Chediak-Higashi syndrome in cats

36
Q

What is important to keep in mind with neutropenia?

A

Breed differences and individual differences
Broad spectrum ABs if below 2.0x10^9/L
Relate clinical signs to blood count when interpreting results

37
Q

What is neutrophilia?

A

Increased numbers of WBCs

38
Q

What causes neutrophilia due to increased production due to increased demand?

A

Infections, immune-mediated diseases, secondary to neoplasia, haemorrhage, haemolysis, necrosis or thrombosis

39
Q

What causes neutrophilia due to increased production independent of demand?

A

Well differentiated neutrophils transformed = chronic granulocytic leukaemia
Poorly differentiated with early precursors transformed = acute myeloid leukaemia

40
Q

What causes neutrophilia due to increased persistence in the circulation?

A

Part of stress/steroid response and look for accompanied monocytosis/lymphopenia
Hypersegmented = can’t marginate

41
Q

What causes neutrophilia due to redistribution?

A

Stress or excitement increases blood pressure causes marginated neutrophils to be swept into circulation which in cats can increase numbers by 200%

42
Q

What are the similarities and differences between B and T cells?

A

Look the same but B cells mostly short lived apart from memory cells and T cells are long lived

43
Q

How are lymphocytes produced?

A

Formed in bone marrow from lymphoid stem cell but production and clonal proliferation occurs in thymus, spleen and LNs

44
Q

What is the kinetics of lymphocytes?

A

Can recirculated from blood into tissues back via lymphatics, in and out of lymphoid tissue and back into blood

45
Q

What causes changes in plasma or Motts cell?

A

Reaction to any antigenic stimulation

46
Q

What is lymphopenia?

A

Reduction in the number of lymphocytes

47
Q

What causes lymphopenia due to increased demand?

A

Some protein losing enteropathies as cells are lost in chyle or through recruitment and emigration into tissue

48
Q

What causes lymphopenia due to redistribution?

A

Influence of steroids causing redistribution to bone marrow, tissue and trapping in lymph nodes

49
Q

What causes lymphopenia due to decreased production?

A

Infection with canine distemper, parvovirus, panleukopenia virsu, FeLV and FIV
Lympholytic drugs such as cyclophophamide/azothioprine and long term corticosteroids
Congenital immunodeficiencies such as those found in Basset Hounds where B and T cells are affected

50
Q

What is lymphocytosis?

A

Increased numbers of lymphocytes

51
Q

What causes lymphocytosis due to increased demand?

A

Persistent antigenic stimulation, post vaccination or in young animals

52
Q

What causes lymphocytosis independent of demand?

A

Chronic lymphocytic leukaemia (well differentiated)
Acute lymphocytic leukaemia (poorly differentiated)
Stage V lymphoma involves bone marrow and release of neoplastic lymphocytes into circulation

53
Q

What causes lymphocytosis due to redistribution?

A

Physiological lymphocytosis is wehre there is inhibition of recirculation and release of thoracic duct due to adrenaline or in 11-20% of hypoadrenocorticism patients

54
Q

What is the general appearance of monocytes?

A

Larger blue grey cytoplasm

Can have vacuoles and nucleus and can look like anything with less slumping of chromatin

55
Q

How are monocytes produced?

A

Monoblasts->monocytes in 6 days in bone marrow but no storage pool but there is a circulating pool and marginated pool

56
Q

How long do monocytes persist in the circulation?

A

Varies but shortens with inflammation

57
Q

What happens when monocytes leave the circulation?

A

Differentiate into macrophages with inflammatory cytokines

58
Q

What is moncytosis?

A

Increased numbers of monocytes

59
Q

What causes monocytosis with increased demand?

A

Bacterial/fungal/protozoal infection
Immune-mediated disease such as IMHA, meningitis or polyarthritis
Necrosis/burns/trauma
Neoplasia

60
Q

What causes monocytosis independent of demand?

A

Secondary to immune neutropenia due to CFU-GM being a common precursor cell
Myelomonocytic leukaemia (acute and chronic)
Acute monocytic leukaemia with or without maturation

61
Q

What causes redistributive monocytosis?

A

Steroids as moved out of marginated pool

62
Q

What is the general appearance of eosinophils?

A

Larger, segmented nucleus, granules, vacuole looking holes are granules that haven’t stained
Species differences in appearance

63
Q

How long does is take eosinophils to differentiate and mature?

A

2-6 days depending on species with variable persistence in circulation

64
Q

What are the kinetics of eosinophils?

A

Random entry into skin, respiratory and Gi tract but directional entry under the influence of chemokines/inflammatory mediators

65
Q

What causes eosinopenia?

A

Mechanisms unclear but can occur due to corticosteroids and catecholamines

66
Q

What causes eosinophilia due to increased demand?

A

Sensitised T cells/Mast cells cause IL-5 release

Parasite antigen, allergic disease or inflammation of mast cell rich tissue

67
Q

What causes eosinophilia independent of demand?

A

Paraneoplastic due to lymphoma, mast cell tumours or other tumour where IL-5 is elaborated
Hypereosinophilic syndrome where numbers increase in circulation or tissue without obvious cause
Eosinophilic leukaemia is rare

68
Q

What is the general appearance of basophils?

A

Larger ribbon shaped segmented nucleus with lavendar granules

69
Q

How long does maturation and release of basophils take?

A

2-5 days and persist in circulation for 6 hours

70
Q

What is the role of basophils?

A

Type 1 hypersensitivities such as anaphylaxis, rhinitis, asthma, GI sensitivities and parasites

71
Q

Why can basopenia not be detected?

A

Reference interval begins at 0 but possible occurs with anaphylactic, inflammatory and steroid responses

72
Q

What causes basophilia due to increased demand?

A

Immediate or delayed hypersensitivities
Parasitism especially Dirofilaria but also Gi parasites, fleas and ticks
Other inflammatory responses

73
Q

What causes basophilia independent of demand?

A

Paraneoplastic

Rarely basophilic leukaemia

74
Q

What is a stress leukogram?

A

Response to corticosteroid either endogenously as cortisol or exogenously such as prednisolone
Mild to moderate mature neutrophilia, lymphopenia, monocytosis and eosinopenia
Addisons can cause it to occur

75
Q

What is an acute inflammatory leukogram?

A

Neutrophilia without left shift, lymphopenia, monocytosis and +/- eosinopenia

76
Q

What is a chronic inflammatory leukogram?

A

Neutrophilia without left shift, lymphocytosis and monocytosis

77
Q

What does adrenaline response have on leukocytes?

A

Neutrophilia and lymphocytosis

Lymphoreticular and haematopoetic (12 decks)

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