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Year 3 MOD > Clinical Pathology- Haematology: Leucocytes and Polycythaemia > Flashcards

Clinical Pathology- Haematology: Leucocytes and Polycythaemia Flashcards

1
Q

How do leucocytes get transported?

Where are they produced?

What causes their stimulation?

A

Use blood as transport system

Produced/release from bone marrow and egress into peripheral tissues

Stimulated by cytokines

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2
Q

Which 2 leucocytes are involved in innate immunity and phagocytosis of pathogens?

Which leucocytes are part of adaptive immunity?

Which two leucocytes deffend against parasites?

A

Neutrophil and monocytes- innate immunity

Lymphocyte- adaptive

Eosinophil/basophil- defense against parasites

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3
Q

Which leucocytes are granulocytes (polylobed nuclei and granules)?

A

Neutrophil

Eosinophil

Basophil

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4
Q

Fill in the covered names of these leucocytes

A
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5
Q

What it a leukogram?

A

Analysis of leucocytes a differential count is absolutely required

No substitute for a smeal exmaination

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6
Q

How many WBC need to be in a single field for leukopenia and leukocytosis?

A

<15 WBC in a single LPFx10 field- leukopenia

>45 WBC in a single LPFx10 field- leuckocytosis

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7
Q

How can mature and band neutrophils be distinguished?

A

Mature- nucleus divided into 3-5 lobes- cytoplasm clea or pale pink

Band- u-shaped nucleus, parallel sides, minimal indentation which are not >50% of width of nucleus

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8
Q

What is the role of neutrophils?

A

Vital role in defence against pathogens-
kill or inactivate bacteria, yeats, fungi or parasites
eliminate infected or transformed cells
modulate the immune response

Involved in regulation of haemopoiesis

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9
Q

What are the different neutrophil pools and where are they found?

A

Bone marrow:
Proliferative pool
Maturation pool
Storage pool

Blood pools

Some in tissues

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10
Q

Describe neutrophil kinetics

A

Production regulated by cytokines and growth factors

Maturation time in bone marrow is 7 days

Many neutrophils are stored in BM

Average blood transit time 6-10 hours

On exit from circulation, neutrophils are lost across mucosal surfaces or are removed by macrophages in liver/spleen

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11
Q

If haemopoiesis stops what will be the first manifestation in the blood?

A

Neutropenia

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12
Q

What is a left shift of neutrophils?

What causes it?

A

A shift/increase in band immature neutrophils

Caused by a strong inflammatory stimulus- release of more immature forms

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13
Q

What is the difference in regeneratvie and degenerative left shift of neutrophils?

A

Regenerative- neutrophilia with bands

Degenerative- normal or low mature neutrophil count, increased immature cells, poor prognostic indicator

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14
Q

What can cause neutrophilia?

A

Physiolgical response- emotional stress/fear, adrenalin

Acute inflammatory response- infection, IMD, neoplasia, necrosis

Stress/corticosteroid induced

Others- uncommon

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15
Q

What is physiological neutrophilia?

A

Redistribution of mature neutrophils from the marginating pool to the circulating pool:
increased blood flow
stress/fear

May also produce lymphocytosis in cats- can be quite marked, mat also see hyperglycaemia

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16
Q

How can stress/steroid induced neutrophilia be identified?

A

Mature neutrophilia

release of cells from the storage pool
Shift of cells for marginating to circulating pool
reduced endothelial adherance

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17
Q

What shows up in a stress leukogram?

A

Neutrophilia

Lymphopenia

Eosinopenia

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18
Q

What changes about a leucogram with an acute inflammatory response?

A

Neutrophilia with or without a left shift

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19
Q

What happens to leucocytes with toxic change?

Why?

A

Increases cytoplasmic basophilia (blue colour)
Blue granules (Dohle bodies)
Vacuoles (foamy appearence)
Less condensed chromatin

Due to reduced maturation time in bone marrow because of intense stimulation of myelopoiesis

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20
Q

True or false bacterial infection is the commonest cause of neutrophilia?

A

False

21
Q

What can cause neutrophil dysfunction?

A

Immunodeficiency syndromes

Diabetes mellitis

Neoplasia

FeLV

22
Q

What causes neutropenia?

A

Overwhelming demand/decreased survival

Reduced or ineffective granulopoiesis

Rare diseases

23
Q

What overwhelming demand can cause neutropenia?

A

Severe bacterial infection:

especially gram negatives
Pyometra
Peritonitis
Pyothorax

24
Q

What can cause reduced haemopoiesis?

A

Bone marrow hypoplasia causes pancytopenia- deficiency of RBCs, WBCs and platlets

After chemotherapy drug administration
Parvovirus infection
Idiosyncratic drug reaction
Oestrogens
Chronic ehrlichiosis
Bone marrow infiltration in neoplasia

25
Q

What do eosinophils do?

A

Kill parasites

Control hypersensitivity reactions

Effector cells in allergic disease and inflammations

26
Q

What can cause eosinophilia?

A

Pasasitic- ecto and endo

Allergic- feline astma, catine atopy, food hypersensitivity

Inflammatory- eosinophilic enteritis, IBD, eosinophilic

Neoplastic- mast cell tumours, occasional lymphoma

Hyperadrenoccotricism

Hypereosinophilic syndrome

27
Q

What do basophils do?

A

Potentiate inflammatory/hypersensitivty reactions

IgE and antigen causes degranulation

Histamine release- hypersensitivity reaction

Response in line with eosinophils

28
Q

What are monocytes?

A

Circulating precursor of the macrophage

Circulate for short time before migrating into tissues as macrophages

Phagocytose- dead/infected cells, mycobacteria, fungi

Secrete various inflammatory immunomodulatory factors

29
Q

What causes monocytosis?

A

Often reflects chronic inflammation
Acute inflammatory response
Tissue necrosis
Immune mediated disease

Compensatory in neutropenia

Part of stress leukogram

30
Q

What is suggestive of acute inflammation in a leukogram?

A

Neutropenia and left shift

31
Q

Where do T/B cells migrate to and from?

A

T cells from bone marrow to thymus

B cells mature in bone marrow

Second most common leucocyte- most common in cows

32
Q

What is the B lymphocte function?

A

Following antigenic stimulation it casuses plasma cells to release Ig

33
Q

What is the role of T lymphocytes?

A

Following antigenic stimulation

T helper cells

Cytocxic t cells

T-regulatory cells

34
Q

What can cause lymphocytosis?

A

Physiological- adrenalin induced splenic contraction

Prolonged immune stimulation

Youth

Lymphoproliferative disease

Transient post vaccination

Hypoadrenocorticism

35
Q

What causes lymphopenia?

A

Corticosteroids

Viral disease- acute phase of viral infections

Loss of lymphocte rich lymph

Sepsis/endotoxaemia

Lymphoma

36
Q

Can fill in this table?

A
37
Q

What is haemopoietic neoplasia?

A

Leukaemia

38
Q

What are the different types of leukaemias and how are they different?

A

Lymphoid lukaeamia- colonal expansion of neoplasit lymphoid

Myeloid leukaemia- neoplastic leukocytes and precursors

Acute- atypical immature cells

Chronic- well differentiated cells

39
Q

What is polycytaemia/erythrocytosis?

A

Increase in

PCV/Htc

or

RBC count

or

Hb

40
Q

What is the difference between relative and absolute polyctaemia?

A

Relative: proportional changes of RBC numbers in relation to plasma

Absolute: true increase in RBC bumbers due to erythropoiesis

41
Q

What are some reasons for normal increase in RBCs or HCT?

A

Normal- some breeds have higher PCV

Splenic contraction- especially in horses

Artefactual

42
Q

What can cause relative polycytaemia?

A
  • Decreased plasma volume due to fluid shift or dehydration
  • Dehyration
  • Acute GI disease
  • Severe hyperthermia
  • RBC redistribution
  • Splenic contraction
  • Exitement
43
Q

How is relatvie polycytaemia treated?

A

Correct fluid and electrolye imbalences

Treat the cause

44
Q

What is the difference between primary absolute polycytaemia and secondary absolute polycytaemia?

A

Secondary- due to increased EPO- appropriate/inappropriate

Primary- not due to increases EPO- chronic RBC leukaemia

45
Q

What is an appropriate secondary absolute polycytaemia?

Can you name some examples?

A

Response to generalised hypoxia and hypoxaemia

Severe heart disease- congenital right-left shunts, severe lung disease

High altitude

Alveolar hypoventilation

46
Q

What are innapropriate secondary absolute polycytaemias?

A

Innapropriate increase in EPO

Renal tumours or other lesions causing localised renal hypoxia

Non renal tumours producing EPO

47
Q

What can cause a primary absolute polycytaemia?

A

Well-differentiated myeloprolierative disorder:

mutation in JAK2 gene

48
Q

How is absolute polycytaemia treated?

A

remove the underlying cause if possible

stabilise with phlebotomy

Year 3 MOD (42 decks)

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