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Lent term fourth year > HOLS WBCs + platelets > Flashcards

HOLS WBCs + platelets Flashcards

1
Q

Effect of inflammation of white blood cell release

A

Stimulates release of mature cells from storage pool
+ can get release of some from maturational pools so see band neutrophils and earlier precursors in blood

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2
Q

Circulating vs marginating pool of neutrophils

A

Circulating pool = those in blood sample
Marginating pool = temporarily adhered to endothelium

In dogs ratio = 1:1
In cats = 1:3 (circulating:marginating)

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3
Q

What causes decreased adherence of neutrophils from endothelium (marginating pool)

A

Steroids/glucocorticoids

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4
Q

What WBC may be predominant in one species

A

Lymphocytes in cattle
(vs normal = neutrophils)

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5
Q

Which WBC count method gives better leuocyte differentiation

A

Flow cytometric (c/f impedence)

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6
Q

6 causes of neutrophilia

A

Inflammation
Stress/steroid therapy
Excitement
Granulocytic leukaemia
Paraneoplastic disease
Leukocyte adhesion deficiency in Irish setter

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7
Q

Features of acute systemic inflammation (as a cause of inflammatory neutrophilia)

A

Left shift: band neutrophils (no nuclear lobulations; 1/3 diameter)

Toxic changes in neutrophils: produced too fast for removal
e.g Dohle bodies, cytoplasmic basophilia, cytoplasmic vacuolation

Lymphopenia and eosinopenia

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8
Q

What is the bone marrow response to prolonged inflammation

A

Granulocytic hyperplasia; so get increase in size of proliferative and maturational pool

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9
Q

Key difference in neutrophilia between acute and chronic inflammation

A

In chronic inflammation there is increased capacity for production in BM; so get release of MATURE neutrophils (don’t see left shift unless stimulus very marked)
- In fact may see right shift

Can see monocytosis in chronic inflammation but never see this in acute

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10
Q

Changes in other white cell lines in chronic inflammation

A

Increased numbers of monocytes, lymphocytes, eosinophils

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11
Q

Stress/steroid induced neutrophilia characteristics/cause

A

Endogenous = stress, hyperadrenocorticism
Exogenous = steroids

Causes reduced adherence of neutrophils in marginting pool so increase into circulating pool
= MATURE NEUTROPHILIA

UP to 2-4x RI

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12
Q

Differentiation stress leukogram from chronic inflammatory leukogram

A

With stress get fall in lymphocytes and eosinophils
vs chronic inflammation may see rise in these

In both: see increase in neutrophils and monocytes (but monocytosis more marked in chronic inflammation)

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13
Q

Stress leukogram

A

Neutrophilia
Lymphoneia (may only see this one in cats)

[Less common
Monocytosis, Eosinopenia]

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14
Q

What type of neutrophilia seen in catecholamine/excitement

A

MATURE because due to redistribution from marginating to circulating pool

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15
Q

Differentiating neutrophilia due to excitement vs stress

A

Excitement see no monocytosis and mild lymphocytosis (vs lymphopenia becing common in stress)

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16
Q

What would a marked neutrophilia with left shift BUT NO INFLAMMATION indicate

A

Granulocytic leukaemia i.e clonal proliferation of mature neutrophils

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17
Q

Which species has a small storage pool of neutrophils so prone to inflammatory neutropenia

A

Cattle

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18
Q

Non pathological causes of neutropenia

A

Taking blood while under sedation
Clots in sample
Breed variation; low in Sighthounds

19
Q

When might we expect inflammation to cause a neutropenia

A

In severe inflammation; organs with large surface area e.g metritis, often gram -ve infections

Where emigration into tissues from blood is greater than release from bone marrow

20
Q

Effect of endotoxaemia on neutrophil distribution

A

Causes margination of neutrophils from the blood so can contribute to neutropenia

21
Q

Causes of neutropenia

A

Inflammation
Reduced production (no left shift/toxic change)

22
Q

Why might we get a reduced production neutropenia

A

Toxins: oestrogens, chemotherapy
Infections: FeLV, parvo
Myelopthesis: replacement of stem cells in marrow (by neoplastic or fibrotic cells)

23
Q

Causes of lymphocytosis

A

Chronic inflammation
Excitement (NB: only mild elevating up 2X RI)
Hypoadrenocorticism
Young animals e.g post vaccination
Lymphoma/lymphoid leukaemia

24
Q

Hypoadrenocorticism causing lymphocytosis and eosinophilia can be called the..

A

inverse stress leukogram

25
Q

Primary differential for lymphopenia

A

Stress/steroids (or hyperadrenocorticism)

26
Q

Causes of eosinophilia

A

Parasitic disease
Allergic disease
Hypoadrenocorticism (part of inverse stress leukogram)
Paraneoplastic syndrome
Idiopahic eosinophilic syndrome

27
Q

Hypereosinophilic syndrome of cats

A

Very marked eosinophilia in cats;idiopathic

28
Q

What is basophilia a sign of

A

parasitic or allergic disaese

29
Q

Platelet production regulation

A

TPO is secreted by hepatocytes and renal tubules at a constant rate; cleared by platelets/megakryocytes
SO if there is a fall in platelets, get more TPO so more production

30
Q

Effect of inflammation on thrombopoiesis

A

TPO is secreted during inflammation so get increase in platelet production

31
Q

How to approximate platelet count from a blood smear

A

Count number in an 100x hpf
Then multiply by 10-15

32
Q

Causes of thrombocytopenia

A

Pseudothombocytopenia (clumping, macroplatelets, normal for some breeds)
Increased consumption
Sequestration
Fall in production
Increased destruction
Blood loss

33
Q

Which dog breed has lower than normal platelets

A

Sighthounds; normal size
+ cavaliers because they have macroplatelets)

34
Q

Most common pathological cause of thrombocytopenia

A

Consumptive = due to inflammation
In severe inflammation can get DIC which gives MARKED thrombocytopenia

35
Q

Causes of immune mediated increased platelet destruction IMTP

A

Primary = idiopathic
Secondary:
> Drugs: TMPS
> Neoplasia: lymphoma
> Infection: anaplasa, babesia, ehrlicia, leishmania

36
Q

What is Evan’s syndrome

A

Concurrent IMTP and IMHA

37
Q

PResentation and lab results of IMTP

A

Petechiae, epistaxis, lethargy, melaena, [pyrexia, hepato/splenomegaly]

SEVERE thrombocytopenia (<30x10^9/L), left shifted neutrophilia, may see anaemia

38
Q

What would we consider a marked thrombocytopenia

A

<50x10^9/L

39
Q

Drugs that cause reduced platelet production

A

Chemotherapy, oestrogen, TMPS

40
Q

Infectious diseases that can cause reduced platelet production

A

FeLV, FIV, feline panleukopenia virus, FIP, babesia, anaplasma, leishmania, erlichia

41
Q

When might we see thrombocytopenia due to platelet loss

A

In very severe haemorrhage e.g from rat poisoning

42
Q

Low platelets due to sequestration

A

associated splenomegaly; in portal hypertension, neoplasia, hypothermia

ONLY MILD >100x10^9/L

43
Q

How can chronic inflammation cause thrombocytosis

A

Via increased TPO release

Lent term fourth year (38 decks)

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