Lecture 2: Evaluation of Bone Marrow

Question 1

bone marrow biopsy usually performed where

Answer 1

head of femur

Question 2

all blood cells derive from:*

Answer 2

hematopoietic stem cell

Question 3

Prussian blue stains for***

Answer 3

iron

Question 4

last cell stage to have nuclei on path to become erythrocyte

Answer 4

metarubricytes (although some don’t have nuclei, just a bunch of RNA)

Question 5

At what cell stage are RBC progenitors released from the marrow?**

Answer 5

reticulocyte stage

Question 6

degenerative vs. regenerative left shift**

Answer 6

degenerative: have more early precursors than mature precursors of neutrophils
regenerative: have more early precursors than you should, but still have more mature than immature precursors of neutrophils

Question 7

At what developmental stage are neutrophil precursors normally released from the marrow?

Answer 7

when they are mature neutrophils

Question 8

endomitosis (DNK)

Answer 8

division of chromosomes that is not followed by nuclear division and that results in an increased number of chromosomes in the cell

Question 9

most common form of anemia**

Answer 9

anemia of chronic inflammatory disease

Question 10

Pancytopenia**

Answer 10

decreased RBC/neutrophils/platelets (the three most important blood cells)

Question 11

multiple myeloma arises from

Answer 11

several places in the bone marrow

Question 12

perineoplastic syndrome

Answer 12

syndrome that accompanies a tumor

Question 13

reasons for bone marrow exam

Answer 13

• cytopenia
• proliferative abnormalities
• staging lymphomas or mast cell tumors
• evaluate iron stores
• evaluate focal lesions in bone
• unexplained hyperproteinemia
• unexplained hypercalcemia
• search for occult dz (i.e. fever of unknown origin)

Question 14

LSA=

Answer 14

lymphosarcoma

Question 15

What happens to kidney in hypercalcemic state?

Answer 15

makes distal tubules anti-refractory to ADH: makes animal PU/PD

Question 16

When to do a bone marrow biopsy

Answer 16

• unsuccessful aspirate
• eval. of overall cellularity
• dx of myelofibrosis
• id of focal lesions

Question 17

Unexplained cytopenia**

Answer 17

Decreased cell production. Can be selective for 1 cell line, or involve 2 or 3 (pancytopenia**). Can be hyper or hypocellular

Question 18

Thrombocytosis

Answer 18

Too many platelets

Question 19

Lymphocytosis

Answer 19

Too many lymphocytes (T cells, B cells, NK cells)

Question 20

What do plasma cells look like?

Answer 20

Deep blue cytoplasm, eccentric nucleus, pale staining region next to nucleus (Golgi apparatus filled with Ab)

Question 21

What causes “punched out lytic lesions”?

Answer 21

Multiple myeloma

Question 22

Why does multiple myeloma cause hypercalcemia

Answer 22

Ca released as lesions punched out of bone

Question 23

Mast cell tumors like to go to

Answer 23

Bone

Question 24

M:E ratio

Answer 24

Myeloid:erythroid ratio. Normal = 1 for most animals. Evaluated on bone marrow exam

Question 25

T/F: horses do not release reticulocytes into blood**

Answer 25

T. Therefore, you can only count them on a bone marrow exam or PCV

Question 26

Things to eval. On bone marrow exam

Answer 26

``` Overall cellularity Number, morph, stages of megakaryocyte devel./erythroid/granulocytic cells M:E ratio Lymphocytes, plasma cells, macrophages Amt of hemosiderin Retic count in horses ```

Question 27

Know what marrow precursor cells look like**

Answer 27

See slide 10 on notability

Question 28

Hemosiderin is breakdown product of:

Answer 28

Hb

Question 29

Wright-giemsa stains hemosiderin...

Answer 29

Black

Question 30

Name a scenario when you would use prussian blue stain

Answer 30

Looking for anemia of chronic inflammatory dz and te body is sequestering iron