Clin Path - Leukocytes

Front 1

Leukon
-definition

Back 1

-all leukocytes in an animal, including precursors, leukocytes in blood and lymph vessels, and tissue leukocytes

Front 2

3 Neutrophil Pools

Back 2

-Marrow
-Blood
-Tissue

Front 3

Neutrophil Pools of the Marrow

Back 3

-self-renewal stem cells (CFU-Granulocyte)
-ProNP (myeloblasts, progranulocytes, myelocytes)
-MatNP (metamyelocytes, band neutrophils, segmented neutrophils)

Front 4

Neutrophil pools of the blood

Back 4

-MNP
-CNP

Front 5

What are the typical neutrophils that leave the blood and enter tissue?

Back 5

-segmented neutrophils

Front 6

Marrow
-Neutrophil half-life in health

Back 6

-5 days

Front 7

Blood
-neutrophil half-life in health

Back 7

-8 hrs

Front 8

How long does it take to make a new supply of neutrophils?

Back 8

-3 days

Front 9

Lymphocyte Pools
-3 paths

Back 9

-lymph node path
-tissue path
-blood path

Front 10

Most lymphocytes in blood

Back 10

-T-lymphocytes

Front 11

Why is it difficult to get timeline information on disease state from lymphocytes?

Back 11

-don't know where they have been or how long they've been there

Front 12

WBC
-how to find

Back 12

-dilute whole blood
-count the number of WBCs in a defined volume with either an electronic cell counter or hemacytometer
-calculate the concentration

Front 13

Types of Electronic Cell Counters

Back 13

-Impedence Cell Counters
-Optical Cell Cytometer

Front 14

How to use an Impedence Cell Counter to measure [WBC]

Back 14

-lyse RBCs
-ID particles by passiing them through an electron field
-Gives a Total Nucleated Cell Count

Front 15

How to use an Optical Cell Cytometer to measure [WBC]

Back 15

-lyse RBCs
-use nuclei or cytoplasmic staining
-ID cells with light scatter and by stain reaction

Front 16

Species with large platelets

Back 16

-cats

Front 17

Deficiencies/Weaknesses of Electronic Differential Leukocyte Counts

Back 17

-don't ID abnormal cells correctly
-don't detect organisms
-each species needs to have its own computer program

Front 18

Abnormal Morphological Features of Leukocytes Associated with Inflammatory Disease

Back 18

-toxic neutrophils
-giant neutrophils
-hypersegmented neutrophils
-reactive lymphocytes

Front 19

Toxic Neutrophils
-Toxic Changes

Back 19

-Foamy cytoplasm
-Diffuse Cytoplasmic Basophilia
-Dohle Bodies
-Asynchronous Nuclear Maturation
-Giant Neutrophils
-Hyalinized Nuclei
-Toxic granules in horses

Front 20

Diffuse Cytoplasmic Basophilia of Toxic neutrophils is due to:

Back 20

-retention of cytoplasmic RNA during maturation

Front 21

Dohle Bodies
-definition

Back 21

-aggregates of Rough Endoplasmic Reticulum that contain RNA

Front 22

Toxic Neutrophils
-are associated with

Back 22

-severe inflammatory disease
-commonly bacterial infections

Front 23

Hypersegmented Neutrophils
-due to

Back 23

-Steroids/glucocorticoids
-delayed sample analysis

Front 24

Reactive Lymphocyte
-morphology

Back 24

-increased cytoplasmic basophilia
-prominent golgi zone
-hyperchromatic nuclei

Front 25

Reactive lymphocytes
-found associated with

Back 25

-acute & chronic inflammatory diseases
-infectious disorders

Front 26

Reactive lymphocytes
-difficult to distinguish from

Back 26

-neoplastic lymphoid cells

Front 27

Organisms found in leukocytes

Back 27

-Ehrlichial organisms (ewingii, canis, equi)
-Histoplasma capsulatum
-Hepatozoon americanum
-Hepatozoon canis

Front 28

Ehrlichial organisms
-identifying features

Back 28

-mulberry-type morula
-grey/blue staining
-one or multiple morulae

Front 29

Ehrlichial species found in dogs

Back 29

-E. ewingii
-E. canis

Front 30

Ehrlichial species found in horses, cattle, dogs, people

Back 30

-E. equi (A. phagocytophilum)

Front 31

Hisptoplasma capsulatum
-identifying features

Back 31

-round to oval
-nonstaining cell wall w/ internal nuclear staining
-budding

Front 32

Histoplasma capsulatum
-found where in the body

Back 32

-LN
-Intestines
-Lungs

Front 33

Histoplasma Capsulatum
-found in what areas of the country

Back 33

-Mississippi, Missouri, Ohio river valleys

Front 34

Hepatozoon americanum
-species infected

Back 34

-dogs

Front 35

Hepatozoon americanum
-gamont location

Back 35

-monocytes

Front 36

Hepatozoon americanum
-concurrent findings

Back 36

-merozoites in muscle
-leukocytosis (leukemoid)

Front 37

Hepatozoon canis
-gamont location

Back 37

-neutrophils

Front 38

Hepatozoon canis
-location in body

Back 38

-blood
-spleen
-marrow

Front 39

Major disorders that create a leukocytosis

Back 39

-Inflammation (infectious, non-infectious)
-Stress/Steroids (Endogenous, Iatrogenic)
-Fight or Flight (epinephrine)
-Neoplastic (leukemia)

Front 40

Why would neutrophilia be seen in a blood sample?

Back 40

-Inc. release from marrow
-Shift from MNP to CNP
-Dec. migration to tissues

Front 41

Nonsegmented neutrophils

Back 41

-band neutrophils
-neutrophilic metamyelocytes
-neutrophilic myelocytes

Front 42

Left Shift
-definition

Back 42

-Inc. in [nonsegmented neutrophil]

Front 43

What does the presence of a left shift indicate?

Back 43

-release of immature neutrophils from the maturation pool

Front 44

Left shift
-due to

Back 44

-response to inflammatory cytokines
-could be steroid response if [band cell] <1000/uL

Front 45

Who is the father of veterinary hematology

Back 45

Dr. O.W. Schalm

Front 46

Regenerative left shift criteria

Back 46

-[nonsegs] < [segs]

Front 47

Degenerative left shift criteria

Back 47

-[segs] < [nonsegs]

Front 48

How is severity of a left shift determined?

Back 48

-immaturity of neutrophils
-magnitude of increased concentration

Front 49

Severity of left shift
-by immaturity of neutrophils

Back 49

-mild = bands
-moderate = bands and metamyelocytes
-marked = bands, metamyelocytes, myelocytes

Front 50

Severity of left shift
-by magnitude of increased concentration

Back 50

-mild = [nonsegs] < 1000/uL
-moderate = [nonsegs] 1000/uL-10K/uL
-marked = [nonsegs] > 10K/uL

Front 51

Hallmark sign of an acute inflammatory reaction

Back 51

-left shift

Front 52

Regenerative left shift indicates:
-why

Back 52

adequate response to inflammatory disorder
-increased need for neutrophils and the marrow is responding to the need by releasing neutrophils from the maturation pool

Front 53

Degenerative left shift indicates:
-why

Back 53

inadequate response by to inflammatory disorder
-marrow is not keeping up with the demand
-usually due to a severe bacterial infection

Front 54

Species that is an exception in distinguishing degenerative left shift
-why

Back 54

Bovine
-very small SNP

Front 55

Right Shift
-indicative of

Back 55

-Inc. [hypersegmented neutrophils]

Front 56

Right shift
-clinical significance

Back 56

-glucocorticoids are decreasing the emigration of neutrophils to tissue and increasing their life span in the blood

Front 57

Neutrophilia
-causes

Back 57

-acute and chronic Inflammatory (infection, immune hemolytic anemia, necrosis)
-Steroid (stress, glucocorticoid therapy)
-Physiologic shift (fight or flight)

Front 58

Acute Inflammatory Neutrophilia
-common sign

Back 58

-Regenerative left shift

Front 59

Acute inflammatory disorder
-takes how long to occur

Back 59

-hours to days

Front 60

Acute inflammatory neutrophilia
-due to

Back 60

-stimulated release of neutrophils from the SNP
-stimulated release of bands from the MatNP
-cytokine stimulated production of neutrophils (granulocytic hyperplasia)
-marrow release greater than tissue migration

Front 61

Chronic Inflammatory neutrophilia
-takes how long to occur

Back 61

-weeks to months

Front 62

Chronic inflammatory neutrophilia
-due to

Back 62

-cytokine stimulated production of neutrophils (granulocytic hyperplasia)
-release of neutrophils from MatNP and SNP

Front 63

Steroid neutrophilia
-due to

Back 63

Down regulation of adhesion proteins in vessels due to glucocorticoids
-shift from MNP to CNP
-Dec. migration to tissues (Inc. blood life span)
-Possibly increase release from SNP and MatNP

Front 64

Physiologic (shift) neutrophilia
-due to

Back 64

Inc. in catecholamines from fight or flight stimulus
-Dec. in adhesion proteins
-Inc. flow rate through small vessels

Front 65

Species with a large MNP

Back 65

-cats

Front 66

Conditions that cause Lymphocytosis

Back 66

-Chronic Inflammation (bacterial infection/anaplasma)
-Physiologic shift (fight or flight)
-Lymphoproliferative disorders (lymphoma)

Front 67

Chronic Inflammatory Lymphocytosis
-takes how long to occur

Back 67

-weeks to months

Front 68

Chronic Inflammatory Lymphocytosis
-due to

Back 68

-Cytokine release stimulating lymphocyte production in lymph nodes (lymphoid hyperplasia)

Front 69

Physiologic (shift) lymphocytosis
-due to

Back 69

Inc. in catecholamines
-Dec. in adhesion proteins causing shift from MNP to CNP
-Inc. blood flow rate in small vessels

Front 70

Physiologic (shift) lymphocytosis
-seen in which spp. the most

Back 70

-cats

Front 71

Physiologic (shift) lymphocytosis
-concurrent finding

Back 71

-neutrophilia

Front 72

Lymphoproliferative disorder
-aka

Back 72

-neoplastic lymphocytosis
-leukemia

Front 73

Lymphoporliferative disorder
-due to

Back 73

-neoplastic transformation of a lymphocyte causing increased production and release of neoplastic lymphocytes

Front 74

Most common lymphocytosis in a sick animal

Back 74

-lymphoproliferative disorder

Front 75

Monocytosis
-causes

Back 75

-inflammation
-steroids

Front 76

Eosinophilia
-causes

Back 76

-hypersensitivity
-parasitism
-mast cell degranulation
-idiopathic

Front 77

Basophilia
-causes

Back 77

-hypersensitivity
-parasitism

Front 78

Leukopenia
-major causes

Back 78

-Inflammatory (infectious, noninfectious)
-Marrow disorder (spontaneous, toxicosis)
-other

Front 79

Reasons for a decreased [neutrophil] in the blood sample

Back 79

-dec. release from marrow
-shift from CNP to MNP
-inc. migration to tissues

Front 80

Neutropenia
-causes

Back 80

-inflammation (overwhelming tissue demand (bacterial & viral))
-Granulocytic hypoplasia

Front 81

Granulocytic hypoplasia
-definition

Back 81

-Dec. in the # of neutrophil precursors in marrow

Front 82

Why are cattle an exception to inflammatory neutropenia?

Back 82

-cattle do not have much of a SNP
-when there is a need for neutrophils, not many get released

Front 83

Acute Inflammatory Neutropenia
-common sign

Back 83

-degenerative left shift

Front 84

Acute inflammatory neutropenia
-takes how long to occur

Back 84

-hours to days

Front 85

Acute Inflammatory neutropenia
-due to

Back 85

infection causing release of cytokines
-migration of neutrophils to inflamed tissue
-release of band cells from the MatNP (left shift)

Front 86

# of neutrophils required to determine a left shift

Back 86

- > 300/uL

Front 87

Inflammatory Neutropenia
-role of endotoxins

Back 87

-shift from CNP to MNP (1-3 hrs)
-but can have release of neutrophils in 8-12 hrs

Front 88

Granulocytic neutrophilia
-due to

Back 88

Disease causing damage to granulocytic stem cells
-dec. number of granulocytic precursors

Front 89

Granulocytic neutrophilia
-concurrent findings

Back 89

-possible anemia and thrombocytopenia

Front 90

Aplastc anemia
-definition

Back 90

-anemia, neutropenia, and thrombocytopenia due to decreased production of cells

Front 91

Lymphopenia
-causes

Back 91

-acute inflammation (bacterial, viral)
-steroid (stress, glucocorticoids)
-Depletion

Front 92

Acute Inflammatory Lymphopenia
-takes how long to occur

Back 92

-hours to days

Front 93

Acute Inflammatory Lymphopenia
-due to

Back 93

Release of cytokines
-homing of lymphocytes to lymph nodes and dec. efflux from lymph nodes
-lymphocyte migration to inflamed tissue

Front 94

Acute Inflammatory Lymphopenia
-concurrent conditions

Back 94

-neutrophilia with a left shift
-inflammatory neutropenia

Front 95

Steroid lymphopenia
-due to

Back 95

Inc. glucocorticoid in blood
-shift of lymphocytes from circulation to marrow or lymph node
-lymphotoxic effects

Front 96

Steroid lymphopenia
-concurrent findings

Back 96

-mature neutrophilia
-monocytosis
-hyperglycemia
-dilute urine

Front 97

Depletion lymphopenia
-due to

Back 97

Damaged lymph vessel
-loss of lymph into thorax or peritoneal cavity (chylothorax, chyloabdomen)
-drainage of fluid from the cavity causing lymphocytes to not get reabsorbed into circulation

Front 98

leukemia
-definition

Back 98

-group of neoplastic diseases with a clonal proliferation of hematopoietic cells in marrow

Front 99

2 groups of leukemias

Back 99

-lymphoproliferative diseases
-myeloproliferative diseases

Front 100

lymphoproliferative disease
-cells found

Back 100

lymphocytes:
-B
-T
-NK

Front 101

myeloproliferative disease
-cells found

Back 101

nonlymphoid cells:
-granulocytes
-monocytes
-erythroid cells
-megakaryocytes

Front 102

Leukemia
-classifications

Back 102

-acute
-chronic

Front 103

Acute leukemia
-definition

Back 103

-blastic (less differentiated) cells

Front 104

Chronic leukemia
-definition

Back 104

-well-differentiated cells

Front 105

Signs to diagnose leukemia

Back 105

-marked leukocytosis
-blastic cells in blood

Front 106

Lymphoproliferative diseases

Back 106

-lymphoma
-lymphoid leukemia (neoplastic cells in marrow and blood)
-myeloma/plasmacytoma

Front 107

Myeloproliferative disease
-clinical findings

Back 107

-nonregenerative anemia
-macrocytosis
-marked rubricytosis
-neutropenia
-thrombocytopenia
-leukocytes with atypical cells

Front 108

MNP:CNP
-typical ratio
-cats

Back 108

-typical = 1:1
-cats = 3:1

Front 109

In health, neutrophils circulate in the blood for about:

Back 109

-8 hrs