Midterm 2 Neutrophil Material

Front 1

What is the leukon?

Back 1

All the leukocytes in the body--bone marrow, blood, lyphatics, tissues, and cavities

Front 2

Where are precursors for all leukocytes located?

Back 2

bone marrow

Front 3

Where are lymphocyte precursors found?

Back 3

spleen, lymph node, and theymus

Front 4

What do leukocytes use blood for?

Back 4

Just to travel from site of production to site of fn

Front 5

What are the 5 types of peripheral blood leukocytes?

Back 5

neutrophils, monocytes, lymphocytes, eosinophils, and basophils

Front 6

What are the three types of granulocytes?

Back 6

neutrophils, eosinophils, basophils

Front 7

What type of granules do neutrophils have and what do they do?

Back 7

neutral stain. phagocytosis, bacterialcidal

Front 8

What type of granules do eosinophils have and what do they do?

Back 8

eosinophilic,basic protein attracs acidic dye; hypersensitivity and some phagocytosis and bacterialcidal

Front 9

What type of granules do basophils have and what do they do?

Back 9

basophilic. hypersensitivity.

Front 10

Which cell has the highest percentage in WBC?

Back 10

neutrophils>lymphocytes>monocytes>eosinophils
*ruminants MAY have lower neutrophil counts than other species

Front 11

How is the absolute count for each leukocyte type determines?

Back 11

mult percentage of each type by number of total WBC/microLiter. ALWAYS USE ABSOLUTE COUNT TO INTERPRET LEUKOGRAM

Front 12

How is neutrophil fn evaluated?

Back 12

using assays for phagocytic and bactericidal capability

Front 13

What does bone marrow evaluation provide info about as far as leukogram goes? (2 things)

Back 13

production and maturation of leukocytes

Front 14

What is the significance of plasma fibrinogen concentration?

Back 14

fibrinogen is an acute phase protein prod by liver and concentration rises in inflammatory cond. Two main causes of hyperfibrinogenemia are inflammation and hemoconcentration (ex dehydration)

Front 15

What is the heat precipitation method for fibrinogen concentration?

Back 15

microhematocrit tube filled w/ anticoagulated blood heated and spun. Heating causes fibrinogen to precipitate and centrifugation fibrinogen no longer present in supernatant. Protein concentration measured in supernatant by heating. Diff is est of fibrinogen concentration.
EX
TP=7.6 g/dL bf heating
TP=7.1 g/dL after heating
fibrinogen=7.6-7.1=0.5 g/dL=500 mg/dL

Front 16

What can cause a mild increase in fibrinogen?

Back 16

dehydration

Front 17

What is fibrinogen concentration used in evaluating large animals?

Back 17

their leukograms less revealing of inflammation than cats and dogs. Hyper if indicating inflammation

Front 18

Where do neutrophils arise from?

Back 18

stem cells in bone marrow.

Front 19

What other cell does neutrophil share common stem cell with?

Back 19

monocyte

Front 20

What is the order of cell differentiation in neutrophil lineage?

Back 20

myeoblast-->progranulocyte (containing primary granules) -->myelocyte (specific secondary granules formed)-->metamyelocyte--> band neutrophil-->segmented neutrophil

Front 21

How is neutrophil production regulated?

Back 21

colony-stimulating factors (CSF), including GM-CSF and G-CSF, and interleukins (IL), including IL-1 and IL-3.

Front 22

How are colony stimulating factors and interleukins (trophic factors) produced?

Back 22

Produced by macrophages in response to inflammatory stimuli. Lymphocytes and endothelial cells may also produce trophic factors

Front 23

Which types of neutrophils are in the proliferation or mitotic pool of bone marrow?

Back 23

myeloblasts, progranulocytes, myelocytes

Front 24

Which types of neutrophils are in the maturation or postmitotic pool of bone marrow?

Back 24

metamyelocytes, bands, segmented neutrophils

Front 25

Which types of neutrophils are in the storage pool of bone marrow?

Back 25

It is a subpool in the maturation pool, containing segmented neutrophils ready for release to circulation

Front 26

What are some species differences in size of neutrophil storage pool?

Back 26

dogs have largest, followed by cats and horses. Cattle have small storage pools!

Front 27

How long are neutrophils in the proliferation or mitotic pool?

Back 27

about 3 days

Front 28

How long are neutrophils in the maturation or postmitotic pool?

Back 28

about 2-3 days

Front 29

What is the transit time through bone marrow in healthy animals and how is it affected if demands for neutrophils increases?

Back 29

normally 6-10 days but will decrease if demand is high for neutrophils

Front 30

What is the half-life of neutrophils in blood?

Back 30

5-10 hours

Front 31

What are the two blood pools that neutrophils exist in?

Back 31

CNP=circulating neutrophil pool which is in free circulation and
MNP=margination neutrophil pool which are adhering to vessel wall, mostly in small veins and capillaries

Front 32

What is the ratio of CNP:MNP?

Back 32

1:1 except cats 3:1

Front 33

When blood is collected for a CBC which neutrophils are sampled?

Back 33

Blood from the CNP

Front 34

What do neutrophils do in tissues?

Back 34

live for days, contripbuting to host defense esp thru phagocytosis and killing of microorganisms. Mostly in pumonary or gastroinestinal tissues.

Front 35

What is the concentration of blood neutrophils influenced by?

Back 35

rate of prodction and release from bone marrow, factors that affect dist of neutrophils btwn CNP and MNP and tissue demand for neutrophils

Front 36

When does toxic change occur in neutrophils?

Back 36

when rate of neutropoiesis accelerates rapidly, maturation defects occur in neutrophils as dev in BONE MARROW, and circulating neutrophils in all stages manifest these changes.

Front 37

When is toxic change most often seen in animals?

Back 37

when they hav bacterial infections or other cond like acute pancreatitis

Front 38

What are three things about hypersegmentation?

Back 38

considered hypersegmented when have 5+ lobes, considered aging change as nucleus cont to segment as neutrophil gets older, most freq cause is increased blood concentrations of clucocorticoids bc neutrophils stay in circulation longer (stays w/ increase androgenous glucocorticoids. Decrease in tissues once normal)

Front 39

What is hyposegmentation?

Back 39

left shift: increased band neutrophils. Response to tissue demand for neutrophils, bone marrow releases mature neutrophils from storage pool. If demand too great, sometimes myelocytes appear in circulation.

Front 40

What is pelger-huet or pseudo pelger huet anomaly?

Back 40

mature neutrophils with normal nuclear condensation have round, indented, bilobed, or band-shpaed nucleus. Avoid interpreting as part of left-shift inflammation.

Front 41

**Look up neutrophil inclusions**

Back 41

**Do it**

Front 42

What is the dominant pathophysiologic process in which neutrophils respond?

Back 42

inflammation

Front 43

How does the neutrophil response work?

Back 43

monocyte or macrophage derived cytokines, secreted as part of inflammatory process, circulate to bone marrow, increase stem cell input into neutrophil lineage and increase proliferation, maturation, and release of neutrophils from bone marrow. Circulating neutrophil concentration reflects rates at which neutrophils enter circulation from bone marrow and migrate to tissue from blood.

Front 44

What is neutrophilia?

Back 44

increased concentration of neutrophils in blood

Front 45

what are the causes of neutrophilia?

Back 45

acute inflammation, chronic inflammation, glucocorticoid-ass neutrophilia, physiologic neutrophila, and leukemia. Inflammation may be septic or non-septic and may be caused by infectious organisms, immune mediated disease, tissue necrosis, toxic substances, hemolysis, or hemorrhage

Front 46

What happens in neutrophilia ass w/ acute inflammation

Back 46

neutrophil prod and release from bone marrow greater than migration and consumption of neutrophils in tissue. Mature neutrophilia indicates only segmented neutrophils increased.

Front 47

What does mature neutrophilia indicate?

Back 47

only segmented neutrophils are increased

Front 48

What does neutrophilia w/ left shift indicate?

Back 48

segmented neutrophils increased and band neutrophils have been released from bone marrow, suggesting high tissue demand for neutrophils

Front 49

What does toxic change indicate?

Back 49

neutropoiesis accelerated

Front 50

How does neutrophilia ass w/ acute inflammation begin?

Back 50

neurophilia results from release of mature neutrophils from storage pool, and in case of left shift, release band neutrophils from mat pool. Increased prod of neutrophils from myelocytes (in proliferation pool) req 2-4 days and stem cells req 5 days

Front 51

What is common in acute inflammation in cattle?

Back 51

owing to small storage pool, left shirt, even back to myelocyte is common.

Front 52

When is neutrophilia not seen in inflammation of certain tissues?

Back 52

superficial skin, CNS, lower urinary tract infection, prob bc inflammatory mediators lost to external env or protected from reaching CNS.

Front 53

What are some other cell changes that occur during accute inflammation?

Back 53

lymphopenia and monocytosis

Front 54

What happens in neutrophilia ass w/ chronic inflammation?

Back 54

duration of inflammation exceeds 1 week, granulocytic hyperplasia occurs in the marrow, restocking the storage pool of neutrophils. Usually left shift diminishes but if tissue demand for neutrophils is still high left shift may persist

Front 55

What can cause a neutrophilia ass w/ chronic inflammation?

Back 55

animal has 'closed' pyogenic infection (meaning pus held w/in closed space rather than draining to external env). Can make concentration of stimuli high resulting in leukemoid response (neutrophil count extremely high)

Front 56

what are some other leukocyte changes ass w/ chronic inflammation?

Back 56

lymphocytosis, monocytosis, eosinophilia, basophilia. Toxic change may be present in neutrophils. Left shift may persist.

Front 57

What is glucocorticoid ass neutrophilia?

Back 57

stress neutrophilia. Glucocorticoids, mainly cortisol, released from adrenal gland in response to stressful cond (i.e. systemic illness or pain). Increased cortisol causes leukocyte change. may also be seen during hyperadrenocorticism or w/ admisered corticosteriods.

Front 58

What does neutrophilia ass w/ increased glucocorticoids result from?

Back 58

neutrophils moving from marginating to circulating blood pool, which results in doubling circulating neutrophils. Neutrophils stay in circulation longer and may be hypersegmented. Shift from MNP to CNP results from decreased adhesion molecultes on endothelium

Front 59

What does the typical glucocorticoid induced leukogram consist of?

Back 59

mature neutrophilia, lymphopenia (due to changes in lymphocyte circulation patterns and possibly apoptosis of lymphocytes), monocytosis (caused by decreased margination of monocytes), and eosinopenia.

Front 60

What is physiologic neutrophilia?

Back 60

catecholamines, esp epinephrine, released when animal experiences fear, excitement, or exercise. Causes shift of neutrophils from MNP to CNP.

Front 61

How long does physiologic neutrophilia last?

Back 61

transient neutrophilia. Lasts up to an hour. Magnitude of neutrophilia about 2x upper reference interval (URI) for most animals except cats (that is 4x).

Front 62

What is neoplastic neutrophilia?

Back 62

Chronic granulocyte (or myelogenous) leukemia. Rare. Neutrophil prod uncontrolled and differentiated neutrophils accumulate. Neutrophil count may be extreme. Often left chift.

Front 63

Brief overview of acute inflammation leukogram.

Back 63

more neutrophils in tissue. more adhesion molecultes. more neutrophil binding. no storage pool. All emptied into perpheral blood.

Front 64

Brief overview of chronic inflammation leukogram.

Back 64

increased adhesion. increased stem cell input. increased pro and mat and storage pool. Granulocytic hyperplasia

Front 65

Brief overview of leukemoid rxn leukogram

Back 65

leukemia-like. Excessively high leukocyte count. Often in pyogenic infection in closed space. See leukocytosis, monocytosis, basophilia, eosinophilia. Chronic inflammation

Front 66

Brief overview of glucocorticoid leukogram

Back 66

happens over a couple of days. involves corticoids. stimulates glucose (speeds up metabolism). Neutrophils don't bind. decreased number of binding molecules so can't get into tissue. All stay in circulating pool. Marginating pool when hooks on to binding site

Front 67

Brief overview of physiologic leukogram.

Back 67

neutrophils off adhesion, into circulating pool. Lasts only an hour. seen in cats and foals for extended time. No decrease in binding sites like glucocorticoids.

Front 68

Brief overview of granulocytic leukemia

Back 68

huge prolif pool

Front 69

What is neutropenia?

Back 69

decreased concentraion of neutrophils in blood

Front 70

What are causes of neutropenia

Back 70

acute inflammation with overwhelming tissue demand for neutrophils, endotoxemia, immune-mediated neutropenia, decreased prod of neutrophils by bone marrow (granulocytic hypoplasia). Phagocytosis of neutrophils by macrophages and ineffective prod of neutrophils.

Front 71

Describe neutropenia ass w/ acut inflammation.

Back 71

When demand high, leave circulation and enter tissue at faster rate than marrow can replace. Excessive migration of neutrophils into tissue can occur w/in hours. Bone marrow releases neutrophils from storage pool initially, followed by cells in maturation pool; left shift may be present. Neutrophil prod increases in bone marrow. Usually req several days until neutrophil prod increases.

Front 72

What are the changes in bone marrow pools w/ neutropenia ass w/ acute inflammation/

Back 72

Early: depletion of storage pool; possible decreases in rest of maturation pool
2-3 days: stem cells enter prolif pool, increasing size of pool
5-7 days: prolif and mat pool increased and overall granulocytic hyperplasia of bone marrow noted

Front 73

What are common causes of neutropenia ass w/ acute inflammation?

Back 73

Gram-neg bacteria and toxic or chem injuries. i.e. GI perforations w/ acute septic peritonitis, acute pancreatitis, acute mstitis, acute metritis, or py0metra (open cervix), aspiration pneumonia, diffuse cellulitis, rumenitis.

Front 74

What is a left shift?

Back 74

presence of increased numbers of immature neutrophils--usually bands, but sometimes metamyelocytes and even myelocytes--in peripheral blood. The terms 'regenerative' and 'degenerative' are used to indicate how well bone marrow is meeting the demand for neutrophils in tissues

Front 75

What is a regenerative left shirt?

Back 75

mature neutrophilia and left shift in which leukocyte count increased and segmented neutrophils comprise majority of cells

Front 76

What is a degenerative left shift?

Back 76

normal or low leukocyte count in which the band count is close to or even greater than number of segmented neutrophils. Someimes leukocyte count increased but w/ disproportionate increase in bands

Front 77

What does dev of mature neutrophilia of an animal that previous had degen left shift suggest?

Back 77

improving bone marrow response

Front 78

Describe neutropenia ass w/ endotoxemia

Back 78

early response to circulating endotoxin from gram-negative bacteria is to shift neutrophils from CNP to MNP. Neutrpenia seen if blood sampled in early phase bf neutrophils released from bone marrow or bf increased prod of neutrophils occurs

Front 79

Describe neutropenia ass w/ immune mediated neutropenia

Back 79

animal prod anti-neutrophil antibodies that bind to neutrophils, neutrophils destoryed by macrophages in tissues (spleen). Not freq cause. Initiating cause diff to det

Front 80

Describe neutropenia ass w/ granulocytic hypoplasia

Back 80

bone marrow diease may result in decreased number of dev neutrophils bc decreased stem cells or alterations in microenv. Must exam bone marrow to detect granulocytic hypoplasia.

Front 81

What can cause neutropenia ass w/ granulocytic hypoplasia

Back 81

panleukopenia/parvovirus infection, FeLV-induced disease, toxoplasmosis, BVD, exposure to drugs, or toxins like estrogen, chemotherapeutic drugs, bracken fern, etc