Leukocytes: Granulocytes and Neutrophils

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Questions and Answers

Which term refers to white blood cells?

  • Myelocytes
  • Thrombocytes
  • Leukocytes (correct)
  • Erythrocytes

What is the primary role of leukocytes?

  • Transporting oxygen
  • Defending against disease (correct)
  • Clotting blood
  • Producing hormones

Which category includes polymorphonuclear cells?

  • Agranulocytes
  • Mononuclear cells
  • Granulocytes (correct)
  • Lymphocytes

Which feature is characteristic of mature granulocytes?

<p>A segmented nucleus (C)</p> Signup and view all the answers

What staining characteristic is associated with eosinophils when using Romanowsky-type stains?

<p>Eosinophilic/acidophilic (red/orange) (D)</p> Signup and view all the answers

Neutrophils in which species do NOT typically have neutral or non-staining granules?

<p>Birds (D)</p> Signup and view all the answers

What is the small nuclear projection seen in neutrophils of female mammals called?

<p>Barr body (B)</p> Signup and view all the answers

What is the primary function of neutrophils?

<p>Defense against microorganisms (D)</p> Signup and view all the answers

Which process is NOT a basic step in neutrophil extravasation?

<p>Differentiation into macrophages (B)</p> Signup and view all the answers

What is the result of a defect in integrin adhesion protein (CD18)?

<p>Decreased neutrophil migration (B)</p> Signup and view all the answers

What stimulates neutrophil production?

<p>Presence of microorganisms or cell injury (B)</p> Signup and view all the answers

Which pool of neutrophils is measured in a standard blood WBC count?

<p>Circulating pool (C)</p> Signup and view all the answers

What does a 'left shift' indicate?

<p>Increased number of immature neutrophils (A)</p> Signup and view all the answers

In dogs, what is the band neutrophil count that is considered a significant left shift?

<blockquote> <p>1,000 bands/µl (D)</p> </blockquote> Signup and view all the answers

What defines a degenerative left shift?

<p>Immature cells outnumber mature neutrophils (B)</p> Signup and view all the answers

What are Döhle bodies?

<p>Bluish cytoplasmic inclusions (C)</p> Signup and view all the answers

What can severe toxic change in neutrophils make them difficult to differentiate from?

<p>Monocytes (C)</p> Signup and view all the answers

Which of the following is a characteristic of toxic heterophils in birds and reptiles?

<p>Hypogranulation (A)</p> Signup and view all the answers

Degenerate neutrophils are typically observed where?

<p>Inflammatory lesions in tissues or body cavities (B)</p> Signup and view all the answers

What is the primary morphological characteristic of degenerate neutrophils?

<p>Swollen, pale-staining nucleus (karyolysis) (B)</p> Signup and view all the answers

What condition might cause degenerate changes in blood leukocytes?

<p>Delayed sample processing (D)</p> Signup and view all the answers

What is the defining characteristic of hypersegmented neutrophils?

<p>More than 5-6 nuclear lobes (B)</p> Signup and view all the answers

What condition results in chromatin condensed into a single, dense 'ball'?

<p>Pyknosis (D)</p> Signup and view all the answers

What are hemosiderin aggregates within neutrophils or monocytes called?

<p>Siderotic inclusions (D)</p> Signup and view all the answers

Canine distemper viral inclusions in neutrophils resemble what?

<p>Pink-red Döhle bodies (A)</p> Signup and view all the answers

What type of infectious agent is Anaplasma phagocytophilum?

<p>Bacteria (D)</p> Signup and view all the answers

How is Hepatozoon americanum transmitted?

<p>Ingestion of infected Gulf Coast ticks (A)</p> Signup and view all the answers

What is the term for circulating bacteria?

<p>Bacteremia (A)</p> Signup and view all the answers

What is a key feature of Pelger-Huet anomaly?

<p>Hyposegmented neutrophils (C)</p> Signup and view all the answers

Which canine breed is Cyclic Hematopoiesis most commonly observed in?

<p>Grey Collie dogs (D)</p> Signup and view all the answers

What is the role of eosinophils?

<p>Mediating hypersensitivity (A)</p> Signup and view all the answers

What is the typical appearance of feline eosinophils?

<p>Rod-shaped granules (A)</p> Signup and view all the answers

What is the most typical characteristic of basophils?

<p>Segmented cells with purple-staining granules (B)</p> Signup and view all the answers

Which cytokine is a major regulator of basophil production?

<p>IL-3 (B)</p> Signup and view all the answers

What is a defining feature of feline basophils?

<p>Lavender-colored cytoplasm (C)</p> Signup and view all the answers

Mast cells in blood smears are typically associated with what condition, especially in cats?

<p>Mast cell neoplasia (D)</p> Signup and view all the answers

What is used to differentiate Siderotic Inclusions from other inclusions?

<p>Prussian blue stain (A)</p> Signup and view all the answers

A veterinarian observes a blood smear from a reptile and notices cells with fine, magenta-staining granules. What type of cells are these most likely to be?

<p>Azurophils (C)</p> Signup and view all the answers

Monocytes share several characteristics with neutrophils, yet they have some key differences. Which of the following is MOST accurate regarding the similarities and differences between monocytes and neutrophils?

<p>Monocytes and neutrophils both combat infectious agents via phagocytosis; however, unlike neutrophils, monocytes can re-enter the bloodstream after migrating into tissues. (B)</p> Signup and view all the answers

All of the following statements accurately describe siderotic inclusions and Döhle bodies EXCEPT:

<p>While both inclusions often require a blood smear to become visible, Döhle bodies are able to be differentiated using positive staining. (C)</p> Signup and view all the answers

What is a primary characteristic of leukocytes?

<p>They are nucleated cells with roles in body defense. (A)</p> Signup and view all the answers

Which of the following is a general category of leukocytes?

<p>Granulocytes (A)</p> Signup and view all the answers

What is the typical nuclear characteristic of mature granulocytes?

<p>A segmented nucleus (A)</p> Signup and view all the answers

Which statement accurately describes the staining characteristics of granulocytes using Romanowsky-type stains?

<p>Eosinophils stain red/orange. (D)</p> Signup and view all the answers

What is the usual number of lobes found in the nuclei of mature neutrophils?

<p>2-4 lobes (C)</p> Signup and view all the answers

Apart from segmenters, how else are mature neutrophils often referred to?

<p>PMNs (B)</p> Signup and view all the answers

What is the staining characteristic of granules in most species of neutrophils?

<p>Neutral or non-staining (B)</p> Signup and view all the answers

Which of the following best describes the granules present in rabbit neutrophils?

<p>Red-orange (A)</p> Signup and view all the answers

Which of the following accurately describes the primary granules of neutrophils?

<p>They are lysosomes, which do not stain after the promyelocyte stage. (D)</p> Signup and view all the answers

During the extravasation process, what mediates the initial adherence of neutrophils to the vessel wall?

<p>Adhesion molecules (D)</p> Signup and view all the answers

What is the role of Colony-stimulating factors (stem cell factor, G-CSF, GM-CSF) in neutrophil production?

<p>Stimulating neutrophil production (A)</p> Signup and view all the answers

Which pool of neutrophils does a standard blood WBC count reflect?

<p>The circulating pool (D)</p> Signup and view all the answers

In which animal is a degenerative left shift after acute inflammation NOT necessarily indicative of a poor prognosis?

<p>Ruminants (B)</p> Signup and view all the answers

What cellular component aggregation leads to the formation of Döhle bodies in neutrophils?

<p>Rough endoplasmic reticulum (A)</p> Signup and view all the answers

What morphological characteristic is associated with degenerate neutrophils?

<p>Swollen, pale-staining nucleus (A)</p> Signup and view all the answers

Which condition can lead to hypersegmentation of neutrophils?

<p>Corticosteroid therapy (A)</p> Signup and view all the answers

What cellular process describes chromatin condensed into a single, dense 'ball' in cells undergoing apoptosis?

<p>Pyknosis (C)</p> Signup and view all the answers

What stain is used to differentiate siderotic inclusions from other inclusions?

<p>Prussian blue stain (D)</p> Signup and view all the answers

Viral inclusions observed with canine distemper resemble what?

<p>Pink-red Döhle bodies (B)</p> Signup and view all the answers

In an animal with Anaplasma phagocytophilum infection, what cytopenias may be observed upon examination?

<p>Thrombocytopenia, leukopenia, and anemia (B)</p> Signup and view all the answers

What is the primary route of transmission for Hepatozoon americanum?

<p>Ingestion of infected Gulf Coast ticks (A)</p> Signup and view all the answers

Which canine breed has a relatively high incidence of Pelger-Huet anomaly?

<p>Australian Shepherds (C)</p> Signup and view all the answers

How do canine eosinophil granules differ from feline eosinophil granules?

<p>Canine eosinophils have variably sized round granules. (B)</p> Signup and view all the answers

Which avian and reptile blood cell is characterized by fine, magenta-staining granules?

<p>Azurophil (B)</p> Signup and view all the answers

Which blood cell shares similar granules to mast cells but has a segmented nucleus?

<p>Basophil (C)</p> Signup and view all the answers

Which cytokine is important in basophil production and regulation?

<p>IL-3 (B)</p> Signup and view all the answers

In which species is it common to find more basophils in circulation compared to other mammals?

<p>Rabbits (C)</p> Signup and view all the answers

What microscopic feature is often observed in the nuclei of feline basophils due to overlying granules?

<p>&quot;Moth-eaten&quot; appearance (A)</p> Signup and view all the answers

When mast cells are found in blood smears, what condition is it most indicative of in cats?

<p>Mast cell neoplasia (B)</p> Signup and view all the answers

What is the typical transit time of eosinophils in canine blood?

<p>Less than 1 hour (D)</p> Signup and view all the answers

In the context of neutrophil kinetics, what is the primary characteristic of cells within the proliferative pool?

<p>Cells are capable of dividing. (C)</p> Signup and view all the answers

Physiologic conditions such as increased epinephrine or corticosteroid levels can shift neutrophils from which pool to the circulating pool?

<p>Marginal Pool (D)</p> Signup and view all the answers

After neutrophils leave the bloodstream, where are they eventually removed?

<p>Macrophages in tissues or body cavities (C)</p> Signup and view all the answers

According to the material, what condition is NOT necessary for toxic change in neutrophils to occur?

<p>Endotoxemia (C)</p> Signup and view all the answers

In general, how do monocyte responses in blood compare to neutrophil responses?

<p>They are similar. (C)</p> Signup and view all the answers

Mature granulocytes are named based on characteristic staining affinity using Romanowsky-type stains. If a granulocyte stains blue/purple, which type of cells does this describe?

<p>Basophils (C)</p> Signup and view all the answers

If a dog has >1,000 bands/µl or more than 10% of neutrophil count, what does it indicate?

<p>Significant left shift (B)</p> Signup and view all the answers

Which of the following correctly describes bacteremia, and why it is considered rare to find in blood smears?

<p>Circulating bacteria, usually present in very low numbers (A)</p> Signup and view all the answers

Pelger-Huet anomaly is generally a very rare disease, but fairly common in which canine breed?

<p>Australian Shepherd (B)</p> Signup and view all the answers

How do eosinophils contribute to hypersensitivity reactions?

<p>By releasing their granule contents in response to IgE-antigen complexes (C)</p> Signup and view all the answers

In the context of neutrophil migration during inflammation, which process is directly mediated by integrins and selectins?

<p>Adherence to vessel wall (D)</p> Signup and view all the answers

Which statement best describes the difference between 'true' and 'pseudo' Pelger-Huet anomaly with respect to cellular morphology?

<p>'True' anomaly presents with mature, clumped chromatin, while 'pseudo' anomaly has lighter, immature chromatin under closer inspection. (D)</p> Signup and view all the answers

A blood smear from a reptile shows cells that appear similar to mammalian monocytes but contain numerous fine, magenta-staining granules. Which type of cell is most likely observed?

<p>Azurophils (C)</p> Signup and view all the answers

A veterinarian is assessing a blood smear and identifies a neutrophil with a nucleus that appears swollen and stains very faintly. This leukocyte is interpreted as which of the following?

<p>Degenerate neutrophil (D)</p> Signup and view all the answers

A researcher is studying neutrophils in vitro and observes that cellular adhesion to endothelial cells is significantly reduced despite normal expression of selectins. Which of the following genetic defects is MOST likely responsible for this observation?

<p>Mutation in the gene encoding CD18 (C)</p> Signup and view all the answers

A veterinary hematologist observes a canine blood smear and notes the presence of a few mast cells. Which of the following conditions is least likely to cause these observations?

<p>Acute parasitic infection (B)</p> Signup and view all the answers

What is the general term for white blood cells that play a primary role in defending the body against disease and pathogens?

<p>Leukocytes (B)</p> Signup and view all the answers

What nuclear characteristic is typically found in mature granulocytes?

<p>A segmented nucleus (B)</p> Signup and view all the answers

Which of the following BEST describes the staining characteristic of eosinophils when using Romanowsky-type stains?

<p>Eosinophilic/acidophilic, stain red/orange (A)</p> Signup and view all the answers

Neutrophils are also known as what?

<p>Segmenters or PMNs. (A)</p> Signup and view all the answers

What component mediates the initial adherence of neutrophils to the vessel wall during extravasation?

<p>Adhesion molecules (integrins and selectins) (B)</p> Signup and view all the answers

Which of the following are responsible for stimulating neutrophil production?

<p>Colony-stimulating factors (stem cell factor, G-CSF, GM-CSF) (C)</p> Signup and view all the answers

Which pools of neutrophils does the blood WBC count reflect?

<p>Only the circulating pool (D)</p> Signup and view all the answers

In which animal would a degenerative left shift AFTER acute inflammation NOT necessarily indicate a poor prognosis?

<p>Ruminants (B)</p> Signup and view all the answers

What is a key characteristic of degenerate neutrophils?

<p>Swollen, pale-staining nucleus (A)</p> Signup and view all the answers

Under which condition might hypersegmentation of neutrophils be observed?

<p>Delayed sample processing (B)</p> Signup and view all the answers

What process results in chromatin condensed into a single, dense 'ball' in cells?

<p>Pyknosis (D)</p> Signup and view all the answers

What stain is used to differentiate siderotic inclusions from other inclusions in neutrophils or monocytes?

<p>Prussian blue stain (D)</p> Signup and view all the answers

What type of inclusions do canine distemper viral inclusions in neutrophils most closely resemble?

<p>Döhle bodies (D)</p> Signup and view all the answers

Which cytopenias may be observed upon examination of an animal with Anaplasma phagocytophilum infection?

<p>Leukopenia, anemia, and/or thrombocytopenia (A)</p> Signup and view all the answers

What is a key transmission route for Hepatozoon americanum?

<p>Ingestion of infected ticks (C)</p> Signup and view all the answers

If a homozygous condition of Pelger-Huet anomaly occurs, what is the expected outcome?

<p>The condition is fatal, typically <em>in utero</em> (B)</p> Signup and view all the answers

How do avian and reptile eosinophils differ from heterophils, particularly concerning their granules?

<p>Eosinophils have similar staining granules with oval shapes and heterophils have elongated granules (D)</p> Signup and view all the answers

In reptiles, a granulated blood cell type is found that has variable numbers of magenta-staining granules. It shares similar characteristics with the monocyte, what is this cell type?

<p>Azurophil (A)</p> Signup and view all the answers

Imagine a scenario where a researcher is investigating a novel mutation affecting neutrophil function. They discover that neutrophils from affected individuals exhibit normal selectin expression and initial rolling along the endothelium but fail to firmly adhere and migrate into inflamed tissues. Further analysis reveals a complete absence of CD18 expression. Based on this information, which step is MOST directly impaired by the defect?

<p>Stable adhesion (D)</p> Signup and view all the answers

After the promyelocyte stage, what is the next stage in granulocyte development characterized by an oval-shaped nucleus?

<p>Myelocyte (B)</p> Signup and view all the answers

During granulopoiesis, which cell type is characterized by the presence of primary granules (lysosomes) that appear magenta or reddish in color?

<p>Promyelocyte (A)</p> Signup and view all the answers

Which cell type is characterized by the disappearance of primary granules and the appearance of secondary granules that define the specific cell type?

<p>Myelocyte (A)</p> Signup and view all the answers

What is the correct order of neutrophil maturation, starting with the least mature cell?

<p>Myeloblast → Promyelocyte → Myelocyte → Metamyelocyte → Band cell → Segmented neutrophil (D)</p> Signup and view all the answers

What name is given to segmented neutrophils with multiple indentations?

<p>Seg (A)</p> Signup and view all the answers

What is the most immature stage of granulocyte development?

<p>Myeloblast (C)</p> Signup and view all the answers

Which characteristic helps differentiate a myeloblast from a rubriblast during a bone marrow count?

<p>Lumpy, irregular nucleus (B)</p> Signup and view all the answers

A veterinary technician observes a bone marrow smear and identifies a cell with an indented, kidney bean-shaped nucleus. Which stage of granulocyte maturation is the technician most likely observing?

<p>Metamyelocyte (A)</p> Signup and view all the answers

What is the significance of observing myeloblasts and promyelocytes in large numbers in a peripheral blood sample?

<p>Suggestive of neoplasia or leukemia (A)</p> Signup and view all the answers

Which observation in a blood smear is most indicative of a regenerative response to anemia?

<p>Elevated numbers of polychromatophilic erythrocytes (C)</p> Signup and view all the answers

What term describes the release of immature cells into the blood, commonly associated with inflammation?

<p>Left shift (C)</p> Signup and view all the answers

In a blood smear, if immature cells are observed predominantly, indicating a shift towards earlier stages of cell development, how is this condition referred?

<p>Left Shift (C)</p> Signup and view all the answers

What term best describes the process by which neutrophils adhere loosely to the endothelium, often described as 'bouncing' or 'rolling'.

<p>Margination (C)</p> Signup and view all the answers

What is the role of adhesion molecules, like selectins and integrins, in neutrophil migration during inflammation?

<p>Regulate neutrophil sticking to the blood vessel wall (A)</p> Signup and view all the answers

What is the expected outcome in an animal with defective integrin adhesion proteins?

<p>Recurrent infections and high neutrophil count in blood (C)</p> Signup and view all the answers

Which recombinant human granulocyte colony-stimulating factor is sometimes used to stimulate neutrophil production?

<p>Neupogen (Filgrastim) (A)</p> Signup and view all the answers

Which neutrophil pool contains cells that are capable of actively dividing?

<p>Proliferative pool (A)</p> Signup and view all the answers

In the context of neutrophil kinetics, what is the primary characteristic of cells within the maturation pool?

<p>Fully differentiated and non-dividing (A)</p> Signup and view all the answers

What physiological change best describes the shift in neutrophils seen in a stress leukogram?

<p>Decreased stickiness of neutrophils and endothelium (D)</p> Signup and view all the answers

In general, what occurs after neutrophils leave the bloodstream?

<p>They are removed eventually. (D)</p> Signup and view all the answers

In diagnostic testing, what is indicated by a significant neutrophilic left shift?

<p>Suggests inflammation. (C)</p> Signup and view all the answers

Which statement best describes a degenerative left shift?

<p>Immature cells that outnumber segs (C)</p> Signup and view all the answers

Which condition is NOT a typical cause of toxic change in neutrophils?

<p>Old age (B)</p> Signup and view all the answers

Which of the following cellular changes comes from retained ribosomes and RNA?

<p>Increased cytoplasmic basophilia (D)</p> Signup and view all the answers

Following severe inflammation induced by the administration of experimental endotoxins, a veterinary technician observes what appears to be distinct neutrophil cytoplasmic aggregate within cells. What is the MOST appropriate name for this lesion?

<p>Döhle bodies (A)</p> Signup and view all the answers

Which cellular characteristic is LEAST likely to be mistaken for toxic change in neutrophils?

<p>Uneven cell distribution on the slide (C)</p> Signup and view all the answers

Unlike morphologic features observed with regular analysis, what alteration can occur, along with cytoplasmic changes, with severe toxic change?

<p>Nuclear swelling (C)</p> Signup and view all the answers

What cytological feature is the hallmark of degenerate neutrophils?

<p>Karyolysis (B)</p> Signup and view all the answers

In analyzing a sample where neutrophils appear necrotic rather than going through defective maturation, what would a student be MOST likely to see?

<p>Neutrophils barely able to retain shape (C)</p> Signup and view all the answers

What clinical condition is LEAST associated with presence of vacuolated degenerate neutrophils?

<p>Heat Stroke (D)</p> Signup and view all the answers

An automated hematology analyzer reports a high neutrophil count with the presence of hypersegmented neutrophils. What condition is a MOST accurate differential?

<p>Accelerated Cell Aging (A)</p> Signup and view all the answers

How is a pyknotic cell classically defined?

<p>One dark, dense ball of chromatin. (B)</p> Signup and view all the answers

What change describes chromatin condensed into a dense ball in cells undergoing apoptosis?

<p>Pyknosis (B)</p> Signup and view all the answers

What inclusions are aggregates of protein and iron resulting from hemoglobin degradation?

<p>Hemosiderin (D)</p> Signup and view all the answers

To accurately identify hemosiderin inclusions within neutrophils, what specific type of staining should be done given their resemblance to Dhohle bodies?

<p>Prussian blue stain (A)</p> Signup and view all the answers

Which type of cell primarily hosts the inclusions associated with Anaplasma phagocytophilum?

<p>Neutrophils (C)</p> Signup and view all the answers

During blood smear evaluation, a veterinary technician identifies small, basophilic (blue) inclusions in the cytoplasm of neutrophils. The veterinarian suspects Anaplasma phagocytophilum infection. What are these inclusions called?

<p>Morulae (C)</p> Signup and view all the answers

What is the MOST significant diagnostic method for identifying bacteria in a patient suspected of bacteremia or septicemia?

<p>Blood Culture (A)</p> Signup and view all the answers

What can be stated regarding when bacteria are seen in blood smears?

<p>Usually a severe disease (D)</p> Signup and view all the answers

How is Hepatozoon americanum, a protozoal disease, primarily transmitted to canines?

<p>Ingestion of infected ticks (C)</p> Signup and view all the answers

If you have a homozygous condition of Pelger-Huet anomaly, what is the expected outcome?

<p>Small number of litters and reduced neutrophil functionality, leading to immune compromise (D)</p> Signup and view all the answers

During granulopoiesis, what is the defining characteristic of the myelocyte stage?

<p>The presence of secondary granules and a roughly oval-shaped nucleus. (D)</p> Signup and view all the answers

What change is associated with the transition from metamyelocyte to band cell?

<p>The nucleus elongating, assuming a linear shape with parallel sides. (D)</p> Signup and view all the answers

What is a key morphological feature that distinguishes a myeloblast from a rubriblast during bone marrow evaluation?

<p>Myeloblasts have lumpy, irregular nuclei, while rubriblasts have perfectly round nuclei. (D)</p> Signup and view all the answers

Which stage is characterized by the presence of primary granules (lysosomes) that appear magenta or reddish in color?

<p>Promyelocyte (A)</p> Signup and view all the answers

If a veterinarian observes a large number of myeloblasts and promyelocytes in a peripheral blood sample, what condition is MOST likely?

<p>Neoplasia, specifically leukemia. (B)</p> Signup and view all the answers

What is the typical progression observed when immature cells are released into the blood due to inflammation?

<p>Bands, then metamyelocytes, then myelocytes. (A)</p> Signup and view all the answers

What is the correct order of neutrophil maturation?

<p>Myeloblast, Promyelocyte, Myelocyte, Metamyelocyte, Band Neutrophil, Segmented Neutrophil (C)</p> Signup and view all the answers

What is the term for segmented neutrophils with multiple indentations?

<p>Hypersegmented neutrophils (D)</p> Signup and view all the answers

Which describes the normal staining pattern of primary granules in a mature neutrophil?

<p>Primary granules typically do not stain after the promyelocyte stage unless toxic change is present. (A)</p> Signup and view all the answers

What is implied when a veterinary professional describes a blood smear as exhibiting a "left shift"?

<p>An increased number of immature neutrophils. (C)</p> Signup and view all the answers

Under what circumstances is a significant neutrophilic left shift a typical finding among ruminants?

<p>During recovery from acute inflammation. (C)</p> Signup and view all the answers

What is the underlying implication of observing a degenerative left shift in a canine patient?

<p>The patient's bone marrow is unable to keep up with tissue demand for neutrophils. (D)</p> Signup and view all the answers

If a complete blood count (CBC) reveals 300 neutrophils per microliter, with 200 bands and 100 segmented neutrophils (segs), how would this be classified?

<p>Degenerative left shift (A)</p> Signup and view all the answers

Following experimental administration of endotoxin, a veterinary technician observes what appears to be distinct neutrophil cytoplasmic aggregate within cells. What is the MOST appropriate name for this lesion?

<p>Toxic Change (B)</p> Signup and view all the answers

What alteration can occur, along with cytoplasmic changes, with severe toxic change?

<p>Nuclear swelling (C)</p> Signup and view all the answers

Which statement accurately differentiates canine distemper inclusions from Döhle bodies within neutrophils?

<p>Canine distemper inclusions are typically pink and similar in size and shape to Döhle bodies. (A)</p> Signup and view all the answers

What is most significant to ensure is true before determining that there is bacteremia on a blood smear?

<p>It is not an artifact (B)</p> Signup and view all the answers

How does the presence of intracellular bacteria in a blood smear MOST influence diagnostic and treatment strategies?

<p>It generally prompts a blood culture to identify the bacterial species for targeted antibiotic therapy. (D)</p> Signup and view all the answers

What factors are MOST important to assess to differentiate toxic change in avian heterophils from a bacterial septicemia?

<p>Confirm absence of intracellular pathogen/bacteria to rule out septicemia (C)</p> Signup and view all the answers

In Pelger-Huet anomaly, what is MOST significant about the functionality of neutrophils?

<p>Neutrophils function normally. (A)</p> Signup and view all the answers

What is the MOST important discriminatory factor in differentiating true Pelger-Huet anomaly from a pseudo-Pelger-Huet anomaly?

<p>Presence of concurrent toxic changes in the neutrophils (C)</p> Signup and view all the answers

When evaluating a blood smear from an Australian Shepherd with a suspected infection, which finding would MOST strongly suggest an inflammatory response rather than just the breed-related Pelger-Huet anomaly?

<p>Mature neutrophils with non-segmented nuclei alongside toxic changes (B)</p> Signup and view all the answers

What is MOST important to remember if a homozygous condition of Pelger-Huet anomaly exists?

<p>Smaller litter sizes (D)</p> Signup and view all the answers

Which characteristics BEST define cyclic hematopoiesis in Gray Collie dogs?

<p>A periodic drop in neutrophil counts approximately every two weeks. (B)</p> Signup and view all the answers

Which function is MOST attributed to eosinophils?

<p>Defense against parasites like nematodes and in hypersensitivity reactions. (D)</p> Signup and view all the answers

Where does eosinophil production and differentiation primarily take place?

<p>Bone Marrow (C)</p> Signup and view all the answers

If a veterinary technician observes what appears to be non-staining granules in canine eosinophils, which canine breed would MOST be expected to exhibit this?

<p>Golden Retrievers (A)</p> Signup and view all the answers

How can the morphology of feline granules prove beneficial in sample evaluation?

<p>Can help spot errors in sample submission. (D)</p> Signup and view all the answers

What is the MOST typical characteristic of basophils and mast cells in the blood?

<p>They both contain granules that have similar basophilic staining patterns. (D)</p> Signup and view all the answers

What is the major cytokine that is going to increase basophil production?

<p>IL-3 (D)</p> Signup and view all the answers

Select which animal has more basophils readily in circulation compared to other mammals.

<p>Rabbits (D)</p> Signup and view all the answers

What is common to be visualized in images of feline basophils?

<p>Moth-eaten Nucleus (B)</p> Signup and view all the answers

A veterinarian observes a blood smear with basophils in the peripheral sample. What is MOST accurate to remember?

<p>If seeing mast cells in canine and low, mast cells might just be indicative of general inflammation. (B)</p> Signup and view all the answers

What is implied when canine MAST cells are observed on blood smear analysis?

<p>There is a neoplastic presence and or a inflammatory process happening (C)</p> Signup and view all the answers

During granulocyte production, what feature characterizes maturation?

<p>Production of cytoplasmic granules and nuclear segmentation (D)</p> Signup and view all the answers

What is the defining characteristic of a promyelocyte during granulopoiesis?

<p>The presence of primary granules (B)</p> Signup and view all the answers

Which of the following describes a myelocyte?

<p>A roughly oval-shaped nucleus (A)</p> Signup and view all the answers

What feature defines a metamyelocyte stage of granulocyte development?

<p>A kidney bean-shaped, slightly indented nucleus (B)</p> Signup and view all the answers

What nuclear shape characterizes a band cell?

<p>Elongated with parallel sides (D)</p> Signup and view all the answers

During granulopoiesis, at what stage do the secondary granules, which define the specific cell type, appear?

<p>Myelocyte (A)</p> Signup and view all the answers

When examining a bone marrow smear, what characteristic helps differentiate a myeloblast from a rubriblast?

<p>Shape of the nucleus (D)</p> Signup and view all the answers

What color is the cytoplasm of a myeloblast?

<p>Dark blue (D)</p> Signup and view all the answers

What cell type are primary granules (lysosomes) observed in during granulopoiesis?

<p>Promyelocyte (C)</p> Signup and view all the answers

Which of the following is the correct order of neutrophil maturation?

<p>Myeloblast, Promyelocyte, Myelocyte, Band Cell, Segmented Neutrophil (A)</p> Signup and view all the answers

What term is used to describe the presence of immature cells in the blood, indicative of a shift towards earlier stages of cell development?

<p>Left Shift (D)</p> Signup and view all the answers

While evaluating a cow with acute metritis (uterine infection), a veterinarian notes neutropenia a degenerative shift. Which is MOST important to remember in cattle?

<p>A degenerative left shift is common after acute inflammatory processes. (A)</p> Signup and view all the answers

What does the term 'stab cell' refer to?

<p>A band cell (C)</p> Signup and view all the answers

A blood smear evaluation reveals the presence of toxic change. What is the underlying implication?

<p>Indication of inflammation and or increased neutrophil production (A)</p> Signup and view all the answers

What cellular change is a hallmark of toxic neutrophils?

<p>Cytoplasmic morphologic abnormalities (C)</p> Signup and view all the answers

What is the origin of Dohle bodies observed in neutrophils?

<p>Aggregates of rough endoplasmic reticulum (C)</p> Signup and view all the answers

What cellular change underlies increased cytoplasmic basophilia observed in toxic neutrophils?

<p>Retained ribosomes and RNA (D)</p> Signup and view all the answers

Which cellular change is MOST indicative of severe toxic change?

<p>Nuclear swelling with loss of chromatin pattern (C)</p> Signup and view all the answers

Which of the following is true regarding degenerate neutrophils?

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What cellular feature is LEAST associated with an aging neutrophil?

<p>Plump granulocyte with a normal nucleus (D)</p> Signup and view all the answers

Flashcards

What are Leukocytes?

Also known as white blood cells (WBCs), these nucleated blood cells primarily defend the body from pathogens and disease.

What are Granulocytes?

A primary category of leukocytes characterized by granules in their cytoplasm; examples include neutrophils, eosinophils, and basophils.

Granulocyte naming

Cells are named this way due to the staining of their secondary granules with Romanowsky-type stains.

What are Neutrophils?

A type of granulocyte characterized by a segmented nucleus (2-4 lobes) and granules that are usually non-staining in most species.

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What are Primary Granules?

Lysosomes found in neutrophils that do not stain after the promyelocyte stage, only during toxic change.

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What are Secondary Granules?

Granules in neutrophils that usually do not stain in most species, but show pale pink staining in some.

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What are Heterophils?

Orange-red staining granules within cells in birds and reptiles. Also granules in rabbit neutrophils.

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Neutrophil Extravasation

The process of neutrophils leaving blood vessels to reach sites of inflammation.

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What is a Left Shift?

An increase in the number of immature neutrophils (bands) above the reference interval.

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What is a Degenerative Left Shift?

Condition where immature cells outnumber mature segmented neutrophils, which often indicates a poor prognosis (except in ruminants).

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What is Toxic Change?

Cytoplasmic abnormalities in neutrophils resulting from abnormal maturation in the bone marrow. Can be caused by inflammation

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What are Döhle Bodies?

Irregularly shaped, bluish cytoplasmic inclusions in neutrophils resulting from aggregation of rough endoplasmic reticulum.

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Heterophil hypogranulation

Condition in birds and reptiles where toxic heterophils have fewer granules present; granules may be fused.

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What are Degenerate Neutrophils?

Swollen, pale-staining nucleus (karyolysis) observed in neutrophils within inflammatory lesions, indicating damage by bacterial toxins.

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What are Hypersegmented Neutrophils?

Neutrophils that exhibit an increased number of lobes (>5-6) or pronounced nuclear lobulation, often due to aging or corticosteroid therapy.

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Pyknosis and Karyorrhexis

The process where senescent neutrophils undergo apoptosis, with chromatin condensing into a single, dense "ball" (pyknosis) or multiple fragments (karyorrhexis).

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Siderotic Inclusions

Aggregates of hemosiderin within neutrophils (or monocytes); stained with Prussian blue.

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Distemper inclusions

Viral inclusions sometimes seen in blood cells of infected animals, particularly in RBCs and/or WBCs, varying in appearance.

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Ehrlichiosis/Anaplasmosis

Small, gram-negative, obligate intracellular bacteria transmitted by ticks that may be found in neutrophils, eosinophils or monocytes.

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Hepatozoonosis

A protozoal infection transmitted by arthropods where the protozoa may be observed in neutrophils or monocytes in blood films.

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What is Bacteremia?

A condition of circulating bacteria, although bacteria are rarely found on blood smears.

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Pelger-Huet Anomaly

A hereditary disease where neutrophils are functionally normal but have hyposegmented nuclei, often seen in Australian Shepherds.

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Pseudo Pelger-Huet

Condition caused by a severe degenerative left shift that mimics Pelger-Huet anomaly due to the lack of segmented neutrophils.

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Cyclic Hematopoiesis

A lineage of leukocytes most commonly seen in grey collie dogs, where there is a cyclic/recurrent arrest in hematopoiesis.

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What are Eosinophils?

These WBCs play a key role in mediating hypersensitivity and defense against parasites, releasing granule contents extracellularly.

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What are Basophils?

Segmented cells with round, purple-staining cytoplasmic granules that contain vasoactive mediators involved in hypersensitivity reactions and defense against helminths.

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What are Macrophages?

Derived from blood monocytes. They phagocytize senescent cells and foreign material, process antigens, and produce cytokines.

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What are Lymphocytes?

Cells that play a key role cellular and humoral immunity and the production of cytokines.

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What are Lymphoblasts?

Large lymphocytes with pale-staining chromatin and nucleoli; high numbers suggest neoplasia.

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What are Plasma Cells?

Differentiated B lymphocyte that produces antibodies. Have eccentrically-located nucleus and deeply basophilic cytoplasm.

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Granulocyte maturation

Production of cytoplasmic granules & nuclear segmentation.

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What defines a myelocyte?

Cell is roughly oval-shaped nucleus.

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What defines a metamyelocyte?

Nucleus is indented, kidney bean shaped.

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What defines a band cell?

Elongated nucleus w/ parallel sides

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What happens to the nucleus over time?

Shrinks into a dense ball, fragments.

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What defines a myeloblast?

Open chromatin, nucleoli, lumpy nucleus. Basophilic cytoplasm (dark blue, but not as dark as a rubriblast).

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When do you see Polychromatophilic erythrocytes?

Increased red cell production.

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Romanowski-type stain

Eosin dye (acidic), thiazine dye (basic).

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What is a Barr body?

Extra X chromosome projection from a neutrophil.

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What adhesion molecules do neutrophils use?

Integrins and selectins which regulates sticking.

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What is stress leukocytosis?

Less sticky neutrophils/endothelium.

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Factors affecting neutrophil production.

Stem cell factor, GCSF, GMCSF, IL-1

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Neutrophil pools in bone marrow

Proliferation, maturation, and storage.

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What is the marginal pool in blood?

Transiently stuck to blood vessel walls.

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What is the circulating pool in blood?

Free floating in the blood.

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What are Toxic Neutrophils?

Cytoplasmic changes that are an indicator of inflammation and increased neutrophil turnover

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What are the morphologic signs of toxic change?

Increased cytoplasmic basophilia, Dohle bodies, vacuolated cytoplasm, toxic granulation (rare), nuclear swelling (rare).

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What color are eosinophil granules?

Red-orange color.

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What do 'degranulated' eosinophils look like?

Vacuoles where the granules didn't stain

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What shape are feline eosinophil granules?

Rod-shaped shaped.

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How do eosinophils combat parasites?

Releasing granule contents.

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What is the function of Basophils?

Release contents, cause allergic reactions.

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Study Notes

  • The maturation of granulocytes is characterized by cytoplasmic granule production and nuclear segmentation
  • Granule type determines the granulocyte type

Granulocyte Production

  • Myeloblast is the first stage and will look the same for any cell type
  • Promyelocyte is the second stage and has primary granules, also looks the same for any cell type
  • Myelocyte has an oval-shaped nucleus
  • Metamyelocyte has an indented, kidney bean-shaped nucleus
  • Band cell has an elongated nucleus with parallel sides
  • Eosinophils, neutrophils, or basophils are examples of segmented granulocytes that have segmented nuclei
  • Nuclear maturation involves a change to a darker color and more segmentation, eventually shrinking into a dense ball and separating into fragments

Myeloblasts

  • Features include open chromatin, nucleoli, and a light-staining nucleus, usually not perfectly round
  • Cytoplasm is basophilic, a dark blue color (but not as dark as a rubriblast)

Promyelocytes

  • Contain primary granules (lysosomes) that have a magenta or reddish color and a gritty appearance
  • Primary granules are also called azurophilic granules

Myelocytes

  • Primary granules disappear, and secondary granules appear
  • Secondary granules usually don't stain (or stain very pale) in neutrophils

Metamyelocytes

  • Nucleus starts to become indented

Band Cells

  • Nucleus starts to elongate
  • Stabilocyte (STAB or ST) and is an archaic term for band cell

Segmented Cell

  • Cells become indented, constricting the nucleus and creating a segmented cell
  • Segs, used without modifiers, refers to mature neutrophils

Immature Cells in Blood Circulation

  • Noted in blood, indicating increased RBC production and release from bone marrow
  • Bands are the first cells seen, with metamyelocytes and myelocytes being less common
  • Myeloblasts or promyelocytes indicate neoplasia (leukemia)

Left Shifting

  • Immature cells on the left and mature cells on the right

Leukemia

  • Immature blast-type cells indicate acute leukemia
  • Mature cell types indicate chronic leukemia

Other Cells Produced in Bone Marrow

  • There are fibroblast precursors
  • There are osteoblast precursors
  • There are mast cell precursors
  • There are dendritic cells
  • There are langerhaunt cells

Romanowsky-type Stain

  • The stain uses Wright stain and Giemsa stain
  • Acidophilic indicate substances that tend to bind that particular dye

Feline Granulocytes

  • Neutrophils have neutral-staining granules
  • Eosinophil granules are red
  • Basophils stain a light lavender-purple (or sometimes almost pink) color

Neutrophils

  • Have non-staining cytoplasm, or very pale pink to orange-stained granules
  • An elongated, segmented nucleus can sometimes be folded back, making it hard to see the full nucleus
  • Bar body is a drumstick-shaped projection from the nucleus and indicates the cell is from a female patient
  • Primary granules are lysosomes that don't stain after the promyelocyte stage unless there is toxic change
  • Secondary granules contain microbicidal proteins and enzymes that combat infectious agents

Heterophils

  • Differently stained granules, a neutrophil equivalent
  • Rabbit heterophils have numerous red-orange granules with the preferred terminology being heterophils
  • Birds and reptiles have heterophils
  • Guinea pigs can have neutrophils, heterophils, or pseudoheterophils
  • Porcupines have dark, almost basophil-like granules in their cytoplasm and these are neutrophils
  • Amphibians tend to have neutrophils rather than heterophils
  • Fish may have neutrophils as well
  • Heterophils from red-tailed boas have fused granules

Neutrophils

  • These are the first responders to infection/inflammation
  • These cells defends against microorganisms by phagocytizing and destroying bacteria
  • Adhesion molecules regulate the sticking to the blood vessel wall
  • Integrins and selectins cause sticking to the blood vessel wall
  • Chemotaxis migrate the cells to the site of inflammation
  • They phagocyte bacteria

Adhesion Molecule Deficiency

  • Seen in Holstein cattle and Irish setters
  • Defective integrin adhesion protein (CD18) causes decreased neutrophil migration into tissues
  • Inflammation occurs, but neutrophils cannot find/reach it
  • This results in high neutrophil counts and recurrent infections

Neutrophil Production

  • Production is stimulated by stem cell factor, G-CSF (granulocyte colony stimulating factor), GM-CSF (granulocyte monocyte colony stimulating factor), and interleukins (IL-1) in response to inflammation
  • Neupogen (or Vilgrastim) is recombinant human granulocyte colony stimulating factor and may be used to stimulate neutrophil production

Pools of Neutrophils

  • There is the proliferative pool
  • Cells still capable of dividing, such as stem cells, myeloblasts, and promyelocytes
  • There is the maturation pool
  • Cells in later stages not capable of dividing, such as myelocytes, metamyelocytes, and bands
  • There is the storage pool
  • Mature segmented neutrophils waiting to go out
  • Horses and ruminants don't have a large maturation/storage pool
  • Blood has circulating and marginal pools

Circulating and Marginal Pools

  • The circulating pool contains cells free in the blood
  • The marginal pool contains cells that are transiently stuck to the blood vessel wall
  • Neutrophils bouncing in between
  • In most species, about half circulating and half marginal
  • In cats, the marginal pool is about 3x the circulating pool
  • WBC count reflects the circulating pool only
  • Decreased stickiness of neutrophils and endothelium due to increased epinephrine or corticosteroid levels causes stress leukocytosis/physiologic leukocytosis and makes the neutrophils less sticky and increases blood flow, increasing the WBC count
  • Transit time in blood is about 10 hours and once they leave the blood, they do not go back in
  • Once they immigrate to the blood vessel wall they move into tissues

Left Shift

  • This is caused by an increased number above the reference interval of immature neutrophils, signifying inflammation
  • In a dog or cat, a significant left shift is >1,000 bands/µl or more than 10% of the neutrophil count
  • In cattle or horses, a significant left shift is >300 bands/µl or more than 10% of the neutrophil count

Degenerative Left Shift

  • This occurs when there are more immature cells than segs
  • In dogs and cats, this indicates a poorer prognosis
  • In ruminants, it is not considered an indication of a poor prognosis

Toxic Change

  • These are cytoplasmic morphologic abnormalities
  • Increased cytoplasmic basophilia
  • There are Dole bodies, irregularly shaped cytoplasmic inclusions of aggregated rough endoplasmic reticulum
  • There is vacuolated cytoplasm, foamy appearance from dissolution of granules within the cytoplasm
  • There is toxic granulation, persistent staining of primary granules
  • Rarely the nucleus swells and loses chromatin pattern, becoming lighter staining
  • In birds and reptiles
  • Heterophils can experience this where hypogranulation occurs with fewer granules present and the granules fuse or enlarge in size
  • There is basophilic cytoplasm
  • There are NO dohle bodies

Degenerate Neutrophils

  • Known as karyolytic neutrophils with karyolysis
  • Not usually seen in the blood, but in cytology more often
  • Necrotic neutrophils
  • Indication of a bacterial infection and if this is not present, the evidence of intracellular bacteria within the cytoplasm must be present

Morphologic aspects

  • The nucleus swells up and loses its shape
  • Blood with heat stroke cases or really severe fevers causes
  • Cannot be distinguished from very severe toxic change

Hypersegmented Neutrophils

  • As neutrophils age, they become more segmented
  • Presence is due to Neutrophils hanging around too long in the blood causes:
  • Corticosteroid therapy or increased corticosteroids from hyperadrenocorticism
  • Chemotherapy treatment of lymphoma
  • Accelerated cell aging with pyrexia or heat stroke
  • Delayed sample processing

Nuclear segments

  • Increase in number of segments
  • Prominence with thin filament-like connection between the lobes

Batryoid

  • Like a grape-like, cluster-like nucleus
  • Karyorrhexis and pyknosis: chromatin condenses into a dark, dense ball, becoming pyknotic
  • May break up into dark, dense balls-karyorrhexis

Siderotic inclusions

  • Neutrophils (or monocytes) that are aggregates of hemosiderin in neutrophils (or monocytes)

Leukophagocytosis

  • phagocytosis of white blood cells
  • Normal to see occasionally in spleen or lymph nodes

Hemosiderin

  • These are aggregates of protein and Iron from hemoglobin degradation
  • Can see with hemolytic anemias, hemorrhage in tissues
  • Look for darker and more distinct bodies when differenting from Dohle

Viral inclusions

  • Very meaningful when present, distemper example

Anaplasmosis/Ehrlichiosis

  • A bacteria that transmits through tick vectors
  • May find in neutrophils and eosinophils-granulocytic ehrlichiosis
  • May find in monocytes-monocytic ehrlichiosis
  • Anaplasma phagocytophilum: most common granulocytic in horses, dogs, cats, humans, camels
  • Ehrlichia ewingii: canine granulocytic ehrlichiosis found in SE and south-central US
  • Ehrlichia canis: Causes canine monocytic ehrlichiosis

Diagnosis

  • Direct microscopic visualization
  • Morulae in WBCs (neutrophils & eosinophils)
  • Sensitivity by buffy coat prep
  • Morphologically
  • Cannot distinguish Anaplasma phagocytophilum & Ehrlichia ewingii
  • Serology 4DX- AB detection
  • Test inaccurate in cats
  • AB presence does not mean active infection
  • PCR analysis of blood can also be conducted

Important Clinical Signs

  • Fever, lethargy, anorexia, cytopenias (thrombocytopenia, leukopenia, anemia)

IDEXX Snap test

  • Tests for
  • Heartworm antigen testing
  • Anaplasma
  • Ehrlichia Canis cross
  • Lyme diseas

Gamonts in the blood

  • Gamonts show up in neutrophils and also in monocytes.
  • Must be extremely lucky to find to even find one on a typical blood smear

Hepatozoan

  • Canine hepatozoonosis: canis/Americanum
  • Hepatozoon americanum =US cases in dogs, southeast, south central US, ingestion of infected Gulf Coast ticks (Amblyomma maculatum) More severe than H. canis, fewer gamonts in circulation

Clinical findings with Hepatozoon americanum

  • Fever, lethargy, muscle pain, hyperesthesia, ocular discharge, anemia, marked neutrophilia
  • Gamont can be seen on blood films, buffy coat preps helpful
  • PCR testing also available

Bacteremia

  • Indicates severe disease
  • Requires blood culture for diagnosis

Hereditary Neutrophil Abnormalities

  • Pelger-Huet Anomaly
  • Canids, cats, rabbits, Human-
  • Autosomal dominant disease, in utero lethal homozygous condition,
  • Very rare but common in Australian Shepherds (10%) Severe degenerative left shift may be referred to as -pseudo Pelger True lacks neutrophils/eosinophils that are segmented beyond bilobed form
  • Pseudo will have toxic change
  • Pseudo cases will have metamyelocytes, myelocytes and/or bands with lighter and immature chromatin
  • Cyclic Hematopoiesis: usually gray collie dogs -Autosomal recessive with recurrent arrest in hematopoiesis
  • At approximately 11-14 day intervals neutropenia begins
  • Other cell lines effected but longer life spans make this less obvious
  • May have recurrent infections

Eosinophils

  • Mediates hypersensitivity
  • Defense against parasites
  • Granule contents
  • Major basic protein
  • Proinflammatory cytokines
  • Toxins
  • Most mammals have red-orange granules: canids, horses, cats

Canid Eosinophils

  • Gray hounds may have non uniform stained
  • "Can look degranulated"

Feline Eosinophils

  • Have rod shaped
  • Easy for sample mix ups when reviewing cytology

Avian, Reptile Eosinophils

  • Blue eosinophil granules-Cytosine, snakes, Elongated heterophil -Round Eosinophil/ Distinct, grain -High power examination needed for diagnosis

Basophils

  • Granules,
  • Often blue/ variable
  • Cats, can look like neutrophil at low magnifications Hypersensitivity- release of base active mediators.
  • IL -3: cytokine increase

Reagent numbers

  • Very low/hard to discern
  • Turtles-more basophils
  • Round and oval- avian/reptiles

Mast cells

Tissue cells- can find in circulation occasionally- Mastocytemia Located at feather edges

  • High numbers means neoplasia (5%+)
  • Dogs can have Mast at 1-2% without neoplasia -inflammation, necrosis, anemia.

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