Inflammation (Cram)

What type of WBC will show the biggest response to inflammation?

Neutrophils

Term for an increased number of immature neutrophils in the blood

Left shift

What are the three levels of severity of a left shift?

1. Mild

2. Moderate

3. Marked

What level of left shift are bands observed?

Mild

What level of left shift are bands and metamyelocytes observed?

Moderate

What level of left shift are myelocytes and promyelocytes observed?

Marked

What are the two classifications of left shifts?

1. Regenerative: Good bone marrow response

2. Degenerative: Poor bone marrow response

In regenerative left shift what kind of neutrophil predominates?

Mature neutrophils

In degenerative left shift what kind of neutrophil predominates?

Immature neutrophils approach or exceed number of mature neutrophils

What are the three disorders that have a left shift?

1. Leukemoid response

2. Chronic myeloid leukemia (CML)

3. Pelger–Huët anomaly (PHA)

Term for an inflammation induced neutrophilia with a left shift so marked that it must be differentiated from leukemia

Leukemoid response

A leukemoid response has a marked left shift back to at least what stage of cell development?

Myelocyte

What condition can cause a leukemoid response?

Pyometra

In what species is Chronic myeloid leukemia primarily seen?

Dogs

Is the WBC count in CML very high or low?

Very high

Does CML have a left shift, if so, how severe?

Marked left shift

What do the nuclei of granulocytes look like with Pulger–Huët anomaly?

Immature shapes (dumbell/peanut) but with mature chromatin

How does an animal get PHA?

Congenital

What are the four classifications of inflammation?

1. Per acute

2. Acute

3. Severe or overwhelming

4. Chronic

The demand for neutrophils overwhelming and they leave circulation faster than the bone marrow is able to release them. What type of inflammation is this?

Per–acute inflammation

What is the net effect of per–acute inflammation?

Neutropenia

In a short time, the supply of mature neutrophils from the marrow is used up, and increasing numbers of band cells are then released. What type of inflammation is this?

Acute inflammation

What is the net effect of acute inflammation?

Neutrophilia with an increased # of bands (regenerative left shift)

Tissue demand is so great that neutrophils leave the circulation in greater numbers than the bone marrow can keep up with production. What type of inflammation is this?

Severe inflammation

What is the net effect of severe inflammation?

Neutrophilia with increased number of bands (degenerative left shift)

Marrow production of neutrophils establishes a balance with tissue demand for neutrophils. What type of inflammation is this?

Chronic inflammation

What is the net effect of chronic inflammation?

Normal or near normal leukogram

What does the body produce in response to stress or pain?

Glucocorticoids

What is the hallmark for a stress response?

Mild to moderate lymphopenia

What differentiates a stress response from inflammation?

Absence of a left shift with stress response

Is the stress response with dogs or cat more common?

Dogs

What hormone is released during an excitement response?

Epinephrine

What is an excitement response characterized by, especially in dogs?

Neutrophilia

What is an excitement response characterized by, especially in cats and horses?

Lymphocytosis

What is tissue necrosis characterized by?

Monocytosis

What is systemic toxemia characterized by?

Neutrophil toxicity

What are some causes of systemic toxemia?

Bacterial toxin (most common), lead, some drugs, tissue necrosis

What are the three levels of severity of toxic neutrophils?

1. Mild

2. Moderate

3. Severe

Blue cytoplasmic inclusions that can be seen in mild toxic neutrophils

Döehle bodies

Term to describe blue to patchy blue–purple cytoplasm seen in moderate neutrophil toxicity

Cytoplasmic basophilia

What shape can nuclei take on in severe neutrophil toxicity?

Ring–shaped

What is this condition called?

Chediak–Higashi syndrome