Infection and Immunity Wk 8 - Lesson 56

What is the Impendence method of counting?

each nucleus of the leukocyte impedes electron flow and is counted

What is optical method of counting?

each whole cell intersects laser beam and light scatter defines their size, granularity, and nuclear shape

What is manual method of counting?

100-leukocyte subsets stained on a blood film are counted using a microscope and cell counter

What is the best type of cell counting for sick animals?

manual because is gives a more accurate blood leukocyte subset concentration

What proteins are negative acute phase?

albumin and transferrin

What happens with synthesis for negative acute phase proteins?

synthesis is decreased early (<2 days) in inflammation

What organ produces negative acute phase proteins?

liver

What proteins are positive acute phase?

haptoglobin and fibrinogen

What happens with synthesis of positive acute phase proteins?

synthesis is increased early (<2 days) in inflammation

What organ produces positive acute phase proteins?

liver

What proteins are delayed phase?

immunoglobulins

What happens with synthesis of delayed phase proteins?

increase synthesis occurs 1-3 weeks after onset of inflammation

What organ produces delayed phase proteins?

B-lymphocytes in lymph nodes

What does serum TP detect?

acute phase and delayed phase proteins

What does serum ALB detect?

acute phase proteins

What does serum GLB detect?

acute phase and delayed phase proteins

What does albumin and globulin fractions detect?

acute and delayed phase proteins

What does plasma TP detect?

acute and delayed phase proteins

What is increased serum TP?

hyperproteinemia

What is decreased albumin?

hypoalbuminemia

What is increased globulin?

hyperglobulinemia

What is increased plasma TP?

hyperproteinemia

What is increased fibrinogen?

hyperfibrinogenemia

What are the three pools of neutrophils?

marrow, blood, tissue

How long does neutropoiesis take in healthy animals?

5 days in marrow, 8 hours in blood, days in tissues

How long does neutropoiesis take with inflammation?

What happens to neutropoiesis in inflammation?

neutropoiesis is accelerated

What is increased WBCs?

leukocytosis

What is increase in segmented neutrophils?

neutrophilia

What are the phases of neutrophils in the marrow?

proliferating phase, maturation phase, storage phase

What phase are band neutrophils located in?

maturation phase

What phase are segmented neutrophils located in?

storage phase

What are the pools of neutrophils in the blood?

circulating pool and marginating pool

What pool of neutrophils is taken with a blood sample?

circulating pool

What pool of neutrophils does not get taken with blood sample and travels into tissues?

marginating pool

What is an increase in bands?

left shift

What is the difference between band and segmented neutrophils?

band neutrophil is younger and lack indentation of the nucleus

segmented neutrophil is mature and has a definitive indentation in nuclear outline

What is the band vs seg rule-of-thumb?

when in doubt, call it the older cell

What are the two types of left shifts?

regenerative and degenerative

What is regenerative left shift?

leukocytosis due to neutrophilia with increase in bands

segs > bands

What is degenerative leukocytosis?

usually leukopenia, but WBC maybe WRI

bands > segs

What is the prognosis of degenerative left shift?

poor prognosis; 2x at risk at being euthanized

What is the hallmark of acute inflammatory reaction?

regenerative left shift

What kind of response to inflammatory disorder is reg. left shift?

adequate

What does the marrow do in response to cytokines?

releasing seg cells from SNP and bands from maturation pool

What kind of response to inflammatory disorder is deg. left shift?

inadequate

What is happening in the marrow in response to the deg. left shift?

marrow is not keeping up with the demand; SNP is depleted and WBC is decreased; leukopenia present; cytokines lead to depletion of cells

What can cause deg. left shift?

severe bacterial infection

What is acute inflammation recognized by?

neutrophilia with regenerative left shift, lymphopenia

What are some causes of acute inflammatory disorder?

infectious (Bacterial) and noninfectious (necrosis, immune)

What cells release cytokines?

macrophages and lymphocytes

What process are the cytokines stimulating in acute inflammation?

release of neutrophils from SNP (neutrophilia) and release of bands from maturation pool (left shift)

What are toxic neutrophils?

seg or band neutrophils that haven't completed maturation associated with severe inflammatory disease commonly bacterial infections and inflammatory disorders

What are histologic classifications of toxic neutrophils?

foamy cytoplasm, cytoplasmic basophilia (retained RNA), giant neutrophil with cytoplasmic basophilia

What are Dohle bodies?

retained RNA in the toxic neutrophil

What causes toxic neutrophils?

release of immature band neutrophils/accelerate neutropoiesis

Why is there lymphopenia in acute inflammatory leukogram?

cytokines promote lymphocytes migrating to inflamed tissues and homing to lymph nodes; there is decrease of lymphocyte efflux from lymph nodes because they are getting activated and it takes time

What can cortisol (stress) leukogram look similar to?

acute inflammatory leukogram

What is the main difference between cortisol leukogram and acute inflammatory leukogram?

bands are both increased but in stress they will be < 1,000/microliter

How does cortisol cause a similar leukogram to acute inflammation?

it leads to neutrophilia but it does not change bone marrow instead it decreases expression of adhesion molecules causing neutrophils in marginating pool to shift to the circulating pool

What is the pattern for acute inflammatory leukogram?

leukocytosis, neutrophilia, reg. left shift with >1,000 bands, lymphopenia, monocytosis, eosinopenia

What is the pattern for cortisol stress leukogram?

leukocytosis, neutrophilia, reg. left shift with <1,000 bands, lymphopenia, monocytosis, eosinopenia

What is the pattern for chronic inflammatory leukogram?

leukocytosis, neutrophilia, bands WRI, lymphocytosis, monocytosis, eosinophilia

What is the pattern for catecholamine leukogram?

leukocytosis, neutrophilia, bands WRI, lymphocytosis, monocytosis, eosinophils WRI

What is the pattern for acute overwhelming inflammatory?

leukopenia, neutropenia, deg. left shift, lymphopenia, monocytes WRI, eosinopenia

What is chronic inflammation recognized by?

neutrophilia with little or no left shift, lymphocytosis

Why does chronic inflammation have little to no increase of bands?

the bone marrow has time to expand to meet the need for more neutrophils

What process does cytokines stimulate in chronic inflammation?

production of neutrophils, granulocytic hyperplasia happens to increase the production and release of segmented neutrophils

What can cause chronic inflammation?

bacteria, protozoa, fungus, virus

Why is there lymphocytosis in chronic inflammatory leukogram?

chronic antigenic or cytokine stimulation causes increase production of lymphocytes in lymph nodes (lymphoid hyperplasia); can create reactive lymphocytes

What is the common cause of lymphocytosis?

lymphoid leukemia; chronic inflammation is uncommon cause of lymphocytosis

What histologic characteristics do reactive lymphocytes have?

increased cytoplasmic basophilia, prominent golgi zone, hyperchromatic nuclei

Where do reactive lymphocytes stem from?

stimulated B-cells or T-cells; differentiate from neoplastic cells; usually from infectious disorders

What are the common causes of monocytosis?

acute and chronic inflammation, steroids (stress), or catecholamines

What are the common causes of eosinophilia?

often seen in chronic inflammation; hypersensitivity/allergic disorders, parasitism, hypoadrenocorticism

What are the common causes of basophilia?

often seen in chronic inflammation; hypersensitivity/allergic disorders, parasitism

What does catecholamine leukogram look similar to?

chronic inflammatory leukogram

When is catecholamine leukogram seen?

in excited cats

What is catecholamine leukogram recognized by?

neutrophilia without a left shift

What causes the catecholamine leukogram?

fight or flight stimulus increases catecholamines which increases blood flow rate through small vessels and causes shifting of neutrophils from MNP to CNP of blood causing neutrophilia

What is acute overwhelming inflammation recognized by?

neutropenia with a degenerative left shift

What can cause acute overwhelming inflammation?

primarily bacteria, few viruses

Why is there neutropenia in acute overwhelming inflammation?

cytokines are stimulating migration of neutrophils to inflamed tissue and the neutrophils are overwhelmingly going on to tissue