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Leukogram, Hemogram, Leukocyte Responses
JJC Vet Tech 260
127
Veterinary Medicine
Undergraduate 2
09/05/2014

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Term
Inflammation can be __, __, or __.
Definition
acute, chronic, overwhelming
Term
Leukocyte response to acute inflammation?
Definition
total WBC, segs, bands: increased
lymphs: decreased / WNL
mono: varies
Term
Leukocyte response to acute inflammation?
Definition
total WBC, segs, bands, lymphs: increased / WNL
monos: increased
Term
Leukocyte response to overwhelming inflammation?
Definition
total WBC: decreased
segs, lymphs: decreased / WNL
bands: increased
mono: varies
Term
Terms for the leukocyte response to epinephrine?
Definition
physiologic / excitement leukocytosis
Term
A physiologic leukocytosis is caused by ____, whereas a stress leukogram is caused by ____.
Definition
physio: epinephrine, acute stress
stress leuko: glucocorticoids, chronic stress
Term
Leukocyte response to epinephrine?
Definition
total WBC: transiently increased (1 hr)
segs: increased in dogs, increased/WNL in cats
bands: WNL
lymphs: WNL in dogs, increased and transient in cats
monos: WNL
Term
Leukocyte response to glucocorticoids?
Definition
total WBC: transiently increased (1-3d)
segs: increased
bands: WNL
lymphs: decreased
monos: increased or WNL
Term
What is the most reliable indicator of chronic stress in the leukogram?
Definition
lymphocytopenia
Term
Term for when a leukogram shows qualities of different leukocyte responses, e.g. stress leukogram as well as acute inflammation.
Definition
superimposed stress leukogram
Term
What is commonly seen as a superimposed stress response?
Definition
lymphopenia
Term
Leukocyte response to tissue necrosis?
Definition
monocytosis
Term
Leukocyte response that indicates an immune response?
Definition
reactive lymphocytes
Term
Dohle bodies, granulation, and foaminess in WBCs indicates what?
Definition
toxic change
Term
MCV stands for ___ and describes...?
Definition
Mean Corpuscular Volume, describes avg size of RBC
Term
MCH stands for ___ and describes...?
Definition
Mean Corpuscular Hemoglobin, describes avg. amount of hemoglobin
Term
MCHC stands for ___ and describes...?
Definition
Mean Corpuscular Hemoglobin Concentration, describes the ratio of hemoglobin : RBC volume
Term
Normal # platelets seen under the scope?
Definition
8-10 / HPF
Term
Why might you need to correct a WBC count done by a machine?
Definition
nRBCs - machine can't differentiate them from WBCs so it gives an artificially high WBC count
Term
Describe the following levels of toxic change:
1+
2+
3+
4+
Definition
1+ dohle bodies, cytoplasmic granules/vacuoles
2+ " " and diffuse cyto. basophilia
3+ " " and excessive foamy cyto. vacuoles
4+ " " and gigantism or nuclear lysis
Term
Advantages of in-house CBC:
Definition
-earlier diagnosis = earlier treatment
-better pre-anesthesia management
-minimization of artifacts bc blood is fresh
-can see abnormalities that lab only checks for upon request
Term
Disadvantages of in-house CBC:
Definition
-$/time?
-technical skill
Term
All blood cells arise from a common ___ stem cell.
Definition
pluripotent
Term
Maturation of a granulocyte:
Definition
myeloblast > promyelocyte > myelocyte > metamyelocyte > band > mature N/E/B
Term
Describe the chromatin pattern "fine / smooth."
Definition
uniform pattern of thin chromatin strands, no clumping
Term
Describe the chromatin pattern "finely stippled."
Definition
smooth chromatin pattern with discrete aggregates of chromatin
Term
Describe the chromatin pattern "lacy / reticular."
Definition
uniform pattern of medium-sized chromatin strands with no significant clumping
Term
Describe the chromatin pattern "coarse."
Definition
ropey, cord-like chromatin strands
Term
Describe the chromatin pattern "clumped."
Definition
large aggregates of chromatin throughout nucleus; may occur in lacy or coarse chromatin
Term
Describe the chromatin pattern "smudged."
Definition
not a discrete pattern of chromatin
Term
Describe the appearance of a myeloblast:
Definition
-round/oval nucleus
-chromatin is fine, diffused like dust
-nucleoli
Term
Describe the appearance of a promyelocyte:
Definition
-round/oval nucleus
-somewhat condensed chromatin
-nucleoli
Term
Describe the appearance of a myelocyte:
Definition
-nucleus is condensing, smaller
-chromatin aggregating
-nucleoli fading
Term
Describe the appearance of a metamyelocyte:
Definition
-cell is smaller
-kidney bean-shaped nucleus
-pinker cytoplasm
Term
Bone marrow maintains a ___ supply of segs in circulation.
Definition
5 day
Term
Segs circulate for __ before cell migration.
Definition
~10 hours
Term
Transit time for marrow generation?
Definition
4-6 days
Term
Is transient eosinophilia a concern?
Definition
No, check for persistent eosinophilia.
Term
Basophils produce ___ and ___.
Definition
histamines and heparin.
Term
Describe the appearance of granules in the basophil.
Definition
Few or densely packed granules
Term
What type of WBC is common in exotics but rare in cats/dogs?
Definition
basophils
Term
Maturation of agranulocytes:
Definition
lymphoblast > lymphocyte
monoblast > monocyte > macrophage
Term
What WBC precursors would you not expect to find in the blood because they are instead in the bone marrow?
Definition
lymphoblast, monoblast
Term
Describe the appearance of a lymphocyte:
Definition
-high nuclear : cytoplasmic ratio
-eccentric nucleus
-usually pale blue cytoplasm
Term
Describe the appearance of a monocyte:
Definition
-pleomorphic (irregular) nucleus
-lacy/fine granules / foamy / ground glass
-grey-blue cytoplasm
Term
How fast can monocytosis show up in a blood smear?
Definition
within 12 hours of the start of inflammation
Term
Is automated or manual WBC count more accurate?
Definition
automated, but for exotics you must do manual
Term
How to record the amount of platelets in a smear?
Definition
adequate, increased, or decreased; clumped, mega
Term
Clumps of platelets may occur because of __.
Definition
inflammation
Term
What is the unopette system?
Definition
dilution which lyses RBCs, allowing you to more easily count WBCs with a hemocytometer
Term
Diff-Quick doesn't stain ___ very well.
Definition
basophils
Term
Why is Diff-Quick not the best stain to use with exotics?
Definition
Doesn't stain basophils well, and exotics have more basophils.
Term
Name of the microscope slide with a tiny grid system for counting WBCs?
Definition
hemocytometer
Term
Names of the two different methods for blood smears:
Definition
squash prep, push/pull
Term
3 things to check for in centrifuged blood sample?
Definition
-lipemia (white)
-hemolysis (pink/red)
-icterus (yellow)
Term
The most helpful indicator of hydration status is __.
Definition
TP
Term
Centrifuged blood samples separate into:
Definition
-plasma or serum
-buffy coat
-red cells
Term
Buffy coat contains:
Definition
WBCs, platelets
Term
Maturation of platelets:
Definition
megakaryoblast > megakaryocyte > platelet (thrombocyte)
Term
Function of platelets:
Definition
-essential for hemostasis, inflammatory response
-initial wound repair
Term
The only blood cell that gets bigger as it matures:
Definition
megakaryoblast
Term
Platelet estimates should be performed on what power?
Definition
100x oil immersion
Term
erythropoietin:
Definition
hormone produced by kidneys to stimulate stem cell production of RBC in marrow
Term
What two species become anemic quicker in a diseased state? Why is this?
Definition
Cats and birds, because RBCs have shorter life span.
Term
What is splenic contraction?
Definition
compensatory mechanism after blood loss, in which the spleen releases stored RBCs
Term
Hemoglobin becomes ___ until it is cleared by the liver.
Definition
methemoglobin
Term
Maturation of a RBC:
Definition
rubriblast > prorubricyte > rubricyte > metarubricyte > polychromatophil >erythrocyte
Term
When would you typically use the formulas MCV, MCH, MCHC?
Definition
when anemia is suspected
Term
What is microcytosis? When can it occur?
Definition
small RBCs, anemias with decreased MCV
Term
What is macrocytosis? When can it occur?
Definition
large RBCs, responsive anemias with increased MCV
Term
What is rouleaux? When can it occur?
Definition
stacks of RBCs arranged in lines, normal in horses and sometimes cats
Term
What is agglutination? When can it occur?
Definition
clumps of RBCs, can be pathologic or by poor smear technique
Term
How to test if agglutination is pathologic or from bad smear technique?
Definition
add 1 drop PSS to 1 drop blood, wet mount, will break up if not agglutinated
Term
What is PSS?
Definition
physiologic sterile saline
Term
Echinocytes can also be called...
Definition
burr cells
Term
Describe an echinocyte:
Definition
-evenly spaced, uniform projections
-most common artifact (crenation)
-can result from renal Dz, lymphosarcoma, snake bite
Term
What are some causes for crenation?
Definition
blood dries too slow because of:
-too much blood on smear
-humid environment
Term
How to differentiate poikilocytosis from crenation?
Definition
poik: some cells
cren: all cells
Term
Acanthocytes can also be called...
Definition
spur cells
Term
Describe an acanthocyte:
Definition
-irregular projections with knobs on ends
-can result from altered lipid metab assoc. with liver Dz, or hemangiosarcoma
Term
Name for a RBC with evenly spaced, uniform projections?
Definition
echinocyte, burr cell
Term
Name for a RBC with irregular, knobbed projections?
Definition
acanthocyte
Term
Describe a schistocyte:
Definition
RBC fragment usually caused by intravascular trauma, can result from iron deficiency or DIC
Term
What is DIC?
Definition
"death is coming"
"disseminated intravascular coagulation" - a pathologic condition marked by widespread activation of the clotting cascade, resulting in tiny blood clots forming in the vessel; eventually the body uses up clotting factors, potentially resulting in bleeding out
Term
Drepanocytes can also be called...
Definition
sickle cells
Term
Name for a RBC fragment that usually results from intravascular trauma?
Definition
schistocyte
Term
Name for a RBC that looks like a sickle?
Definition
drepanocyte
Term
Describe a drepanocyte:
Definition
-sickle-shaped RBC that is normal in deer, antelope, sheep, goats, and some carnivores like genets and mongoose
Term
A keratocyte can also be called...
Definition
-blister cell
-helmet cell
Term
Describe a keratocyte:
Definition
-horn-like projections on the RBC, looks like a cartoon cat head to me; can result from liver Dz or membrane damage
Term
Describe a spherocyte:
Definition
-darkly staining RBC which lacks central pallor; easier to ID in dogs and may indicate IMHA
Term
A codocyte can also be called...
Definition
leptocyte
Term
What is a codocyte?
Definition
A category of abnormal RBCs in which the membrane is damaged; includes target cells and stomatocytes
Term
Describe a target cell:
Definition
-looks like a bulls-eye
-a few can be normal
-can indicate anemia or liver Dz
Term
Describe a stomatocyte:
Definition
-looks like a smile
-artifact if near feathered edge
-can indicate anemia and liver Dz
Term
Describe a dacrocyte:
Definition
-teardrop shaped RBC
-myeloproliferative Dz
Term
What tubes can be used for CBC samples?
Definition
EDTA (lavendar) or Heparin (green)
Term
What to do if there's a blood clot in your CBC sample?
Definition
get a new sample, you can't use one with any clots
Term
Never run a chemistry with blood from a ___ tube.
Definition
EDTA (lavendar)
Term
When to spin hep or RTT for chemistries?
Definition
immediately after CBC to avoid low glucose
Term
What is a leukogram?
Definition
description of the WBCs
Term
Types of leukocyte shifts?
Definition
-Left (regen or degen)
-Right
-Leukemoid
Term
Types of leukocyte cell changes?
Definition
-toxicity
-degenerative nuclear
-reactive
-atypical
Term
Define "left shift."
Definition
presence of excessive numbers of immature neutrophils in the peripheral blood
Term
How to record the severity of a left shift?
Definition
slight, moderate, marked
Term
What is a leukemoid reaction?
Definition
Extremely high leukocyte count (> 50,000 WBC), usually very immature cells resembling leukemia. Generally a sign of underlying infection (TB, malaria, pneumonia).
Term
What is a regenerative left shift?
Definition
-neutrophilia with seg > immatures
-favorable response
-bone marrow needs 3-5 days to respond to peripheral demands for neutrophils
Term
What is a degenerative left shift?
Definition
-neutrophil count low or slightly elevated
-more immature neutrophils than segs
-unfavorable prognosis (except cattle)
Term
What is leukopenia?
Definition
-decrease in WBCs in circulation
-dog/cat: <5,000 cells/microliter
-usu. neutropenia
Term
Pelger-Huet Anomaly
Definition
-genetic condition which prevents nuclear maturation
-leukogram looks like left shift
-humans, rabbits, purebred dogs, rarely cats
Term
What is toxicity?
Definition
Cytoplasmic changes, usu. in neutrophils, caused by exposure to bacterial toxins, toxic products of metabolism, or tissue necrosis.

-cell development in marrow is arrested
Term
What is a dohle body?
Definition
-chunk of RNA in the cytoplasm
-low #s normal in cats
Term
What is toxic granulation?
Definition
Mature neutrophil retains granules of precursor cells, makes it look like a basophil.
Term
What is a toxic left shift?
Definition
LS with granulation and dohle bodies
Term
What two parameters must be noted for all cell changes?
Definition
quantity and quality (severity)
Term
% of the following:
slight
moderate
marker
Definition
slight 5-10%
moderate 11-30%
marked > 30%
Term
The majority of toxic changes will fall into what severity category?
Definition
1+ or 2+
Term
Only ___ can be toxic, and only ___ can be reactive.
Definition
toxic = segs
reactive = lymphs/monos
Term
A reactive change in an agranulocyte results in:
Definition
-increased size
-very basophilic cytoplasm
-cytoplasmic granules
-lymphs may have eccentric nucleus with perinuclear clear zone
-monos have cytoplasmic vacuoles
Term
What is a distinct feature of reactive lymphs?
Definition
perinuclear clear zone
Term
What is a mott cell?
Definition
plasma cell with packets of immunoglobulins (packets = Russell bodies)
Term
Describe an atypical lymphocyte:
Definition
-larger, more cytoplasm
-nucleoli in their nuclei
-cytoplasm indented by surrounding RBCs
Term
Significance of an atypical lymphocyte?
Definition
could be infection or neoplasia - needs pathology review
Term
When might basophilia occur?
Definition
-in conjunction with eosinophilia
-systemic mast cell tumors
-basophilic leukemia (rare)
-can be benign in cats
Term
What is bacteremia?
Definition
presence of bacteria in the blood
Term
Most common cause of bacteremia on a smear?
Definition
contaminated stain
Term
How to tell if bacteremia is mistake or pathologic?
Definition
look for cells engulfing the bacteria
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