70 Monocytosis and Monocytopenia

Question 1

Monocyte that highly phagocytic and proinflammatory, compose virtually all marrow monocytes and approximately 85% of blood monocytes

Answer 1

“Classical” monocytes

Question 2

Marker of “Classical” monocytes

Answer 2

CD14 ++ CD16 −

Question 3

Chemokine receptor of classical monocytes

Answer 3

CCR2 hi CX3CR1 lo

Question 4

Marker and receptor of “Intermediate” subset monocytes

Answer 4

Marker: CD14 ++ CD16 +

Receptor: CCR2 mid CX3CR1 hi CCR5 mid

Question 5

Marker and receptor of “Non-classical”” subset monocytes

Answer 5

Marker: CD14 lo CD16 ++

Receptor: CCCR lo CX3CR1 hi

Question 6

Subset of monocyte referred to as the “patrolling” subset and contains dendritic cell precursor

Answer 6

“Non-classical” subset

Question 7

Specific macrophage populations :

brain: _____________
liver : _____________
bone: _____________

Answer 7

brain [astroglia]
liver [Kupffer cells]
bone [osteoclasts]

Question 8

Monocytes constitute _________% of blood leukocytes

Answer 8

1%–9% (mean, 4%)

Question 9

Monocytosis is defined as

Answer 9

Monocyte count consistently exceeds 0.8 × 10 9 /L

Question 10

The blood monocyte count cycles with a periodicity of ______ days

Answer 10

Five days

Question 11

Approximately______% of patients with a myelodysplastic syndrome (MDS) have an increase in the absolute monocyte count.

Answer 11

25%

Question 12

TRUE OR FALSE

Patients with myelodysplasia and monocytosis have a high propensity to evolve into acute or chronic myelomonocytic leukemia.

Answer 12

TRUE

Patients with myelodysplasia and monocytosis have a high propensity to evolve into acute or chronic myelomonocytic leukemia.

Question 13

This feature of primary myelofibrosis, may be a harbinger of rapid progression.

Answer 13

Monocytosis

Question 14

Absolute number of monocytes in the blood of patients with chronic myelomonocytic leukemia

Answer 14

≥1.0 × 10 9 /L

Question 15

Transcript of CML associated with monocytosis

Answer 15

p190 BCR-ABL

Question 16

Monocytosis occurs in a number of neutropenic states:

Answer 16

Cyclic neutropenia, chronic granulocytopenia of childhood, familial benign chronic neutropenia, infantile genetic agranulocytosis, and chronic hypoplastic neutropenia

Question 17

TRUE OR FALSE

Monocytosis characteristically appears later in the recovery phase of agranulocytosis and may be a harbinger of recovery.

Answer 17

TRUE

Monocytosis characteristically appears later in the recovery phase of agranulocytosis and may be a harbinger of recovery.

Question 18

TRUE OR FALSE

Monocytosis has been noted in approximately 25% of cases of Hodgkin lymphoma at it correlates with prognosis.

Answer 18

FALSE

Monocytosis has been noted in approximately 25% of cases of Hodgkin lymphoma, although it does not correlate with prognosis.

Question 19

A statistically significant increase in blood monocyte concentration has been reported in myeloma and has been correlated with the presence of _________ light-chain containing monoclonal immunoglobulin

Answer 19

λ light-chain containing monoclonal immunoglobulin

Question 20

Syndrome induced by drugs such as carbamazepine, phenytoin, phenobarbital, and valproic acid, is associated with monocytosis

Answer 20

Pseudolymphoma syndrome

Question 21

Infectious diseases are an uncommon cause of monocytosis except in the ff:

Answer 21

Tonsillitis, dental infection, recurrent liver abscesses, candidiasis, and tuberculous peritonitis

A number of infections formerly thought to be associated with monocytosis are not, when examined systematically. These include rickettsial diseases, leishmaniasis, typhoid fever, malaria, disseminated candidiasis, brucellosis, and dengue hemorrhagic fever.

Question 22

TRUE OR FALSE

Neither the monocyte count nor the ratio of monocytes to lymphocytes correlates with the stage or activity of tuberculosis.

Answer 22

TRUE

Neither the monocyte count nor the ratio of monocytes to lymphocytes correlates with the stage or activity of tuberculosis.

Question 23

Viral infection associated with monocytosis

Answer 23

Cytomegalovirus, varicella-zoster virus, and influenza virus

Question 24

Monocytosis that occurs after myocardial infarction, reaching a peak on _______

Answer 24

Day 3

Question 25

TRUE OR FALSE

A correlation exists between serum creatine kinase activity and monocyte count, suggesting a relationship between extent of infarction and monocytosis.

Answer 25

TRUE

A correlation exists between serum creatine kinase activity and monocyte count, suggesting a relationship between extent of infarction and monocytosis.

After myocardial infarction, persistent monocytosis is correlated with pump failure.

Question 26

Characteristic of monocytosis associated with depressive and anxiety disorders

Answer 26

High plasma levels of β endorphins and dysfunctional (hypophagocytic) monocytes

Question 27

A monocyte distribution width of greater than ________was found to be an important indicator of sepsis.

Answer 27

Greater than 20 units

Question 28

Patients with monocyte counts below______had higher rates of bacteremia and organ dysfunction and a higher 28-day mortality rate

Answer 28

Below 0.250 × 10 9 /L

Question 29

Syndrome with extreme monocytopenia, and sometimes amonocytosis and frequency of Mycobacterium avium complex (MAC) opportunistic infections

Answer 29

MonoMAC syndrome

Question 30

Mutation in MonoMAC syndrome

Answer 30

GATA2 gene

Question 31

Triad of lymphedema, monosomy 7, and myelodysplasia or acute myelogenous leukemia

Answer 31

Emberger syndrome

Question 32

Blood dendritic cells are composed of two principal phenotypic subtypes:

Answer 32

Myeloid-derived (HLA-DR + CD11c + CD123 + )- 2/3

Lymphoid-plasmacytoidderived (HLA-DR + CD11c − CD123 + ) - 1/3

Question 33

Proportion of a myeloid-derived type dendritic cells

Answer 33

2/3

Question 34

TRUE OR FALSE

Fluctuations in blood dendritic cells are often independent of changes in total blood monocyte count.

Answer 34

TRUE

Fluctuations in blood dendritic cells are often independent of changes in total blood monocyte count.

Question 35

Dendritic cells make up approximately ________% of blood cells (range, 0.15%–1.30%) and represent__________ (range, 3 to 30 × 10 6 cells/L).

Answer 35

0.6%

14 × 10 6 cells/L

Question 36

TRUE OR FALSE

Blood dendritic cell counts decrease with aging and increase with surgical stress (and presumably other stressful reactions) in relation to plasma cortisol levels.

Answer 36

TRUE

Blood dendritic cell counts decrease with aging and increase with surgical stress (and presumably other stressful reactions) in relation to plasma cortisol levels.