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POM 3: Haematology > 3: White Blood Cells > Flashcards

3: White Blood Cells Flashcards

Covers Granulocytes and monocytes, Lymphocytes and WBC diseases (67 cards)

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1
Q

What do myeloid growth factors do?

A

Signalling controls proliferation and survival of myeloid cells

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2
Q

3 myeloid growth factors

A

G-CSF : granulocyte colony stimulating factor
M-CSF: macrophage colony stimulating factor
GM-CSF : both granulocyte and macrophage colony stimulating factor

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3
Q

Myeloblasts are initial granulocytes, where do they develop

A

in the bone marrow
cell size reduced and granules develop as they mature

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4
Q

Neutrophils are

A

primary immune defence cells
- lobulated nucleus
-survive 7-10h in circulation
- migrate in tissue to carry out pathogen phagocytosis

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5
Q

what is chemotaxis

A

first step of neutrophil migration into tissues
- primed by cytokines ready to phagocytose pathogens

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6
Q

Characteristics of eosinophils

A

pink granules in stains
bilobed nucleus
less time circulating than neutrophils

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7
Q

2 functions of eosinophils

A

1) defence against parasitic infections and phagocytosis
2) regulation of type 1 hypersensitivity reactions - inactivate histamine and leukotrienes released by basophils and mast cells

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8
Q

Components of basophils

A

contain granules storing :
histamine
heparin
proteolytic enzymes

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9
Q

2 inflammatory responses of basophils

A

mediation of T1 hypersensitivity reaction where IgE-coated basophils release histamine and leukotrines

modulation of inflammatory responses by releasing heparin and proteases

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10
Q

3 functions of Monocytes

A

1)Phagocytosis of micro-organisms covered in antibody and complement
2)Phagocytosis of bacteria and fungi
3)Antigen presentation to lymphoid cells

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11
Q

Macrophages are formed from

A

Developed monocytes migrated in tissues with other cells that have a phagocytic scavenging function

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12
Q

4 types of granulocytes

A

Basophil
Neutrophil
Eosinophil
Monocyte

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13
Q

3 types of lymphocytes

A

B
T
natural killer cells

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14
Q

B lymphocytes originate form

A

foetal liver and bone marrow

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15
Q

Where do B lymphocytes develop

A

in bone marrow
- differentiate into plasma cells involving Ig heavy and light chain rearrangement

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16
Q

Function of mature B lymphocytes

A

mature after being exposed to antigens in lymphoid tissue e.g. lymph nodes

recognition of non-self antigens triggers production of specific Igs and antibodies

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17
Q

function of T lymphocytes

A

cell mediated immunity

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18
Q

Where do foetal lymphocyte progenitors migrate from to develop

A

from the liver to the thymus to develop

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19
Q

Function of natural killer cells

A

part of innate immune system
kill tumour cells and cells infected with viruses

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20
Q

Leukocytosis means

A

Too many WBCs

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21
Q

Normal leukocytosis

A

Occurs during infections, levels rise and then fall back down
- Transient leukocytosis
Infections, inflammation, infarction
Bacterial infection : neutrophilia/ monocytosis
Viral infection : lymphocytosis
Parasitic infection : eosinophilia

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22
Q

Abnormal leukocytosis

A

Leukaemia, lymphoma, myeloma
Examples -
Acute lymphoblastic leukaemia
Acute myeloid leukaemia
Chronic lymphocytic leukaemia
Chronic myeloid leukaemia

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23
Q

Neutrophilia is

A

Too many neutrophils

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24
Q

Causes of neutrophilia

A

Infection
Inflammation
Exercise
Infarction or tissue damage
Myeloproliferative disorders (CML)
Pregnancy - heavy toxic granulation of neutrophils
Use of corticosteroids

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25
How to spot neutrophilia on a blood film
Left shift - non-segmented neutrophil precursors due to increased output from bone marrow
26
When can eosinophilia occur
Due to allergy / parasitic infection Asthma / eczema / drugs But can occur in leukaemia
27
Blood film in patients with basophilia
Myelocytes seen Band forms Neutrophilia Left shift
28
What does basophilia occur due to
Leukaemia (uncommon)
29
3 causes of monocytosis
Infection esp chronic Chronic inflammation Some types of leukaemia
30
Two main types of lymphocytosis
Transient lymphocytosis Persistent lymphocytosis
31
Transient lymphocytosis is caused by
Viral infections often atypical lymphocytes present
32
Persistent lymphocytosis is a
Lymphoproliferative disorder
33
Infectious mononucleosis is also known as
Mono Or Glandular fever
34
glandular fever
Lymphocytosis due to viral infection - resulting in atypical lymphocytes
35
WBCs in mono
Scalloped margins and hugging of nearby RBCS
36
Leukaemia is
Cancer or WBC - can be myeloid or lymphoid
37
How does a leukaemia clone arise ?
Leukaemic cells from in bone marrow and replace normal haemopoietic stem cells - can overspill into blood 🩸 Spontaneous mutations or exposure to mutagenic agents in oncogenes and tumour suppressor genes 🧬 Mutated cell has survival and growth advantage so replaces normal cell by clone 🧫
38
What issues can an leukaemic clone cause 🧫
Clones don’t require usual growth factors Proliferation and maturation disturbance Faliure of apoptosis
39
What type of cancer is leukaemia
Acute / chronic - depending on nature of mutation As cells circulate in blood stream and migrate into tissues
40
4 types of leukaemia 🩸🧫
Acute lymphoblastic Acute myeloid Chronic lymphocytic ( Chronic myeloid )
41
Changes to cells in acute lymphoblastic leukaemia
Large High nucleus to cytoplasm ratio
42
Blast means
Immature cells
43
Cystic means
Mature cells
44
In chronic myeloid leukaemia (CML)
Increase in granulocytes and their precursors in blood and bone marrow
45
Causes of CML
Translocation between (ABL1) gene on chr 9 (encoded tyrosine kinase enzyme) (BCR) gene on chr22 causing chr 22 to have BCR-ABL1 (now called Philadelphia 🥯🧀 chromosome Ph) which causes uncontrolled tyrosine activity giving rise to a leukaemic clone
46
Causes of CLL
47
Causes of CLL
pluripotent HSC turns into Bcell progenitor in bone marrow due to common lymphoid progenitor causing chronic lymphocytic leukaemia (long period of time)
48
Characteristics of CLL on blood film
smudge / smear lymphocytes
49
what is the most common cause of leukaemia in elderly people
CLL
50
What is CLL staged according to
degree of lymph node/ liver/spleen involvement and if Hb and platelet count is reduced
51
What is the most common cause of leukaemia in children
ALL
52
Cause of Acute lymphoblastic leukaemia
Pluripotent HSC changed into B cell acute lymphoblastic leukaemia (via common lymphoid progenitor) progenitor cell picks up mutations (esp. in genes for TF) cells unable to mature, but still proliferate, leading to lots of blast cells rapidly
53
What happens as there is a large number of B cell acute lymphoblastic leukaemia
Bone marrow inflitrated with lymphoblasts resulting in impaired haemopoiesis - only lymphoblasts in circulation
54
effects of ALL
leukocytosis of lymphoblasts leading to : neutropenia thrombocytopenia anaema
55
Clinical signs of ALL
prominent bruising due to thrombocytopenia pale skin due to anaemia
56
Treatment for ALL
supportive therapy - red cell / platelet transfusion, antibiotics systemic chemotherapy - through body intrathecal chemotherapy - through spine (sanctuary site for lymphoblasts)
57
Clinical features of leukaemia due to accumulation of abnormal cells
leukocytosis bone pain - acute leukaemia hepatomegaly splenomegaly lymphadenopathy - if lymphoid thymic enlargement if T lymphoid skin infiltration
58
clinical features of leukaemia due to metabolic effects of leukaemic cell proliferation
Hyperuricaemia and renal faliure weight loss low grade fever sweating
59
Clinical features of leukaemia due to crowding out of normal haemopoises
fatigue, lethargy, pallor, breathlessness (anaemia) fever + features of infection (neutropenia) bruising, petechiae, bleeding (thrombocytopenia)
60
Clinical fetaures of leaukemia due to loss of normal immune function
Loss of normal T and B cell function - feature of chronic lymphocytic leukaemia
61
Neutropenia is
low neutrophil count
62
What are individuals with neutropenia at risk of
v low count below 0.5 x10^9 / L risk of serious infection urgent need for Iv Abx
63
what can result in neutropenia
-supressed bone marrow activity after chemo/radiotherapy - Autoimmune disorders -physiological effects e.g benign ethnic neutropenia in african heritage
64
Lymphopenia is
too few lymphocytes (below 1x10 L)
65
what cells are lymphocytes in normal blood
CD4+ T cells
66
Causes of lymphopenia
HIV Infection Chemo / Radiotherapy corticosteroids severe infection (transient)
67
Neutrophil hypersegmentation
neutrophil has more than 3-5 lobes (normal) - right shift - results from lack of B12/folic acid (megaloblastic anaemia)

POM 3: Haematology (3 decks)

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