Exam 4 Flashcards by Jim connelly

What are the characteristics of acute leukemia?

progresses rapidly, anemia, thrombocytopenia, mostly immature cells. Can be seen in all ages (most common in children), immature cells in peripheral blood

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Chronic leukemia

occurs mostly in adults, progresses slowly, mature cells in peripheral blood

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What environmental factors can increase the incidence of leukemia?

chemicals, ionizing radiation, infections or disease processes, genetic factors, hormones

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What is the FAB classification?

(French American British) Classifies acute leukemias

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What cytochemical stains or cellular contsituents are used to diagnose AML?

Sudan Black B positive, peroxidase positive, LAP decreased, Auer rods may be present

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Which leukemia is associated with an increased incidence of bleeding disorders?

APL- Acute Promyelecitic Leukemia due to abnormal granules

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What is Naegli’s leukemia and what are its distinguishing characteristics?

AMML- Acute Myelomonocitic Leukemia. Myelomonocyte is the predominant cell. All stages of monocytes and myelocytes are seen.

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What cytochemical stains are positive in ALL?

PAS (Periodic Acid-Schiff) and TdT

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What cytochemical stains are positive in AMoL?

Non-specific esterase is positive, completely inhibited by fluoride
Peroxidase

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What cytochemical stains are positive in AMML

both SE (specific esterase) and non-specific is weakly positive
not completely inhibited by fluoride
Peroxidase

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What cytochemical stains are positive Erythroleukemia

PAS

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Characterize CML according to the following:
predominant cells seen on a differential, bone marrow cellularity, percentage of blasts, number of eos and basos, frequency of blast crisis

all stages of granulocytes, peak in myelocytes and neutrophils, bone marrow 100%, blasts 10% or less, increased up to 10% eos and basos, 70% blast crisis (usually terminates in blast crisis). Lots of myelocytes, bands and segs

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What type of leukemia is most frequently seen in children? In middle age? In older patients?

ALL
CML
CLL

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What does the PBS in CLL usually show? The bone marrow?

PBS: small very mature lymphs, smudge cells, increased eos, basos, and all stages of granulocytes
Bone marrow: sheets of small lymphs will be seen (40-100%)

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What leukemia is characterized by fluffy undifferentiated cells?

stem cell leukemia

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What is another name for erythroleukemia?

DeGuglielmo’s syndrome

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Erythroleukemia usually terminates in?

AML

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What are the characteristics of myeloid metaplasia?

tear drop cells- indicates extramedullary hematopoiesis, bizarre platelets, anemia, bone marrow has been replaced by noncellular elements

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What are the characteristics of leukemoid reactions?

young white cells 
shift to the left
LAP would be increased
Dohle bodies
toxic granulation
toxic vacuoles

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Name several causes of leukopenia

viral infections, severe neutropenia, radiation, certain bacterial infections, immunosuppresses, certain drugs

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What is agranulocytosis? What are the WBC, RBC, and platelet counts?

severe reduction in neutrophils with a marked leukopenia
WBC-2000 or less-decreased
platelets-adequate
RBC-normal

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What is another name for hairy cell leukemia? What cell type does it involve?

leukemia reticuloendotheliosis

B-cell

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Patients with ALL can relapse due to repopulation of the peripheral blood with cells from the?

CSF; spinal fluid

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Foam cell

Niemann Pick Disease

Reed-Sternberg Cell

Hodgkin's Disease

Downey Cell

Infectious mononucleosis

Plasma Cell

multiple myeloma

Philadelphia chromosome

CML; very increased platelets;negative LAP

Rouleauz formation

multiple myeloma

phagocytes with ingested, altered nucleprotein

LE cells (lupus)

leukemoid reaction with increased eos

Hodgkin's Disease

presence of Auer rods

CML

hyposegmentation of neutrophils

Pelger-Huet

increased basophils

CML, mast cell leukemia, basophilic leukemia

What are the characteristics of Waldenstrom's macrogloulinemia?

rouleauz, cryoglobulins, plasma cytoid lymph, sed rate greatly increased, IgM

What is the L.E. factor?

anti-nucleoprotein IgG antibody

What portion of the blood specimen Is used to make an L.E. prep?

buffy coat

What test should be done to confirm a diagnosis of SLE?

anti-nuclear antibody (ANA)

Describe the appearance of a atypical lymph

scallops around adjacent RBC

Describe the appearance of an Auer rod

pinkish rod-shaped inclusion usually in blasts (found in CML)

Describe the appearance of Dohle bodies

leukemoid reactions, small blue inclusions in periphery of neutrophil

What abnormalities (other than ATLs) can be found in association with IM?

positive heterophile antibody test- antibodies to Epstein-Barr virus

LAP

differentiate CML neg form from neutrophilic leukemoid positive reaction

Myeloperoxidase

differentiate ALL from AML. AML is positive

PAS

positive in ALL and erythroleikemia

NBT

positive when patient has recent bacterial infection-cells recently phagocytic, used to distinguish bacterial from non bacterial infections

TdT

positive for ALL | enzyme test-deoxynucleotidaltransferase confirms all

Which cells are myeloperoxidase negative?

lymphocytes and blasts

What is the most common childhood non-Hodgkin's lymphoma?

Burkitt's lymphoma

What is the principle of operation of the Hema-Tek slide stainer?

fix, stain, air dry, and rinse

What is the impedence principle of cell counting?

cell interrupts the flow of electrons creating resistence

The principle of flow cytometry

interruption of a light source as it passes through a flow cell

What RBC parameters are directly measured by the Coulter Maxim (and the Mindray BC-3200)? Which are calculated?

MCV measured directly Hct is estimated

When using an impedence counter, why is it necessary that the cell counts be corrected for coincidence?

more than one cell can pass through at one time; more than 10,000 WBCs should be corrected

blasts

ALL

lymphs

CLL

only leukemia with both negative SE and NSE

ALL

greatly increased platelets

CML

Bence-Jones protein

multiple myeloma