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Hematopathology II Flashcards

White Blood Cells (46 cards)

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1
Q

What does the spleen participate in?

A

Hematologic and immune homeostasis

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2
Q

What cells are in the spleen?

A

Mononuclear phagocytic and lymphoid cells

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3
Q

What is leukopenia?

A

Decrease in circulating WBCs

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4
Q

Leukopenia most commonly involves

A

Neutrophils (neutropenia)

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5
Q

Leukopenia can be from inadequate/ineffective production from

A

Chemo, aplastic anemia or leukemia

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6
Q

Leukopenia can be from accelerated destruction/utilization of neutrophils from

A

Severe infections, immunological attack, enlarged spleen

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7
Q

What is agranulocytosis?

A

Virtual absence of neutrophils (depletion of blood and marrow storage pools)

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8
Q

What is the most common cause of agranulocytosis?

A

Drug toxicity

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9
Q

Agranulocytosis ANC levels

A

<500/uL

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10
Q

What is neutropenia?

A

Absolute neutrophil count <1500 cells/uL

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11
Q

Neutropenia: production defects:

A

Inadequate or ineffective granulopoiesis

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12
Q

Neutropenia: peripheral destruction/utilization:

A

Accelerated removal from the peripheral blood

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13
Q

What are the etiologies of inadequate or ineffective Granulopoiesis?

A
  • Suppression of stem cells: aplastic anemia, infiltrative marrow disorders
  • Suppression of granulocytic precursors: drugs/toxins
  • Ineffective hematopoiesis: Megaloblastic anemia, myelodysplasia
  • Rare congenital conditions (cyclic neutropenia, Kostmann syndrome)
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14
Q

Describe cyclic neutropenia

A
  • Typically 3 weeks cycle of neutropenia
  • Pathogenic ELANE gene mutation, increased neutrophilic apoptosis
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15
Q

Describe Kostmann Syndrome

A

Severe congenital neutropenia- inherited defects; impaired differentiation

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16
Q

How is neutropenia treated?

A

By controlling infection, remove offending drug; G-CSF to stimulate bone marrow production of neutrophils

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17
Q

Serious neutropenia infections are more likely when the neutrophil count falls below

A

500/uL

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18
Q

How is neutrophil removal accelerated from the blood?

A
  • Immunologically mediated: SLE
  • Splenomegaly: sequestration
  • Increased peripheral utilization: overwhelming infections
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19
Q

What is lymphopenia?

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A

Absolute lymphocyte count <1000 cells/uL

20
Q

What is the 2nd most common form of leukopenia?

21
Q

What is a hallmark of advanced HIV?

22
Q

Lymphopenia can be caused by what?

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A
  • Advanced HIV
  • Autoimmune disorders
  • After glucocorticoids or cytotoxic drugs treatment
  • Malnutrition
  • Viral infections
23
Q

What is leukocytosis?

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A

Increased WBC count

24
Q

Describe how increased production in the marrow causes leukocytosis?

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A
  • Chronic infection or inflammation (growth factor dependent)
  • Paraneoplastic (Hodgkin lymphoma, growth factor dependent)
  • Myeloproliferative disorders (Chronic myeloid leukemia, growth factor independent)
25
Describe how increased release from marrow stores causes leukocytosis?
Endotoxemia, infection, hypoxia, glucocorticoids
26
Describe how increased decreased margination causes leukocytosis?
Exercise, catecholamines, glucocorticoids
27
Describe how decreased extravasation into tissues causes leukocytosis?
Glucocorticoids
28
What is neutrophilia?
Absolute neutrophil count >7800 cells/uL
29
What are reactive etiologies of neutrophilia?
- Infections (mostly bacterial) - Medications (GFs, steroids, lithium) - Acute tissue necrosis - Inflammatory disorders - Tumor associates such as paraneoplastic syndrome - Miscellaneous such as psychic and physical stress, exercise, seizures, pain, pregnancy, smoking
30
Leukemoid reaction is associated with what clinical conditions?
Infections (bacterial such as C. diff), medications (G-CSF)
31
What is leukemoid reaction?
WBC count >50,000 cells/uL from causes other than leukemia with the majority of the cells being mature neutrophils with a left shift in maturation (presence of immature neutrophils)
32
What is lymphocytosis?
Absolute lymphocyte count >4000cells/uL in adults
33
What is the etiology of lymphocytosis?
- Infectious: viral (Hep A, cytomegalovirus, EBV, B. pertussis) - Chronic immunological stimulation (TB, brucellosis) - Lymphoproliferative disorders
34
What is the lymphocytic morphology often seen in EBV infections?
Reactive lymphocytes - Increased size, smudgy chromatin, may have nucleoli, abundant pale gray-blue cytoplasm - Ballerina skirt lymphocytes
35
What are ballerina skirt lymphocytes?
Amoeboid cytoplasm that partially surrounds adjacent red cells with a darker staining, furled margin
36
What is the lymphocytic morphology often seen in B. pertussis?
Small mature lymphocytes
37
What is the lymphocytic morphology seen in HIV, rheumatoid arthritis, and large granular lymphocyte leukemia?
Large granular lymphocytes
38
In infectious mononucleosis, what does a monospot test detect?
IgM antibodies (heterophile antibodies)
39
In infectious mononucleosis, the reactive T lymphocytes (CD8 T cells, Downey cells) resemble what?
Monocytes
40
What is monocytosis?
Absolute monocyte count >1000 cells/ul
41
What is the etiology of monocytosis?
- Chronic infectious diseases - Collagen vascular diseases (systemic lupus) - IBD - Bacterial endocarditis, rickettsiosis and malaria - Some myeloid neoplasms
42
What is eosinophilia?
Absolute eosinophil count >500 cells/uL
43
What are the etiologies of eosinophilia?
- Allergic disorders - Collagen vascular disease - Infectious diseases - Drug reactions - Malignancies - Skin diseases (pemphigus, dermatitis herpetiformis) - Addisons dz
44
What is basophilia?
Absolute basophil count >200 cells/uL
45
What are the etiologies of basophilia?
- Asthma and allergic conditions - Often indicated a myeloproliferative neoplasm (such as CML, polycythemia vera) - Chronic inflam diseases (TB, ulcerative colitis, rheumatoid arthritis)
46
Reactive Lymphoid hyperplasia: Antigenic stimulation of lymphoid tissue often results in what?
Lymph node enlargement Can also get lymphadenitis (inflam and infection to lymph node)

Systems 1 (26 decks)

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