Module 6: Non-Malignant Leukocyte Disorders

Question 1

Definition and cause of neutrophilia

Answer 1

Neutrophils > 7.5 x 10^9/L

Acute bacterial infection

Question 2

Definition and cause of neutrophilia

Answer 2

Neutrophils > 7.5 x 10^9/L

Acute bacterial infection

Question 3

Definition and cause of lymphocytosis

Answer 3

Lymphocytes > 4.0 x 10^9/L

Acute viral infection

Question 4

Definition and cause of monocytosis

Answer 4

Monocytes >0.8 x 10^9/L

Chronic infection

Question 5

Definition and causes of eosinophilia

Answer 5

> 0.44x 10^9/L

Allergies, parasites, skin diseases

Question 6

Definition and causes of neutropenia (agranulocytosis)

Question 7

Definition and cause of lymphocytosis

Answer 7

Lymphocytes > 4.0 x 10^9/L

Acute viral infection

Question 8

Definition and cause of monocytosis

Answer 8

Monocytes >0.8 x 10^9/L

Chronic infection

Question 9

Definition and causes of eosinophilia

Answer 9

> 0.44x 10^9/L

Allergies, parasites, skin diseases

Question 10

Definition and causes of basophilia

Answer 10

> 0.1 x 10^9/L
Hypersensitivity reactions, colitis, RA, diabetes mellitus
Rare

Question 11

Definition and causes of neutropenia (agranulocytosis)

Question 12

Definition and causes of neutropenia (agranulocytosis)

Question 13

Definition and causes of lymphocytopenia

Question 14

Description and lab findings of Niemann-Pick disease

Answer 14

Enzyme deficiency results in accumulation of sphingomyelin and cholesterol in macrophages
Refractive globules accumulate in cytoplasm of Riemann-Pick in marrow

Question 15

Description and lab findings of Chediak-Higashi syndrome

Answer 15

Defective lysosome membrane fusion proteins result in grossly abnormal granulation
Anemia, abnormal bleeds, endocrine problems, abnormal growth, recurrent infections, die preteens
Characteristic abnormal granulation in granulocytes, lymphs, monocytes in blood and marrow

Question 16

Description and lab findings of Alder-Reilly anomally

Answer 16

Enzyme deficiency results in accumulation of polysaccharides
Mental deficiency and physical deformities
Very prominent and dark azurophil granules

Question 17

Description and lab findings of Pelter-Huet anomaly

Answer 17

Hypo segmentation of neutrophils

Look abnormal, function normal

Question 18

Description and lab findings of May-Hegglin anomaly

Answer 18

Abnormal bleeding
Doyle like bodies in granulocytes, monocytes, and lymphocytes
Thrombocytopenia and giant platelets

Question 19

Description and lab findings of Gaucher’s disease

Answer 19

Enzyme deficiency results in accumulation of glycolipids in macrophages
Big, wrinkled Gaucher cells in bone marrow
Anemia, leukopenia, thrombocytopenia

Question 20

Description and lab findings of Niemann-Pick disease

Answer 20

Enzyme deficiency results in accumulation of sphingomyelin and cholesterol in macrophages
Refractive globules accumulate in cytoplasm of Riemann-Pick in marrow

Question 21

Description and lab findings of Chediak-Higashi syndrome

Answer 21

Defective lysosome membrane fusion proteins result in grossly abnormal granulation
Anemia, abnormal bleeds, endocrine problems, abnormal growth, recurrent infections, die preteens
Characteristic abnormal granulation in granulocytes, lymphs, monocytes in blood and marrow

Question 22

Description and lab findings of Alder-Reilly anomally

Answer 22

Enzyme deficiency results in accumulation of polysaccharides
Mental deficiency and physical deformities
Very prominent and dark azurophil granules

Question 23

Reactive lymphocyte morphology

Answer 23

Nucleus - oval, notched, indented or elongated; may be “soft” and intended by adjacent RBCs
Chromatin - irregular, variable clumping and staining intensity, parachromatin more apparent
Nucleoli - 1 or more may be visible, large
Cytoplasm - Increased volume, irregular staining, edges dark and scalloped
May have vacuoles or azurophilic granules

Question 24

Reactive neutrophil morphology

Answer 24

Basophilic cytoplasm
Toxic granulation
Doyle bodies
Vacuolization
Hyper segmentation

Question 25

Lab findings in infectious mononucleosis

Answer 25

Increased WBC count 20-97% reactive lymphs, usually absolute lymphocytosis RBC normal, spherocytes rare Mild thrombocytopenia in half of cases Slight increase in serum bilirubin and liver enzymes (mild hepatitis due to EBV) Positive slide test

Question 26

Define infectious mononucleosis and name the etiological agent

Answer 26

Acute viral disease with fever, swollen lymph nodes, absolute reactive lymphocytosis, positive slide test Caused by Epstein Barr virus

Question 27

Cause and lab findings of whooping cough

Answer 27

Bordetella pertussis infection High WBC, relative and absolute lymphocytosis RBC and plts normal

Question 28

Cause and lab findings of infectious lymphocytosis

Answer 28

Coxsackie A virus or adenovirus High WBC, relative and absolute normal lymphocytosis Symptoms like mono, but negative slide test

Question 29

Cause and lab findings of rubella

Answer 29

Rubella virus Lymphocytopenia common Relative reactive lymphocytosis

Question 30

Cause and lab findings of lupus erythematosus

Answer 30

Autoimmune disorder of unknown cause Pancytopenia common Indirect fluorescent antibody test for ANA positive