Quantitative WBC Abnormalities (Part 1)

Question 0

What is the composition of a neutrophils secondary granule?

Answer 0

Leukocyte Alkaline

Question 1

When do primary granules appear?

Answer 1

Promyelocyte

Question 2

These things describe what cell?

• dawn of neutrophilia (2’ Granules)
• flattend side of the nucleus
• perinuclear clearing (Hoff area)

Answer 2

myelocyte

Question 3

Dark blue/purple cytoplasmic granules in metamyelocytes, bands, or neutrophils; primary cause is infection

Answer 3

Toxic Granulation

Question 4

Decreased sideroblasts (RBC precursors with iron) are present in patients with what form of anemia?

Answer 4

ACD

Question 5

________ granules that are peroxidase positive are present in toxic granulation

Answer 5

primary

Question 6

CRP and Toxic granulation are considered a marker of _________

Answer 6

inflammation

Question 7

small oval, pale blue inclusions in the peripheral cytoplasm of bands and segs; pushed to the edge; may be in single or in multiples

Answer 7

Doehle Bodies

Question 8

The DOehle Body is made of ______

Answer 8

RNA

Question 9

Doehle body primary cause.

Answer 9

Infection (can also be burns, trauma, pregnancy, etc)

Question 10

absent or decreased number of granules in neutrophils that can be caused naturally

Answer 10

hypogranulation/agranulation

Question 11

this is caused by fusion of cytoplasmic granules with phagosome (infection); a toxic change

Answer 11

Hypogranulation/Agranulation

Question 12

primary cause linked to chromosomal abnormalities in hypogranulation/agranulation

Answer 12

Myelodysplastic Syndrome (MDS)

Question 13

toxic change in the cytoplasm of neutrophils; primarily caused septicemia and bacterial infections; other important causes include prolonged exposure to EDTA and acute alcoholism

Answer 13

Vacuolization/vacuolation

Question 14

what are the 3 comrades often seen together in infections?

Answer 14

Vacuoles, toxic granulation, and Doehle Bodies

Question 15

red staining rods or bodies found in the cytoplasm of malignant immature myeloid cells; found in Faggot cells; bundle of sticks

Answer 15

Auer Rods

Question 16

Auer rods are composed of fused ________ granules

Answer 16

Primary

Question 17

What is the primary cause of Auer Rods?

Answer 17

Acute myeloid Leukemia (AML)

Question 18

inclusions in neutrophils that are morphologically indistinguishable from Doehle bodies; rare autosomal dominant trait

Answer 18

May-Hegglin Anomaly

Question 19

May-Hegglin Anomaly are composed of _______

Answer 19

RNA

Question 20

these are associated with thrombocytopenia and giant platelets

Answer 20

may-hegglin anomaly

Question 21

prominant azurphilic granules, resembles toxic granulation; the granules are fromed by the accumulation of partially degraded mucopolysaccharides in lysosomes

Answer 21

Alder-Reilly Anomaly

Question 22

Alder-Reilly Anomaly is autosomal _________

Answer 22

recessive

Question 23

lysosomal organelles affected; large azurophilic granules; red granules predominant in LYMPHOCYTES; grey/blue seen in neutrophils; causes impaired chemotaxis and defective granulation and abnormal membranes of abnormal lysosomes

Answer 23

Chediak-Higashi Anomaly

Question 24

Chediak-Higashi Anomaly is rare and autosomal ________

Answer 24

recessive

Question 25

anomaly caused by failure of segmentation of granulocyte nuclei; band form with two lobes, dumbbell, bikini top, peanut

Answer 25

Pelger-Huet Anomaly

Question 26

Pelger-Huet Anomaly is autosomal _________; and >______ of neutrophils are affected

Answer 26

dominant; 80%

Question 27

Is heterozygous or homozygous more common in Pelger-Huet Anomaly?

Answer 27

Heterozygous

Question 28

in acquired Pelger-Huet, when less than 50% of neutrophils are affected the most common disease is ________ ________

Answer 28

myelodysplastic syndromes (MDS)

Question 29

greater than 5 lobes in a poly or > or equal to 6 polys with 5 lobes

Answer 29

Hyperseg

Question 30

three different disorders demonstrating hypersegs

Answer 30

Autosomal dominant (no known clinical abnormalities), aquired (megaloblastic anemia with Vit B12 or folate deficiency), autosomal dominant (myelokathexis-with neutropenia and pyknotic/dying cells)

Question 31

in this cell the cytoplasm is basophilic and can be indented by RBCs/ballerina skirt; chromatin is less clumped than normal lymph; normal changes in response to antigenic stimulus

Answer 31

reactive lymphs

Question 32

Most common viral infections that lead to reactive lymphs

Answer 32

Infectious mononucleosis, EBV, and CMV

Question 33

Can confirm mono vs CMV with what test?

Answer 33

Monospot test

Question 34

Infectious mononucleosis primarily infects what kind of cells?

Answer 34

B cells

Question 35

Common age group affected by mono?

Answer 35

age 17-25

Question 36

2 complications of infectious mono

Answer 36

cold agglutinins and hemolytic anemia

Question 37

are granules more common in reactive or normal lymphs?

Answer 37

in reactive lymphs

Question 38

nuclear remnant of lymphocyte; no discernable cytoplasm; also known as a basket cell

Answer 38

Smudge cells

Question 39

What disease is most commonly seen with smudge cells?

Answer 39

Chronic lymphocytic leukemia (CLL)

Question 40

If more than _____% smudge cells are present, what do you do?

Answer 40

10%; remake smear using 1 drop of albumin and 10 drops of blood

Question 41

After remaking smudge cell slide with albumin how do you report it?

Answer 41

Differential is reported from the albumin smear but everything else is reported from the original smear (because you are diluting by 10% when you add ALB); occasional=10% or more than 5 remake this slide

Question 42

degeneration of a cell; may be seen in any nucleated cell as a result of aging and degeneration; nuclear chromatin condenses to a solid or structure-less mass

Answer 42

pyknosis/necrosis

Question 43

how do you report reactive lymps?

Answer 43

count reactive and non-reactive lymphs on separate keys and report % of each; for absolute lymph count, use the TOTAL percentage

Question 44

How do you report Pelger-Huet?

Answer 44

Count as polys and make notation that PH-like cells are present

Question 45

How are Toxic granulation, Dohle bodies, hypersegs, hypo- or agranulation, and Auer rods reported?

Answer 45

reported as present

Question 46

smudge cells and megakaryocytes are not reported in the 100 cell diff but are included in the _____ _______

Answer 46

WBC Estimate

Question 47

Fungus that is prevalent in Ohio and Mississippi River valleys; seen in the cytoplasm of leukocytes

Answer 47

histoplasma capsulatum

Question 48

obligate intracellular gram negative bacteria creates a morulae; usually Zoonotic, but it has been transferred to humans by ticks

Answer 48

anaplasma phagocytophilum

Question 49

filarial nematode that is most common in AFRICA and India

Answer 49

Loa Loa

Question 50

protozoan parasite that is the cause of MALARIA; presents in peripheral blood as rings and as crescent shaped gametocytes

Answer 50

Plasmodium falciparum

Question 51

protozoan blood parasite that appears similar to malaria on a blood smear but crescent gametocytes are absent

Answer 51

Babesia (Babesiosis)

Question 52

linked to African sleeping sickness

Answer 52

Trypanosoma gambiense