WBC intro

Question 1

neutrophil percentage and characteristics

Answer 1

• 35-70%
• multi segmented nucleus
• faint granules
• “segs” “PMNs”

Question 2

bands

Answer 2

• 1-5%
• increased in infection
• immature neutrophil with curved but not yet segmented nucleus

Question 3

monocytes

Answer 3

• 4-8%
• act like neutrophils in terms of phagocytosis and microorganism killing
• indented nucleus, cytoplasmic vacuoles

Question 4

eosinophils

Answer 4

• 0-7%
• bilobed nucleus
• red cytoplasmic granules
• in hyper sensitivity reactions

Question 5

basophils

Answer 5

• 1-2%
• polysegmented nucleus
• large purple granules
• releases leukotrienes

Question 6

WBC suffixes

Answer 6

• penia - means too few

- philia or cytosis - too many

Question 7

define leukocytosis and explain use of modifiers

Answer 7

• total WBC count above two standard deviations

- when due to specific cell such as neutrophils, it would be neutrophilic leukocytosis

Question 8

what is a left shift?

Answer 8

• increase in band cells

- also called “bandemia”

Question 9

what is the absolute neutrophil count (ANC)?

Answer 9

ANC = WBC x [(% segs + % bands)/100]

Question 10

circulating vs marginal pool

Answer 10

available neutrophils split approximately in half, one have circulates for 6-8 hours before being cleared or entering tissues, the other half remains on periphery of small blood vessels and “demarginates” in response to stressor

Question 11

neutrophils vs monocytes

Answer 11

• neutrophils dominate in the first 8-24 hours of inflammation, and then monocytes take over, so monocytes play a bigger role in chronic infections

Question 12

cyclic neutropenia

Answer 12

• 21 day cycle of neutropenia with infections recurring
• AD
• ELA2 gene

Question 13

severe congenital neutropenia

Answer 13

• constant neutropenia
• AD
• ELA2 gene

Question 14

Kostmann Syndrome

Answer 14

• Infantile agranulocytosis presenting with multiple severe infections
• AR
• HAX1 gene

Question 15

infections is greatly increased if ANC falls below…

Answer 15

1000 cells/uL

Question 16

what type of infections carry the worst prognosis in neutropenia?

Answer 16

• gram negative infections
• followed by mycoses and fungi
• viruses and parasites are generally not at added risk with isolated neutropenia

Question 17

measure of mild, moderate, severe neutropenia

Answer 17

mild - 1000-1500
moderate - 500-1000
severe - under 500

Question 18

define neutrophilia

Answer 18

counter greater than the upper level of normal, generally greater than 7000

Question 19

hyperimmunoglobulin E syndrome (congenital neutrophil function)

Answer 19

• high IgE and IgD
• dermatitis, mental status, staph, candida, pulm infections
• CHEMOTAXIS

Question 20

leukocyte adhesion deficiency (congenital neutrophil function)

Answer 20

• ADHESION AND ROLLING
• bacterial infections from birth
• neutrophilia but no pus

Question 21

Chediak-Higashi sydrome

Answer 21

• DEGRANULATION
• abnormal granules, slow killing of bacteria
• partial albinism
• giant inclusion bodies

Question 22

chronic granulomatous disease

Answer 22

• MICROBIAL ACTIVITY

Question 23

some causes of acquired neutrophil disfunction

Answer 23

• myelodysplasia
• alcoholism
• metabolic disorders
• HIV infection

Question 24

what is the primary function of the eosinophil?

Answer 24

• kill parasites via phagocytosis

Question 25

definition of eosinophilia

Answer 25

greater than 1500 cells/uL for greater than 6 weeks

Question 26

causes of eosinophilia

Answer 26

secondary - to infection, allergy, asthma, meds etc primary - eosinophilic leukemia, hypereosinophilic syndrome idiopathic - diagnosis of exclusion

Question 27

what is the NAACP mnemonic?

Answer 27

``` causes of eosinophilia Neoplasm Allergies Asthma Collagen vascular diseases Parasites ```

Question 28

monocytes are precursors to.....

Answer 28

macrophages, histiocytes, and dendritic cells

Question 29

normal monocyte count

Answer 29

300-700 cells/uL

Question 30

define lymphopenia

Answer 30

absolute lymphocyte count less than 1000

Question 31

causes of lymphopenia

Answer 31

``` 1 - infection, HIV 2 - congenital - wiscott aldrich 3 - medications such as corticosteroids 4 - lymphomas 5 - nutritional ```

Question 32

define lymphocytosis

Answer 32

absolute lymphocyte count greater than 4000

Question 33

causes of lymphocytosis

Answer 33

- non-malignant - such as viral infections | - malignant - lymphoproliferative disorders

Question 34

what is pancytopenia?

Answer 34

- low WBC but also anemia and thrombocytopenia

Question 35

general causes of pancytopenia

Answer 35

1 - primary bone marrow replacement or failure 2 - secondary bone marrow replacement or failure 3 - ineffective myelopoiesis 4 - hypersplenism