WBC Part 6

Question 1

in lymphocytosis what would one expect CBC and smear to show

Answer 1

increased lymphocytes

Question 2

Lymphocytosis can be due to what two morphologies

Answer 2

reactive and non-reactive

Question 3

reactive lymphocytosis occurs in what conditions

Answer 3

acute viral illness (EBV, CMV)

drug reactions

Question 4

non-reactive lymphocytosis occurs in what conditions

Answer 4

transient stress (MI, seizure, trauma)
whooping cough (Bordetella pertussis)
persistent polyclonal B-cell lymphocytosis (female smokers)
neoplastic (ALL, CLL)

Question 5

infectious mononucleosis infects where

Answer 5

oropharynx (pharyngitis), tonsils, and adenoids
liver
B cells

Question 6

what kind of lymphocytes are seen in the blood in response to infectious mononucleosis

Answer 6

virus specific CD8+ T cells (Atypical lymphocytes)

Question 7

the mono spot test detects what

Answer 7

IgM antibodies that cross react with sheep or horse red blood cells (heterophile antibodies)

Question 8

what are the normal pools of neutrophils

Answer 8

marrow pool (BM)-75%
marginating pool (blood vessels)- cells adherent to blood vessel walls
circulating pool (blood)- same size as marginating pool

Question 9

demargination of neutrophils occurs after how long and due to what

Answer 9

minutes

due to epinephrine, acute stress, exercise

Question 10

release of neutrophils from marrow pool occurs after how long and due to what

Answer 10

hours

due to steroids, infection/inflammation

Question 11

increased bone marrow production of neutrophils occurs after how long and due to what

Answer 11

days

due to sustained inflammation, G-CSF (secreting tumors or therapy), lithium

Question 12

splenomegaly occurs in mono why?

Answer 12

T-cell hyperplasia in periarterial lymphatic sheath (PALS)

Question 13

what are some toxic changes that occur in neutrophils

Answer 13

toxic granulation
Dohle bodies (endoplasmic reticulum)
Vacuolization of the cytoplasm
Left Shift
LAP Test

Question 14

what is a left shift seen in neutrophils

Answer 14

presence of granulocytic precursors in the blood

Question 15

eosinophilia due to reactive processes occurs in what conditions

Answer 15

allergic response
medication/drug hypersensitivity
connective tissue disease
parasitic infection

Question 16

eosinophilia due to neoplastic processes occurs in what conditions

Answer 16

T-Cell LPD
Hodgkin lymphoma
Hypereosinophilic syndrome
chronic eosinophilic leukemia

Question 17

monocytosis occurs due to what

Answer 17

chronic infection or inflammatory disorders

neoplasms

Question 18

when one notices lymphocytosis in a patient what should one suspect

Answer 18

acute viral states

neoplastic (ALL, CLL)

Question 19

when one notices neutrophilia with left shift what should be suspected

Answer 19

leukemoid reaction (acute bacterial infections)
neoplastic process (CML or other myeloproliferative neoplasm)

Question 20

the characteristics of the neoplasm of abnormal hematopoiesis depend on

Answer 20

the stage at which the cell is when it escaped from normal control
the effect this stage has on differentiation
divisions between entities can sometimes be blurred

Question 21

common myeloid stem cell and common lymphoid stem cells are examples of what kind of stem cells

Answer 21

multipotent stem cells

Question 22

what cells cannot self-renew, but actively differentiate

Answer 22

morphologically recognizable precursors (blasts)

Question 23

Acute Myeloid Leukemia (AML) can be due to what

Answer 23

acquired genetic alteration causing impaired maturation of leukemic cells
mutations of genes involved in signal transaction allow for survival and proliferation of neoplastic clone

Question 24

what acquired genetic alteration causing impaired maturation of leukemic cells are seen in AML

Answer 24

RUNX1, RARA, NPM1

Question 25

what mutations of genes involved in signal transaction allow for survival and proliferation of neoplastic clone in AML

Answer 25

FLT3, JAK2, KIT

Question 26

over 20% blasts in peripheral blood or bone marrow is seen in what

Answer 26

Acute Myeloid Leukemia (AML)

Question 27

myeloblasts are usually characterized by positive cytoplasmic staining for what

Answer 27

myeloperoxidase (MPO)

Question 28

what are Auer Rods

Answer 28

crystal aggregates of MPO (azurophilic granules)

Question 29

Acute Monocytic Leukemia is due to proliferation of what and lacks what

Answer 29

proliferation of monoblasts | usually lack MPO

Question 30

Acute Myeloid Leukemia due to myeloblast proliferation has what morphology

Answer 30

``` Auer rods MPO + CD34+ CD13+ CD33+ NSE- ```

Question 31

Acute Myeloid Leukemia due to monoblast proliferation has what morphology

Answer 31

``` CD11b+ CD14+ HLADR+ NSE + MPO - ```

Question 32

Acute Promyelocytic Leukemia (APL) is characterized by what

Answer 32

t(15;17) which involved retinoid acid receptor (RAR)

Question 33

``` Auer rods MPO + CD34+ CD13+ CD33+ NSE- ```

Answer 33

Acute Myeloid Leukemia due to myeloblast proliferation

Question 34

``` CD11b+ CD14+ HLADR+ NSE + MPO - ```

Answer 34

Acute Monocytic Leukemia | Acute Myeloid Leukemia due to monoblast proliferation

Question 35

Acute Monocytic leukemia tends to infiltrate what part of the body

Answer 35

gums

Question 36

In Acute Promyelocytic Leukemia (APL) what is the chimeric protein and what does it block

Answer 36

PML/RARA | blocks maturation and promyelocytes (blasts) build up

Question 37

how is Acute Promyelocytic Leukemia (APL) treated

Answer 37

all trans retinoic acid (ATRA) which is a vitamin A analog

Question 38

the FAB (French American British) classification of Acute Myeloid Leukemias is based on what

Answer 38

morphology, differentiation, phenotype M0-M7 M3 is Acute Promyelocytic Leukemia (APL)

Question 39

Auer rods are diagnostic for what

Answer 39

Acute Myeloid Leukemia

Question 40

Acute Promyelocytic Leukemia (APL) is associated with what

Answer 40

disseminated intravascular coagulation (DIC) due to release of procoagulants and fibrinolytic by the neoplastic cells

Question 41

t(15;17) is what and associated with what

Answer 41

PML/RARA fusion protein | Acute Promyelocytic Leukemia (APL)

Question 42

AML with myelodysplasia related changes has what kind of prognosis

Answer 42

poor

Question 43

a tissue mass of blasts is known as what

Answer 43

Granulocytic sarcoma