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Lab Diagnosis > WBCs > Flashcards

WBCs Flashcards

0
Q

The basic function of blood leukocytes is as a defense system against infectious foreign invaders and non-infectious challenge. This is divided into two separate, but interconnected events, what are they?

A

–  Phagocytosis

– Development of a specific immune response

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1
Q

What is the basic function of blood leukocytes?

A

A defense system against infectious foreign invaders and non-infectious challenge

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2
Q

Phagocytosis involves which type of WBCs?

A

granulocytes and monocytes

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3
Q

Development of a specific immune response involves which type of WBCs?

A

monocytes (macrophages) and lymphocytes

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4
Q

The vascular system is only a temporary residence for leukocytes. The main function of the vasculature with respect to WBCs is to do what?

A

transport the leukocytes to body tissues

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5
Q

Where is the production site for all hematopoiesis (cells that comprise blood)?

A

Bone Marrow

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6
Q

What are the two types of marrow?

A

red and yellow

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7
Q

Majority of RBCs, WBCs and platelets are formed where?

A

in red marrow

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8
Q

Pluripotent: pluri = more + potential = power, refers to the ability of a cell to do what?

A

become many different types of cells

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9
Q

What are the 2 types of stem cells in bone marrow?

A

– Mesenchymal

– Hematopoietic

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10
Q

Mesenchymal stems cells make up which 3 types of cells?

A
  • connective tissue
  • blood vessels
  • lymphatic tissue
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11
Q

Hematopoietic stem cells make up which 3 types of cells?

A
  • RBCs
  • WBCs
  • platelets
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12
Q

Leukocytes are differentiated from each other by which 2 characteristics?

A
  • nuclear

- cytoplasmic

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13
Q

The granules in eosinophils have affinity for which part of the Wright’s stain, which ultimately stains them which color?

A
  • the acid part

- orange-pink

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14
Q

The granules of basophils have affinity for which part of the stain and what color do they stain?

A
  • the basic part

- bluish-black

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15
Q

The granules of neutrophils have an affinity for which part of the stain and what color do they stain?

A
  • both acid and basic parts

- pinkish-blue

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16
Q

Monocytes are usually large or small? What is the shape of their nucleus?

A
  • large

- horseshoe shaped

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17
Q

T/F: Lymphocytes may be small (non-reactive) with a large nuclear to cytoplasmic ratio or large (reactive) with a smaller nuclear to cytoplasmic ratio.

A

True

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18
Q

The nucleus of a lymphocyte is usually which 2 sizes and shapes?

A
  • round (small lymphs)

- slightly indented (large lymphs)

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19
Q

Leukocytes differentiate into mature cells from what?

A

pluripotential stem cell in the bone marrow

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20
Q

In the general maturation scheme in direction of LESS mature ⇒ MORE mature, what are the first 4 characteristics that apply to WBC (and RBC) development?

A
  • Cytoplasm: More basophilia ⇒ less basophilia
  • Large nucleus ⇒ smaller nucleus
  • Large nucleoli ⇒ Small nucleoli ⇒ then absent
  • Large cell size ⇒ smaller cell size
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21
Q

What is the 5th characteristic of the general maturation scheme for WBC granulocytes only?

A

nucleus large & round ⇒ smaller & segmented

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22
Q

What are the six general stages of maturation following commitment of stem cell in bone marrow:

A
  1. Myeloblast
  2. Promyelocyte
  3. Myelocyte
  4. Metamyelocyte
  5. Band
  6. Segmented cell
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23
Q

What are 2 characteristics of a myeloblast?

A
  • non-granular cytoplasm

- red nucleus

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24
Q

What is a characteristic of a promyelocyte?

A

distinct granules

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25
Q

What is a characteristic of a myelocyte?

A

[cell division possible through this stage] granules differentiate enough to be identified n/e/b

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26
Q

What is a characteristic of a metamyelocyte?

A

slightly indented nucleus

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27
Q

What is a characteristic of a band cell?

A

Indentation > ½ Width hypothetical round nucleus

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28
Q

Which condition would you suspect if you found myeloblasts, promyelocytes, myelocyte, and/or metamyelocytes in a blood smear?

A

blood pathology like leukemia

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29
Q

In the assessment of circulating WBCs, the total white blood cell count (WBC) and differential are measured in an automated counter. WBC reflects what of myeloid and lymphoid cells?

A

the circulating pool

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30
Q

For WBCs, what are numbers for panic low and panic high?

A

Panic Low: less than 500 per mm3

Panic High: greater than 30,000

31
Q

Which group of people has the highest normal WBC rate?

A

Newborns

32
Q

The following conditions are examples of which type of WBC issue?
•  Infections •  Leukemic neoplasia •  Other malignancy •  Trauma, stress, hemorrhage •  Tissue necrosis •  Inflammation •  Dehydration •  Thyroid storm •  Steroid drugs •  Post Splenectomy

A

Leukocytosis

33
Q

The following conditions are examples of which type of WBC issue?

•  Drug toxicity •  Bone marrow depression/ failure •  Severe infections •  Dietary deficiencies •  Marrow aplasia •  Marrow infiltration •  Autoimmune disease •  Hypersplenism •  Chemotherapy

A

Leukopenia

34
Q

An increase or decrease in WBC count may be caused by what?

A

an alteration of all WBC cell lines, but more commonly results from an alteration of only one type of WBC

35
Q

Most variations in the leukocyte count are due to increases or decreases in the number of _________ since by percentage they are the most numerous.

A

neutrophils

36
Q

T/F: Cell structures with basic groups bind the acidic dye & appear blue. Cell structures with acidic groups bind the basic dye & appear various shades of pink or red-orange.

A

FALSE!!! Cell structures with acidic groups bind the basic dye & appear blue. Cell structures with basic groups bind the acidic dye & appear various shades of pink or red-orange.

37
Q

60-30-6-3-0, Never Let Motor Engines Blow is the mneumonic for order what?

A

WBCs to include their percentage ratio of how they present in the blood

38
Q

“Absolute” (ABS) number of cell type is important for determining what?

A

if patient has a sufficient # cells of a specific type

39
Q

What are the most common PMN (polymorphonuclear leukocytes) & are primary defense against microbial invasion?

A

Neutrophils

40
Q

Neutrophils are stored in bone marrow for __-__ days (mature neutrophil reserve). Circulate in blood for about __ hours. And live in tissue for __ more before they apoptose.

A
  • 5-7 days
  • 7 hours
  • 2 hours
41
Q

Which 3 things stimulate neutrophil production leading to increased total WBC count?

A
  • acute bacterial infection
  • inflammation
  • trauma
42
Q

Granules contain what component?

A

leukocyte alkaline phosphatase (LAP)

43
Q

Cytoplasm may show __________ during active phagocytosis.

A

vacuoles

44
Q

Dark purple granules in cytoplasm due to severe infections, burn pts. is referred to as what?

A

Toxic granulation

45
Q

With a shift to the left, increases in band neutrophils in peripheral circulation is a response to which type of infection?

A

bacterial

46
Q

The nucleus of a neutrophil becomes hypersegmented with which types of deficiency?

A
  • vitamin B12

- folic acid

47
Q

Toxic granulation is found in severe inflammatory states. The toxic granules are azurophilic, and is thought to be due to what?

A

impaired cytoplasmic maturation in the effort to rapidly generate large #’s of granulocytes

48
Q

More that 3 cells (per 100) with 5 lobes or one with 6 lobes is evidence of what?

A

hypersegmentation

49
Q

The following characteristics are indicative of what neutrophil condition? •  Acute infection •  Trauma •  Physical/emotional stress •  Inflammatory disorders •  Metabolic disorders •  Myelocytic leukemia •  Cushing’s syndrome

A

Neutrophilia = increase

50
Q

The following characteristics are indicative of what neutrophil condition? •  Overwhelming bacterial infection •  Viral infections •  Aplastic anemia •  Radiation therapy •  Addison’s disease •  Chemotherapy •  Dietary deficiency

A

Neutropenia = decrease

51
Q

What are the 4 proteins in eosinophils that help eliminate parasites:

A
  • peroxidase
  • major basic protein
  • eosinophil cationic protein
  • eosinophil-derived neurotoxin
52
Q

What can suppress eosinophils?

A

increased cortisol levels

53
Q

Increased eosinophils in nasal smear aid in diagnosis of which condition?

A

allergic rhinitis

54
Q

The following conditions are indicative of which eosinophil term? •  Parasitic infections •  Allergic reactions •  Asthma, hay fever •  Hodgkin’s Disease •  Eosinophil Myalgia Syndrome •  Eczema •  Leukemia •  Autoimmune disease •  Ovarian Cancer

A

Eosinophilia (>5%) = increase

55
Q

The following conditions are indicative of which eosinophil term?
•  Cushing Syndrome •  Endogenous or exogenous cortisol excess •  Stress (shock, severe burns, severe infections)

A

Eosinopenia = decrease

56
Q

Which type of cell is similar to mast cells and is capable of phagocytosis of immune complexes?

A

Basophils

57
Q

Basophil granules contain which 3 things?

A
  • heparin
  • histamine
  • serotonin
58
Q

Basophils and mast cells degranulate during _________ reactions, releasing ________ (among other things)…

A
  • allergic

- histamine

59
Q

The following conditions are indicative of which basophil term?
•  Myleoproliferative diseases: Polycythemia •  Granulocytic leukemia •  Chronic Myelocytic Leukemia (CML) •  Hodgkin’s Lymphoma

A

Basophilia >50/mm3 increase

60
Q

The following conditions are indicative of which basophil term?
•  Acute phase of infection •  Hyperthryoidism •  Stress reactions •  Prolonged steroid therapy

A

Basopenia <20/mm3 = decrease

61
Q

What are the 3 types of lymphocytes?

A
  1. T cells: Mature in thymus. Involved in cellular mediated immunity: T-suppressor cells (CD8) T-Helper cells (CD4)
  2. B cells (CD19, CD20): Mature in bone marrow. Participate in humoral immunity, as plasma cells they produce antibodies.
  3. NK -Natural killer cells (CD56, CD57)
62
Q

Which cells arise from the fixed tissue reticulum cell in the bone marrow?

A

Lymphocytes

63
Q

Where do B lymphocytes mature?  T lymphocytes?

A
  • bone marrow

- thymus

64
Q

What are B lymphocytes that are committed to active production of antibodies?

A

Plasma cells

65
Q

Atypical lymphocytes are seen in which type of conditions?

A

some viral infections, e.g. infectious mononucleosis

66
Q

The following conditions are indicative of which lymphocyte term?
•  Viral infections: CMV, HIV •  Some bacterial infections (pertussis,TB) •  Lymphocytic leukemia •  Multiple myeloma (plasma cell proliferation) •  Infectious mononucleosis/EBV •  Infectious hepatitis •  Hypoadrenalism (Addison’s Disease)

A

Lymphocytosis >4000/mm3

67
Q

The following conditions are indicative of which lymphocyte term?
•  Non-lymphocytic leukemia’s (dt relative shift) •  Hodgkin’s Disease •  Sepsis •  Immunodeficiency diseases •  SLE /Lupus •  Drug therapies – adrenocorticosteroids, chemotherapy •  Radiation therapy

A

Lymphopenia

68
Q

Which cells arise in bone marrow from a common progenitor cell with the granulocytes, can be produced rapidly as needed, and spend longer time in circulation?

A

Monocytes

69
Q

T/F: Monocytes function as phagocytes, much the same as neutrophils do by engulfing bacteria and removing necrotic debris from blood

A

True

70
Q

What are 3 classic characteristics of a monocyte?

A
  • large
  • deeply indented nucleus
  • large amount of cytoplasm
71
Q

The following conditions are indicative of which monocyte term?
•  Some viral infections, •  infectious mono=EBV •  Chronic bacterial inf. •  Tuberculosis •  Subacute Bacterial Endocarditis SBE •  Syphilis •  Chronic ulcerative colitis •  Parasites, e.g. malaria •  Monocytic leukemia

A

Monocytosis (>500/mm3) increase

72
Q

The following conditions are indicative of which monocyte term?
•  Prednisone •  HIV •  Hairy Cell Leukemia •  Aplastic Anemia

A

Monocytopenia (<100/mm3) decrease

73
Q

An increased # of WBCs released from bone marrow pool, an increase production from myelocyte stage in bone marrow via cell division, immature cell types are released from bone marrow are indications of what?

A

WBC response to infection

74
Q

Band cells are most common and equal what type of shift?

A

left shift

75
Q

T/F: •  Severe infections may see occasional metamyelocyte

A

True

Lab Diagnosis (6 decks)

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