White Blood Cells

Question 1

Examples of granulocytes

Answer 1

Neutrophils, basophils and eosinophils. They are called granulocytes as they have granules in the cytoplasm that contain substances essential for phagocytosis.

Question 2

What are monocytes

Answer 2

Precursors of tissue macrophages which are derived from myeloid progenitor cells.

Question 3

What is the function of neutrophil granulocytes

Answer 3

Chemotaxis, phagocytosis , killing of phagocytosis bacteria

Question 4

Function of monocytes and macrophages

Answer 4

Chemotaxis , phagocytosis, killing of microbes and antigen presentation

Question 5

Function of eosinophil granulocytes

Answer 5

Chemotaxis, phagocytosis , killing of phagocytosed bacteria, defence against parasitic infection

Question 6

Function of basophils granulocytes

Answer 6

Mediation of immediate-type hypersensitivity and modulation of inflammatory responses by releasing heparin and proteases

Question 7

Function of lymphocytes

Answer 7

Humoral and cellular immunity

Question 8

How does a monocyte form

Answer 8

MSC forms myeloblast which then forms granulocytes and monocytes

Question 9

G-CSF

Answer 9

Granulocyte colony - stimulating factor

Question 10

M-CSF

Answer 10

Macrophages colony stimulating factor

Question 11

GM-CSF

Answer 11

Granulocyte macrophages stimulating factor

Question 12

Normal granulocyte maturation

Answer 12

Myeloblast - promyelocyte-myelocyte- band form- neutrophil . Apart from neutrophil , other cells should only be present in the bone marrow

Question 13

How can you recognise myeloblasts

Answer 13

Large size, open chromatin pattern of nuclei and prominent nucleoli

Question 14

What happens to appearance of granulocytes as they mature

Answer 14

Reduction in cell size and addition of granules that are essential for cell function

Question 15

What is the appearance of a neutrophil

Answer 15

The nucleus of the cell is segmented ( lobulated)

Question 16

How do neutrophils carry out phagocytosis

Answer 16

Become marinated in vessel lumen, adhere to the endothelium and then migrate to the tissues. Follows chemotaxis ( based on toxic acidic substances released by the pathogen) . Kills PHAGOCYTOSED bacteria

Question 17

Appearance of eosinophil

Answer 17

Characterised by bright red colour. Spend less time in circulation than neutrophils ( neutrophils spend 7-10 hrs in circulation )

Question 18

What do the granules of basophils contain

Answer 18

Histamine ( inflammatory response ) and heparin ( anticoagulant)

Question 19

What do monocytes do

Answer 19

Monocytes present antigens to lymphoid cells. Monocytes migrate to tissues where they develop into macrophages ( also known as histocytes) and other specialised cells that have a phagocytic and scavenging function. Macrophages also store and release iron

Question 20

What do lymphocytes differentiate into

Answer 20

T cells, B cells and NK cells

Question 21

Role of B lymphocytes

Answer 21

Mature into plasma cells and produce antibodies

Question 22

How can you distinguish a plasma cell

Answer 22

Their nucleus is towards the edge of the cell

Question 23

What do T lymphocytes do

Answer 23

Involved in cell mediated immunity. t helper cells produce cytokines such as interpherons which then activate macrophage and B cell synthesis

Question 24

What do NK cells do

Answer 24

They are part of innate immune system. They kill tumour cells and virus infected cells

Question 25

What are the diseases , neutrophilia, lymphocytosis , monocytes is , eosinophilia and basophilia example of ?

Answer 25

Leucocytosis ( too many white cells )

Question 26

What is the name given to the condition that results in a reduction of the number of white cells ?

Answer 26

Neutropenia and lymphopenia

Question 27

Causes of neutrophillia

Answer 27

Infection ( particularly bacterial) , inflammation , infarction or other tissue damage, CML, pregnancy and following exercise

Question 28

What is Chronic Myeloid Leukemia ( CML)

Answer 28

Example of a myeloproliferative neoplasm ( where too many rbc or wbc or platelets are made which may cause problems for blood flow). Increase in all granulocytes in blood and bone marrow. Genetic . Gives cell a growth and survival advantage which gives rise to a leukaemic clone.

Question 29

How can CML be treated

Answer 29

Tyrosine kinase inhibitors which inhibits the BCR-ABL1 protein signals between cell surface and nucleus. Disease also results in an enlarged spleen.

Question 30

What is neutropenia

Answer 30

Too few neutrophils

Question 31

What can cause neutropenia

Answer 31

Chemotherapy, radiotherapy, autoimmune diseases ( bacterial, viral and drugs - anticonvulsant antipsychotic and some antimalarials) , African or Afro-Caribbean history.

Question 32

Treatment for neutropenia

Answer 32

Need urgent treat,ent either intravenous antibiotics as they are at high risk of infection.

Question 33

Abnormalities in neutrophils in neutropenia

Answer 33

Normal neutrophils should have 3-5 segments but there is hypersegmentation which is an increase in the number of lobes. This usually results from a lack of vitamin B12 or Folic acid ( cells are able able to grow but unable to divide -megoblastic anaemia)

Question 34

What does left shift mean

Answer 34

Increase in non-segmented neutrophils or that there are neutrophil precursors in blood

Question 35

What is eosinophilia and what causes it

Answer 35

Too many eosinophils. Usually due to allergy or parasitic infection. Can occur in leukemia.

Question 36

What is basophilia and what causes it

Answer 36

Too many basophils and uncommon but mainly due to leukemia or related condition

Question 37

What is lymphocytosis

Answer 37

Too many lymphocytes

Question 38

What causes lymphocytosis

Answer 38

Often as a response to viral infection ( transient) of can result from lymphoproliferative disorders such as lymphomas and chronic lymphocytic leukaemia ( persistent)

Question 39

Give an example of a disease which is an imp cause if lymphocytosis in children

Answer 39

Bordatella pertussis ( whooping cough)

Question 40

What happens to the the lymphocytes during lymphocytosis due to viral infection

Answer 40

Lymphocytes is in the middle and has intensely basophilic cytoplasm Scalloped margins and hugging of surrounding RBC’s

Question 41

What is the most common cause of persistent lymphocytosis in the elderly

Answer 41

Chronic lymphocytic eukaemia

Question 42

What is leukemia

Answer 42

Cancer originating in haemopoietic or lymphoid cells

Question 43

Difference between acute and chronic lymphoid leukaemia

Answer 43

In acute = increase in very immature cells (lymphoblasts) and these do not develop into mature cells Acute are very sudden and severe in onset- If untreated disease is aggressive and patients die quickly In chronic= the leukemic cells are mature although abnormal T cells B cells or NK cells. In both bone marrow is infiltrated with immature lymphoblasts resulting in impaired haemopoiesis , lymphoblasts circulate in peripheral blood

Question 44

What are the haematological features of acute lymphoblastic leukaemia

Answer 44

Leukocytosis with lymphoblasts in blood, anaemia ( normocytic and normochromic) , neutropenia , thrombocytopenia ( low platelet count) , replacement of normal bone marrow cells by lymphoblasts

Question 45

What does thrombocytopenia do

Answer 45

Cause bruising

Question 46

Acute lymphoblastic leukemia treatment

Answer 46

Supportive;red cells, platelets and antibiotics Systemic : chemo Intrathecal chemo

Question 47

What is lymphopenia

Answer 47

Decrease in number of circulating lymphocytes

Question 48

Causes of lymphopenia

Answer 48

HIV, chemo, radiotherapy and corticosteroids

Question 49

What is monocytosis

Answer 49

Too many monocytes

Question 50

Causes of monocytosis

Answer 50

Infection ( chronic bacterial infection ) or chronic inflammation . Some types of leukaemia