White Blood Cells

Question 1

What are granulocytes

Answer 1

Neutrophils Basophils Eosinophils All contain granules

Question 2

What are some myeloid growth factors

Answer 2

Granulocyte colony stimulating factor Macrophage colony stimulating factor Granulocyte macrophage colony stimulating factor

Question 3

Granulocyte maturation

Answer 3

Question 4

Facts about the neutrophil

Answer 4

Nucleus is segmented

Survives 7-10 hr in blood

It phagocytoses

Question 5

What is chemotaxis

Answer 5

Migration to tissues

Adhere to vessel lumen

Question 6

How do neutrophils phagocytose

Answer 6

Superoxide dependent

Oxygen independent - antimicrobial enzymes released

Question 7

Facts about eosinophil

Answer 7

Defence against parasitic infection

Less time in circualtion

Phagocytosis

Question 8

Facts about basophil

Answer 8

Granules that contain histamine and heparin

Involved in a variety of immune and inflammatory reponse

Modulates inflammatory responses by releasing heparin and proteases

Question 9

Facts about monocytes

Answer 9

Spend several days in circulation

Phagocytosis

Antigen presentation

Travel to the tissue where they develop into macrophages/histiocytes

Question 10

Facts about macrophages

Answer 10

Phagocytic and scavenging function

Store and release iron

Question 11

Photo of B lymphocytes

Answer 11

Also known as plasma cell

Nucleus towards edge of cell

Question 12

What are NK cells

Answer 12

Can kill tumour cells and virus infected cells

Question 13

Can T and B cells be distinguished

Answer 13

No

Question 14

How to distinguish lymphocytes

Answer 14

Cell markers

Immunoglobins

T cell receptors

Question 15

What is the definition of leukcytosis

Answer 15

Too many white blood cells

Question 16

What is the definition of leukopenia

Answer 16

Reduction in the total number of white cells

Question 17

Facts about neutrophilia

Answer 17

Causes: infection, inflammation and tissue damage, myeloproliferative disorder (chronic myeloid leukemia)

Pregnancy

Exercise

Corticosteroids

Maybe be accompanied by toxic changes (toxic granulation)

May be more precursors in the blood film - left shift (due to increased neutrophil production)

Question 18

What happens when someone has chronic myeloid leukaemia

Answer 18

Increase in all granulocytes

Translocation between chromosomes 9 and 22

Abnormally short chromosome 22

Question 19

What is the genetic background of CML

Answer 19

ABL1 gene normally codes for tyrosine kinase

BCR-ABL1 encodes for a protein with unctrolled tyrosine kinase activity

Question 20

What are the symptoms of CML

Answer 20

Enlarged spleen

Question 21

How can we cure CML

Answer 21

Have specific tyrosine kinase inhibitors

Question 22

Facts of neutropenia

Answer 22

Chemotherapy and radiotherapy (surpress activity of bone marrow)

Autoimmune diseases

Bacterial infections

Viral infections

Drugs - antipsychotic, anticonvulsant, antimalarials

Ethnic background

At risk of series infection

Question 23

What is neutrophil hypersegmentation

Answer 23

Normally 3 to 5 lobes

Increase in neutrophil lobes - right shift

Normally due to lack of vitamin B12 or folic acid

Question 24

Facts about eosinophilia

Answer 24

Due to allergy or parasitic infection

-asthma, eczema, drugs

Blood film show strongyloidasis

Question 25

Facts about basophilia

Answer 25

Usually uncommon Normally due to CML

Question 26

Monocytosis

Answer 26

Causes: infection (long term bacterial) or chronic inflammation

Question 27

Transient leukocytosis

Answer 27

Infection Bacterial: neutrophilia.monocytosis Viral: lymphocytosis Parasitic: eosinophilia

Question 28

Facts about lymphocytosis

Answer 28

Repsonse to viral infection Can result from lymphoproliferative disorder

Question 29

Blood film of whooping cough

Answer 29

Important cause of lymphocytosis in children

Question 30

Blood film of glandular fever

Answer 30

Lymphocyte in middle has basophilic cytoplasm Scalloped margin Hugging of red blood cells

Question 31

Example of chronic lymphocytic leukaemia

Answer 31

Smear or smudge cell

Question 32

Difference between ALL and CLL

Answer 32

Increase in immature cells (lymphoblasts) with failure of those to develop into mature Bone marrow is infiltrated by immature lymphoblast impaired haemopoiesis Overspill into peripheral blood Severe and onset

Question 33

Difference in ALL and CLL (CLL)

Answer 33

Mature although abnormal leukamic cells

Question 34

What happpens in acute lymphoblastic leukima

Answer 34

B cell Progenitors may acquire mutations Leukocytosis Neutropenia Thrombocytopenia (low platelet count) Anemia (normocytic, normochromic)

Question 35

Genes of acut lymphoblastic leukaemia

Answer 35

Cytogenetic/molecular genetic analysis - Hyperdiploidy - good prognosis - Translocation - 4:11 poor prognosis

Question 36

Clinical features of ALL

Answer 36

Bruising due to reduced platelets Pale due to low Hb

Question 37

Treatment of ALL

Answer 37

Red cells Platelets Antibiotics Systemic & intrathecal chemotherapy

Question 38

Facts about lymphopenia

Answer 38

Causes: HIV, chemotherapy, radiotherapy, corticosteroids

Question 39

How to interpret white cells

Answer 39

Is there an abnormality Which cell line Clinical history Clues in blood film