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haem > white cells > Flashcards

white cells Flashcards

1
Q

what cells are derived from common myeloid progenitors?

A

myeloid cells- i.e. not lymphocytes

megakaryocytes, erythrocytes, mast cells, myeloblasts

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2
Q

what do myeloblasts differentiate into?

A

granulocytes

basophils, neutrophils, eosinophils, monocytes

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3
Q

What is a band form?

A

Left shift neutrophil

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4
Q

In which granulocyte progenitors does cell division occur?

A

myeloblasts, promyelocytes, myelocytes

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5
Q

in which granulocytes does cell division not occur

A

metamyelocytes or band forms

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6
Q

what is the main function of the neutrophil?

A

phagocytosis and killing of micro organisms

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7
Q

what is chemotaxis?

A

first step in neutrophil migration to tissues

neutrophils become marginated in the vessel lumen and adhere to the endothelium and migrate into tissues

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8
Q

what happens after cytokine priming to neutrophils?

A

phagocytosis

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9
Q

what is the eosinophil’s main function?

A

defence against parasitic infection, also important in regulation of hypersensitivity reactions (inactivate histamine and leukotrienes released by basophils and mast cells)

they also do all neutrophil functions

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10
Q

what do basophils do?

A

release histamine and leukotrienes in the mediation of immediate-type hypersensitivity reactions when coated with IgE

modulate inflammatory responses by releasing heparin and proteases

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11
Q

what do the granules of a basophil store?

A

histamine, heparin and proteolytic enzymes

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12
Q

what are mast cells?

A

similar to basophils but reside in tissues rather than circulation

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13
Q

what is the monocyte’s function

A

phagocytosis of micro-organisms covered with antibody and complement

phagocytosis of bacteria and fungi (Fc mediated)

antigen presentation to lymphoid and other immune cells

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14
Q

what is another role of macrophages?

A

they can store and release iron

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15
Q

what cells are derived from the common lymphoid progenitor?

A

natural killer cells, small lymphocytes

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16
Q

where do B lymphocytes originate?

A

fetal liver and bone marrow

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17
Q

what does subsequent B cell maturation require?

A

exposure to antigens in lymphoid tissue, eg lymph nodes

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18
Q

where do T lymphocytes come from?

A

migrate from foetal liver to the thymus

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19
Q

what do natural killer (NK) cells do?

A

kill tumour cells and virus infected cells

20
Q

what does transient leukocytosis suggest?

A

Reactive/secondary cause

occurs when normal/healthy bone marrow responds to an external stimulus (e.g. infection/ inflammation/ infarction)

21
Q

what does persistent leukocytosis suggest?

A

Primary blood cell disorder

leukocyte count abnormal due to acquired somatic DNA damage affecting a haematopoietic precursor cell giving rise to blood cancer

22
Q

which cell count does leukocytosis and leukopenia result from usually?

A

changes in the neutrophil count since it is the most abundant leukocyte in circulation

23
Q

causes of neutrophilia

A

infection (usually bacterial), inflammation, infarction or other tissue damage

normal feature in pregnancy, could be seen following exercise and after the administration of corticosteroids

24
Q

what other abnormalities in the blood film could neutrophilia be accompanied by?

A

toxic changes and left shift- early myeloid cells e.g. metamyelocytes being present in the blood

25
Q

what is toxic granulation of neutrophils?

A

heavy, coarse granulation of neutrophils

26
Q

what is CML

A

myeloproliferative disorder

primary blood cancer associated with neutrophilia, basophilia and left shift

27
Q

what is left shift

A

an increase in non-segmented neutrophils/ there are neutrophil precursors in the blood

28
Q

causes of neutropenia

A

chemo/radiotherapy

autoimmune disorders, severe bacterial infections
viral infections, drugs
sometimes could be physiological (e.g. benign ethnic neutropenia in people with African/Afro-Caribbean ancestry)

29
Q

how many lobes should a normal neutrophil nucleus have?

A

3 to 5

30
Q

what is neutrophil hypersegmentation (right shift)
caused by

A

megaloblastic anaemia (vit b12 or folic acid deficiency)

31
Q

what is the usual cause of eosinophilia?

A

allergy/ parasitic infection, asthma, eczema, drugs

can occur in CML and other forms of leukaemia

32
Q

what is the usual cause of basophilia?

A

usually due to leukaemia

33
Q

cause of monocytosis

A

infection (particularly chronic bacterial infection)
chronic inflammation
some times of leukaemia

34
Q

causes of lymphocytosis?

A

response to viral infection (transient)

lymphoproliferative disorder e.g. CLL (persistent)

35
Q

what is the lymphocyte count threshold for lymphopenia?

A

< 1 x 10 ^9 /L

36
Q

important causes of lymphopenia

A

HIV infection
chemotherapy
radiotherapy
corticosteroids

severe infection could develop transient lymphopenia

37
Q

why does leukaemia occur

A

somatic mutations occurring in primitive cell which has a growth/ survival advantage over normal cells

mutations give rise to a clone which replaces normal cells

mutations may mean cell may not require usual growth factors, disturbance in proliferation/maturation, failure of apoptosis

mutations are in oncogenes or tumour suppressor genes

38
Q

ALL characteristics

A

blasts- immature lymphoid cells

progenitors Aquire mutations, usually in genes encoding TFs
affects cells ability to mature but proliferation continues, leads to accumulation of blast cells

usually seen in childhood (results from somatic mutations in utero

39
Q

CLL characteristics

A

mature lymphoid cells

steady expansion of clone cells which are functionally useless
replacement of normal cells by leukaemia clone

usually seen in the elderly

40
Q

AML characteristics

A

myeloid blast cells

41
Q

CML characteristics

A

mature myeloid cells

results from activation of signalling pathways by fusion protein BCR-ABL1

42
Q

clinical features of leukaemia due to accumulation of abnormal cells?

A

leukocytosis
bone pain (if acute)
hepatomegaly
splenomegaly
lymphadenopathy (if lymphoid)
thymic enlargement (if T lymphoid)
skin infiltration

43
Q

metabolic effects of leukaemic cell proliferation

A

hyperuricaemia and renal failure
weight loss
low grade fever
sweating

44
Q

crowing out of normal haemopoiesis

A

fatigue, lethargy, pallor, breathlessness (caused by anaemia)

fever and other features of infection (neutropenia caused)

bruising, petechiae, bleeding (caused by thrombocytopenia)

45
Q

when can a loss of normal immune function be observed in leukaemia?

A

when the patient has CLL

haem (4 decks)

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