White cells

Question 1

What type of cell is capable of differentiating into all the different types of circulating blood cell?

Answer 1

The haematopoietic stem cell

Question 2

Are haematopoietic stem cells easy or difficult to distinguish in the bone marrow using light microscopy?

Answer 2

Difficult

Question 3

Where do granulocytes spend most of their time?

Answer 3

In the tissues after they transit in the bloodstream

Question 4

What lineage are granulocytes derived from?

Answer 4

The myeloid series

Question 5

Which cells do granulocytes have a common precursor with?

Answer 5

Monocytes

Question 6

What influences what type of granulocyte a granulocyte precursor will be?

Answer 6

Exterior factors such as cytokines

Question 7

What is the first morphologically discernible member of the myeloid series?

Answer 7

A myeloblast

Question 8

How long does the process of division and maturation from a myeloblast to a mature effector granulocyte take?

Answer 8

6-8 days

Question 9

Which granulocytes can stick to vessel walls? What is this called?

Answer 9

Neutrophils

Marginating

Question 10

What is another name for neutrophils? Why are they sometimes called this?

Answer 10

Polymorphs

They can have different shapes due to different segmentation patterns of their nuclei.

Question 11

What is an excess of neutrophils called?

Answer 11

Neutrophilia or neutrophil leucocytosis

Question 12

How long do neutrophils live?

Answer 12

They transit the bloodstream for 6-10 hours then spend a few days in the tissues before dying.

Question 13

Where is there a pool of nearly mature and mature neutrophils that can be released in times of stress?

Answer 13

The bone marrow

Question 14

What are the principle roles of neutrophils?

Answer 14

Phagocytosis

Chemoattraction for other parts of the immune system

Question 15

What parts of the immune system do neutrophils utilise through their surface receptors?

Answer 15

Complement system and immunoglobulins

Question 16

Compare the granules found in neutrophils to those found in basophils and eosinophils

Answer 16

They are finer and are neutrally staining

Question 17

List 5 things which can cause neutrophilia.

Answer 17

Neoplasia
Tissue necrosis
Inflammation
Bacterial infection
Acute haemorrhage

Question 18

List 6 common causes of eosinophilia

Answer 18

Allergic reactions to drugs
Severe skin conditions e.g. atopic dermatitis
Asthma, atopy
Parasitic infections
Hodgkin’s lymphoma, T cell lymphomas
Pulmonary syndromes (e.g. eosinophilic pneumonia, Churg strauss)

Question 19

When may basophilia be seen?

Answer 19

In polycythaemia rubra vera and chronic myeloid leukaemia

Question 20

Are basophils frequent in the circulation?

Answer 20

No

Question 21

What is the appearance of basophils?

Answer 21

The nucleus is often obscured by blue/black granules

Question 22

What do the granules in basophils contain?

Answer 22

Histamine

Heparin

Question 23

What type of hypersensitivity do basophils mediate? How do they do this?

Answer 23

Type 1 hypersensitivity

IgE receptors on the cell surface allow specific antibody/antigen interactions to cause degranulation

Question 24

Which tissue resident cells are basophils analogous with?

Answer 24

Mast cells

Question 25

Which two types of cells have a role in allergy and parasitic infections?

Answer 25

Eosinophils and basophils

Question 26

What may raised serum levels of mast cells indicate?

Answer 26

Systemic mastocytosis | Recent anaphylactic reaction

Question 27

What is released when a mast cell degranulates?

Answer 27

Tryptase Histamine Heparin

Question 28

What can be measured as a marker of mast cell degranulation/mast cell numbers?

Answer 28

Mast cell tryptase

Question 29

What is the name of malignant proliferation of mast cells?

Answer 29

Systemic mastocytosis

Question 30

What can cause monocytosis?

Answer 30

Chronic bacterial infection Malignancy e.g. chronic myelomonocytic leukaemia connective tissue disease e.g. SLE and RA

Question 31

Which type of white cell may be slightly raised in smokers?

Answer 31

Neutrophils

Question 32

Describe the appearance of monocytes

Answer 32

Large monolobular cells with plentiful cytoplasm | Do not have prominent granular contents but fine granules can be seen

Question 33

What do monocytes differentiate into after leaving the bloodstream?

Answer 33

Macrophages

Question 34

What are the roles of monocytes?

Answer 34

Roles in fighting infection through phagocytosis and antigen processing

Question 35

Where are lymphocytes produced?

Answer 35

The bone marrow

Question 36

Where do lymphocytes develop?

Answer 36

In primary lymphoid organs i.e. the bone marrow and thymus.

Question 37

Where are specific immune responses generated?

Answer 37

Secondary lymphoid organs i.e. lymph nodes, the spleen, mucosal lymphoid tissues of gut and respiratory tract

Question 38

What causes lymphocytosis?

Answer 38

Infection Underlying malignant process Removal of the spleen (hyposplenism)

Question 39

What is infective mononucleosis? Describe the appearance of the T cells What causes this?

Answer 39

Activated T cells responding to EBV infection in B cells They take on a typical morphological appearance with abundant blue cytoplasm that wraps against neighbouring red cells on blood film Typically caused by EBV infection Can also be caused by HIV, CMV, viral hepatitis and toxoplasma