10 - Benign Leukocyte Disorders

Question 1

eosinophil protein that gives it eosinophilia

Answer 1

major basic protein

Question 2

normal differential of WBCs

Answer 2

neutrophil - 55%
lymphs - 35%
monos - 6%
eos - 3%
basos - 1%

Question 3

leukemoid reaction

Answer 3

reactive inc in WBC count, usually refers to granulocytes

immature forms may appear in peripheral blood

Question 4

causes of neutrophilia

Answer 4

reactive:
infections (bacterial)
inflammation/necrosis
drugs, hormones, toxins (steroids, Cushings)
strong physical/emotional stimuli / trauma

neoplastic: myeloproliferative neoplasms

Question 5

causes of eosinophilia

Answer 5

reactive:
infxn (parasite, fungal)
allergy
drugs
collagen vascular dz
addison's dz

neoplastic:
myeloproliferative neoplasms
some T cell lymphomas/leukemias

Question 6

causes of basophilia

Answer 6

rare - usually myeloproliferative neoplasm like CML

Question 7

causes of monocytosis

Answer 7

reactive - 
neutropenia
collagen vascular dz
immune disorders
infxns (viral, tb, syph, bact endocarditis

neoplastic -
myeloproliferative neoplasms and leukemias

Question 8

causes of lymphocytosis

Answer 8

reactive:
infxns (viral, pertussis, TB, rickettsia)
infectious mononucleosis
autoimmune
drugs

neoplastic - lymphomas/leukemias

Question 9

when does the absolute neutrophil count become alarmingly low

Answer 9

<500 is REALLY bad

Question 10

consequences of neutropenia

Answer 10

inc risk of bacterial/fungal infection (more of a problem with acute drops than chronic process)
ulcerations of oral cavity, skin, GI, GU
sx related to infxn - fever, chills, malaise

Question 11

causes of neutropenia

Answer 11

inherited - congenital, cyclic
reactive-
nutritional deficiencies
drugs
severe infxn
autoimmune

neoplastic: 
acute leukemia
MDS
large granular lymphocyte leukemia
tumor in bone marrow

Question 12

Kostmann syndrome

Answer 12

rare AR disorder

causes agranulocytosis due to mutation in elastase

Question 13

causes of monocytopenia

Answer 13

aplastic anemia

hairy cell leukemia

Question 14

causes of lymphopenia

Answer 14

HIV
immune deficiency
infxns
drugs (immunosuppressants)
autoimmune dz
malnutrition

Question 15

dohle bodies - what are they

Answer 15

round/oval/rod pale gray/blue inclusions in neutrophil

stacks of RER or denatured aggregates of free ribosomes

Question 16

when do you see dohle bodies?

Answer 16

normal pregnancy
infxn
various neoplasms
severe burns
trauma
G-CSF therapy
kwashiorkor

Question 17

toxic granulation - what is it

Answer 17

fine coarse reddish granules in neutrophil

result from altered maturation of granules

Question 18

when do you see toxic granulation

Answer 18

severe infxn
other inflammatory states
pregnancy
trauma
burns
G-CSF therapy

Question 19

when do you see vacuoles in cytoplasm of neutrophils?

Answer 19

septicemia
acute alcohol poisoning
carnitine deficiency
kwashiorkor
*may be artifact of sample hanging out in EDTA too long

Question 20

Pelger Huet anomaly

Answer 20

AD inheritance
hyposegmentation of neutrophil
function is normal usually

Question 21

when do you see hyposegmentation of neutrophils?

Answer 21

inherited - Pelger Huet anomaly
acquired - myelodysplasia and AML
drugs
infxn (mycoplasma, HIV)
rarely in bone marrow transplant pts

Question 22

when do you see hypersegmentation of neutrophils?

Answer 22

most common - megaloblastic myelopoiesis
B12 or folate deficiency
alcoholism
drugs

Question 23

chronic granulomatous disease

Answer 23

rare X linked disorder
defective oxidative burst - cant make H2O2, so catalase pos organisms cant be killed > make granulomas > recurrent abscesses, infections

Question 24

May Hegglin anomaly

Answer 24

AD inheritance
intracytoplasmic inclusions in granulocytes and monocytes (looks like a basophilic shadow)
giant platelets

Question 25

Chediak Higashi Syndrome

Answer 25

AR inheritance
reduced and abnormally large granules - look very unique
partial oculocutaneous albinism
recurrent infections

Question 26

Alder Reilly anomaly

Answer 26

AR inheritance
seen in mucopolysaccharidoses
abnormally coarse azurophilic granules in neutrophils and sometimes lymphs and monos