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Hematology > 2. Normal Leukocytes > Flashcards

2. Normal Leukocytes Flashcards

1
Q

Which cytokines have leukopoietin activities?

A

Interleukins 1-19
GM-CSF
G-CSF
M-CSF

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2
Q

What are the major functions of the leukocytes?

A

Protection against foreign and malignant cells and molecules

Phagocytosis of foreign antigens
Lysis of foreign and infected body cells

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3
Q

What are the overall functions of the immune system?

A 
Encounters - recognition cells
Recognition
Activation
Deployment
Discrimination
Regulation
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4
Q

What are the types of lymphocytes?

A

B lymphocytes
T lymphocytes
Null cells (killer cells, natural killer cells)

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5
Q

What do B lymphocytes and T lymphocytes do?

A

B lymphocytes - humoral immune responses by transformation into plasma cells

T lymphocytes- cellular immune responses, regulation of antibody reactions, help or suppress B lymphs

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6
Q

What are the sites of maturation?

A

Interleukins differentiate into lymphoid stem cells

Stem cells in the thymus differentiate into T lymphs

Stem cells in the bone marrow differentiate into B lymphs

Secondary tissues - lymph nodes, spleen

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7
Q

What are the 3 stages of lymphocyte development?

A

Lymphoblast
Prolymphocyte
Lymphocyte

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8
Q

What does a cell look like in the lymphoblast phase?

A

15-20 micrometers
Nucleus cytoplasm ratio 4:1
Nucleus is round, 1-2 nucleoli, fine chromatin clumping
Cytoplasm has no granules, small, medium blue, may have dark blue border

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9
Q

What does a cell look like in the prolymphocyte stage?

A

15-18 micrometers
3:1 ratio
Nucleus oval to slightly dented, 0-1 nucleoli, slightly dense chromatin clumping
Cytoplasm may have azurophilic granules, small, medium blue with dark rim

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10
Q

What does a lymphocyte look like?

A

6-9 micrometers small, 17-20 micrometers large
3:1 or 2:1
Nucleus oval may have indents, no nucleoli, dense, clumped chromatin
Cytoplasm few granules, light blue

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11
Q

Why are lymphocytes able to be differentiated from monocytes and granulocytes?

A

Cells have specific antigenic receptors on their membranes and in their cytoplasm that can be identified by antibodies

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12
Q

What is the normal range for lymphocytes in adult blood?

A

20-40%

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13
Q

What is leukopoiesis?

A

The production of leukocytes (wbc’s)

Partially in bone marrow, some in lymphatic tissue

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14
Q

What are some differences between monocytes and lymphocytes?

A 
Shape 
Size
Nucleus
Nucleoli
Cytoplasm
Granules
Vacuoles

SEE PAGE 10

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15
Q

What are neutrophils?

A

Most numerous leukocytes circulating in blood (50-70%), High numbers in the bone marrow and blood because it’s lifespan is the shortest

SEE PAGE 11

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16
Q

What is the maturation sequence of the neutrophil?

A 
Myeloblast
Promyelocyte
Myelocyte
Metamyelocyte
Band cell
Segmented neutrophil
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17
Q

What does a myeloblast look like in the neutrophil maturation sequence?

A

Largest size 15-20micrometers
Ratio 7:1, 5:1
Nucleus round/oval, central, light red blue chromatin clumping, 1-3 nucleoli
Cytoplasm no granules, blue

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18
Q

What does a promyeloctye look like in the neutrophil maturation sequence?

A

Size gets bigger 12-24 micrometers
Ratio 5:1, 3:1
Nucleus is round/oval, central, fine chromatin clumping, red-blue, 1-2 nucleoli
Cytoplasm basophilic, azurophilic, non specific granules are present

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19
Q

What does a myelocyte look like in the neutrophil maturation sequence?

A

First time you can differentiate which of the granulocytes the cell is
Size 10-18 micrometers
Ratio 2:1, 1:1
Nucleus oval/round, may have slight indent, usually eccentric, red-blue, chromatin, slight clumping, 0-2 nucleoli

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20
Q

What does a metamyelocyte look like in the neutrophil maturation sequence?

A

Size 10-18 micrometers
Ratio 1:1
Nucleus indented, kidney shaped, central, light blue/purple, basophilic chromatin, clumped, 0 nucleoli

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21
Q

What does a blast look like in the neutrophil maturation sequence?

A

Size 10-16 micrometers
Ratio 1:1, 1:2
Nucleus elongated, horseshoe shaped, purple-red, clumped chromatin, 0 nucleoli
Cytoplasm pink, neutrophilic granules

22
Q

What does a segmented neutrophil look like in the neutrophil maturation sequence?

A

50-70% in pbs,bm
Size 10-16 micrometers
Ratio 1:3
Nucleus 2-5 distinct lobes, central, purple-red, chromatin clumped, no nucleoli
Cytoplasm pink, abundant amount, neutrophilic granules

23
Q

What are the names of the two types of granules that neutrophils can have?

A

Primary (azurophilic or non specific)
- lysozyme, acid phosphatase, elastase

Secondary (specific)
- lysozyme, NADPH oxidase, Lactoferrin, Cytochrome b

24
Q

What is the function of a neutrophil?

A

To locate and destroy pathogenic microorganisms by phagocytosis

One half of neutrophils are circulating and the other are marginating (rolling along the endothelium)
Movement is one way

25
Q

What is the migration sequence of the neutrophil?

A
  1. Margination, adherence and anchoring
  2. Diapedesis
  3. Migration
26
Q

What is margination?

A

Normal

Cells roll along in contact with the endothelial cells, patrolling the inside walls of the vessels

27
Q

What is adherence?

A

Neutrophil flattens against the endothelial wall due to chemicals released during inflammation

Can be irreversible due to anchoring

28
Q

What is diapedesis?

A

Follows anchoring, where neutrophils move through the junctions between endothelial cells in response to chemotaxins, and into the tissues

29
Q

What is migration?

A

Neutrophils respond to the chemotaxins and move towards areas of infection

30
Q

What are chemotaxins?

A

Naturally occurring substances
Released from injured or infected tissues, lymphocytes, leukocytes involved in immune response, and invading organisms.

Neutrophil must have membrane receptors for the chemotatic substance

31
Q

What is involved in the killing cascade (phagocytosis)?

A 
Immune adherence (recognition)
Endocytosis (engulfment)
Lysosome fusion
Killing and digestion 
Exocytosis

Begins when the neutrophil arrives at the site of inflammation

32
Q

What is involved in the recognition/immune adherence stage of phagocytosis?

A

Neutrophil must recognize the foreign antigen that’s causing the infection and bind to it through the process immune adherence, stimulating endocytosis

33
Q

What is endocytosis?

A

The pseudopods of the neutrophil membrane surround the bacterium and form a phagocytic vacuole, called a phagosome, and is engulfed by the neutrophil

34
Q

What is lysosome fusion?

A

Once a phagosome is formed, azurophilic and neutrophilic granules attach to its walls and empty their contents into the vacuole

35
Q

What is the most potent killing device in the neutrophil?

A

The respiratory burst

NADPH Oxidase is activated and reacts to reduce oxygen to superoxide. It is then combined with hydrogen ions by the enzyme superoxide dismutase to produce hydrogen peroxide and oxygen. The enzyme myeloperoxidase uses the peroxide and halide elements to generate highly reactive oxidizing radicals, killing bacteria by peroxidation.

36
Q

What is exocytosis?

A

The dead microorganism is digested by the hydrolytic enzymes from the lysosomes and useful components are absorbed by the neutrophils cytoplasm, waste is ejected from the cell

37
Q

How long does a neutrophil continue to phagocytosing?

A

Will continue until they are degranulated and full of vacuoles, they will then lyse, die, and convert to pus cells. This amplifies the inflammatory response.

A healthy response to a infection will produce 15-30x10^9/L neutrophils

38
Q

What are the stages of monocyte development?

A

Monoblast
Promonocyte
Monocyte

39
Q

What are monocytes?

A

2-9% in peripheral blood
Monocytes in blood are immature cells, once in the tissues the monocytes undergo rapid transformation into macrophages, which produce a lot of lysozymes.

40
Q

What are the functions of macrophages?

A 
Phagocytic response to foreign antigens
Immune recognition
Secretory effector 
Iron metabolism 
Preserve a youthful and healthy population of blood cells
41
Q

What is the macrophages role in the phagocytic response to foreign antigens?

A

Macrophages are responsible for phagocytosis of dead neutrophils and body tissue in acute infections, but predominate in chronic infections where neutrophils are ineffective.
Are activated by cytokines from CD4 T Cells (INF-y), secrete monokines such as interleukin-1 which activates CD4 T cells, stimulates hepatocytes to secrete proteins and GM-CSF production for the inflammatory response.

42
Q

What suppresses activation of microphages?

A

Suppressed by the secretion of prostaglandin E2 (PGE2) from T cells and from the macrophage itself

43
Q

What is the macrophages role in immune recognition?

A

Play a role in recognizing foreign antigens by lymphocytes
Act as APC (antigen presenting cells), in which they bind, engulf, digest and modify the antigen and present it to CD4 and B lymphs for recognition

44
Q

What are the functions of monocyte/macrophage secretions?

A 
Removal of old blood cells
Stimulation of self-defence 
Modulation of immune function
Regulation of hematopoiesis 
Stimulation of inflammatory reactions
Removal of infectious organisms by phagocytosis
45
Q

What are eosinophils?

A

A granulocyte
Eosinophils make up 2-4% of blood, granules are rich in major basic protein, the membrane has large numbers of H1 and H2 histamine receptors and IgE receptors.

46
Q

What is the function of H1 and H2 receptors?

A

H1 receptors tend to produce the symptoms and activate allergic reactions
H2 receptors tend to act as negative feedback and turn the allergic reaction off

47
Q

What is the function of eosinophils?

A

To release their secondary granules to kill parasites and function in instantaneous hypersensitivity reactions in tissues

Show up more in people with allergies

48
Q

What are basophils?

A

A granulocyte, also called mast cells
0-2% in blood
Blood basophils are immature and transform into mast cells in the tissues
Have irregular shaped specific basophilic granules
Granules contain sulphated glycosaminoglycans, histamine, some enzymes, and eosinophil chemotatic factor (ECF-A)
Presence of large numbers of high-affinity IgE-Fc receptors

49
Q

What is the function of a basophil?

A

Are capable of ingesting foreign particles and produce heparin and histamine
Help to initiate immune responses

50
Q

How to eosinophils and basophils work together in immune responses (allergic responses)?

A

Mast cells produce the immediate hypersensitivity reaction and symptoms of anaphylaxis. Eosinophils follow up and suppress, at the appropriate time, what the mast cells have created.

SEE PAGE 31

Hematology (2 decks)

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