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POM 2 G: HAEMATOLOGY > 2.5 White Blood Cells > Flashcards

2.5 White Blood Cells Flashcards

1
Q

Lineage of granulocytes and monocytes

A

HSC - common myeloid progenitor - myeloblast - granulocytes and monocytes

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2
Q

Granulocytes

A

Neutrophils, basophils, eosinophils

Have granules in their cytoplasm containing agents for their microbicidal function

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3
Q

Growth factors essential to wbc growth and proliferation

A

Myeloid growth factors G-CSF, M-CSF, GM-CSF

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4
Q

G-CSF

A

Granulocyte colony stimulating factor

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5
Q

M-CSF

A

Macrophage colony stimulating factor

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6
Q

GM-CSF

A

Granulocyte macrophage colony stimulating factor

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7
Q

Which stages of granulocyte maturation does cell division occur

A

Myeloblasts, promyelocytes and myelocytes

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8
Q

Which stages of maturation does cell division not occur in

A

Metamyelocytes and band forms

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9
Q

Neutrophil life span

A

7-10 hours

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10
Q

Neutrophil looks

A

Segmented/ lobulated nucleus

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11
Q

Function of the neutrophil

A

Defence against infection by phagocytosis and killing of microorganisms

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12
Q

What might dots in a neutrophil be

A

Bacteria

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13
Q

What is the first step in neutrophil migration to tissues

A

Chemotaxis

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14
Q

Neutrophil tissue migration

A

Adhesion and migration
Rolling
Diapedesis
Migration
Phagocytosis

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15
Q

Eosinophil circulation

A

Less than the neutrophils 7-10 hours

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16
Q

Eosinophil function

A

Defence against parasitic infection (e.g. worms)

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17
Q

Eosinophil appearance

A

Two larger nuclei

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18
Q

Basophil granules

A

Contain stores of histamine and heparin as well as proteolytic enzymes

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19
Q

Basophil function

A

Variety of immune and inflammatory responses

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20
Q

How are mast cells and basophils similar

A

Basophils in circulation mast cells in tissues

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21
Q

Which granulocyte contains heparin and histamines

A

Basophil

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22
Q

What do monocytes differentiate to

A

Macrophage

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23
Q

Monocyte function

A

Phagocytosis of mo, bacteria, fungi
Antigen presentation
Store and release iron

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24
Q

Where do b lymphocytes originate

A

Fetal liver and bone marrow

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25
Q

Development of b lymphocytes includes

A

Ig heavy and light chain gene rearrangement giving surface Ig against many different antigens (Humoral immunity)

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26
Q

Further maturation of b lymphocytes requires

A

Requires exposure to antigens in lymphoid tissue e.g. lymph nodes

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27
Q

Development of t lymphocytes

A

Lymphocyte progenitors migrate from fetal liver to the thymus

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28
Q

Leukocytes

A

White cells

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29
Q

Transient

A

Short term

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30
Q

Persistent

A

Long term

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31
Q

Cause of transient leukocytosis

A

Reactive (secondary)

Bone marrow reacts to external stimulus such as infection, inflammation, infarction

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32
Q

Cause of persistent leukocytosis

A

Primary blood cell disorder

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33
Q

Infarction

A

Tissue death (necrosis) due to inadequate blood supply

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34
Q

Bacterial infection leads to

A

Neutrophillia

Monocytosis

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35
Q

Viral infection leads to

A

Lymphocytosis

36
Q

Parasitic infection leads to

A

Eosinophilia

37
Q

Primary blood cell disorder

A

Persistent leukocytosis where leukocyte count is abnormal due to dna damage affecting haemopoietic precursor cell giving rise to blood cancers

38
Q

Leukocytosis

A

Too many white cells

39
Q

Most abundant leukocyte in the circulation

A

Neutrophils

40
Q

Too many neutrophils

A

Neutrophillia

41
Q

Too many eosinophils

A

Eosinophilia

42
Q

Too many basophils

A

Basophilia

43
Q

Too many lymphocytes

A

Lymphocytosis

44
Q

Too many monocytes

A

Monocytosis

45
Q

Leukopenia

A

Reduction in number of leukocytes

46
Q

Too little neutrophils

A

Neutropenia

47
Q

Too little lymphocytes

A

Lymphopenia

48
Q

Causes of Neutrophillia

A

Infection (bacterial)

Inflammation

Infarction or tissue damage

49
Q

Which normal physiological process is Neutrophillia seen in

A

Pregnancy exercise

50
Q

Why do neutrophils increase during exercise

A

Rapid shift of neutrophils from the marinated pool to circulating pool

51
Q

What other changes can be seen by Neutrophillia

A

Toxic changes and left shift (early myeloid cells)

52
Q

Which primary blood cancer is associated with Neutrophillia, Basophilia and left shift

A

Chronic myeloid leukaemia CML

53
Q

Left shift with neutrophils

A

Increase in non segmented neutrophils in the blood

54
Q

Neutropenia

A

Too little neutrophils

55
Q

Cause of neutropenia

A

Following chemo or radiotherapy

Results of autoimmune disorder

Severe bacterial infections

Viral infections ans drugs

56
Q

Hypersegmented neutrophil

A

Right shifted too many lobes

More than 5

57
Q

Causes of hypersegmented neutrophil

A

Lack of b12 and folic acid (megaloblastic anaemia) [affects dna division]

58
Q

Causes of eosinophilia

A

Allergy or parasitic infection

Asthma eczema drugs. Can occur in CML

59
Q

Causes of Basophilia

A

CML or leukaemias

60
Q

Causes of Monocytosis

A

Chronic infection or inflammation

Some leukaemias

61
Q

Transient Lymphocytosis causes

A

Response to a viral infection

62
Q

Persistent Lymphocytosis cause

A

Lymphoproliferative disorder e.g. CLL

63
Q

Cause of Lymphocytosis in children

A

Whooping cough

64
Q

Lymphopenia definition

A

Defined as total lymphocyte count less than 1x10^9/ l

65
Q

Causes of Lymphopenia

A

HIV

chemo or radiotherapy

Corticosteroids

Severe infection

66
Q

Leukaemia

A

Cancer of the blood

67
Q

Types of leukaemias

A

Myeloid or lymphoid (which progenitor is the mutation in)

68
Q

Why does leukaemia occur?

A

Number of somatic mutations in a primitive cell which has a survival advantage and steadily replaces normal cells

Mutations are in oncogenes and sometimes in tumour suppressor genes

69
Q

How do clones/ mutated cells replace normal cells

A

Failure of apoptosis
Disturbance in proliferation/ maturation
May not require growth factors

70
Q

How is leukaemia classified

A

Acute and chronic (not benign or maligant)

Determined by the nature of the mutation

71
Q

Acute leukaemias

A

Sudden and severe onset

72
Q

Chronic leukaemias

A

Disease and deterioration go on for long periods of time

73
Q

Main types of leukaemia

A

ALL
AML
CLL
CML

74
Q

ALL

A

Acute lymphoblastic leukaemia

Blast = immature cells
Particularly a disease of childhood from mutations in uteri

75
Q

AML

A

Acute myeloid leukaemia

76
Q

CLL

A

Chronic lymphocytic leukaemia

Cystic = mature lymphoid cells
Predominant in elderly

77
Q

CML

A

Chronic myeloid leukaemia

Mature myeloid cells
Activation of signalling pathways by cushion protein BCR-ALB1

78
Q

Clinical features in leukaemia

A

Accumulation of abnormal cells
Crowding out of normal haemopoiesis
Loss of normal immune function
Metabolic effects

79
Q

Accumulation of abnormal cells leads to

A

Leukocytosis
Bone pain
Hepatomegsly
Splenomegaly
Thymidine enlargement
Skin infiltration
Lymphadenopathy

80
Q

Hepatomegaly

A

Enlargement of liver

81
Q

Splenomegaly

A

Enlargement of spleen

82
Q

What is thymic enlargement seen in

A

T lymphoid leukaemia

83
Q

Clinical (metabolic) effects of leukaemic cell proliferation

A

Hyperuricaemia and renal failure
Weight loss
Low grade fever
Swearing

84
Q

Hyperuriciaemia

A

Elevated Uris acid levels

85
Q

Crowding out of normal haemopoiesis causes

A

Anaemia, neutropenia, thrombocytopenia

Fwtigue, lethargy, pallor, breathlessness, fever, bruising, bleeding

POM 2 G: HAEMATOLOGY (8 decks)

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