5.2 - WBC's Flashcards
Types of White Blood Cells
1) Granulocytes
1. neutrophils - early responders
2. eosinophils - combat parasites
3. basophils - release histamine
2) Agranulocytes
1. Monocytes/macrophages
- monocytes in the blood mature
into macrophages in tissue
2. Lymphocytes
a. T cells
b. B cells
c. Natural killer cells
White Blood Cell Count
Leukocytosis - elevated WBC
- occurs in response to infection and inflammation
Leukopenia - decreased WBC
- caused by bone marrow disorders and chemo/radiation that suppress bone marrow
WBC Differential: Neutrophils
Neutrophilia - increased neutrophils
- neutrophil count can be mature/segmented or immature/bands
- in serious infection, bone marrow is stimulated to release more neutrophils
- the neutrophils that get released are immature, bands
- client with high level of bands = bacterial infection
Neutropenia - decreased neutrophils
- can occur due to SEVERE Bacterial infection or bone marrow suppression
WBC Differential: Lymphocytes
Lymphocytosis - increased lymphocytes
- due to bacterial and viral infections
Lymphocytopenia - low lymphocyte
- increases risk of developing infection
- caused by AIDS, immunosuppresion
WBC Differntial: Abnormal Findings
Eosinophilia - elevated eosinophils
- occurs due to parasitic infections
- involved in allergic reactions
Monocytosis - increased monocytes
- occurs due to having to remove dead tissue
-occurs in crohns and colitis
Conditions Related to Leukocytes
1) Acute Lymphocytic Anemia
2) Chronic Myeloid Leukemia
3) Non-Hodgkins Lyphoma
Leukemias
- cancers that originate in the bone marrow
Acute: fast growing
Chronic: more slow growing
Acute Lymphocytic Anemia
Cause
- genetic and environmental factors
Patho
- lymphoblasts rapidly proliferate and overcrowd the bone marrow
- result = decreased # of healthy blood cells
- the lymphoblasts lose their ability to undergo normal differentiation
Changes
- overcrowded bone marrow
- Philadelphia chromosome: chromosome 9 and 22 exchange parts and shorter chromosome 22 gives cell new instructions to follow
Significance
- anemia (crowds out RBC’S)
- thrombocytopenia (overcrowding limits production of plts)
- swollen lymph nodes
- bone pain
- neutropenia - interferes w production of healthy WBC’s (neutrophils)
Chronic Myeloid Leukemia
Cause
- gene fusion on BRC- ACL = makes tyrosine kinase continuously active = uncontrolled cell proliferation
Patho
- kinase is always turned on = excessive production of myeloid cells
- abnormal cells accumulate in blood; which suppresses normal blood cell production
Changes
- unregulated proliferation of myeloid cells
Significance
Chronic Phase: mild or asymptomatic
Accelerated Phase: symptoms worse, treatment resistance
Blast Crisis: transforms into aggressive leukemia = bone marrow failure
Lymphomas
- cancers that arise in lymphocytes or in lymphatic system: spleen, lymph nodes, thymus, bone marrow
1) Hodgkins
- starts from single lymph node and spreads in orderly fashion
- presence of Reed-steenberg cells (large and abnormal cells)
2) Non-Hodgkins
- can arise from T or B cells
- more common
- spreads in less predictable fashion
Non- Hogdkins Lymphoma
Cause
- over-expression of BCL2 gene - involved in cell survival
- chronic infxns
- immunodeficiency
Patho
- malignant transformation of lymphocytes (B and T cells) that form tumours
Changes
- lymph nodes enlarge (bc of malignant lymphocytes)
- malignant lymphocytes can infiltrate into bone marrow and cause pancytopenia
- extranodal involvement (can affect organs outside of lymphatic system)
Significance
- lymphadenopathy: enlarged lymph nodes
- extra nodal symptoms
- B symptoms: fever, high sweats, weight loss
Indolent: slow growing
Aggressive: grows rapidly
