Abnormal WBC

Question 1

What is a left shift?

Answer 1

Seeing 5% or more band neutrophils (young neutrophils).

Question 2

When do you typically see a left shift?

Answer 2

Toxic cells (vacules/foamy cytoplasm, basophilic granules, dohle bodies) caused by early release

Question 3

Answer 3

Banded Neutrophil

Question 4

What is a regenerative left shift ?

Answer 4

Number of mature cells is greater or equal to the number of immature cells. This is good because it means that the bone marrow is still producing cells.

Question 5

What is non-regenerative left shift?

Answer 5

Number of mature neutrophils is less than the number of immature cells. Unresponsive Bone Marrow (bone marrow is not refilling the “storage pool”)

Question 6

What is a right shift?

Answer 6

Seeing 5% or more hyper-segmented neutrophils

Question 7

What are some causes of a right shift?

Answer 7

Caused by Vitamin B deficiency and steroids. Blood greater than 12 hours old (EDTA)

Question 8

Answer 8

Hyper-segmented Neutrophil

Question 9

Answer 9

Pyknosis (Pyknotic Cell)

Question 10

Answer 10

Pelger Huet

Question 11

Answer 11

Toxic Neutrophils

Question 12

What causes toxic neutrophils?

Answer 12

Mature fast, early release
Inflammatory Responses

Question 13

Answer 13

Dohle bodies

Question 14

Answer 14

Reactive Lymphocyte

Question 15

Answer 15

Reactive Lymphocyte

Question 16

Answer 16

Neoplastic / Cancer Cells

Question 17

Answer 17

Viral inclusions

Question 18

Answer 18

Smudge Cells/Skip-O-Cytes/basket cell

Question 19

Answer 19

Bacteria in blood smear

Question 20

What causes reactive/atypical lymphocytes?

Answer 20

antigenic stimulation