Basics Flashcards
There’s an increase in Eosinophils/Basophils immature forms in those specific conditions: (7)
o Bacterial infections o Acute inflammatory diseases o Cancer o Tissue necrosis o Acute transplant rejection o Myeloproliferative diseases o Third trimester of pregnancy
What is Cytopenia? Name the four most common causes?
Reduction in the number of mature blood cells
Caused by:
- Eosinopenia
- Basopenia
- Monocytopenia: rare, often comes with hairy-cell leukemia and aplastic anemia. Consider glucocorticoid therapy
- Lymphopenia: normal process of aging, but indicative of immune deficiency in children
What are lymphocytes
Non-granulocytes responsible for immune response to specific organisms
5 factors influencing complete blood count:
- Activity: increases white blood cells amount
- Stress: increases white blood cells amount
- Altitude: larger and more red blood cells
- Time of day
- Medications
What are T cells? Where are they made?
Matures in the thymus, responsible for cell-mediated immunity via stimulation of B Cells
What are reticulocyte? Erythrocytes?
Erythrocyte = RBC Reticulocyte = young RBC (1-2day old), which we can distinctly stain
What is Microcytosis? What are the three causes?
Microcytosis: smaller RBCs Caused by: - Iron deficiency - Thalassemias (disorders of hemoglobin synthesis) - Lead poisonin
What is special about Pluripotent stem cells?
Becomes the different blood cells
What are the platelets? What do they contain? (2)
Platelets: fragments of bone marrow cells called megakaryocytes
Contains serotonin and thromboxanes for blood clotting
What are neutrophils, and their function?
largest percentage of leukocytes that are stuck to the walls of blood vessels until a treat or corticosteroids is detected and force their release (this is called demargination). Activated function is phagocytosis and activation of bactericidal mechanisms.
What are B cells? Where are they made?
Matures in the bone marrow. Triggers humoral/antibody-mediated immunity. Includes regulator and effector types
“Shift to the left” =?
Increased number of bands and immature neutrophils from the bone marrow
What are the Hematopoetic Stem cells? What do they do and what are the two markers?
o Self-renewal and can become pluripotent stem cells among other things (basis of bone marrow transplant)
o Identified by cell markers CD34 and Sca-1
What is:
- stimulated by thrombopoietin (TPO)
- Produced in liver
- Requires megakaryocytic growth factor
Platelets
What is Basophilia?
Most common cause of elevated WBC count: High Basophils count
What are dendritic cells? What is their function?
Watcher cells, really. Activated function is antigen uptake in peripheral site
“Shift to the right” =?
Increased neutrophil counts without the immature cells
What are Segmented Neutrophils?
Oldest neutrophils, with segmented nucleus lobes
What are Macrocytosis? What are the four causes?
Macrocytosis: larger RBCs Caused by: - Vitamin B12 defficiency - Thyroid disease - Drug and alcohol - Myelodysplasia (disorder of the marrow)
From Proerythroblast to Erythocyte, what are the steps? (6)
Proerythroblast Basophililc Normoblast Polychromatic Normoblast Orthochromatic Normoblast Reticulocyte Erythrocyte
Types of neutrophils? (3)
o Metamyelocyte
o Neutrophil band/stab
o Segmented neutrophil
What is the function of Mast cells?
Function is the release of granules containing histamine and active agents
What is Eosinophilia? By what is it caused?
Increase in eosinophil count
Caused by:
- Parasitic infections (toxoplasmosis, GI parasites)
- Bronchoallergic reactions (asthma, allergic rhinitis, hay fever)
- Hypereosophilic syndrome: rare, can be linked to malignancy
What is Neutropenia? What are the three possible causes?
Low neutrophil count (<2000x10^9/L) that makes the patient vulnerable to infection
Causes:
- Prolonged infections
- Destruction of WBCs (like in the case of chemotherapy)
- Increased splenetic pooling known as “Hypersplenism”
What are Metamyelocytes?
Youngest neutrophils, they are large and round
Anemia in men and women in terms of RBC quantities?
Anemia: fewer normal RBCs or less hemoglobin per RBC
Men: hemoglobin <140g/L
Women: hemoglobin <120g/L
Common sources of error during complete blood count (8)
- Watch out for the relative flags, you can get a flag on a relative count because the amount of cells that is used to compare the relative number of cells of interest is too high
- Watch out for flags on absolute counts: some cells appear bigger for normal reasons (like dividing)
- Hemolysis
- Clot/Clumping: low platelet count
- Disintegration of cells during procurement
- Renal failure: low hemoglobin
- Contamination bacteria/drugs
- Dilution from distal IV lines
What are Monocytes/Macrophages? What is their function?
Monocytes are the largest white blood cells in peripheral blood. They enter tissue and then become macrophages. Activated function is phagocytosis and activation of bactericidal mechanisms. This overall system is called the mononuclear phagocyte system
They are the predominant leukocyte within 48h of an injury
After they engulf, they process an antigen/cell surface marker as they destroy the organism
At what point of neutropenia is there a high risk of gram-negative infection, gram-positive sepsis and fungal infections?
If count if <1x10^9/L
What are the other progenitor cells [not hematopoietic stem cells or pluripotent stem cells] that annot renew themselves infinitely? (4)
o Marrow progenitor cells o Common myeloid progenitor Common megakaryocytic/Erythroid progenitor Common granulocyte/Monocyte progenitor o Common lymphoid progenitor
What are the subtypes of lymphocytes?
T cells
B cells
NK cells
What are Neutrophil band/stab?
Elongated nucleus, presence toxic forms indicates involvement of the bone marrow producing more neutrophils
What is Hematopoiesis? Where does it occur according to age? (4)
Hematopoiesis: formation of blood cellular components
Where does it occur?
- Fetus: yolk sac
- <7 months old: liver and spleen
- >7months old: axial skeleton and distal long bones
- >Puberty: axial skeleton only
What are Eosinophils/Basophils?
Bilobed nucleus, with granules. Function is killing antibody-coated parasites. Throws base at enormous microbes to help its breaking down
What are NK cells? What is their function?
Killers of abnormal cells (like tumor cells or virally infected host cells). Function is the release of lytic granules that kill virus-infected cells
What is Neutrophilia? In what settings does it occur? (4)
Disease caused by acute bacterial infection where neutrophils count rise 4-6h after invasion
Neutrophilia also occur in the setting of:
- Myeloproliferative disorders:
o Polycythemia vera
o Chronic myelocytic leukemia
- Smoking
- Obesity
Lymphocytosis is indicative of what? (3)
- Viral etiology: mononucleosis, cytomegalovirus, measles
- Malignancy
- Leukemia
What are the two types of bone marrow?
- Red/Hematogenous bone marrow: produce lots of blood and blood-forming cells
- Yellow bone marrow: produce blood cells and lots of adipose cells
Causes of anemia? (2) Reticulocyte count can indicate what? (2)
A reticulocyte count should by the starting for anemia assessment:
- Too few reticulocyte impaired production
- Increased reticulocytes accelerated destructions of RBC
Caused by:
- Defects in the red cell cytoskeleton
- Not enough iron (iron is the central component of hemoglobin)
At what point do we reach critical neutropenia?
<500x10^9/L is critical neutropenia
