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Diagnostic medicine > CBC WBC > Flashcards

CBC WBC Flashcards

1
Q

WBC abnormalities

A

infection, inflammation, neoplasm, malignancy

drug reactions

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2
Q

what are the two components of the WBC

A

WBC count
The total number of white blood cells (leukocytes)

The Differential
The percentage of each type of leukocyte present in the sample and the Reference ranges for each type

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3
Q

Reference ranges for total WBC count

A

5,000 to 10,000 mm3 adult
6,700 to 17,000 mm3 child greater the 2 years old
9,000 to 30,000 mm3 newborns

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4
Q

newborns and WBC

A

newborns tend to have high WBC counts and they gradually decline to normal ranges over 2 weeks

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5
Q

WBC differentials

A 
Neutrophils				40-85%
Lymphocytes				10-45%
Monocytes				3-15%
Eosinophils				0-7%
Basophils				0-2%
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6
Q

Granulocytes

A

have granules in their cytoplasm & multilobed nuclei
AKA: PMNs
include neutrophils, basophils and eosinophils

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7
Q

eosinophils and basophils are involved in

A

allergic reactions

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8
Q

most common PMN

A

neutrophils

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9
Q

neutrophils are involved in the phagocytosis of

A

bacteria

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10
Q

what are the Nongranulocytes?

A

the lymphocytes and the monocytes

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11
Q

what are the lymphocytes?

A

T and B cells that fight acute viral infections and chronic bacterial infections

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12
Q

monocytes are phagocytic cells that

A

are capable of fighting bacteria like neutrophils do

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13
Q

elevated WBC count

A

typical response to acute bacterial infection is increase of total WBC count with a left shift

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14
Q

what is Leukocytosis?

A

an elevated WBC count

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15
Q

what is the left shift seen in bacterial infection

A

Elevated WBC count due to an increase in neutrophils
Bands enter the circulation when neutrophil production is highly stimulated
Often see a reciprocal decrease in percentage of lymphocytes

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16
Q

Leukemoid Response

A

The development of early neutrophilic cells (metamyelocytes)
Markedly elevated WBC, >50,000/mm3
May initially be confused with leukemia
Associated with infection
Benign, typically resolves as the associated condition resolves

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17
Q

neutrophilia is an

A

Elevated neutrophil count

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18
Q

conditions that cause neutrophilia

A 
bacterial infections 
leukemia 
inflammation 
medication 
stress
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19
Q

medications tha cause neutrophilia

A

steroids, epinephrine

20
Q

neutropenia is

A

decreased neutrophil count

21
Q

conditions that cause neutropenia

A

viral infections, aplastic anemia, overwhelming bacterial infection, drugs

22
Q

example of overwhelming bacteria infection

A

infections in the elderly, the elderly may not be able to generate neutrophilic responses

23
Q

drugs that cause neutropenia

A

Chemotherapeutic

Sulfa, antithyroid meds, phenothiazines

24
Q

chemo drugs and neutropenia

A

may need to hold chemo if neutrophil count is too low

25
Q

lymphocytosis

A

elevated lymphocyte count

26
Q

what causes lymphocytosis

A

viral infections such as mono and viral hepatitis

lymphocytic leukemia

27
Q

Lymphocytopenia

A

decrease lymphocytes count

28
Q

conditions that cause lymphocytopenia

A

corticosteroids, immunodeficiency diseases like late stage HIV
leukemia

29
Q

eosinophilia

A

elevated eosinophil count

30
Q

conditions that cause eosinophilia

A

neoplasm (including leukemia) allergic reactions (drug allergies) and conditions (eczema and atopic conditions)
Addison’s disease
collagen vascular disease (includes autoimmune diseases such as lupus)
parasites
coccidiomycosis

31
Q

eospinopenia

A

decreased eosinophil count

32
Q

conditions that cause eosinopenia

A

corticosteroids

acute stress or inflammatory conditions

33
Q

eosinophils and basophils do not respond to

A

bacterial or viral infections

34
Q

Total neutrophil count is a common and very useful

A

parameter of infection, especially in a bacterial infection

35
Q

the percentage of bands is ____ reliable than a total neutrophil count

A

less

36
Q

if you have an elevated percentage of neutrophils you should think

A

that the patient has an acute bacterial infection

37
Q

serial WBC and differential counts are used for

A

diagnosis and prognosis

help determine if an infection is getting worse or better

38
Q

WBC should be taken in consideration to

A

the clinical picture

39
Q

if WBC is abnormal and clinical picture is benign then check

A

medications

40
Q

history questions for WBC abnormalities

A

Does the patient have an active infection or inflammatory condition?
What medications is the patient taking?
Is the patient pregnant or has she recently delivered?
Has the patient ever been diagnosed with a hematologic disease (e.g. leukemia, myelodysplastic disease, sickle cell disease)?
Has the patient recently had surgery or experienced trauma (incl. an insect or snake bite)?
Has the patient had a splenectomy?
Has the patient recently received a vaccine?
Family history?
Does the patient smoke?

41
Q

Cigarette smoking can cause

A

neutrophilia

42
Q

WBC abnormalities physical exam

A

Fever
Abscess or localized infection (e.g. HEENT)
Hypotension, shock, tachycardia, hypothermia (i.e. overwhelming sepsis)
Signs of pulmonary consolidation or pleural effusion
Urinary symptoms
Abdominal tenderness
Hepatosplenomegaly
Lymphadenopathy
Joint swelling, erythema, tenderness

43
Q

point of WBC abnormalities physical exam

A

looking for source of infection or inflammation

44
Q

Leukemoid reaction blood smear

A

Peripheral blood smear may show metamyelocytes & bands but rarely myeloblasts
Bone marrow shows more cells but is otherwise typical (with a mix of neutrophil precursors in various stages).

45
Q

actue leukemia bone marrow

A

predominance of the most immature elements such as myeloblasts

Diagnostic medicine (9 decks)

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