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Hematology > Ch15 White Blood Cell Disorders > Flashcards

Ch15 White Blood Cell Disorders Flashcards

0
Q

What is the first phagocytize cell to mobilize at site of infection?

A

Neutrophil

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1
Q

Which phagocyte is capable of ameboid movement into tissues to engulf and destroy bacteria or fungus?

A

Neutrophil

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2
Q

What are the 2 types of cytoplasmic granules in neutrophils?

A

Primary (azurophilic or non-specific) and secondary (specific)

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3
Q

What does the migration pool of neutrophils do?

A

Cells adhere to the vessel endothelium within the vascular spaces searching for areas of injury or inflammation

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4
Q

What is the function of neutrophils in the circulating pool?

A

Circulate in the blood stream for about 7h, then enter the tissue, and do not return to the blood stream. Live 2-5 days in tissue

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5
Q

What is the main function of a neutrophil?

A

Internalization of microorganism for destruction - referred to as phagocytosis

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6
Q

Name the 3 phases of phagocytosis

A
  1. Migration and diapedesis
  2. Opsonization and recognition
  3. Ingestion, killing, and destruction
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7
Q

Bacteria and sites of inflammation send out signals called what?

A

Chemo attractants

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8
Q

What is the function of a chemoattractant?

A

Change morphology and migration pattern of the neutrophils - they migrate to the area of highest level of chemoattractants

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9
Q

What is the direction of neutrophils migrating to the chemoattractants called?

A

Chemotaxis

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10
Q

In diapedesis the neutrophil does what?

A

Penetrates through narrow junctions between endothelial cells and into the tissues

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11
Q

What facilitates recognition and attachment by marking the organism for ingestion by the neutrophil?

A

Opsonization

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12
Q

How is a bacteria marked for recognition?

A

By circulating immunoglobulin and activated complement components that coat the surface of the bacteria

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13
Q

What is a marked bacteria referred as?

A

Opsonin

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14
Q

Which proteins effectively mark bacteria for recognition and attachment?

A

IgG1, igG3, C3b, C3bi

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15
Q

When does ingestion of opsonized microbe begin?

A

As soon as the membrane surface receptor of the neutrophil and the microbe bind together

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16
Q

What is the effect of the neutrophil cell line not working properly?

A

Recurrent bacterial infections that are resistant to treatment

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17
Q

Decrease or increase in the absolute neutrophil number describes what type of neutrophil if disorder?

A

Neutropenia or neutrophilia (quantitative)

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18
Q

Neutrophil dysfunction resulting in impaired migration or altered bacteriocidal activity describes what neutrophilic disorder?

A

Qualitative

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19
Q

The classic response to infection and inflammatory processes is an increase in the relative number of neutrophils. This is called what?

A

Neutrophilia

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20
Q

What defines an increased number of metamyelocytes and band forms in the circulating pool?

A

The accelerated release from the bone marrow reserve

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21
Q

An increase increase in circulating neutrophils and immaturity is observed in what disorder?

A

Chronic myeloid leukemia and other chronic myeoloproliferative disorders

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22
Q

What stain test would be used to differentiate neutrophilic response to infection from chronic myeloid leukemia (CML)?

A

LAP - leukocyte alkaline phosphate

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23
Q

LAP is increased in ______ and decreased in ______

A

Leukemoid reaction; CML

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24
Reactive changes to neutrophil morphology in infections is referred to as what?
Leukemia reactions
25
Which cytoplasmic granules are most frequently observed in a leukemoid reaction?
Toxic granulation
26
What is the name of the change in the cytoplasm of neutrophil which is observed as pale blue inclusions at the peripheral of the cytoplasm?
Dhole bodies
27
What are the 3 changes in the cytoplasm of neutrophil which are part of the leukemoid reaction?
Toxic granulation Dohles bodies Cytoplasmic vacuolization
28
An absolute decrease in the number of circulating neutrophils is defined as what?
Neutropenia
29
Neutropenia bacterial infections are usually due to what?
S. aureus, S. viridans, and gram negative enteric organisms
30
What is the major concern with neutropenia bacterial infections?
That is will progress to septicemia
31
Persistent problems of neutropenia are attributed to what?
Intrinsic problem in the hematopoietic system
32
Reduction in circulating neutrophils maybe be caused by what?
Increased peripheral destruction Decreased production Impaired bone marrow release Abnormal distribution
33
Name a type of neutropenia disorder that exhibits an increased destruction or removal of neutrophils
Infections or immune disorders
34
Name a maturation defect in neutropenia
Megaloblastic anemia
35
Name a neutropenia disorder that exhibits a proliferation defect
Aplastic anemia, BM fibrosis, BM replacement disorder
36
Name a pathogenesis of neutropenia that has abnormal distribution
Hyperspenism
37
Acquired neutropenia is usually a transient condition caused by factors extrinsic to the bone marrow such as:
``` Viral infections (most common) Ingestion of certain medications Alloantibody or autoantibody activity ```
38
Name viral infections of acquired neutropenia
Influenza A and B, rubella, rubeola, herpes simplex, hepatitis A and Bk, and respiratory syncytial virus (RSV)
39
Qualitative disorders of neutrophilic functions are characterized by what?
Bacterial infections that are caused by hereditary abnormalities in function
40
Name functional defects of neutrophils (acquired or inherited)
Phagocytize/killing defects Motility/chemotasis defect Granule function and structure defects Adhesion defects
41
What syndrome has a rare disorder of neutrophilic function that is characterized by recurrent bacterial infections, partial albinism, and the presence if giant lysosomal granules in nucleated cells?
Chediak-higashi syndrome
42
Name a qualitative disorder of neutropenia that is usually seen in males that can be attributed to the vacuoles not releasing the super oxidase, which should destroy the bacteria
Chronic granulomatous disease
43
A hyposegmentation of the nucleus in which the nucleus is found to be bilobed or to not have a lobulation at all is a characteristic of what anomaly?
Pelger-huet
44
What are characteristics of the may-Hegglin anomaly?
Large blue cytoplasmic inclusions found in neutrophils, eosinophils, basophils, and monocytes.
45
What are some characteristics of Chediak-higashi.?
Giant cytoplasmic granules in granulocytes and lymphocytes
46
What lymphocyte functions to release their secondary granules to destroy parasites and function in immediate hypersensitive reactions
Eosinophils
47
What is the most common cause of basophilia?
Chronic myelogenous leukemia (CML)
48
What lymphocyte functions in phagocytosis and microbial activities, tissue repair, and various other functions in cellular and humoral immunity
Monocytes
49
Name the enzymes found in the granules of monocytes
Lipzyme Collagenase Acid phosohatase Elastase
50
What is termed to describe transformed or benign lymphocytes , usually less than 10% in normal individuals.
Reactive lymphocyte
51
Describe normal lymphocyte morphology
Small, high C:N, nucleus is oval, chromatin clumped, cytoplasm is blue
52
Large granular lymphocytes represents what percentage of the mononuclear cells in the peripheral blood
10-15%
53
What is the reactive lymphocytes range in size?
9-30um
54
What is the most distinguishing feature of reactive lymphocytes?
Abundant cytoplasm
55
Infectious mononucleosis is caused by what?
Epstein Barr virus
56
What does test is used to measure IgM heterophile antibodies
Mono spot test
57
Name some symptoms of IM
Soar throat, swollen lymph nodes, fever, excessive fatigue - persists for 2-3 weeks
58
What is the most common cause of heterophile-negative IM?
CMV
59
What viruses should you consider when the monospot test is negative?
Rubella, HIV, herpesvirus-6, and adenovirus
60
Malignant lymphoid cells are what?
Monoclonal
61
What test plays a crucial role in establishing the diagnosis in patients with absolute lymphocytsis?
Serological test
62
How will the lymphocytes be characterized if considered malignant
By flow cytometetric immunophenotypjc analysis
63
What is the name of the disorder resulting in decreased in T lymphocytes - usually CD4 (helper) T cells
Lymphocytopenia
64
The enzyme contents of primary (azurophilic) granules includes:
Myeloperoxidase and lysozyme
65
Directional migration towards a gradient stimulated by chemoattractants is referred to as:
Chemotaxis
66
The marking of an invading microbe with IgG and complement to facilitate recognition is referred to as:
Opsonization
67
What is the correct sequence order for phagocytosis
Binding of particle Ingestion Fusion of phagolysosome Release of cytoplasmic granules
68
In oxy-dependent killing, the enzyme responsible for mediating the production of active oxygen metabolizes during the respiratory burst is:
NADPH oxidase
69
The 2 most important biochemical products of the respiratory burst that are involved with particle digestion during active phagocytosis are:
Superoxidase anion and hydrogen peroxide
70
The morphological characteristics associated with Chediak-Higash syndrome is:
Giant lysosomal granules
71
The defect in granulomatous disease is attributed to:
Defective bacterial killing
72
Identify the characteristics associated with Chediak-Higashi syndrome
Partial albinism Recurrent infections Mild bleeding tendencies
73
Pelger-Huët anomaly may be described as
Hyposegmentation of the nucleus with the majority of the neutrophils being bilobed or monolobed
74
Reactive lymphocytes may be best distinguished from blasts by the presence of what morphological features
Heterogenous cell population
75
What antigen is detectable first by ELISA?
EBV-VCA (IgM)
76
The Epstein-Barr virus infects which following cells?
B lymphocytes
77
What is the most frequent cause of heterophile (monospot) negative mononucleus like syndrome?
CMV
78
What conditions are reactive lymphocytes found in?
Infectious mononucleus CMV infection Rubella
79
Absolute lymphocytsis is best described as:
Greater than 4.0 x 10^9 lymphocytes per liter in an adult
80
Which of the following features are seen in reactive lymphocytsis?
Low N:C ratio Blue cytoplasm Indented cytoplasmic boarders
81
What clinical manifestation would be expected in infectious mononucleosis
Soar throat Fatigue Fever
82
What features best differentiates malignant lymphocytes from infectious mononucleosis?
Clonality Monotony Pattern of lymphadenopathy
83
Which viral agent causes infectious mononucleus?
EBV

Hematology (10 decks)

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