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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
Q

Reactive changes to neutrophil morphology in infections is referred to as what?

A

Leukemia reactions

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25
Q

Which cytoplasmic granules are most frequently observed in a leukemoid reaction?

A

Toxic granulation

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26
Q

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?

A

Dhole bodies

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27
Q

What are the 3 changes in the cytoplasm of neutrophil which are part of the leukemoid reaction?

A

Toxic granulation
Dohles bodies
Cytoplasmic vacuolization

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28
Q

An absolute decrease in the number of circulating neutrophils is defined as what?

A

Neutropenia

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29
Q

Neutropenia bacterial infections are usually due to what?

A

S. aureus, S. viridans, and gram negative enteric organisms

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30
Q

What is the major concern with neutropenia bacterial infections?

A

That is will progress to septicemia

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31
Q

Persistent problems of neutropenia are attributed to what?

A

Intrinsic problem in the hematopoietic system

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32
Q

Reduction in circulating neutrophils maybe be caused by what?

A

Increased peripheral destruction
Decreased production
Impaired bone marrow release
Abnormal distribution

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33
Q

Name a type of neutropenia disorder that exhibits an increased destruction or removal of neutrophils

A

Infections or immune disorders

34
Q

Name a maturation defect in neutropenia

A

Megaloblastic anemia

35
Q

Name a neutropenia disorder that exhibits a proliferation defect

A

Aplastic anemia, BM fibrosis, BM replacement disorder

36
Q

Name a pathogenesis of neutropenia that has abnormal distribution

A

Hyperspenism

37
Q

Acquired neutropenia is usually a transient condition caused by factors extrinsic to the bone marrow such as:

A 
Viral infections (most common)
Ingestion of certain medications
Alloantibody or autoantibody activity
38
Q

Name viral infections of acquired neutropenia

A

Influenza A and B, rubella, rubeola, herpes simplex, hepatitis A and Bk, and respiratory syncytial virus (RSV)

39
Q

Qualitative disorders of neutrophilic functions are characterized by what?

A

Bacterial infections that are caused by hereditary abnormalities in function

40
Q

Name functional defects of neutrophils (acquired or inherited)

A

Phagocytize/killing defects
Motility/chemotasis defect
Granule function and structure defects
Adhesion defects

41
Q

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?

A

Chediak-higashi syndrome

42
Q

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

A

Chronic granulomatous disease

43
Q

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?

A

Pelger-huet

44
Q

What are characteristics of the may-Hegglin anomaly?

A

Large blue cytoplasmic inclusions found in neutrophils, eosinophils, basophils, and monocytes.

45
Q

What are some characteristics of Chediak-higashi.?

A

Giant cytoplasmic granules in granulocytes and lymphocytes

46
Q

What lymphocyte functions to release their secondary granules to destroy parasites and function in immediate hypersensitive reactions

A

Eosinophils

47
Q

What is the most common cause of basophilia?

A

Chronic myelogenous leukemia (CML)

48
Q

What lymphocyte functions in phagocytosis and microbial activities, tissue repair, and various other functions in cellular and humoral immunity

A

Monocytes

49
Q

Name the enzymes found in the granules of monocytes

A

Lipzyme
Collagenase
Acid phosohatase
Elastase

50
Q

What is termed to describe transformed or benign lymphocytes , usually less than 10% in normal individuals.

A

Reactive lymphocyte

51
Q

Describe normal lymphocyte morphology

A

Small, high C:N, nucleus is oval, chromatin clumped, cytoplasm is blue

52
Q

Large granular lymphocytes represents what percentage of the mononuclear cells in the peripheral blood

A

10-15%

53
Q

What is the reactive lymphocytes range in size?

A

9-30um

54
Q

What is the most distinguishing feature of reactive lymphocytes?

A

Abundant cytoplasm

55
Q

Infectious mononucleosis is caused by what?

A

Epstein Barr virus

56
Q

What does test is used to measure IgM heterophile antibodies

A

Mono spot test

57
Q

Name some symptoms of IM

A

Soar throat, swollen lymph nodes, fever, excessive fatigue - persists for 2-3 weeks

58
Q

What is the most common cause of heterophile-negative IM?

A

CMV

59
Q

What viruses should you consider when the monospot test is negative?

A

Rubella, HIV, herpesvirus-6, and adenovirus

60
Q

Malignant lymphoid cells are what?

A

Monoclonal

61
Q

What test plays a crucial role in establishing the diagnosis in patients with absolute lymphocytsis?

A

Serological test

62
Q

How will the lymphocytes be characterized if considered malignant

A

By flow cytometetric immunophenotypjc analysis

63
Q

What is the name of the disorder resulting in decreased in T lymphocytes - usually CD4 (helper) T cells

A

Lymphocytopenia

64
Q

The enzyme contents of primary (azurophilic) granules includes:

A

Myeloperoxidase and lysozyme

65
Q

Directional migration towards a gradient stimulated by chemoattractants is referred to as:

A

Chemotaxis

66
Q

The marking of an invading microbe with IgG and complement to facilitate recognition is referred to as:

A

Opsonization

67
Q

What is the correct sequence order for phagocytosis

A

Binding of particle
Ingestion
Fusion of phagolysosome
Release of cytoplasmic granules

68
Q

In oxy-dependent killing, the enzyme responsible for mediating the production of active oxygen metabolizes during the respiratory burst is:

A

NADPH oxidase

69
Q

The 2 most important biochemical products of the respiratory burst that are involved with particle digestion during active phagocytosis are:

A

Superoxidase anion and hydrogen peroxide

70
Q

The morphological characteristics associated with Chediak-Higash syndrome is:

A

Giant lysosomal granules

71
Q

The defect in granulomatous disease is attributed to:

A

Defective bacterial killing

72
Q

Identify the characteristics associated with Chediak-Higashi syndrome

A

Partial albinism
Recurrent infections
Mild bleeding tendencies

73
Q

Pelger-Huët anomaly may be described as

A

Hyposegmentation of the nucleus with the majority of the neutrophils being bilobed or monolobed

74
Q

Reactive lymphocytes may be best distinguished from blasts by the presence of what morphological features

A

Heterogenous cell population

75
Q

What antigen is detectable first by ELISA?

A

EBV-VCA (IgM)

76
Q

The Epstein-Barr virus infects which following cells?

A

B lymphocytes

77
Q

What is the most frequent cause of heterophile (monospot) negative mononucleus like syndrome?

A

CMV

78
Q

What conditions are reactive lymphocytes found in?

A

Infectious mononucleus
CMV infection
Rubella

79
Q

Absolute lymphocytsis is best described as:

A

Greater than 4.0 x 10^9 lymphocytes per liter in an adult

80
Q

Which of the following features are seen in reactive lymphocytsis?

A

Low N:C ratio
Blue cytoplasm
Indented cytoplasmic boarders

81
Q

What clinical manifestation would be expected in infectious mononucleosis

A

Soar throat
Fatigue
Fever

82
Q

What features best differentiates malignant lymphocytes from infectious mononucleosis?

A

Clonality
Monotony
Pattern of lymphadenopathy

83
Q

Which viral agent causes infectious mononucleus?

A

EBV

Hematology (10 decks)

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