Disorders of White Blood Cells Flashcards
How is neutropenia defined?
absolute neutrophil count (ANC) less than 1500 cells/uL
What is the most common cause of neutropenia and how is it diagnosed?
- benign familial neutropenia
- diagnosis of exclusion
What 4 drug classes are known to cause drug-induced agranulocytosis?
- thionamides
- clozapine
- bactrim
- B-lactams
If a hospitalized patient develops an ANC of 0 within days of admission what should you immediately do?
- run the med list
How is neutropenia fever defined?
- fever of > 100.4 F
- ANC <1000
How is neutropenic fever treated? (3 step)
- immediate hospital admission
- infection workup (cultures)
- initiation of broad-spectrum antibiotics
What does the term left shift signify?
increase in the % of bands in peripheral blood
How is a leukemoid reaction diagnosed?
WBC >50,000 that are usually all mature neutrophils
What are the 3 main causes of neutrophilia
- Infection
- corticosteroids
- G-CSF (iatrogenic)
HIV/AIDS may lead to what WBC disorder?
Lymphopenia (Lymphocytopenia)
Infectious mononucleosis is known to cause this WBC disorder.
lymphocytosis
A 18 year old patient presents with a fever and malaise. On physical exam you notice splenomegaly. CBC with diff demonstrates lymphocytosis. What do you think the diagnosis is?
infectious mononucleosis
What are the 5 causes of hypereosinophilia (>1500)? (consider mnemonic NAACP)
- neoplasms (MPNs)
- adrenal insufficiency (Addison’s disease)
- allergy
- collagen vascular diseases
- parasites
Eosinopenia is commonly d/t this.
- corticosteroids use
This is defined as a family of clonal hematopoietic disorders resulting in overproduction of one or more myeloid cell lines.
- Chronic myeloproliferative neoplasms
What is the cause of chronic myelogenous leukemia?
- translocation 9;22 (BCR-ABL) chromosome
“Philadelphia (Ph) chromosome”
What is the treatment for CML?
TKI
Polycythemia Vera is due to a mutation to _____.
Janus Kinase 2 (JAK2)
A patient presents with aquagenic pruritis. On physical exam you notice splenomegaly. CBC lab demonstrates excessive erythropoiesis. What type of chronic myeloproliferative neoplasm do you suspect this patient has?
- Polycythemia vera
If you see elevated Hgb/Hct without any secondary cause, what should you be concerned for?
- Polycythemia vera
What is the best treatment we have for polycythemia vera?
- phlebotomy
This is defined as a clonal disorder of excessive thrombopoiesis only.
- essential thrombocytosis
A 46 year old male presents to a clinic for a regular routine follow up. He is doing well but notes he has occasional unexplained bleeding. CBC with diff demonstrates a platelet count of >450,000. Other values are normal. He does not have any infection, inflammation, or iron deficiency. What are you concerned for?
- essential thrombocytosis
How is essential thrombocytosis treated?
Aspirin and Hydrea (if high risk)
If you notice hepatosplenomegaly on physical exam with an associated leukocytosis with left shift what chronic myeloproliferative neoplasm should you be concerned about?
primary meylofibrosis
What are the 4 chronic myeloproliferative neoplasm diseases?
- polycythemia vera
- essential thrombocytosis
- primary myelofibrosis
- chronic myelogenous leukemia (CML)
Myelophthisic anemia (known for the tear cells) are seen in this chronic myeloproliferative neoplasm disease.
primary myelofibrosis
A patient presents with night sweats and weight loss. Labs demonstrates elevated WBCs with left shift. What chronic myeloproliferative neoplasm is this?
chronic myelogenous leukemia (CML)
