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)
