Exam 4 Flashcards
What are the characteristics of acute leukemia?
progresses rapidly, anemia, thrombocytopenia, mostly immature cells
What ages is acute leukemia seen in?
can be seen in all ages, most common in children
What are the characteristics of chronic leukemia?
progresses slowly, mature cells in peripheral blood
What ages is chronic leukemia seen in?
occurs mostly in adults
What environmental factors can increase the incidence of leukemia?
chemicals, ionizing radiation, infections or disease processes, genetic factors, hormones
What does FAB stand for?
French American British
What is FAB classification?
classifies acute leukemias
What cytochemical stains or cellular constituents are used to diagnose AML?
Sudan Black B +, peroxidase +, LAP decreased, Auer rods may be present
Which leukemia is associated with an increased incidence of bleeding disorders?
APL Acute promyelocytic leukemia due to abnormal granules
What is Naegli’s leukemia?
AMML, myelomonocyte is the predominant cells, all stages of monocytes and myelocytes are seen
What does AMML stand for?
acute myelomonocytic leukemia
What cytochemical stains are positive in ALL?
PAS and TDT
What does PAS stand for?
periodic acid-schiff
What cytochemical stains are positive in AMoL?
non-specific esterase, completely inhibited by fluoride, peroxidase
What cytochemical stains are positive in AMML?
both specific esterase and non-specific esterase are weakly positive, not completely inhibited by fluoride, peroxidase
What cytochemical stains are positive in erythroleukemia?
PAS
What are the predominant cells seen on a differential in CML?
all stages of granulocytes, peak in myelocytes and neutrophils
What is the bone marrow cellularity in CML?
bone marrow 100%
What is the percentage of blasts in CML?
10% or less
What is the number of eos and basos in CML?
increased up to 10%
What is the frequency of blast crises found in CML?
70% blast crises, usually terminates in blast crises
What type of leukemia is most frequently seen in children?
ALL
What type of leukemia is most frequently seen in middle age?
CML
What type of leukemia is most frequently seen in older patients?
CLL
What does the PBS in CLL usually show?
small very mature lymphs, smudge cells, increased eos, basos, and all stages of granulocytes
What does the bone marrow in CLL usually show?
sheets of small lymphs will be seen (40-100%)
What leukemia is characterized by “fluffy” undifferentiated cells?
stem cell leukemia
What is another name for erythroleukemia?
DeGuglielmo’s syndrom
What does erythroleukemia usually terminate in?
AML
What are the characteristics of myeloid metaplasia?
tear drop cells, bizarre platelets, anemia, bone marrow has been replaced by noncellular elements
What doe tear drop cells indicate?
extramedullary hematopoiesis
What are the characteristics of leukemia reactions?
young white cells, shift to the left, LAP increased, Döhle bodies, toxic granulation, toxic vacuoles
Name several causes leukopenia.
viral infections, severe neutropenia, radiation, certain bacterial infections, immunosupression, certain drugs
What is agranulocytosis?
severe reduction in neutrophils with marked leukopenia
What is the WBC count in agranulocytosis?
200 or less
What is the RBC count in agranulocytosis?
normal
What is the platelet count in agranulocytosis?
adequate
What is another name for hairy cell leukemia?
leukemia reticuloendotheliosis
What type of cell does hairy cell leukemia involve?
B-cell
Patients with ALL can relapse due to repopulation of the peripheral blood will cells from the blood with the cells from the?
CNS, spinal fluid
With what condone is the foam cell associated?
Niemann Pick Disease
With what condition is Reed-Sternberg cell associated?
Hodgkin’s disease
With what condition is Downey cell associated?
Infections mononucleosis
With what condition is plasma cell associated?
multiple myeloma
What is the WBC abnormality indicated by Bence-Jones Protein?
multiple myeloma
What is the WBC abnormality indicated by increased platelets?
CML
What is the WBC abnormality indicated by Philadelphia chromosome?
CML, very increased platelets, LAP =
What is the WBC abnormality indicated by Rouleaux formation?
multiple myeloma
What is the WBC abnormality indicated by phagocytes with ingested, altered nucleoprotein?
SLE cell (lupus)
What is the WBC abnormality indicated by leukemoid reaction with increased eos?
Hodgkin’s disease
What is the WBC abnormality indicated by negative LAP?
CML
What is the WBC abnormality indicated by presence of Auer rods?
AMML, AMoL, AML, erythroleukemia
What is the WBC abnormality indicated by hypo segmentation of neutrophils?
Pelger-Huet
What is the WBC abnormality indicated by increased basophils?
CML, mast cell leukemia, basophilic leukemia
What are the characteristics of Waldenstrom’s macroglobulinemia?
Rouleaux, cryoglobulins, plasma cytoid lymph, greatly increased sed rate, IgM
What is the L. E. factor?
anti-nucleoprotein IgG antibody
What portion of the blood specimen is used to make and L. E. preparation?
buffy coat
What test should be done to confirm a diagnosis of SLE?
anti-nuclear antibody (ANA)
Describe the appearance of an atypical lymph.
enlarged, looks like monocyte, scallops around adjacent RBC, take shape of surrounding RBCs, looks blue where it touches RBC
Describe the appearance of an Auer rod?
Pinkish rod-shaped inclusion usually in blasts (AML, AMML, AMoL)
Describe the appearance of Döhle bodies
leukemoid reactions, small blue inclusions in periphery of neutrophil
What abnormalities can be found in association with IM?
positive heterophile antibody test, antibodies to Epstein-Barr virus, ATLs
What is the use of LAP?
differentiate CML (=) form from neutrophil leukemoid reactions (+)
What is the use of myeloperoxidase?
differentiate ALL (=) from AML (+)
What is the use of PAS?
positive in ALL and erythroleukemia
What is the use of NBT?
positive when patient has recent bacterial infection; cells recently phagocytic, used to distinguish bacterial from nonbacterial infections
What is the use of TdT?
positive for ALL
What is the enzyme test used in TdT?
deoxynucleotidaltransferase, confirms ALL
Which cells are myeloperoxidiase negative?
lymphocytes and blasts
What is the most common childhood non-Hodgkin’s lymphoma?
Burkitt’s lymphoma
What is the principle of operation of the Hema-Tek slide stainer?
fix, stain, air dry, and rinse
What is the impedance principle of cell counting?
cell interrupts the flow of electrons, creating resistance
What is the principle of flow cytometry?
interruption of a light source as it passes through a flow cell
What RBC parameters are directly measured by the coulter LH (and the Mindray BC-3200)?
MCV, HgB, RBCs, WBCs
What RBC parameters are calculated by the Coulter LH (and the Mindray BC-3200)?
Hct, MCH, MCHC
When using an impedance counter, why is it necessary that the cell counts be corrected for coincidence?
more than one cell can pass through at one time; more than 10,000 WBCs should be corrected