Exam 4 Flashcards
What are the characteristics of acute leukemia?
progresses rapidly, anemia, thrombocytopenia, mostly immature cells. Can be seen in all ages (most common in children), immature cells in peripheral blood
Chronic leukemia
occurs mostly in adults, progresses slowly, mature cells in peripheral blood
What environmental factors can increase the incidence of leukemia?
chemicals, ionizing radiation, infections or disease processes, genetic factors, hormones
What is the FAB classification?
(French American British) Classifies acute leukemias
What cytochemical stains or cellular contsituents are used to diagnose AML?
Sudan Black B positive, peroxidase positive, LAP decreased, Auer rods may be present
Which leukemia is associated with an increased incidence of bleeding disorders?
APL- Acute Promyelecitic Leukemia due to abnormal granules
What is Naegli’s leukemia and what are its distinguishing characteristics?
AMML- Acute Myelomonocitic Leukemia. Myelomonocyte is the predominant cell. All stages of monocytes and myelocytes are seen.
What cytochemical stains are positive in ALL?
PAS (Periodic Acid-Schiff) and TdT
What cytochemical stains are positive in AMoL?
Non-specific esterase is positive, completely inhibited by fluoride
Peroxidase
What cytochemical stains are positive in AMML
both SE (specific esterase) and non-specific is weakly positive
not completely inhibited by fluoride
Peroxidase
What cytochemical stains are positive Erythroleukemia
PAS
Characterize CML according to the following:
predominant cells seen on a differential, bone marrow cellularity, percentage of blasts, number of eos and basos, frequency of blast crisis
all stages of granulocytes, peak in myelocytes and neutrophils, bone marrow 100%, blasts 10% or less, increased up to 10% eos and basos, 70% blast crisis (usually terminates in blast crisis). Lots of myelocytes, bands and segs
What type of leukemia is most frequently seen in children? In middle age? In older patients?
ALL
CML
CLL
What does the PBS in CLL usually show? The bone marrow?
PBS: small very mature lymphs, smudge cells, increased eos, basos, and all stages of granulocytes
Bone marrow: 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 syndrome
Erythroleukemia usually terminates in?
AML
What are the characteristics of myeloid metaplasia?
tear drop cells- indicates extramedullary hematopoiesis, bizarre platelets, anemia, bone marrow has been replaced by noncellular elements
What are the characteristics of leukemoid reactions?
young white cells shift to the left LAP would be increased Dohle bodies toxic granulation toxic vacuoles
Name several causes of leukopenia
viral infections, severe neutropenia, radiation, certain bacterial infections, immunosuppresses, certain drugs
What is agranulocytosis? What are the WBC, RBC, and platelet counts?
severe reduction in neutrophils with a marked leukopenia
WBC-2000 or less-decreased
platelets-adequate
RBC-normal
What is another name for hairy cell leukemia? What cell type does it involve?
leukemia reticuloendotheliosis
B-cell
Patients with ALL can relapse due to repopulation of the peripheral blood with cells from the?
CSF; spinal fluid
Foam cell
Niemann Pick Disease
Reed-Sternberg Cell
Hodgkin’s Disease
Downey Cell
Infectious mononucleosis
Plasma Cell
multiple myeloma
Philadelphia chromosome
CML; very increased platelets;negative LAP
Rouleauz formation
multiple myeloma
phagocytes with ingested, altered nucleprotein
LE cells (lupus)
leukemoid reaction with increased eos
Hodgkin’s Disease
presence of Auer rods
CML
hyposegmentation of neutrophils
Pelger-Huet
increased basophils
CML, mast cell leukemia, basophilic leukemia
What are the characteristics of Waldenstrom’s macrogloulinemia?
rouleauz, cryoglobulins, plasma cytoid lymph, sed rate greatly increased, IgM
What is the L.E. factor?
anti-nucleoprotein IgG antibody
What portion of the blood specimen Is used to make an L.E. prep?
buffy coat
What test should be done to confirm a diagnosis of SLE?
anti-nuclear antibody (ANA)
Describe the appearance of a atypical lymph
scallops around adjacent RBC
Describe the appearance of an Auer rod
pinkish rod-shaped inclusion usually in blasts (found in CML)
Describe the appearance of Dohle bodies
leukemoid reactions, small blue inclusions in periphery of neutrophil
What abnormalities (other than ATLs) can be found in association with IM?
positive heterophile antibody test- antibodies to Epstein-Barr virus
LAP
differentiate CML neg form from neutrophilic leukemoid positive reaction
Myeloperoxidase
differentiate ALL from AML. AML is positive
PAS
positive in ALL and erythroleikemia
NBT
positive when patient has recent bacterial infection-cells recently phagocytic, used to distinguish bacterial from non bacterial infections
TdT
positive for ALL
enzyme test-deoxynucleotidaltransferase confirms all
Which cells are myeloperoxidase 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 impedence principle of cell counting?
cell interrupts the flow of electrons creating resistence
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 Maxim (and the Mindray BC-3200)?
Which are calculated?
MCV measured directly
Hct is estimated
When using an impedence 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
blasts
ALL
lymphs
CLL
only leukemia with both negative SE and NSE
ALL
greatly increased platelets
CML
Bence-Jones protein
multiple myeloma
