HAEM - WBC

Question 1

Origin of blood cells barring the lymphocytes

Answer 1

Common myeloid progenitor -> myeloblast -> forms your granulocytes (basophil/neutrophil/eosinophil) and MONOCYTE (this is what goes on to form your macrophage)

Question 2

What types of cells do myeloblasts give rise to?

Answer 2

Granulocytes (neutrophils/basophils/eosinophils) and monocytes

Question 3

Granulocytes characteristic

Answer 3

They have granules present in the cytoplasm that contains agents essential for their microbicidal (something that kills microbes) function

Question 4

What controls proliferation/survival of myeloid cells?

Answer 4

Myeloid growth factors such as G-CSF/M-CSF and GM-CSF (granulocyte-macrophage colony stimulating factor)

Question 5

Eosinophil staining?

Answer 5

They are that reddish colour - that all arises from the granules in the cell

Question 6

Basophils

Answer 6

Alkali - stain is very dark blue ; can barely see the nucleus

Question 7

Neutrophils

Answer 7

Neutrally charged ; granules are a neutral colour

Question 8

What can the colony stimulating factors be used for?

Answer 8

As drugs (in chemotherapy to recover the immune system for example)

Question 9

Staging process ; normal granulocyte maturation

Answer 9

Myeloblast to promyelocytes into myelocytes to form a band form and neutrophils
Nucleus is lobulated - connected by fine filaments

Question 10

Where does cell division occur in maturation?

Answer 10

Myeloblasts promyelocytes and myelocytes but NOT in metamyelocytes or band forms

Question 11

Normaloblasts?

Answer 11

Erethrocytes

Question 12

Neutrophil role?

Answer 12

survives 7-10 hours in circulation and the nucleus itself is segmented/lobulated ; main function is to phagocytose and kill micro-organisms

Question 13

Neutrophil migration

Answer 13

Chemotaxis ; neutrophils become marginated in the vessel lumen and adhere to the endothelium migrating into tissues ; phagocytosis of micro-organisms occurs following cytokine priming

Question 14

Sequence of events in chemotaxis?

Answer 14

Adhere + margination
Rolling
Diapedesis
Migration
Phagocytosis

Question 15

Eosinophil

Answer 15

Spend less time in circulation than neutrophils ; main function is to defend against parasites

Question 16

Why else are eosinophils important?

Answer 16

Regulation of Type 1 hypersensitivity reactions ; inactive the histamine and leukotrienes released by basophils/mast cells
INCREASE IN MAST CELLS = INCREASE IN EOSINOPHILS = INCREASE IN BASOPHILS

Question 17

Basophils

Answer 17

Granules contain stores of histamine + heparin and proteolytic enzymes ; basic pH ; dark dark blue/purple

Question 18

Mast cells vs basophils

Answer 18

Mast cells are same as basophils but reside in tissue rather than circulation

Question 19

Basophil function

Answer 19

Modulation of inflammatory responses and mediation of immediate-type hypersensitivity reactions

Question 20

Monocytes

Answer 20

Bloodstream equivalent of macrophages ; circulate for time and involved in phagocytosis

Question 21

When monocytes migrate into tissues?

Answer 21

They become macrophages

Question 22

Macrophages are involved in

Answer 22

Storing and releasing iron

Question 23

How long do monocytes stay in circulation for?

Answer 23

Several days in circulation

Question 24

Monocyte functions

Answer 24

Phagocytosis of micro-organisms as well as antigen presentation to lymphoid and other immune cells

Question 25

Plasma cells description

Answer 25

Got this bluish basophilic circumference ; bluish colour is protein (ribosomes which stain bluish colour) ; because these cells are really busy building antigens

Question 26

Normal lymphocyte appearance?

Answer 26

Quite small and a dense nucleus

Question 27

B lymphocytes originate then developed in in?

Answer 27

Fetal liver and bone marrow originate Development is just Ig heavy and light chain gene rearrangement leading to production of surface Igs against MANY DIFFERENT antigens (HUMORAL)

Question 28

Then how are B cells narrowed down?

Answer 28

They are exposed to antigens in lymphoid tissue/nodes which results in recognition of non-self antigens by mature B cells and production of specific Igs

Question 29

T lymphocytes formation

Answer 29

Progenitors migrate from fetal liver to thymus leading to development of T lymphocytes ; involved in cell-mediated immunity

Question 30

NK cells can

Answer 30

kill tumour/virus-infected cells ; they are part of innate immune system

Question 31

How can you identify gender of a patient by looking at a neutrophil?

Answer 31

In the nucleus - there is a small protrusion which is an X chromosome that has been pushed out

Question 32

Reactive lymphocytes?

Answer 32

Usually associated with viral illnesses; they do not have the regular circular shape more plasmolysed ; irregular cytoplasm

Question 33

Transient leukocytosis

Answer 33

Reactive cause and occurs when a a normal or health bone marrow responds to an external stimulus such as infection/inflammation/infarction

Question 34

Persistent leukocytosis

Answer 34

Primary blood cell disorder ; not responsive but autonomous ; could be due to somatic DNA damage affecting precursors giving rise to leukaemia/lymphomas/myelomas

Question 35

Leukocytosis

Answer 35

Broad term for an elevated WBC count

Question 36

Term given for too many WBCs

Answer 36

Ends in ilia or cytosis

Question 37

Term for reduced WBC count

Answer 37

Ends in penia (neutropenia/lymphopenia)

Question 38

What is the most common cause of leukocytosis/leukopenia?

Answer 38

Changes in the neutrophil count since this is usually the most abundant leukocyte in circulation

Question 39

Neutrophilia - when is it seen?

Answer 39

Pregnancy/or following exercise/after prescribing corticosteroids

Question 40

Why does exercise cause neutrophilia?

Answer 40

Because vast majority of neutrophils are sat in vasculature

Question 41

What is neutrophilia associated with?

Answer 41

Toxic granulation ; heavy coarse granulation of neutrophils and left shift (when IMMATURE neutrophils are released in response to an infection)

Question 42

Example of myeloproliferative disorder

Answer 42

Chronic myeloid leukaemia - associated with neutrophilia + basophilia

Question 43

Neutropenia causes

Answer 43

Chemo/radio or from autoimmune disorders/severe bacterial + viral + drugs like antimalarials/antipsychotic

Question 44

Physiological basis of neutropenia

Answer 44

People of African descent

Question 45

What do patients with neutropenia need?

Answer 45

Urgent treatment with intravenous antibiotics

Question 46

When does a hypersegmented neutrophil occur?

Answer 46

Increase in the number of neutrophil lobes - RIGHT SHIFT ; results from a lack of vitamin B12/folic acid (megaloblastic anaemia)

Question 47

How many lobes should a neutrophil usually have?

Answer 47

3 to 5

Question 48

Eosinophilia

Answer 48

Allergy or parasitic infection ; can occur in CML too

Question 49

Basophilia

Answer 49

Usually due to leukaemia

Question 50

Monocytosis

Answer 50

Due to infection/chronic inflammation and present in some types of leukaemia

Question 51

Lymphocytosis

Answer 51

Response to viral infection and can result from CML ; often pertussis infections

Question 52

Lymphopenia

Answer 52

Les than 10^9/l ; often due to chemo/radio/HIV/corticosteroids

Question 53

What are the most common lymphocytes in blood?

Answer 53

CD4+ T cells

Question 54

Why does leukaemia occur?

Answer 54

Somatic mutations occurring in a primitive cell ; gives rise to its own clones that replaces normal cells + failure of apoptosis

Question 55

Where are mutations present for leukaemia?

Answer 55

In oncogenes/tumour suppressor genes

Question 56

Granulocyte maturation

Answer 56

Different stages

Question 57

Granulocyte maturation

Answer 57

Different stages