Hemaptoesis & Leukocyte Disorders Flashcards
Neutrophil
PMN: Most numerous leukocytes
Primary defense against infection
Phagocytic, kills with ROS
Short life span: 6-24 hours
Bands
Immature neutrophil, present in serious infection/some types of blood cancer
Lymphocytes
“disk inside a disk”
second most numerous leukocyte
Antibody production, destroy virus infected cells & cancer cells, coordinate immune response
T cells, NK cells, and B cells
Monocytes
“garbagemen”
third most common wbc in peripheral blood
antigen presenting cells
differentiate into macrophages
Eosinophils
Big red granules, bilobed nucleus
Granules filled with vasoactive compounds
Mediators of allergy including anaphylaxis
Basophils
Rarest, nobody knows what they do
Granules contain heparin and histamine
Elevatd in hematologic neoplasia (blood cancer)
Granules overly the nucleus which is different than all the other wbc’s
Platelets
Full of granules that are procoagulant
Anucleate
Key components of hemostasis
Bind to damaged endothelium via VWF
Production driven by thrombopoietin (liver hormone –> goes to marrow –> stimulates platelet precursor cell)
From which precursor cells do platelets form?
Megakaryocytes: hyperdiploid, keep undergoing mitosis without dividing
Erythrocyte
Anucleate sack of hemoglobin
Biconcave disk shape essential to function
Lifespan 120 days
Erythropoietin drives their production
1/3-2/3 of it should be central pallor
Reticulocyte
Immature form of RBC, purplish bc more mRNA
0.5-1.5% of the RBC population
Normal hematocrit for men and women
Men: 42-48%
Women: 40-45%
Proportion of packed red cells after you spin down the blood
Mean corpuscular volume: normal values
80-100 phentoliters
Hereditary spherocytosis
Spectrin or ankyrin deficiency (proteins of RBC cytoskeleton)
RBC lose central pallor bc they lose their cytoskeleton & turn into baseballs instead of disks “spherocytes” –> get stuck in spleen & are devoured there by macrophages, bite by bite
Causes hemolytic anemia
Hereditary Elliptocytosis
Overlapping protein mutations involving cytoskeleton structure
You get cigar-shaped RBC
Erythropoietin
Kidney detects low O2 tension –> increases erythropoitin production/release –> tells bone marrow to make more RBC’s
Morphology of hematopoiesis: size, chromatin condensation, nuclear size
Size is inversely proportional to maturity
Chromatin condenses with maturity
Nucelar:cytoplasmic ratio is bigger when less mature
Granules: if present, it’s a WBC not RBC precursor
Complete blood count (CBC)
Cell type/frequency
Leukopenia
Low WBC <3000
Neutropenia
ANC <1500
If <500, you’re susceptible to infections
If <100, you can spontaneously get infection
Lymphopenia
ALC <1200
Not pathological but the lower you go, higher risk of infection
What can cause neutropenia?
Infections: sepsis, HIV, marrow infiltration i.e. TB, metastatic cancers
Medications: chemo, immunosuppressants, antibiotics
Blood cancers: leukemias, myelodysplastic syndromes
Autoimmune: lupus, Felty’s syndrome
Inherited: ethinc/benign neutropenia (in blacks), cyclic neutropenia (elastase mutation)
What causes lymphopenia?
HIV/AIDS
Medications: corticosteroids (depete your lymphocytes), immunosuppressives, chemo
Viral infections in immunocompromised (EBV, CMV)
Hodgkins lymphoma
What can cause neutrophilia?
Acute infection
Corticosteroids (they reduce lymphocyte counts but increase neutrophil count)
Autoimmune dz (bc they’re inflammatory)
Leukemoid reaction (solid tumors –> high neutrophil count bc cancer gives off chemicals that cause neutorphils to get high)
Blood cancers
What is demargination of neutrophils?N
Neutrophils live in marrow, circulation, and outside of endothelial cells waiting for something to happen
They leave when you get an infection but also when you give steroids = demargination
Eosinophilia
You should only see one eos in a high powered field; if more than one, think NAACP
Neoplasia
Allergy
Addisons dz
Collagen-vascular dz
Parasite infection
Rare leukocyte disorders
Pelger-Huet abnormality
May-Hegglin anomaly
Chediak-Higashi
Chronic granulamatous dz
Bruton’s agammaglobuinamia
Severe combined immunodeficiencies
