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Clin Lab Medicine > Hematology II > Flashcards

Hematology II Flashcards

1
Q

How do WBC’s look different than RBC’s?

A

WBC’s appear to be more rounded and fluffy

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2
Q

RBC’s do not divide. Do WBC’s?

A

yes

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3
Q

produced in the bone marrow, produced under influence of GM-CSF, maturation occurs within 12 days, transforms from myeloblast to myelocyte, increased demand from body means mitosis increases and maturation decreases, remains in tissues once they are there, primarily for infection and inflammation, lifespan of 8 hours when in peripheral circulation, cytoplasmic components responsible for bacteriocidal activity, migrate to infection due to chemotactic substances

A

Neutrophils

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4
Q

produced in bone marrow by division and maturation, growth stimulated by ECSF and IL-5, attracted to tissue invasion by parasites and allergic reactions, contain cytoplasmic granules that damage parasites and impede replication, decrease anti-inflammatory pathway

A

Eosinophils

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5
Q

produced in bone marrow, enter tissues within several hours after release into circulation, function in hypersensitivity reactions, bind to antigens, cause degranulation of the cytoplasm and release of histamine, body sensitivity to food, medication or autoimmune

A

Basophil

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6
Q

produce in the bone marrow, mature within 4 days, no storage in the marrow, influenced by many growth factors, 3 days in circulation before entering tissues, made on demand, help to remove old RBC’s, function as tissue macrophages or specialized cells in tissues, play vital role in cell mediated and humoral immunity by presenting and processing antigens to both T an B lymphocytes

A

Monocytes

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7
Q

stem from the bone marrow, after maturation cells migrate to occupy peripheral lymphoid tissue including lymph nodes, spleen, tonsils, and mucosal sites, have a long half life, responsible for recognition of self vs. nonself, can proliferate when activated, CD4 and CD8

A

Lymphocytes

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8
Q

undergo differentiation and maturation in the bone marrow

A

B lymphocytes

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9
Q

undergo differentiation and maturation in the thymus

A

T lymphocytes

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10
Q

How are CD4 and CD8 cells named?

A

based on the glycoproteins in their cells

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11
Q

helper cells that signal other immune cells, order lysis, assist in production of antibodies by B cells and active macrophages

A

CD4 cells

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12
Q

killer cells that kills and destroys, moderate immune reactions and are able to lyse viral infected cells

A

CD8 cells

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13
Q

may or may not be T cells, able to cause cell lysis without prior antigen exposure

A

Natural killer cells

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14
Q

Laboratory tests for WBC’s include an anticoagulant. Why cannot the anticoagulant be heparin?

A

heparin causes WBC clumping and a blue background when examining

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15
Q

How long can WBC tests be kept?

A

counts can performed up to 24 hours after specimen collection if the vial has been stored at 4C

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16
Q

Can a traumatic or difficult venipuncture alter WBC results?

A

yes, the coagulation cascade could be activated which traps WBC and platelets producing falsely low levels

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17
Q

How do instruments determine [WBC]?

A

either electrical impedance or light scattering

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18
Q

What can cause falsely elevated WBC levels?

A

presence of reticulocytes, giant platelets, or blood born parasites

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19
Q

What can cause falsely lowered WBC levels?

A

paraproteins secreted during cancers, especially in leukemias

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20
Q

provides individual %’s of each WBC, usually automated report, faster than manual procedure

A

CBC-differential

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21
Q

-penia

A

decrease in number

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22
Q

-philia

A

increase in number

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23
Q

infections caused by bacteria, viruses, rickettsia, protozoa, debilitated patients, nutritional deficiencies, myelotoxic medications, seen regularly in acute leukemia and as a manifestation of myelodysplasia

A

Neutropenia

24
Q

myelotoxic

A

kills marrow

25
Q

What are reasons that could cause Neutrophilia?

A

acute infection, tissue dammage, necrosis, acute hemmorage, eclampsia, corticosteroids

26
Q

-cytosis

A

elevated levels

27
Q

What are reasons that could cause Lymphocytosis?

A

in children and young adults almost always non-neoplastic, incidence of neoplasm increases with age, worrisome if infection is not present, pertussis, chronic lymphocytic leukemia, mononucleosis, infections hepatis

28
Q

What could cause Lymphocytopenia?

A

variety of infections, immune disorders, medications, in HIV patients T helper cells (CD4) used to monitor disease progression

29
Q

What could cause a Monocyte disorder?

A

numerous infections and neoplasms, TB, malaria, syphillis, typhus, Hodgkin’s Disease, multiple myeloma, melanoma

30
Q

What can cause an Eosinophil disorder?

A

may be seen in healthy individuals, without disease, allergic reactions, parasitic infections, neoplasm such as CML, acute inflammation or stress, corticosteroid use

31
Q

elevated Eosinophil levels indicates

A

allergies

32
Q

What can cause a Basophil disorder?

A

CML, ulcerative colitis, chronic sinusitis, iron deficiency, smallpox, Hodgins disease

33
Q

metastasize

A

spreading to other parts of the body

34
Q

unregulated proliferations of hematopoetic cells in bone marrow, acute or chronic, often infiltrate other organs, can live with it for many years

A

Leukemia

35
Q

characterized by proliferations of immature or precursor cells, rapid clinical course

A

acute Leukemia

36
Q

proliferations of mature cells, longer clinical course

A

chronic Leukemia

37
Q
  1. ) Establish Diagnosis
  2. ) Subtype Leukemia for treatment and prognosis
  3. ) Perform cytogenic studies
  4. ) Perform monogenic studies
  5. ) Examine extramedullary tissues and fluids for involvement
  6. ) Evaluate effectiveness of therapy
A

Goals of a Leukemia Workup

38
Q

What are 3 ways to subtype and diagnose a Leukemia?

A
  1. ) peripheral blood smear
  2. ) bone marrow biopsy
  3. ) bone marrow aspirate
39
Q

present with nonspecific complaints such as fatigue, persistent infection, most have normocytic normochromic anemia, WBC count can range from high to low, large number of blast cells, in order to make acute diagnosis, blast cells must be 30% or more of all marrow cells

A

Acute Leukemia

40
Q

commonly seen in children, prognosis favorable in females ages 2-10, favorable with WBC count less than 10, cells usually have a suspicious nuclei, nucleus smaller and darker

A

Acute Lymphoblastic Leukemia (ALL)

41
Q

What age group of children best responds to ALL treatment?

A

children aged 2-10

42
Q

predominately disease of middle aged and older adults, most common leukemia in newborns and infants, subtyping depends on tendency toward differentiation, cells have multiple and a large nuclei, presence of an Auer rod is indicative

A

Acute Myelogenous Leukemia (AML)

43
Q

The presence of this is indicative of AML

A

Auer rod

44
Q

usually disease of adults, presentation is variable, usually found incidentally upon evaluation for other complaints, blood findings can rage fro pancytopenia (all cells almost gone) to marked leukocytosis

A

Chronic Leukemias

45
Q

primarily affects adults, median age of 50, males slightly greater than females, nonspecific clinical symptoms, anywhere from weight loss to fatigue, splenomeagly common, lymphadenopathy usual, half of patients are asymptomatic

A

Chronic Myelogenous Leukemia

46
Q

What does a left shift mean?

A

population or number is increasing

47
Q

highly suggested by peripheral blood smear, neutrophilic leukocytosis with a left shift, WBC counts typically greater than 25, myelocytes and neutrohils predominate, normally normochromic, normocytic anemia

A

Chronic Myelogenous Leukemia

48
Q

What is present in 90% of all chromic myelogenous leukemia cases?

A

the Philadelphia chromosome

49
Q

initial phase lasts 3-4 years, after that patient may develop a blast crisis or accelerated phase, after a blast crisis, median survival is 2-6 months and resistant to chemo

A

Chronic Myelogenous Leukemia

50
Q

most common adult leukemia, average age of diagnosis is 55, males outnumber females 2.5:1, results of accumulation of small round lymphocytes in the blood, bone marrow and organs, most discovered incidentally

A

Chronic Lymphocytic Leukemia

51
Q

total WBC count may reach 600 or more, WBC’s are small, condensed, blotchy chromatin, inconspicuous nuclei and scant cytoplasm, almost all patients have splenomegaly and lymphadenopathy, increased number of other malignancies such as melanomas, carcinomas of GI ract and lungs

A

Chronic Lymphocytic Leukemia

52
Q

Hodgkin’s Lymphoma vs. Non Hodgins lymphoma, clinical persentation similar due to elevated WBC count, tumors in lymph nodes, hard, non-mobile, non-tender is cancer until proven otherwise, fatigue night sweats and weight loss are common symptoms

A

Lymphoma

53
Q

What confirms Hodgkin’s lymphoma?

A

presence of Reed- Sternberg cell on biopsy

54
Q

delicate balance is needed to respond to injury and prevent hemorrhage

  1. ) vessel wall
  2. ) platelets
  3. ) coagulation system
A

platelets

55
Q

What are the 4 steps to primary hemostasis?

A
  1. ) Adhesion to collagen at the site of vascular injury
  2. ) Aggregation of additional platelets to “plug” the leak in the blood vessel
  3. ) Platelets release chemotatic elements to promote hemostasis, vessel wall constricts
  4. ) Body’s coagulation cascade activated
56
Q

reference range usually 150-400, hemorrhage not usually apparent until levels drop far below normal, levels below 50 will be dangerous when challenged with surgery or trauma, levels below 20 may result in spontaneous bleeding, young function better than old

A

platelet count

Clin Lab Medicine (3 decks)

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