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Hematology > Heme 3 > Flashcards

Heme 3 Flashcards

1
Q

Where do Leukocytes Differentiate and Proliferate?

A

BM

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2
Q

What Differentiates and Proliferates in the Thymus?

A

T-lymphocytes

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3
Q

What do Leukocytes develop from?

A

Pluripotent Hematopoietic Stem Cells

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4
Q

What is the normal Leukocyte Range for Newborns?

A

9-30 x 10^3

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5
Q

What is the normal Leukocyte Range for Children?

A

4.5-18 x 10^3

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6
Q

What is the normal Leukocyte range for adults?

A

4.5-11 x 10^3

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7
Q

What is the normal Absolute range for Neutrophils for adults?

A

1.8-7.0 x 10^3

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8
Q

What is the normal Relative range for Neutrophils for adults?

A

40-80%

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9
Q

The morphological stages for Neutrophils

A
  1. Myeloblast
  2. Promyelocyte
  3. Myelocyte
  4. Metamyelocyte
  5. Band Neutrophil
  6. Segmented Neutrophil
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10
Q

What stage can the Golgi Apparatus be seen?

A

Myeloblast

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11
Q

What stage do the Primary Granules of Neutrophil become prominent?

A

Promyelocyte

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12
Q

What is the Neutrophil’s last stage capable of mitosis?

A

Myelocyte

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13
Q

What stage for Neutrophils do the secondary granules start being produced?

A

Myelocyte

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14
Q

When do Neutrophil’s primary granules lose visibility?

A

Metamyelocyte

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15
Q

What stage of a Neutrophil can Barr bodies be seen?

A

Segmented Neutrophil

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16
Q

What are Neutrophil’s primary granules also called?

A

Azurophilic Granules
Non-Specific granules

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17
Q

Contents of Neutrophils’s Primary granules?

A

Cytotoxic compounds
Myeloperoxidase
(all encased in phospholipid membrane)

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18
Q

What are Neutrophil’s Secondary granules also called?

A

Specific granules

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19
Q

What are the content of Secondary Granules of Neutrophils?

A

Pro-Inflammatory
Chemotatic factors
**NO peroxidase
(encased in phospholipid membrane)

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20
Q

What WBC is one of the 1st responders to inflammation?

A

Neutrophils

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21
Q

What are the 4 steps of Neutrohils?

A

Adherence
Migration
Phagocytosis
Bacterial killing

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22
Q

What activates Adherence in Neutrohils

A

Inflammatory cytokines

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23
Q

What is diapedesis

A

Cells squeezes through endothelial cells into tissues

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24
Q

What is chemotaxis

A

Cells following cytokines to the site of infection once in the tissues

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25
Q
A

Myeloblast

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26
Q
A

Lymphoblast

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27
Q
A

Monoblast

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28
Q
A

Promyelocyte

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29
Q
A

Promonocyte

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30
Q
A

Prolymphocyte

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31
Q
A

Early myelocyte

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32
Q
A

Late Myelocyte

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33
Q
A

Eo myelocyte

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34
Q
A

Baso myelocyte

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35
Q
A

metamyelocyte

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36
Q
A

Metamyelocyte

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37
Q
A

Eo metamyelocyte

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38
Q

Steps in Neutrophil phagocytosis

A
  1. Recognition of pathogen enhanced by opsonization
  2. Pseudopods surround and internalize organism
  3. Fusion of granules/lysosomes
  4. Organism is murdred
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39
Q

What is ROS catalyzed by?

A

MPO
*contained in the primary granules

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40
Q

What is produced from the ROS?

A

Hypochlorous acid

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41
Q

What is the Absolute Eosinophil count in adults and children?

A

Children- 0.0-0.7
Adults- 0.0-0.4

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42
Q

What is the Relative Eosinophil % in adults and children

A

0-5%

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43
Q

What are the 6 stages of Eosinophil maturation?

A
  1. Myeloblast
  2. Promyelocyte
  3. Eosinophilic myelocyte
  4. Eosinophilic metamyelocyte
  5. Eosinophilic band
  6. Eosinophil
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44
Q

What stage is the first recognizable stage for an Eosinophil

A

Eosinophilic myelocyte

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45
Q

What does the eosinophilic granules contain

A

proinflammatory cytokines

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46
Q

What are the functions of Eosinophils

A

Degranulation in allergies and parasitic worms
Phagocytosis

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47
Q

What is the absolute Basophil count in children and adults

A

Children- 0.0-0.3
Adults- 0.0-0.2

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48
Q

What is the Relative Basophil % in children and adults

A

0-1%

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49
Q

What are the 6 stages of Basophilic maturation

A
  1. Myeloblast
  2. Promyelocyte
  3. Basophilic myelocyte
  4. Basophilic metamyelocyte
  5. Basophilic band
  6. Basophil
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50
Q

What do the granules in Basophils contain

A

Histamine
Tryptase
Heparin

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51
Q

What does histamine do

A

Vasodilation
Increase vascular permeability

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52
Q

What is tryptase

A

An inflammatory enzyme

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53
Q

What is heparin

A

An anticoagulant

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54
Q

What binds to Mast cells to mediate allergies

A

IgE

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55
Q

What happens when IgE binds to Ag

A

Degranulation of the mast cell

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56
Q

Degranulation of Mast cell causes

A

Immediate hypersensitivity reaction

57
Q

What occurs bc of the hypersensitivity reaction from mast cells

A

allergic rhinitis
asthma
urticaria (hives)
anaphlyaxis

58
Q

What is the absolute Monocyte range for children and adults

A

Children- 0.4-1.4
Adults- 0.1-0.8

59
Q

What is the relative Monocyte % in children and adults

A

2-10%

60
Q

What cell produces Monocytes

A

Bipotential progenitor cell (CFU-GM)

61
Q

What are the 3 stages in Monocyte maturation

A
  1. Monoblast
  2. Promonocyte
  3. Monocyte
62
Q

What is a monocyte called once it is in the tissues

A

Macrophage (aka histiocytes)

63
Q

What is the role of macrophages in Innate immunity

A

Phagocytic scavengers
-clean up: cellular debris, denatured proteins, aged RBCs

64
Q

What is the role of macrophages in Acquired immunity

A

Professional antigen presenting cell

65
Q

How does macrophage present an Ag

A

Via MHC-II to Helper T-cells

66
Q

What do cytokines from macrophages do

A

Stimulate hematopoiesis
Chemotactic factors for more immune cells

67
Q

What are the professional APC

A

Macrophage
B-Cell
Dendritic

68
Q

How do nucleated cells present Ag to Cytotoxic T-cells

A

MHC-I

69
Q

What are the absolute Lymphocyte count for children and adults

A

Children- 2.0-8.8
Adults- 1.0-4.8

70
Q

What is the relative Lymphocyte % for children and adults

A

Children- 50-65%
Adults- 25-35%

71
Q

Where are 95% of all lymphs found?

A

Lymph nodes
spleen

72
Q

What can lymphocytes develop into

A

memory cells

73
Q

What do memory cells do upon re-activation

A

Proliferate

74
Q

What are the 3 types of lymphocytes

A

T cells
B cells
Natural Killer cells

75
Q

Ag-Independent T and B cells do what?

A

Become immunocompetent
Do not interact with Ag
Are considered naive
Exit primary lymphoid tissues
Migrate to secondary lymphoid tissues

76
Q

What do T and B cells do once in 2nd lymphoid tissues

A

Proliferate
Perform their unique role or become memory cells
Mediate the acquired immune response

77
Q

What are the roles of the Cytotoxic T cells

A

Recognize Ag presented from MHC I
Induce those cells to undergo apoptosis

78
Q

What is the role of Helper T Cells

A

Recognize Ag presented from MHC II
Proliferate and activate acquired immunity

79
Q

What does Helper T cell do to B cell

A

Stimulate to become Ab producing plasma cell

80
Q

How do B Cells function in Humoral immunity

A

Become plasma cells
produce Ag specific Ab
Neutralize or opsonize the Ag

81
Q

How are Natural Killer Cells different than Cytotoxic T Cells

A

Do not require an Ag
Major component of the innate immune system

82
Q

What are the stages of Lymphocyte maturation

A

Lymphoblast
Prolymphocyte
Lymphocyte

83
Q

What is prominent in a Prolymphocyte

A

Nucleolus

84
Q

What is seen in the cytoplasm of a plasma cell

A

Golgi apparatus

85
Q

What are the associated conditions with neutrophilia

A

Bacterial infection
Tissue necrosis/inflammation
Leukemoid reaction

86
Q

What happens in immediate neutrophilia

A

marginating neutrophils temporarily release and freely circulate

87
Q

What can cause immediate neutrophilia

A

exercise
epinephrine
anesthesia

88
Q

When does Acute neutrophilia set in

A

4-5 hours after pathologic stimulus

89
Q

What can be increased in acute neutrophilia

A

bands
metas
myelos

90
Q

What is released when tissue damage occurs

A

chemotactic factors

91
Q

What is tissue necrosis/inflammation caused by

A

RA
Tissue infarctions
Burns
Trauma

92
Q

What is leukemoid reaction

A

An extreme neutrophilic reaction caused by severe infection or necrosis

93
Q

What does the WBC count exceed in leukemoid reaction

A

50 X 10^3/uL

94
Q

What can cause neutropenia

A

Severe infections
Aplastic anemia
Megaloblastic anemia
Chemotherapy
Hereditary

95
Q

What are the Neutrophil nuclear abnormalities

A

Hyper segmentation
Apoptotic nucleus
Pelger Huet anomaly

96
Q

What correlates with hyper segmented neutrophils

A

Megaloblastic anemia

97
Q

What is apoptotic nucleus also known as

A

Necrobiotic
pyknotic

98
Q

What is Pelger Huet anomaly

A

Hereditary hypo segmentation
Look like dumbbells

99
Q

What are the neutrophilic cytoplasmic abnormalities

A

Toxic granulation
dohle bodies
vacuoles
intracellular organisms

100
Q

What does Toxic granulation indicative of

A

Infection

101
Q

What is often seen with toxic granulation

A

dohle bodies

102
Q

What are dohle bodies composed of

A

rough endoplasmic reticulum

103
Q

What are dohle bodies indicative of

A

severe infections

104
Q
A

Dohl bodies

105
Q

What are the inherited neutrophil abnormalities

A

Alder-Reilly
Chediak-Higashi
May-Hegglin
Chronic granulomatous disease
Myeloperoxidase deficiency

106
Q

What causes Alder-Reilly anomaly

A

A buildup of mucopolysaccharides

107
Q

How does Alder-Reilly cells appear

A

Abnormal granules that are large, dense and lilac colored

108
Q
A

Alder-Reilly anomaly

109
Q

What is the patient outcome for Alder-Reilly anomaly

A

Progressive mental retardation and organ failure
Death by 10

110
Q

What is Chediak-Higashi a disorder of

A

Phagocytosis

111
Q

What is happening in Chediak-Higashi syndrome

A

Abnormal fusion of primary and secondary granules which prevents the release of cytotoxic contents

112
Q

What syndrome has patients that exhibit albinism

A

Chediak-Higashi Syndrome

113
Q
A

Chediak-Higashi

114
Q

What neutrophil disorder causes issues with bleeding

A

May-Hegglin anomaly

115
Q

What is May-Hegglin associated with

A

Leukopenia
Giant platelets
thrombocytopenia

116
Q

What is in the granulocytes of a patient with May-Hegglin

A

Dohle bodies

117
Q

What is defective in chronic granulomatous disease

A

respiratory burst

118
Q

What disorder has the respiratory burst it is just not as effective

A

Myeloperoxidase deficiency

119
Q

What are the qualitative Monocyte disorders

A

Gaucher disease
Niemann-Pick disease
Systemic Lupus erythematosus

120
Q

What is monocytosis caused by

A

Chronic infections
Inflammatory and immune disorders
Compensation for neutropenia

121
Q

What is deficient in Gaucher Disease

A

glucocerebrosidase

122
Q

Where do lipids accumulate in Gaucher disease

A

Spleen
Liver
BM

123
Q

How are Gaucher Disease cells described as

A

tissue-paper like cytoplasm

124
Q

What is deficient in Niemann-Pick disease

A

sphingomyelinase

125
Q

What Monocyte disorder is fatal by 3 years old

A

Niemann-Pick

126
Q

What disorder has cells described as foamy

A

Niemann-Pick

127
Q
A

LE cell

128
Q

What is rarely accompanied by leukocytosis

A

Lmyphocytosis

129
Q

Exceptions to lymphs and WBC being elevated are

A

Mono
Cytomegalovirus
Bordetella pertusis

130
Q

What is Mono

A

Viral infection of B cells by Epstein-Barr virus

131
Q

What does mono cause

A

benign, self limiting proliferation of B cells

132
Q

Symptoms of Mono

A

Fever
Pharyngitis
Swollen lymph nodes
Hepatosplenomegaly

133
Q

In mono, what type of lymph is seen in the peripheral blood

A

T cells

134
Q

What do T cell do in mono

A

eliminate virally infected cells

135
Q

What is mono thought to be associated with

A

Burkitt’s lymphoma

136
Q

What lymphocyte disorder is cogenital

A

Cytomegalovirus

137
Q

Symptoms of Cytomegalovirus

A

Jaundice
Microcephaly
Hemolytic anemia

138
Q

How does someone get cytomegalovirus

A

Acquired:
Transplant recipients
Blood transfusions
Close contact in healthy individuals

139
Q

When does HIV switch to AIDS

A

T helper count is <0.2 x 10^3

Hematology (4 decks)

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