Heme 3 Flashcards
Where do Leukocytes Differentiate and Proliferate?
BM
What Differentiates and Proliferates in the Thymus?
T-lymphocytes
What do Leukocytes develop from?
Pluripotent Hematopoietic Stem Cells
What is the normal Leukocyte Range for Newborns?
9-30 x 10^3
What is the normal Leukocyte Range for Children?
4.5-18 x 10^3
What is the normal Leukocyte range for adults?
4.5-11 x 10^3
What is the normal Absolute range for Neutrophils for adults?
1.8-7.0 x 10^3
What is the normal Relative range for Neutrophils for adults?
40-80%
The morphological stages for Neutrophils
- Myeloblast
- Promyelocyte
- Myelocyte
- Metamyelocyte
- Band Neutrophil
- Segmented Neutrophil
What stage can the Golgi Apparatus be seen?
Myeloblast
What stage do the Primary Granules of Neutrophil become prominent?
Promyelocyte
What is the Neutrophil’s last stage capable of mitosis?
Myelocyte
What stage for Neutrophils do the secondary granules start being produced?
Myelocyte
When do Neutrophil’s primary granules lose visibility?
Metamyelocyte
What stage of a Neutrophil can Barr bodies be seen?
Segmented Neutrophil
What are Neutrophil’s primary granules also called?
Azurophilic Granules
Non-Specific granules
Contents of Neutrophils’s Primary granules?
Cytotoxic compounds
Myeloperoxidase
(all encased in phospholipid membrane)
What are Neutrophil’s Secondary granules also called?
Specific granules
What are the content of Secondary Granules of Neutrophils?
Pro-Inflammatory
Chemotatic factors
**NO peroxidase
(encased in phospholipid membrane)
What WBC is one of the 1st responders to inflammation?
Neutrophils
What are the 4 steps of Neutrohils?
Adherence
Migration
Phagocytosis
Bacterial killing
What activates Adherence in Neutrohils
Inflammatory cytokines
What is diapedesis
Cells squeezes through endothelial cells into tissues
What is chemotaxis
Cells following cytokines to the site of infection once in the tissues
Myeloblast
Lymphoblast
Monoblast
Promyelocyte
Promonocyte
Prolymphocyte
Early myelocyte
Late Myelocyte
Eo myelocyte
Baso myelocyte
metamyelocyte
Metamyelocyte
Eo metamyelocyte
Steps in Neutrophil phagocytosis
- Recognition of pathogen enhanced by opsonization
- Pseudopods surround and internalize organism
- Fusion of granules/lysosomes
- Organism is murdred
What is ROS catalyzed by?
MPO
*contained in the primary granules
What is produced from the ROS?
Hypochlorous acid
What is the Absolute Eosinophil count in adults and children?
Children- 0.0-0.7
Adults- 0.0-0.4
What is the Relative Eosinophil % in adults and children
0-5%
What are the 6 stages of Eosinophil maturation?
- Myeloblast
- Promyelocyte
- Eosinophilic myelocyte
- Eosinophilic metamyelocyte
- Eosinophilic band
- Eosinophil
What stage is the first recognizable stage for an Eosinophil
Eosinophilic myelocyte
What does the eosinophilic granules contain
proinflammatory cytokines
What are the functions of Eosinophils
Degranulation in allergies and parasitic worms
Phagocytosis
What is the absolute Basophil count in children and adults
Children- 0.0-0.3
Adults- 0.0-0.2
What is the Relative Basophil % in children and adults
0-1%
What are the 6 stages of Basophilic maturation
- Myeloblast
- Promyelocyte
- Basophilic myelocyte
- Basophilic metamyelocyte
- Basophilic band
- Basophil
What do the granules in Basophils contain
Histamine
Tryptase
Heparin
What does histamine do
Vasodilation
Increase vascular permeability
What is tryptase
An inflammatory enzyme
What is heparin
An anticoagulant
What binds to Mast cells to mediate allergies
IgE
What happens when IgE binds to Ag
Degranulation of the mast cell
Degranulation of Mast cell causes
Immediate hypersensitivity reaction
What occurs bc of the hypersensitivity reaction from mast cells
allergic rhinitis
asthma
urticaria (hives)
anaphlyaxis
What is the absolute Monocyte range for children and adults
Children- 0.4-1.4
Adults- 0.1-0.8
What is the relative Monocyte % in children and adults
2-10%
What cell produces Monocytes
Bipotential progenitor cell (CFU-GM)
What are the 3 stages in Monocyte maturation
- Monoblast
- Promonocyte
- Monocyte
What is a monocyte called once it is in the tissues
Macrophage (aka histiocytes)
What is the role of macrophages in Innate immunity
Phagocytic scavengers
-clean up: cellular debris, denatured proteins, aged RBCs
What is the role of macrophages in Acquired immunity
Professional antigen presenting cell
How does macrophage present an Ag
Via MHC-II to Helper T-cells
What do cytokines from macrophages do
Stimulate hematopoiesis
Chemotactic factors for more immune cells
What are the professional APC
Macrophage
B-Cell
Dendritic
How do nucleated cells present Ag to Cytotoxic T-cells
MHC-I
What are the absolute Lymphocyte count for children and adults
Children- 2.0-8.8
Adults- 1.0-4.8
What is the relative Lymphocyte % for children and adults
Children- 50-65%
Adults- 25-35%
Where are 95% of all lymphs found?
Lymph nodes
spleen
What can lymphocytes develop into
memory cells
What do memory cells do upon re-activation
Proliferate
What are the 3 types of lymphocytes
T cells
B cells
Natural Killer cells
Ag-Independent T and B cells do what?
Become immunocompetent
Do not interact with Ag
Are considered naive
Exit primary lymphoid tissues
Migrate to secondary lymphoid tissues
What do T and B cells do once in 2nd lymphoid tissues
Proliferate
Perform their unique role or become memory cells
Mediate the acquired immune response
What are the roles of the Cytotoxic T cells
Recognize Ag presented from MHC I
Induce those cells to undergo apoptosis
What is the role of Helper T Cells
Recognize Ag presented from MHC II
Proliferate and activate acquired immunity
What does Helper T cell do to B cell
Stimulate to become Ab producing plasma cell
How do B Cells function in Humoral immunity
Become plasma cells
produce Ag specific Ab
Neutralize or opsonize the Ag
How are Natural Killer Cells different than Cytotoxic T Cells
Do not require an Ag
Major component of the innate immune system
What are the stages of Lymphocyte maturation
Lymphoblast
Prolymphocyte
Lymphocyte
What is prominent in a Prolymphocyte
Nucleolus
What is seen in the cytoplasm of a plasma cell
Golgi apparatus
What are the associated conditions with neutrophilia
Bacterial infection
Tissue necrosis/inflammation
Leukemoid reaction
What happens in immediate neutrophilia
marginating neutrophils temporarily release and freely circulate
What can cause immediate neutrophilia
exercise
epinephrine
anesthesia
When does Acute neutrophilia set in
4-5 hours after pathologic stimulus
What can be increased in acute neutrophilia
bands
metas
myelos
What is released when tissue damage occurs
chemotactic factors
What is tissue necrosis/inflammation caused by
RA
Tissue infarctions
Burns
Trauma
What is leukemoid reaction
An extreme neutrophilic reaction caused by severe infection or necrosis
What does the WBC count exceed in leukemoid reaction
50 X 10^3/uL
What can cause neutropenia
Severe infections
Aplastic anemia
Megaloblastic anemia
Chemotherapy
Hereditary
What are the Neutrophil nuclear abnormalities
Hyper segmentation
Apoptotic nucleus
Pelger Huet anomaly
What correlates with hyper segmented neutrophils
Megaloblastic anemia
What is apoptotic nucleus also known as
Necrobiotic
pyknotic
What is Pelger Huet anomaly
Hereditary hypo segmentation
Look like dumbbells
What are the neutrophilic cytoplasmic abnormalities
Toxic granulation
dohle bodies
vacuoles
intracellular organisms
What does Toxic granulation indicative of
Infection
What is often seen with toxic granulation
dohle bodies
What are dohle bodies composed of
rough endoplasmic reticulum
What are dohle bodies indicative of
severe infections
Dohl bodies
What are the inherited neutrophil abnormalities
Alder-Reilly
Chediak-Higashi
May-Hegglin
Chronic granulomatous disease
Myeloperoxidase deficiency
What causes Alder-Reilly anomaly
A buildup of mucopolysaccharides
How does Alder-Reilly cells appear
Abnormal granules that are large, dense and lilac colored
Alder-Reilly anomaly
What is the patient outcome for Alder-Reilly anomaly
Progressive mental retardation and organ failure
Death by 10
What is Chediak-Higashi a disorder of
Phagocytosis
What is happening in Chediak-Higashi syndrome
Abnormal fusion of primary and secondary granules which prevents the release of cytotoxic contents
What syndrome has patients that exhibit albinism
Chediak-Higashi Syndrome
Chediak-Higashi
What neutrophil disorder causes issues with bleeding
May-Hegglin anomaly
What is May-Hegglin associated with
Leukopenia
Giant platelets
thrombocytopenia
What is in the granulocytes of a patient with May-Hegglin
Dohle bodies
What is defective in chronic granulomatous disease
respiratory burst
What disorder has the respiratory burst it is just not as effective
Myeloperoxidase deficiency
What are the qualitative Monocyte disorders
Gaucher disease
Niemann-Pick disease
Systemic Lupus erythematosus
What is monocytosis caused by
Chronic infections
Inflammatory and immune disorders
Compensation for neutropenia
What is deficient in Gaucher Disease
glucocerebrosidase
Where do lipids accumulate in Gaucher disease
Spleen
Liver
BM
How are Gaucher Disease cells described as
tissue-paper like cytoplasm
What is deficient in Niemann-Pick disease
sphingomyelinase
What Monocyte disorder is fatal by 3 years old
Niemann-Pick
What disorder has cells described as foamy
Niemann-Pick
LE cell
What is rarely accompanied by leukocytosis
Lmyphocytosis
Exceptions to lymphs and WBC being elevated are
Mono
Cytomegalovirus
Bordetella pertusis
What is Mono
Viral infection of B cells by Epstein-Barr virus
What does mono cause
benign, self limiting proliferation of B cells
Symptoms of Mono
Fever
Pharyngitis
Swollen lymph nodes
Hepatosplenomegaly
In mono, what type of lymph is seen in the peripheral blood
T cells
What do T cell do in mono
eliminate virally infected cells
What is mono thought to be associated with
Burkitt’s lymphoma
What lymphocyte disorder is cogenital
Cytomegalovirus
Symptoms of Cytomegalovirus
Jaundice
Microcephaly
Hemolytic anemia
How does someone get cytomegalovirus
Acquired:
Transplant recipients
Blood transfusions
Close contact in healthy individuals
When does HIV switch to AIDS
T helper count is <0.2 x 10^3
