Laboratory Investigation of White Cell Disorders

Question 1

Romanowsky Stain - list components

Answer 1

2 main components:

1) Azure B or Methylene Blue Basic Dyes
2) Eosin Y Acidic Dye

  Buffer		 pH 6.8

Question 2

Lymphocytes - functions

Answer 2

Major role is in Adaptive Immune Response

Differentiation between self and non-self

e.g. Viral attack

Lymphocytes produce antibodies to 	destroy that virus

 Memory cells

Question 3

3 major types of lymphocytes:

Answer 3

3 major types of lymphocytes:

T-cells

B-cells

Natural Killer (NK) cells

Question 4

Cell-Mediated Immunity - which cells involved

Answer 4

T-cells are involved in Cell-Mediated
Immunity - CD4+ T-Helper cells
CD8+ Cytotoxic T-cells

Question 5

Humoral Immunity - which cells involved

Answer 5

B-cells in Humoral Immunity i.e. Antibody

Production

Question 6

Innate Immune system - which cells involved

Answer 6

NK cells are part of the Innate Immune
System attacking virally infected cells and
tumour cells

Question 7

Leucocytosis - define

Answer 7

Leucocytosis: Increase in white cells

Question 8

Leucopenia - define

Answer 8

Leucopenia: Decrease in white cells

Question 9

Neutrophilia - define

Answer 9

Neutrophilia: Increase in neutrophils

Question 10

Neutropenia - define

Answer 10

Neutropenia: Decrease in neutrophils

Viral Infection
Drug Induced e.g. sulphonamides
Radiotherapy and chemotherapy

Question 11

Neutrophilia - causes

Answer 11

Normal Physiological Reaction
   Post-operative
   Pregnancy
    Other Causes
   Bacterial Infection
   Inflammation  	     e.g. vasculitis
				            myocardial infarction
   Carcinoma
   Steroid treatment
   Myeloproliferative disorders
   Treatment with myeloid growth factors

Question 12

Investigation of Neutrophilia

Answer 12

FBC and differential white cell count
Blood film examination

Bacterial culture screen for infection

Bone marrow examination + chromosome analysis
for chronic myeloid leukaemia - Philadelphia
chromosome: translocation between
chromosomes 9 and 22
Molecular analysis for BCR-ABL oncogene

Question 13

Investigation of Eosinophilia

Answer 13

FBC and differential white cell count
Blood film examination

Stool examination for ova and parasites

Question 14

Investigation of Monocytosis

Answer 14

FBC and differential white cell count

Blood film examination:

 - for abnormal white blood cells
 - for malarial parasites

Bone marrow examination - leukaemia

TB cultures

Question 15

Investigation of Lymphocytosis

Answer 15

FBC and differential white cell count
Blood film examination

• Atypical mononuclear cells

      ? Glandular Fever caused by EBV (Infectious Mononucleosis; Kissing Disease)
  
      Monospot, Paul Bunnell Test, Clearview
      Infectious Mononucleosis Test

Question 16

Heterophile antibodies - define

Answer 16

Heterophile antibodies are antibodies which
react against an antigen which is completely
unrelated to the antigen which originally
stimulated it
e.g. Human antibodies reacting against sheep
or horse or bovine cells

Question 17

Immunophenotyping to determine what

Answer 17

Immunophenotyping to determine if
lymphocytes are:
B-cells: Demonstrate clonality by light chain restriction

or T-cells: Demonstrate clonality by T-cell Receptor Gene Rearrangement Studies

Question 18

Monocytosis - in which conditions

Answer 18

Tuberculosis (TB)

Acute and chronic monocytic and myelomonocytic leukaemia

Malaria

Question 19

Lymphocytosis - in which conditions

Answer 19

Bacterial Infection
   Viral Infections   e.g.      Hepatitis
				      Mumps
				      Rubella
				      Pertussis
				      Glandular Fever
				    (Infectious Mononucleosis)

Leukaemias and lymphomas

Question 20

Eosinophilia - in which conditions

Answer 20

Allergic diseases		e.g.  asthma
						hayfever
   Parasitic infections
   Drug sensitivity
   Myeloproliferative diseases 
			e.g chronic myeloid  leukaemia
   Hodgkin’s Lymphoma