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Haematology > Laboratory investigations Of White Cell Disorders > Flashcards

Laboratory investigations Of White Cell Disorders Flashcards

1
Q
  1. What is a Haemocytometer Neubauer Chamber?
A

It is the un-automated method of counting blood cells in the past

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2
Q
  1. How does a Haemocytometer Neubauer chamber work?
A

thick glass microscope slide with a rectangular indentation =chamber–>engraved with a laser-etched grid of perpendicular lines. the area bounded by the lines is known, and the depth of the chamber is also known. By observing a defined area of the grid, it is therefore possible to count the number of cells

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3
Q
  1. Describe the layout of the Haemocytometer Neubauer Chamber?
A

You have a cover glass and then then the counting chambers indented in, underneath the cover glass. Along the sides of the chambers , you have the cover glass mounting support

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4
Q
  1. What does Advia do?
A

Sorts cells depending of the size of granules etc..

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5
Q
  1. What is the normal range for Hb for males and females?
A

Normal Male = 130-180 g/L

Normal Females = 120-160 g/L

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6
Q
  1. Why do females have a lower Hb than males?
A

Periods

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7
Q
  1. What is the normal white blood cell count for adults?
A

4.0 - 11.0( x10^9 ) / L

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8
Q
  1. What is the normal platelet count for adults?
A

150 - 400 (x10^9) / L

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9
Q
  1. What is the normal range for adult:
    - Neutrophils
    - Lymphocytes
    - Monocytes
    - Eosinophils
    - Basophils
A 
Neutrophils = "2.0-7.5"
Lymphocytes = "1.5-4.0"
Monocytes = "0.2-0.8"
Eosinophils = "0.04-0.4"
Basophils = "<0.01-0.1"
x10^9 for all 
/L
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10
Q
  1. Why should basophils be very low?
A

They’re raised in haematological malignancies (cancers in blood cells) as they should be very low

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11
Q
  1. Do Monocytes always have vacuoles?
A

yes

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12
Q
  1. What can high eosinophils be a sign of?
A

Parasite Infections

Allergic Reactions

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13
Q
  1. What are eosinophils bursting with?
A

Dense, Orange Granulations

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14
Q
  1. Compare the appearance of normal neutrophils, lymphocytes and natural killer (NK) cells on a peripheral blood film?
A

Normal Neutrophils = purple squiggly lines inside the red blobs
Lymphocytes = Large purple blob bigger than red blobs
NK Cells = All cells are very large

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15
Q
  1. On a microscope slide, whats the :
    -Tail
    -Body
    -Head
    ????
A

Tail is where stain is LEAST concentrated
Body in the middle
Head is where the stain is MOST concentrated

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16
Q
  1. What are the 2 basic dyes that could be used in a Romanowsky Stain?
A

-Azure B
OR
-Methylene Blue

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17
Q
  1. What is the acidic dye that is used in a Romanowsky Stain?
A

Eosin Y

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18
Q
  1. What pH does the buffer have to be in a Romanowsky Stain?
A

6.8

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19
Q
  1. What part of the immune system do lymphocytes play a major role in?
    - Innate or Adaptive
A

Adaptive

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20
Q
  1. What can lymphocytes differentiate against?
A

Self and non-self pathogens

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21
Q
  1. Give an example of when lymphocytes differentiate between self and non-self?
A

Viral attack— Lymphocytes produce antibodies —> Destroy the virus —> Memory cells ( if attack happens 2nd time, we got this )

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22
Q
  1. What are the three major types of lymphocytes?
A
  1. T-Cells
  2. B-Cells
  3. Natural Killer (NK)Cells
23
Q
  1. Match :
    -Cell Mediated Immunity
    -Innate Immune System
    -Humoral Immunity
    TO:
    -T Cells
    -B Cells
    - NK Cells
A

o T-cells are involved in Cell-Mediated Immunity
o B-cells in Humoral Immunity
o NK cells are part of the Innate Immune System

24
Q
  1. Give two examples of T Cells?
A

CD4+ T Helper Cells

CD8+ Cytotoxic T Cells

25
Q
  1. What is humoral immunity?
A

Humoral Immunity is to do with immunity found in our body fluid for eg Antibody Production

26
Q
  1. What is Cell Mediated Immunity?
A

Is immune response thats not to do with antibodies eg T Cells and phagocytes

27
Q
  1. What is the difference between the innate immune response and adaptive immune response?
A

Innate is not antigen specific

Adaptive is

28
Q
  1. What do NK cells do?
A

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

29
Q
  1. On a microscope, How would you tell the difference between a :
    - Monocyte
    - Eosinophil
    - Basophil
A

Monocyte:

  • Kidney shaped nucleus
  • Abundant pale blue cytoplasm

Eosinophil:

  • Bilobed nucleus (two lobes)
  • Red cytoplasmic granules

Basophil:

  • Bilobed nucleus
  • Purple/black cytoplasmic granules. Looks like lots of dots
30
Q
  1. From pluripotent Haemopoietic Stem Cells we can get Myeloid Progenitor Cells and Lymphoid Progenitor Cells,
    We know that lymphoid prog cells produce:
  2. T Lymps
  3. B Lymps
  4. NK Cells
    What about myeloid prog cells?
A
  • Neutrophils
  • Monocytes
  • Eosinophils
  • Basophils
  • Erythroid —-> (RBC)
  • Megakaryocytes —-> (Platelets)
31
Q
  1. What is the difference between Leucocytosis and Leucopenia?
A

Leucocytosis = INCREASE in WBC’s

Leucopenia = DECREASE in WBCs

32
Q
  1. What is the normal adult neutrophil?
A

“2.0 - 7.5 ‘ x10^9

/ L

33
Q
  1. What is Neutrophilia?- whats a risk of this?
A

Neutrophilia: Increase in neutrophils after bacterial infections (higher it goes- larger risk of cancer).

34
Q
  1. What is Neutropenia?
A

Decrease in neutrophils

35
Q
  1. What is toxic granulation?
A

increase in staining density and possibly number of granules that occurs regularly with bacterial infection

36
Q
  1. What does it means if neutrophils have a shift to the left?
A

Left shift or blood shift is an increase in the number of immature leukocytes in the peripheral blood, particularly neutrophil band cells.

37
Q
  1. What does it mean if neutrophils have a shift to the right?
A

more hyper-segmented (9/12 lobes) neutrophil.

38
Q
  1. What are Döhle Bodies?
A

leukocyte inclusions located in the peripheral cytoplasm of neutrophils. Rod shaped, kinda like a C

39
Q
  1. What is neutrophilia caused by?
A

• Normal Physiological Reaction: Post-operative or Pregnancy
Other Causes:
o Bacterial Infection
o Inflammation e.g. vasculitis or myocardial infarction
o Carcinoma (above 50).
o Steroid treatment (neutrophils have steroid receptors).
o Myeloproliferative disorders
o Treatment with myeloid growth factors

40
Q
  1. How do we investigate Neutrophilia?
A

• For every disease: FBC, differential white cell count, blood film examination
• Bacterial culture screen for infection – samples e.g. saliva, sputum etc tested for bacteria presence.
• Exclude drugs – do drug tests and history.
• Bone marrow examination + chromosome analysis for chronic myeloid leukaemia (see basophils/eosinophils).
o Philadelphia chromosome: acquired translocation between chromosomes 9 and 22.
o Molecular analysis for BCR-ABL oncogene

41
Q
  1. What are the causes of neutropenia?
A
  • Viral Infection
  • Drug Induced (most diseases) e.g. sulphonamides
  • Radiotherapy and chemotherapy.
  • Part of a pancytopenia in bone marrow failure (aplastic anaemia) or infiltration e.g. leukaemia.
  • Racial (Afro-Caribbean and Asian population): ‘benign ethnic neutropenia’
42
Q
  1. What is Eosinophilia?
A

an increase in the number of eosinophils in the blood

43
Q
  1. What causes eosinophilia?
A
  • Allergic diseases e.g. asthma or hay fever.
  • Parasitic infection or Drug sensitivity.
  • Myeloproliferative diseases e.g. chronic myeloid leukaemia.
  • Hodgkin’s lymphoma
44
Q
  1. How would you investigate Eosinophilia ?
A
  • FBC and differential white cell count
  • Blood film examination
  • Stool examination for ova and parasites
45
Q
  1. What is monocytosis?
A

When the monocyte number thingy exceeds the upper limit range

46
Q
  1. How do we investigate Monocytosis ?
A
  • FBC and differential white cell count
  • Blood film examination: for abnormal white blood cells or malarial parasites
  • Bone marrow examination - leukaemia
  • TB cultures
47
Q
  1. What is lymphocytosis?
A

higher number than normal of lymphocytes

48
Q
  1. How would you investigate of lymphocytosis?
A

• FBC and differential white cell count
• Blood film examination
• Exam favourite: Atypical mononuclear cells (transformed lymphocytes)– not many granules, pale cytoplasm and scallop to RBC borders.
• Glandular Fever caused by Epstein-Barr VIirus (Infectious Mononucleosis; Kissing Disease)
o Monospot, Paul Bunnell Test, Clearview Infectious Mononucleosis Test

49
Q
  1. What is a heterophiles antibody?
A

o 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.

50
Q
  1. What could too many mature lymphocytes be a sign of (give two diseases)?
A

-> Chronic Lymphocytic Leukaemia
OR
-> Lymphoma

51
Q
  1. What is the difference between Chronic lymphocytic leukaemia or Lymphoma?
A

the cancer cells (leukaemia ) are mainly in the bone marrow and blood, while in lymphoma they tend to be in lymph nodes and other tissues

52
Q
  1. How can we determine if lymphocytes are B cells or T cells?
A

Immunophenotyping

53
Q
  1. How can we use immunophenotyping to determine between B cells and T cells?
A

o B-cells: Demonstrate clonality by light chain restriction (CD3/4/8).
o T-cells: Demonstrate clonality by T-cell Receptor Gene Rearrangement Studies (CD19/20).

54
Q
  1. What can be seen in patients with Chronic Lymphocytic Leukaemia?
A
  • Lymphocytes number same as RBC.

* Smudge cells.

Haematology (8 decks)

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