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Heme and Lymph Exam 2 > Lecture 1.3: WBC Disorders > Flashcards

Lecture 1.3: WBC Disorders Flashcards

1
Q

Which 7 drugs, hormones, or toxins which are common causes of acute neutrophilia?

A
  • Corticosteroids
  • Epinephrine
  • Lithium
  • Endotoxin
  • Smoking
  • Vaccines
  • Venoms
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2
Q

What are some common causes of demargination syndrome leading to neutrophilia?

A
  • Vigorous exercise
  • Acute physical and emotional stress
  • Infusion of epinephrine and other catecholamines
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3
Q

Shift of neutrophils from the marginal to circulating pool is quantitatively more important from which vascular bed and can account for about a doubling in neutrophil count?

A

Pulmonary capillaries

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4
Q

An increase in which cells in the blood can be helpful in distinguishing neutrophilia due to demargination from other causes such as infections, protracted stress, or glucocorticoid administration?

A

↑ in lymphocytes + monocytes + neutrophils

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5
Q

Acute neutrophilia occurs as a consequence of release of neutrophils from where; this type of neutrophilia is seen in response to what?

A

Marrow storage pool; in response to inflammation and infections

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6
Q

Inflammation or tissue necrosis, due to burns, trauma, gout, or vasculitis are causes of what type of neutrophilia?

A

Acute neutrophilia

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7
Q

Malignancy is a cause of what type of neutrophilia?

A

Chronic Neutrophilia

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8
Q

Asplenia and myeloproliferative disorders are causes of what type of neutrophilia

A

Chronic neutrophilia

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9
Q

If neutrophilia persists after repeat labs, what is the next step (flow chart)?

A
  • Examine smear: Leukoerythroblastic?
  • Yes: then proceed to BM examination: morphology, cytogenetics, culture
  • No: determine if pt is febrile (if yes, evaluate and treat), if not then do serologies for AID
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10
Q

If blood smear of pt with neutrophilia shows leukoerythroblastic cells, what are you looking for with the BM examination and what are the DDx’s?

A
  • Tumor granulomatous dx
  • Ph1 or BCR-ABL —> CML
  • JAK2 mutation –> Non-CML MPN = PCV or myelofibrosis
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11
Q

Smoking and obesity can be associated with what WBC abnormality?

A

Mild neutrophilia

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12
Q

Lymphocytes displaying coarse, clumped chromatin, in pt with lymphocytosis should raise suspicion of which primary marrow disorder?

A

CLL

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13
Q

Readily identifiable lymphoblasts in pt with lymphocytosis should raise suspicion of which primary marrow disorder?

A

ALL

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14
Q

An excess of large granular lymphocytes, particularly in a pt with RA, should raise suspicion of which disorder?

A

Large granular lymphocytic (LGL) leukemia

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15
Q

Why is examination of the blood lymphocytes in pt with lymphocytosis so important?

A

Lymphocyte morphology is generally more informative than is the case in neutrophilia

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16
Q

Larged lymphocytes with cleaved nuclei may be seen in which cause of lymphocytosis?

A

Follicular lymphoma

17
Q

Pt presenting with rhinosinusitis, asthma, and eosinophilia should trigger screening for what?

A

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

18
Q

List 3 medications which are common causes of eosinophilia?

A
  • Antibiotics
  • NSAIDs
  • Antipsychotics
19
Q

List 5 allergic diseases associated with eosinophilia

A
  • Allergic rhinitis
  • Atopic dermatitis
  • Urticaria/angioedema
  • Fungal allergy
  • Asthma
20
Q

Unexplained monocytosis, particularly in elderly patients with other cytopenias, should reflex concern for what; which work-up is generally warranted?

A
  • Myeloid malignanacies, such as MDS and CMML
  • Generally warrants examination of bone marrow
21
Q

List 6 antibiotics associated with idiosyncratic neutropenia?

A
  • Cephalosporins
  • Clindamycin
  • Gentamicin
  • Sulfonamides
  • Tetracyclines
  • Vancomycin
22
Q

List 3 anticonvulsants associated with idiosyncratic neutropenia

A
  • Carbamazepine
  • Mephenytoin
  • Phenytoin
23
Q

Which antidepressant is associated with idiosyncratic neutropenia?

A

Amitriptylene

24
Q

List two H2 blockers associated with idiosyncratic neutropenia.

A
  • Cimetidine
  • Ranitidine
25
Q

List 3 cardiovascular drugs associated with idiosyncratic neutropenia

A
  • Hydralazine
  • Captopril
  • Propranolol
26
Q

List 2 diuretics associated with idiosyncratic neutropenia

A
  • Chlorothiazide
  • Hydrochlorothiazide
27
Q

Which drug commonly used to prevent gout is associated with idiosyncratic neutropenia?

A

Allopurinol

28
Q

Which antipsychotic medication is associated with idiosyncratic neutropenia?

A

Chlorpromazine

29
Q

Which 2 infections are commonly associated with chronic neutropenia?

A

HIV and Hepatitis

30
Q

What is Felty’s Syndrome? *likely on exam*

A

Hypersplenism w/ neutropenia, due to long-standing RA

31
Q

What is the management for a pt with neutropenia, fever, localizing signs, and ANC <500/mL?

A

Admit for IV antibiotics and consider G-CSF

32
Q

A pt with a history of neutropenia whom also has a postive family hx or with no family hx but cyclic neutropenia should be worked up for what?

A

ELANE mutation –> the gene coding for neutrophil elastase, seen in cyclic neutropenia

33
Q

What is the one of the most common causes of iatrogenic lymphopenia?

A

Glucocorticoids

34
Q

List 4 congenital immunodeficiency diseases associated with lymphopenia?

A
  • Severe combined immunodeficiency disease (SCID)
  • Common variable immune deficiency
  • Ataxia-telangiectasia
  • Wiskott-Aldrich syndrome
35
Q

List some of the acquired causes of lymphopenia?

A
  • Aplastic anemia
  • Infectious diseases: viral, bacterial, and parasitic
  • Iatrogenic: immunosuppressive agents and chemotherapy
36
Q

What is the most notable entity to exclude in a patient monocytopenia and constitutional sx’s + splenomegaly?

A

Hairy cell leukemia

37
Q

Which 2 markers for Hairy Cell Leukemia can be seen via flow cytometry?

A

CD11c and CD103

38
Q

Severe monocytopenia may be seen in which syndrome; due to what mutation?

A
  • Seen in MonoMAC (monocytopenia and mycobacterial infection) syndrome
  • Mutation in the GATA-2 gene
  • High risk of progressing to MDS or AML

Heme and Lymph Exam 2 (17 decks)

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