Lecture 29

Question 1

Leukocyte Alkaline Phosphatase (LAP) is an enzyme that can be measured to determine if a high WBC count is due to malignancy or not. Is LAP usually present in malignancy, and how does this help make the determination?

Answer 1

LAP is usually NOT present in malignancy, so a High LAP score would indicated NO malignancy.

Question 2

Leukemoid reactions refer to WBC > _____, often with precursor cells, bands, and promyelocytes. ____ ____ infection is a common cause for this finding.

Answer 2

50,000

C. diff

Question 3

More than 50% of neutrophils in circulation are adherent to vascular walls. Your counts can DOUBLE almost immediately in response to stress, toxins, cytokines, or _______ (e.g. cotisol.) The BM is slower to act, and can increase your counts up to 3x in about _____ hours.

Answer 3

Gluccocorticoids

4 hours

Question 4

Keep in mind that other than infections or malignancy, ______ (removal of which organ?) can result in a high Neutrophil count. So too can ____ agonists (used for asthma treatment), Lithium, and smoking.

Answer 4

Splenectomy

Beta agonists

Question 5

Neutrophilia from infection is typically determined by the presence of _____ bodies (remnants of RER) in neutrophils and band cells comprising > ___% of WBCs.

Answer 5

Dohle bodies

20%

Question 6

Hereditary Neutrophilia Syndrome is characterized by extremely high WBC counts (20-100K), and patients often show _____ abnormalities and _____ (elevated or depressed?) LAP scores. Neutrophil function is NORMAL.

Answer 6

Skull abnormalities

Elevated LAP scores

Question 7

____-____ is a disease characterized by bi-lobed nuclei in neutrophils, though these neutrophils have normal function. They are usually read by computers as band cells.

Answer 7

Pelger-Huet

Question 8

Leukocyte Adhesion Deficiency is characterized by Neutrophils lacking CD__, which they normally use to adhere to vascular walls. Without this, they are all in circulation. This can lead to frequent infection and delayed _____ ____ separation in newborns.

Answer 8

CD18

Umbilical cord

Question 9

Severe Neutropenia is classified as ANC < ____ cells/uL.

Answer 9

500 cells/uL

Question 10

Connective Tissue Diseases can show Neutropenia, including Lupus and _____ syndrome of Rheumatoid arthritis.

Answer 10

Felty Syndrome

Question 11

Medication adverse effects can be the cause for Neutropenia, but keep in mind this will typically manifest within ___ months from the start of the medication.

Answer 11

3 months

Question 12

Secondary Lymphocytosis can be caused by bacterial infection. _____ (causes whooping cough) is common, as are bartonella, brucella, syphilis, and scrub typhus.

Answer 12

Pertussis

Question 13

Secondary Lymphocytosis with atypical lymphocytes can also be caused by viral infection. ___ ___ ____ (virus that causes Mono) is a good example, but keep in mind atypical lymphocytes won’t appear until about __-__ weeks into the infection. What other viral infection has basically the same risk factors for acquiring it and also presents with Mononucleosis syndrome?

Answer 13

Epstein Barr Virus

2-3 weeks

HIV

Question 14

Keep in mind that _______ reactions can cause Lymphocytosis.

Answer 14

Hypersensitivity

Question 15

Absolute Lymphocyte count (ALC) < ____ is of concern/ is indicative of severe Lymphopenia.

Answer 15

ALC < 1000

Question 16

Monocytosis often goes hand-in-hand with ______ (term to describe an increase in another WBC).

Answer 16

Neutrophilia

Question 17

Eosinophilia is typically characterized by AEC > ____ in the blood. A count > 1500 increases risk of tissue damage.

Answer 17

500

Question 18

Which parasites are most responsible for Eosinophilia?

Answer 18

Helminths