Lecture 9 A Numerical anomalies of WBCs Flashcards
Leukocytes can be evaluated through—–/ both—–can be assessed in the lab. thus WBC anomalies can be divided into two:
several techniques pf varying complexity and sophistication/ quantitative and qualitative properties/ quantitative(numerical)and qualitative (morphological)
the normal range of WBC is
4,000 to 11,000/mm cubed
leukocytosis
a WBC count above the normal range
leukocytosis is frequently a sign of—
inflammation/most commonly the result of infection and is observed in certain parasitic infections. it may also occur after strenuous
exercise, convulsions such as epilepsy, emotional stress, pregnancy and labour…
the 5 principal types of leukocytosis
neutrophilia (most common)/ lymphocytosis/monocytosis/eosinophilia/basophilia
cytosis/ penia
elevation in cell count/ depression in cell counts
Lekocytosis may be caused by——-
increase in
one or more of the cell types that normally circulate in the peripheral blood, or by the presence of
abnormal cell types.
leukopenia. this is due to a decrease in — or — or —
when he cell count drops below 4000/mm cubed of blood/ neutrphiles/ lymphocytes/ all cell counts
we call a decrease in neutrphiles —-. w in lymphocytes—-w in all WBC counts—
neutropenia or granulocytopenia/lymphopenia/pancytopenia
—-, and— and — are normally present in such low numbers that a decrease in their number usually doesnt cause leukopenia
basophiles, eosinpholes and monocytes
agarnaulocytosis
when the condition of leukopenia is serious enough to result in complete disappearance of neutrophiles. extremely dangerous becasue person cannot respond to infections.
since neutrophiles constitue the largest percentage of WBCs, —
variations in them causes the greatest impact on the total WBC count
the lifespan of a neutrophile is approximately —. it sepnds its life in 3 main parts of the body:—. this movement doesnt reverse so —
9-10 days from myelobalst to death/ BM to PD to tissues/ the netrophiles do not go back into the blood from the tissues
the neurtophile population in the BM can be divided into 2 pools:
mitotic pool and the post mitotic pool (maturation and storage pool)
the mitotic pool of the neutrophiles in the BM Refers to a —-. it has been estimated that these cells stay in the pool for —– and undergo —- divisons.
committed granulocytic progenitor cells that are undergoing
proliferation and differentiation such as myeloblasts, promyelocytes and myelocytes. /a few days/ 4 or 5 divisions
once the cell reaches the —–stage, it is no longer capable of mitosis and and spends its time in maturation.
metamyelocyte
under ceratin stressful or reactive conditions, maturation time may be —-, divisions may be—-and release into the blood may occur —-
shortened, skipped, prematurely
how long do cells spend in maturation and storage pool before they’re released into circulation? this release into PB is only——-. thus fully differentiated mature neutrophiles make up the post mitotic pool——-
5-7 days/ partially understood and is most probbaly based on a selective type of release of mature blood cells rather than a random release. / which forms the BM reserve, ready for release
study the pic page 3
neutrophiles do theri principal function in the— and the highlighted paragraph under it
tissues and then they die
once in the PB, approximately 50% of the neutrophiles circulate freely and make up the circulating pool while the remaining 50%
adhere to the walls of the blood vessels making up the marginating pool (These neutrophils are ready to move into tissues quickly if needed, especially in response to inflammation or infection.)
the cells in the marginal pool are —-so in a blood sample the number of WBC counted represnet only the ——–/ the neutrophiles are continuously —
not included in the WBC count/
half the number actually present in the peripheral blood./ changing back and forth between the marginal and circulating pools.
marginal cells enter the circulating pool for a number of reasons likewise
circiualing become marginal
neutrophilia count is
WBC x %N >8,000/ mm cubed
ANC is
absolute neutrophile count= a measure of the number of neutriophile granulocytes present in blood
AC equation
WBC count times the percenatage of this type of WBC over 100
the conditions associated with neutrophilia may be
pathologic or physiologic
physiologic neutrophilia is usually caused by —–. this neurtophilia is generally —
a shift of marginal nuetriphials to the circulating pool due to hormonal release / transient lasting onlky a few hours and is not characterized by any increase in immature cells hence why it’s called mature neutrophilia
common physiological cuases of neutrophilia include—–in other words, any immediate stress on the body , —. note that is a very rapid phenonmenon that can occur within —-
pregnancy, physical exercise, emotional
stress and newborns./ the 2 hormones epinephrine (Adreneline) and HYDROCORTISONE shift the marginating cells into the circulating pool as a result the neutrophile count is doubled / minutes
neurtophilia is also associated with any PATHOLOGIC condition that —-. pathologic conditions include—. in these conditions, certain factors from the blood such as CSF (colony stimulating factor), IL—-. in addition to the increase in the % of neutrophiles this is accompanied by a shift to the left …. Here,
the mobilization of the maturation/storage compartment can occur within
increases BM output of cells. /inflammations, malignancy , metabolic disorders/ stimulate the BM to release the neutrophiles stored in it. /(increase in number of immature cells)/ hours
In even more severe conditions and for neutrophilia to be sustained, increased bone marrow
production must occur, and it is normally seen —–. production can be increased up to —as a response to—.this is accompanied by a
premature release of cells to the peripheral blood and again a shift to the left. Here, Increased
B.M production occurs after few days.
after a few days. five fold/ cytokines ((CSF-G, CSF-GM, IL-3, IL-6…)
primary WBC’s that respond to bacterial infections are–so most common cause of neutrophilia is–
nuetrophilles /bacterial infection especially pyogenic infections caussed by staph, strep and pneumococci
more moderate neutrophilic responses are due to —
infections caused by bacilli, parasites, rickitsiia and viruses
in acute infections, typical leukocyte counts are —although counts greater than —- usually occur. thsi neutrophilia is frequentally associated with a —. this condition is called a —
15,000-20,000/mm3/ 50,000 /mm cubed occassionally occur/left shift/ lukemoid reaction
a lukemoid reaction
is an increase in WBC count + immature cells similar to what happens in people with leukemeia (CML). however the reaction is a sign if infection or or another disease and is not due to cancer. blood counts will return to normal when underlying condition is treated.
note taht not all bacterial infections lead to neutropilic leukocytosis. some even —-
suppress neutrophile production resulting in neutropenia like salmenellosis and brucellosis
pathogenic reasosn taht lead to increase of neurtophiles
infections/inflammations/metabolic disorders/malignant neoplasms/hereditary disorders
inflammaion reason for increase of neutrophiles: Non infectious inflammatory processes (so there’s an inflammation but not due to bacteria or virus or parasite or anything like that )also frequently cause a neutrophilia. these include:
(appendicitis), pancreatitis, colitis, myocardial infarction, surgical or
traumatic wounds, gout (kind of joint inflammation) thermal injury (severe burns),
severe hemolysis; as well as tissue destruction caused by a wide variety or chemicals
(lead, mercury), drugs (Lithium) and venoms, rheumatoid arthritis,
glomerulonephritis, and hypersensitivity reactions.
metabolsic disorders as the reason for the increase in neutrophiles:
metabolic disorders such as diabetes, renal dysfunction, liver disease produce toxic substances that may cause inflammation and increase the number of neutrophiles
melignant neoplasm as the reason for the increase in neutrophiles:
neoplasm= is an abnormal growth of tissue, which is often referred to as a tumor. tumors can cause an increase in neutrophiles. this increase can also happen in some types of leukemia like CML and CNL (chronic neutrophilic leukomeia)
hereditary conditions as the reason for the increase in neutrophiles:
A form of hereditary neutrophilia has been described in which the neutrophil counts are mildly to
markedly increased.
When the infection or inflammation is over, the marrow proliferative activity returns
to baseline over the period of a
few days
Neutropenia (count of—) is a granulocyte disorder characterized by an abnormally low number of
neutrophils. patients with it are
(neutrophil count of
less than 1800/mm3. )more susceptible to bacterial or fungal infections and, without prompt medical
attention, the condition may become life-threatening and deadly (NEUTROPENIC SEPSIS sepsis=systemic infection )
most common cause of leukopenia
neutropenia
causes of neutropenia are divided between
1)problems i nproduction of neutrophiles by BM
2) poblems in their destruction somewhere else
agents capable of causing marrow suppresion (aplastic/hypoplastic anemia) include:
Ionizing radiation, chemicals such as benzene and a wide variety of
cytotoxic drugs used in the treatment of malignancy that destroy or interfere with the
mitosis of the proliferating cells. In addition, certain drugs can also affect the B.M. as
antimicrobials (chloramphenicol, sulfonamides), anticonvulsants, antithyroid drugs,
antihistamines, anti-inflammatory agents, antipsychotics, cardiovascular drugs …
decreased neutrophile production by the BM happens due to:
1)aplastic anemia: destruction to the BM leads to aplastic or hypoplastic marrow with concomitant (simultaneaous) decreases in all cell types.
2) cancers: particularly blood cancers: marrow replacent by tumors, leukemic cells or fibrous tissue=pancytopenia
3)Vit B12 or folate defiency: it causes pancytopenia becasue they affect all highly dividing cells of the body including all blood elements
4) infections: direct B,M suppression by toxins derived from the infectious agent
increased neutrophile destruction/utilization can be due to:
1) infections: increased passge to the tissues or increased margination (go to PDF ) highlighted in blude
2) Immune reactions : isoiimune, autoimmune, drug induced (Go to PDF) highlighted in blude
3)sequestrion by spleen: trapping basically by the spleen. splenic enlargement (regardless of the cause) may lead to neutropenia wich is usually MILD
erythroblastosis fetalis
treatment of neutropenia
1) antibdies to reduce infection and colony-stimulating factor such as G-CSF or GM-CSF to temporarily
increase neutrophil counts
2) corticosteroids to reduce autoantibody production
3) in severe cases, BM transplant may be the only solution
Eosinophilia is a condition in which the eosinophil count in the peripheral blood exceeds—. several causes are known and te most common are — and —
700 /mm cubed/alleric reactions (asthma, exczema, in
association with certain cancers or certain leukemias and in a certain disorder called
hypereosinophilic syndrome. This latter is a disease characterized by a persistently elevated
eosinophil count (≥ 1500 eosinophils/mm³) in the blood for at least six months without any
recognizable cause. )
and parasitosis (only parasites that have a tissue cycle)
Basophilia:
It refers to an increase in the absolute basophil count above . the main causes are:
200 /mm cubed. allaergic reactions and cancers (MPD: myerloproliferative disorders including CMLs
lymphytosis in adults is when it’s greater than —- whereas in older children it’s when it’s greater than— and in infants it’s greater than —
4,000 microliter/ 7,000 microliter /9,000 per microliter
lymphocytosis is a feature of—especially in children/ in adults it’s a feature of
infection especially in children/lymphoproliferative disorders (diseases where there is abnormal growth of lymphocytes ), including chronic lymphocytic leukaemia (CLL)and lymphomas (they also present with lymphadenopathy=swollen, enlarged lymphnodes).
causes of absolute lymphocytosis include:
PIC PAGE 11
Acute bacterial infections (Whooping Cough that is associated with normal looking
lymphocytes and Brucellosis)
Chronic bacterial infections (Tuberculosis and Syphilis),
Parasitic infections (Malaria, and Toxoplasma),
Viral infections (Infectious
Mumps, Rubella..)
Mononucleosis, Infectious Lymphocytosis, Measles,
Lymphoproliferative disorders (CLL).
In general, viral infections tend to raise the lymphocyte count, but there are two special
conditions where the lymphocyte count becomes very important:
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Monocytosis. it often occurs durin—. watsapp pic.
an
increase in the absolute monocyte count 900/mm3/cronic inflammation
