Leukocytosis and Leukopenia

Question 1

What should you use - the percentage or absolute count of the cell types on a CBC diff?

Answer 1

only care about the absolute

Question 2

What’s the one line where the percentage is helpful?

Answer 2

% of banded neutrophils

Question 3

What blood lab changes do you see with a systemic bacterial infection?

Answer 3

marked toxic change
frequent left shift
leukoerythroblastic reaction
evidence of DIC

Question 4

What are some causes of neutrophilia?

Answer 4

infections
tissue damage
hemolysis (acute)
acute blood loss
collage-vascular disorders
vasculitis
colitis
nephritis
hypersensitivity rxns
uremia
DKA
eclampsia
exercise
pregnancy
stress
surgery
myeloid disorders
malignant neoplasms

Question 5

What are some examples of drug-induced neutrophilia?

Answer 5

corticosteroids
lithium
growth factors

Question 6

What lifestyle activity can cause neutrophilia?

Answer 6

cigarettes

Question 7

Neutropenia is usually caused by what two things?

Answer 7

Bugs or drugs

Question 8

True or false: normal range for neutrophils varies depending on age and ethnicity.

Answer 8

true

kids have a lower normal range, as do african americans

Question 9

What are the most common causes of monocytosis?

Answer 9

Infecions - esp chronic
(Viral, bacterial, esp things with granulomas)

endocarditis
GI disorders
sarcoid
hodgkins
myeloid disorders
solid tumors
collagen-vascular disorders

Question 10

What are the three main causes of monocytopenia?

Answer 10

aplastic anemia
B-cell leukemias
glucocorticoid adminstration

Question 11

What are the most common cause of eosinophilia?

Answer 11

drug reactions
allergies
parasitic infections

Question 12

What are some causes of basophilia?

Answer 12

asthma
urticaria
anaphylaxis
CML!!!
parasites
allergies
hypothyroidism
inflammatory process
TB
Viral infections
Mast cell disease
renal failure

(and basically any time there is an eosinophilia)

Question 13

What are the infections that can cause mononucleosis syndromes?

Answer 13

EBV
CMV
HHV-6
HSV-2
VZV
HIV
Hepatitis
Adenoviruses
Toxo
Bordatella pertussis (classic appearance)

Question 14

Mononucleosis is often characterized by a mild absolute ___ocytosis

Answer 14

lymphocytosis (over 4, but less than 20)

Question 15

If lymphocyte count is over 20, what do you need to think about?

Answer 15

leukemia

infections will never get that high.

Question 16

Lymphocytopenia usually implies reduction in what T cell opulation?

Answer 16

CD4+

Question 17

Why don’t we get as excited about lymphocytopenia as neutropenia?

Answer 17

people can manage to walk around with low lymphocytes without too much problem with infection until something goes awry

it’s less of an emergency

Question 18

What are some causes of lymphocytopenia?

Answer 18

cong immunodeficiencies
viral infections (esp HIV, HHV8)
autoimmune disorders (SLE)
Sarcoid
zinc deficiency
malignant lymphoma
Hodgkin's disease

Question 19

What are some of the drug realted causes of lymphocytopenia?

Answer 19

corticosteroids
immunosuppressive agents
antineoplastic agents
radiation therapy