Leukopoiesis, WBC Differentiation, and Lymphocyte Function Flashcards
How many WBCs are produced daily?
1.5 Billion
What stem cells give rise to WBCs?
Myeloid stem cells and lymphoid stem cells
Myeloid stem cells and lymphoid stem cells originate from?
Pluripotent stem cells
The WBC maturation cycle is more complex than the RBC maturation cycle? T/F
True
How many WBCs are produced for 1 erythrocyte?
5 (4)
Neutrophils, Basophils, Eosinophils, and Monocytes are produced by what type of stem cell?
Myeliod stem cells
Lymphoid stem cells give rise to?
B cells and T cells
Where are B and T cells produced?
Bone marrow and thymus
The word granulocytic applied to?
Only granulated WBCs
Which of the following applies to WBCs of all stages? a. Myelocytic b. Leukocytic c. Granulocytic d. All of the above
b. Leukocytic
Which of the following is synonymous with granulocytic? a. Myelocytic b. Leukocytic c. Granulocytic d. All of the above
b. Myelocytic
What do the majority of leukocytes contain?
Granules with enzymes used for digestion and destruction.
Where are Leukocytes located?
Bone Marrow, Circulation, Tissues, Some storage in the spleen
These defend against bacteria, viruses, fungi, and foreign substances.
Leukocytes
Hematopoeisis is?
Process of cell production that maintains leukocytes, erythrocytes and platelets (3 diff cell lines)
Describe Leukopoiesis?
Process of generating WBCs (leukocytes)
Distinguish between marginating and circulating pools of leukocytes?
Circulating Pool - in the bloodstream Marginating Pool - in the vessel endothelium (inner layer of blood vessels)
The morphology of what features are used to differentiate WBCs?
- Cell Size
- N:C ratio
3 . Chromatin pattern (presence/absence of nucleoli)
- Cytoplasmic quality (presence/absence of granules AND types of granules present).
What are the granulocytes?
Eosinophils Basophils Neutrophils
What are the agranulocytes?
Monocytes
Lymphocytes
What are the 5 stages of (precursor) maturation from immature to most mature for neutrophils, basophils and eosinophils?
- Myeloblast N:C 6:1
- Promyelocyte N:C 3:1
- Myelocyte N:C 2:1
- Metamyelocyte N:C 1:1
- band / eosinophilic band / basophilic band
Final Form: Segmented neutrophil / basophil / eosinophil
What are the stages of Monocytic Maturation?
- Monoblast N:C 6:1
- Promonocyte N:C 3:1
- Monocyte N:C 1:1
What are the 3 stages of Lyphocytic Maturation?
- Lymphoblast N:C 4:1
- Prolymphocyte N:C 3:1
- Small Lymphocyte N:C 4:1 / Large Lymphocyte N:C 3:1
Describe eosinophilic granules?
Round, large, dirty orange
Describe basophilic granules?
large, dark blue
Describe Neutrophilic granules?
Very fine, pinkish color and begin near nucleus
At what stage can granulocytes be distinuished?
Myelocyte stage
What is the function of neutrophils?
Seek, ingest, kill bacteria phagocytocis
What is the most numerous WBC?
Neutrophils
What is the function of eosinophils?
Respond to allergic and parasitic reactions
What is the function of basophils? What do they contain?
Respond to hypersensitivity and reactions and inflammation
Contain: Herparin and hystamine
What are the primary Lymphoid organs?
Bone Marrow and thymus
What are the secondary organs of the lymphatic system? (4)
Spleen, Peyer’s patches, lymph nodes, tonsils
What are the responsibilities of the lymphatic system?
Fluid balance
Lymphopoiesis
Antibody generation
Blood filtration
Describe lymph fluid?
Thin, clear, derived from plasma
How is lymp circulated?
Circulates from respiration
muscle movement
nearby vessel pressure
What are the primary locations of lymphopoiesis?
Bone marrow: B cells
Thymus: T cells
What lymphoid stem cells migrate to the thymus? (2)
T helper cells
T supressor cells
What lymphiod cells stay in bone marrow?
B cells
NK cells
60 - 85% of lymphocytes
Cell mediated immunity
mature in the thymus
T Cells
Once stimulated by antigen contact T cells?
CD4 (T helper cells) help promote antibody production and assist with immune intracellular pathogens
CD8 (T killer cells) cytotoxic elimination of non-self by promoting enzyme activity
10 - 20 % of lymphocytes
Mature into plasma cells that produce anibodies
Humoral immunity
may be stimulated toward a particular immune response
B Cells
<20% of lymphocytes
role in resisting bacteria, viruses and fungi
do not require stimulation
Natural Killer (NK) cells
Foreign bodies emit signals sensed by neutrophils
These signals are used to move towards the site of invasion
Chemotaxis
Neutrophil receptors attach to foreign body. this attachedment is enhanced after body has been opsonized with complement or Igs
Opsonization
Opsonized foreign body is _____ by nuetrophil and ______
Neutrophilic granules ______ _______ which contain elements that destroy foreign body and the neutrophil too.
ingested, killed
release contents
Leukocytosis
Absolute increase in total WBC count
What is a Left Shift?
Exaggerated response to infection and inflammation, which may include:
- toxic vaculozation
- Dohle bodies
- toxic granulation
- immature cells younger than metamyelocyte but rarely blasts
What is Leukoerythroblastic picture?
Peripheral smear contains immature WBCs, nRBCs, and platelet abnormalities.
Significant feature of myeloproliferative disorders
In which stage of neutrophilic maturation are specific secondary granules first seen?
Myelocyte
These following condistions cause what quantitative change in which WBC line?
Infections (bacterial)
Inflammatory response
Stress response
Malignancies
chemical assault
Neutrophilia (increase)
These following condistions cause what quantitative change in which WBC line?
Drugs
chemotherapy
autoimmune disease
Neutropenia
These following condistions cause what quantitative change in which WBC line?
allergies
skin disease
parasitic disease
transplant rejection
myeloproliferative disorders
Eosinophila (increase)
These following condistions cause what quantitative change in which WBC line?
Acute infections
ACTH
Bone Marrow Aplasia
Eosinopenia
These following condistions cause what quantitative change in which WBC line?
Myelo proliferative disorders
hypersensitivity reactions
Ulcerative colitis
Chronic inflammatory conditions
Basophila (increase)
These following condistions cause what quantitative change in which WBC line?
Steriod treatment
inflammation
Basopenia
These following condistions cause what quantitative change in which WBC line?
Chronic infections (TB)
Malignancies
Leukemias w/ stong monocytic component
bone marrow failure
Monocytosis
These following condistions cause what quantitative change in which WBC line?
Autoimmune processes
Hairy cell leukemia
Monocytopenia
These following condistions cause what quantitative change in which WBC line?
Normal in children 4 - 4 months old
Viral (CMV, EBV, HIV)
Leukemias
Lymphocytosis
These following condistions cause what quantitative change in which WBC line?
HIV
malnutrition
chemotherapy
radiation
renal failure
Lymphocytopenia
Infection, Human Erlichiosis, and Megaloblastic processes are _______ conditions causing qualitative WBC changes.
Acquired
- May-Hegglin Anomaly
- Alder-Reily Anomaly
- Palger-Huet Anomaly
- Chediak-Higashi Syndrome
- Lipid Storage Diseases
The above are all __________ conditions causing qualitative WBC changes.
Hereditary
Left shift:
- increase in bands and metamyelocytes in the peripheral smear.
- larger than normal basophilic granules within the cytoplasm of neutrophils, bands, and metamyelocytes. Resemble primary granules or promyelocytes
Toxic vacuolization:
- Round, clear spaces within the granulite cytoplasm
- Dohle bodies
- round, oval light blue staining found in the cytoplasm
- Remnants of RNA
Infection
- Notable white cell inclusion cause by two varieties of Rickettsia-like bacteria:
- Erlichia chafeenis
- Anaplasma phagocytophilum
- Common to both illnesses is low WBC count, elevated liver enzymes, and thrombocytopenia. Inclusions may be seen in the granulocyte or monoytes from the bone marrow.
Human Erlichiosis
- Hypersegmentation
- Folic acid deficiency
- Pernicious anemia
- B12 deficiency
Megaloblastic Processes
- Autosomal Dominant
- Thrombocytopenia and giant platelets (poorly granualated)
- Larger Dohle bodies found in cytoplasm of neutrophils
May-Hegglin Anomaly
- Rare genetic disorder
- Prominent depostion of granules in every cell line
- Lipid deposition in the cytoplasm
Alder-Reilly Anomaly
- Most common (dominant trait)
- 70 - 95% hyposegementation
- Heterozygotes: dumbell shaped nuccleus
- Homozygotes: nucleus is spherical
- Pseudo - _____ _____ - myeloproliferative disorders, severe infections and leukemias.
Pelger-Huet Anomaly
- Rare autosomal recessive disorder of neutrophilic granuels
- giant purple grey cytoplasmic granuels
- lymphocytes and monocytes nay show a signle red granule in cytoplasm
- WBCs show reduced chemotaxis and bactericidal killing function
- hepatospenomegaly and liver failure may develop
- abnormal bleeding time
- Affected children may show albinism and photophobia
Chediak-Higashi Syndrome
Lipid storage diseases are the result of?
a missing or inactive strategic enzyme
caused by a singele gene deletion
- deficiency of the enzyme beta-glucocerebrosidase
- leads to accumulation of glucocerebrosidase mostly in monocytes /macrophages
- characterized by severe bone pain
Gaucher’s disease
(accumution causes Gacher cells)
- Deficiency of the enzyme sphingomyelinase
- enlarged liver and spleen
- thrombocytopenia
- sea-blue histocytes in bone marrow
- macrophages have globular cytoplasm
Neimann-Pick Disease
- deficiency of the enzyme hexaminosidase A
- No large identifiable bone marrow cells
- can be tested prenatally
- deafness and blindness
- seizure
- death in a few years
Tay-Sachs Disease
Normal for young children 1 - 4 years
Differential will show reversal of lymphocytes to segmented neutrophils
normal morphology
Relative lymphocytosis