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Bloc F - Defense > Mar19 M2-CBC and WBC > Flashcards

Mar19 M2-CBC and WBC Flashcards

1
Q

limitations (6) of blood samples

A
  • hemolysis
  • desintegration of cells during procurement
  • clot, clumping and low platelet count
  • renal failure: low Hb
  • contamination (bacteria, drugs)
  • dilution from distal IV lines (not proportional sample)
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2
Q

high K+ in blood sample check what

A 
sample hemolyzed (RBCs ruptured)
*don't worry about bit of hemolysis
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3
Q

how clotting avoided in blood vial

A

chemicals to reduce it. mix blood well in the tube

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4
Q

clot in blood sample content + consequence

A

RBCs + platelets. will have a low RBC count

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5
Q

why contamination (includes septic patients) and drugs is a problem in blood sample

A
  • CBC machine has prob differentiating things
  • bacteria promote clotting
  • meds can interfere with test results
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6
Q

blood drawn near IV line consequence

A

poor dilution and blood looks like saline. will think anemia low RBCs

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7
Q

why relative cell counts are a problem mostly

A

measures % of a cell type compared to all cells. can have normal relative count and low absolute count of WBCs for ex. (leukopenia). not enough neutrophils to live

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8
Q

4 reasons why relative counts are a problem

A
  • machine reads by shape size granularity but these differ in activated cells: misreads
  • cell fragments (after cell shredding) are counted
  • spherocytes (RBCs) counted as lymphocytes
  • not reliable (absolute better)
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9
Q

limitations still existing in absolute counts

A
  • activated WBCs change shape (if cell is in grey zone, machine may not make the diff)
  • must confirm abnormal results with manual differential
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10
Q

manual differential method and limitations

A

blood smear on slide.

human errors + done after absolute so maybe clots before

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11
Q

(imp?) machine indicating atypical lymphocytes meaning + management

A

activated in way that is not common
VIRAL INFECTIONS ESPECIALLY EBV (MONO)
(repeat the test)

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12
Q

(imp?) machine indicating INCREASED abnormal lymphocytes meaning + management

A

cancer

repeat the test

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13
Q

5 factors influencing CBC results

A
  • exercise (mobilizes BM)
  • stress (cortisol. increases WBCs prod)
  • altitude (relative polycythemia bc low O2)
  • time of the day (circadian rhythm and cortisol variations)
  • medications
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14
Q

toxic granulation appearance and what it is

A

neutrophils filled with sachets of toxic substances to kill bacteria

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15
Q

(imp?) number 1 cause of toxic granulation

A

INFECTION (usually bacterial)

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16
Q

why total WBC count used

A
  • dx and manage hemato and infectious diseases pts
  • monitor pts with cytotoxic drugs, radiation therapy and antimicrobial drugs
  • monitor meds effects
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17
Q

WBC differential

A

is the 5 cell types in a WBC count

  • lymphocytes
  • monocytes
  • neutrophils
  • basophils
  • eosinophils
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18
Q

normal Hb values

A

adult: 140 max
newborn: up to 160-180

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19
Q

what influences the values in a CBC

A

age, sex, altitude, type of blood sample

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20
Q

distribution of WBC differential

A 
neutrophils 55%
band neutrophils 5%
lymphocytes 33%
monocytes 5%
eosinophils 3%
basophils 1%
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21
Q

WBCs that are hard to count and why

A

monocytes and basophils. are less in blood and mostly in tissues

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22
Q

differential count goal and limitation

A

check for abnormal numbers and morphology (need hematopathology for morphology)

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23
Q

neutrophils subclassification

A

according to maturity (check changes in nucleus)

  1. metamyelocyte (young. large cyto. round or bean nucleus)
  2. band or stab neutrophil (elongated or curved nucleus)
  3. segmented neutrophil (mature. multilobed)
24
Q

neutrophilia with ‘‘left shifts’’ or band forms or stabs show what

A

INFECTIOUS stimulus leading to activation of the bone marrow

25
Q

eosinophils function

A

parasitic immunity. filled with sachets of toxic chemicals. migrate to parasite and release these. (active immunity)

26
Q

when high eosinophils and high basophils (causes) + question to ask

A

-hypereosinophilic syndrome or hypersensitivies
-parasitic infection
-allergies or transplant rejection (same mech)
-cancer, tissue necrosis, steroid use (bc these stim BM so it makes everything)
ASK FOR TRAVEL HISTORY + ALLERGY HISTORY

27
Q

basophils nucleus charact

A

massive. see stippling

28
Q

Septra (Abx given to HIV pts to avoid deadly pneumonias) consequence

A

possible NEUTROPENIA

29
Q

why eosinophils stain pink

A

filled with major basic protein (toxic substance)

30
Q

other cell type that can increase with corticosteroids

A

basophils

31
Q

why CSs increase WBCs (other than stim BM to make WBCs? not sure if true? also CSs decrease WBCs later on)

A 
cause demargination (detachment of WBCs from vascular walls via their adhesion molecules)
similar to chemokine and cytokine effect when need WBCs
32
Q

monocytes (blood) and macrophages (tissue) charact

A
  • biggest WBCs.
  • specific types as Kupffer cells in liver
  • are the mononuclear phagocyte system
33
Q

how RBCs cleaned from blood

A

reticuloendothelial system in the liver (and spleen) is the macrophages

34
Q

macrophages fct all the time

A

phagocytosis + clearing dead cells (bc turnover everywhere)

*are near mucosal linings

35
Q

macrophages immune fct

A
  • clean up
  • give info on what’s picked up
  • tell if picked something dangerous
36
Q

3 specialized macrophages

A 
Kupffer cells (liver)
Langerhans cells (skin)
specialized macrophage in the lung
37
Q

3 lymphocytes

A

B cells, T cells, NK cells

38
Q

T cells development

A
  • born in BM
  • migrate to thymus
  • maturate in thymus
39
Q

T cells fct

A

adaptive immunity coordination (NKs, B cells, APCs, macrophages : tell them what to do)

40
Q

when immune response present

A

all the time. no on-off switch. always determining if activate or tolerize. make inflammation or not.

41
Q

lymphocytes charact + something that is abnormal

A

large nucleus. granularity is abnormal

42
Q

B cells development

A

born in BM. migrate to lymph nodes

43
Q

NKs fct

A

migrate along tissue surfaces and kill cells that look sick or virally infected (changed their machinery to replicate virus)

44
Q

1st change in cell machinery when virally infected

A

receptor for NK cell disappears. NK cell sees no receptor and kills it

45
Q

(imp?) neutrophilia most common cause

A

ACUTE BACTERIAL INFECTION (rise in 4-6 hrs after invasion)

46
Q

other causes of neutrophilia

A
  • myeloproliferative disorders (like PRV and chronic myelocytic leukemia) bc increase prolif in BM
  • steroids and demargination diseases
47
Q

meaning of VERY HIGH neutrophilia

A

patho condition causing neutrophils to become hypermature (high segmented neutrophils number)

  • liver disease
  • down
  • megaloblastic anemia
48
Q

meaning of elevated band neutrophils (left shift)

A

increased number of IMMATURE neutrophils released by BM (pressure to make Ns often bc INFECTIOUS STIMULUS)

49
Q

neutropenia definition and real value to worry about. severe neutropenia def

A

2000x10E9 and less is the def
1500 and less is real prob
500 and less is severe

50
Q

neutropenia causes and main one

A
  • **severe prolonged infections
  • increased WBC destruction
  • increased splenetic pooling (hypersplenism)
  • drugs (NSAID, antimicrobial, antidepressants, anticonvulsants)
  • chemo
  • congenital syndromes
  • instrumentation (iatrogenic)
51
Q

absolute monocytosis meaning

A

considered myeloprolifertive disorder (like chronic myelomonocytic leykemia) until proven otherwise (BM exam and cyto studies).
**can be anything (malignancy, infection, immune deficiency)

52
Q

relative monocytosis meaning

A

recovery from drug-induced neutropenia

53
Q

lymphocytosis meaning

A
  • leukemia

- infections (mono, cytomegalovirus, measles)

54
Q

lymphopenia meaning

A
  • normal in aging adults

- child : early sign of immune deficiency

55
Q

monocytopenia meaning

A

-hairy-cell leukemia
-aplastic anemia
(glucocorticoid therapy)

Bloc F - Defense (57 decks)

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