Neurtrophils

Question 1

Reference range With Neutrophils

Answer 1

Varies with age infants o to 1yr low N count gradually increase when age

and race (African , middle eastern )

Question 2

Definition of neutropenia

Answer 2

mild 1-1.5
Moderate 0.5-1
Sever <0:5

Question 3

Mechanisms of neutropenia

Answer 3

Decreased production eg chemotherapy
Increased destructiona eg hypersplenism or dilution volume transfusion
Neutropenia may relate to infection

Question 4

Neutropenia clinical examination

Answer 4

Mouth gingivitis mouth ulcers
Staph strep pneumonia and gram neg bacillus
Fungal infections
Pus may be absent in neutropenia

Question 5

Transient neutropenia

Answer 5

Freq seen post viral infection
Ofen well tolerated
Need to. Rpt the FBC post the viral infection when child well
Isolated low N count rarely leukemia
Drugs can cause it. Bactria, thyroid meds / clonazapine rituximad
Stop the drug and repeat the Fbc in one week

Question 6

Chronic neutropenia. Causes and definition

Answer 6

Neutropenia> 3/12. Usually improves 2. -4/12

Causes
1Autoimmune N of infancy commonet causes Antibody detected in 75% cases BM normal except can see the N phagocytosis
Treatment antibiotics if infection and GCSFif severe
2Hypersplenism
3Congenital neutropenia sick from the beginning BM not normal
4Benign granulopenia

Question 7

Treatment of neutropenia

Answer 7

Only use antibiotics if infection 
Establish the cause of the Neutropenia 
Eg reduced production. Or increased destruction
GCSF if autoimmune 
Stem cell transplant

Question 8

Causes of raised neutrophils count

Answer 8

1 infection bacterial ,fungal,viral , Tb
2 inflammation juvenile arthritis
3 blood loss eg lose volume and the. Neutrophils appear high
4 DKA  dehydration high N count
5. Burns
6 steroids
7. Constipation

Question 9

Causes of eosinophilia

Answer 9

Allergy skin parasites immune def

Question 10

Lymphocytes low

Answer 10

Common post viral 
Steroids 
Stress
Abdo pain 
Must rpt 3-4 weeks later to exclude rare immune disorders

Question 11

Raised lymphocyte count

Answer 11

Common viral / pertussis /

Question 12

Atypical lymphocytosis

Answer 12

Adults EBV
Child any virus
Mono spot is usually negative in a child <3-4 yurts
Useful in teenagers

Question 13

In low platelet levels

Answer 13

Avoid trauma
Limite activity in low platelet county’s
Avoid aspirin / NSAI
Symptoms of intracranial haemorrage headache drowsy vomiting weak 2% of cases EMERGENCY