Neutrophilia

Question 1

left shift+ 50,000 WBC>

Answer 1

leukomoid reaction- often response to TB, C diff

Question 2

chronic inflammation–>

Answer 2

increase in neuts and monoctytes

Question 3

most well known cause of neutrophilia + other important causes

Answer 3

1. drugs- most common, includes glucocorticoids (demarginate), lithium, beta agonists .
2. smoking
3. stress (catecholamines)
4. exercise (catecholamines)

Question 4

left shit leukocytosis, thrombocytosis, abnormal RBCs (nucleated and teardrop shaped)

Answer 4

leukoerythroblastic rxn: indicates a tumor has metastazied to the bones

Question 5

20K–100K WBC + splenomegaly + diploe of skull

Question 7

WBC > 50,000 composed of mature and immature neuts and schistocytes on blood smear

Answer 7

leukomerythroblastic reaction

Question 8

lymphocyte count > 5000

Answer 8

LYMPHOCYTOSIS

Question 9

monocytosis

Answer 9

8000+

Question 10

basophilia

Answer 10

100+

Question 11

eosinophilia

Answer 11

less than 50

Question 12

leukopenia

Answer 12

total leykocyte count less than 4300

Question 13

neutropenia

Answer 13

less than 2000

Question 14

lymphopenia

Answer 14

less than 1000

Question 15

normal MCV

Answer 15

80-100

Question 16

normal MCH

Answer 16

26-34 pg/cell

Question 17

normal MCHC

Answer 17

31-37%

Question 18

normal reticulocyte count

Answer 18

.5-1.5%

Question 19

normal neutrophil count with segs and bands

Answer 19

neutrophil count 57-67% of WBC count

segs- 54-62%

bands 3-5%

Question 20

lymphocyte count (normal)

Answer 20

23-33%

Question 21

PT: what it is, what normal is, what it measures

Answer 21

Prothrombin time (PT)—assesses the extrinsic system

Normal 10-13 seconds

Prolonged in deficiencies of Factors II, V, VII, and X as well as fibrinogen deficiency

Prolonged in patients taking warfarin or dicoumarol (not used in the US)

Question 22

PTT: what it is, what normal is, what it measures

Answer 22

Partial thromboplastin time (PTT)—assesses the intrinsic system

Normal 25-40 seconds

Prolonged in deficiencies of Factors VIII, IX, XI, XII Prolonged in patients on heparin

Question 23

Thrombin time

Answer 23

checks for fibrinogen

checks common pathway

Question 24

microangiopathic hemolytic anemia + platelet count < 50,000 + fever + neurologic symptoms =

Answer 24

thrombotic thrombocytopenic purpura

Question 25

MAHA + thrombocytopenia (<50,000) + fever + neurologic symptoms + renal failure =

Answer 25

hemolytic uremic syndrome

Question 26

Microangiopathic anemia

Answer 26

schistocytes (RBC fragments), helmet cells, etc….known as the “Waring blender” effect

Question 27

TTP forms

Answer 27

TTP: Two major forms

1. Hereditary—mutation of ADAMTS13 gene
2. Acquired—autoantibodies directed at ADAMTS13 (Linked to infection, malignancy, immune disorders, others)

Question 28

ADAMTS13 =

Answer 28

1. vWbF cleaving protease
2. mutation causes hereditary thrombotic thrombocytopenic purpura

Question 29

Acquired TTP

Answer 29

Acquired—autoantibodies directed at ADAMTS13 that are linked to infection, malignancy, immune disorders, others