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Heme > Neutrophils > Flashcards

Neutrophils Flashcards

1
Q

calculation for ANC

A

ANC
= absolute neutrophil count
= total WBC * % neutrophils

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2
Q

What type of disorder is Leukocyte Adhesion Deficiency?
What’s the defect?
What does this defect result in?
How would you treat this defect?

A

Congenital disorder
Adhesion & Rolling Defect
Recurrent bacterial infections
trmt: Stem cell transplantation

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3
Q

What type of disorder is Hyper IgE syndrome?
What’s the defect?
What does this defect result in?
How would you treat this defect?

A

Congenital Disorder
chemotaxis defect
recurrent staph, candidal (yeast) and lung infections, high IgE, chronic dermatitis
trmt: prophylactic antibiotics

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4
Q

What type of disorder is Chediak Higashi Syndrome?
What’s the defect?
What does this defect result in?
How would you treat this defect?

A

Congenital Disorder
degranulation defect
recurrent pyogenic infections, albinism
trmt: steroids, chemo, stem cell transplants

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5
Q

What type of disorder is Chronic Granulomatous Disease?
What’s the defect?
What does this defect result in?
How would you treat this defect?

A

Congenital Disorder
oxidative burst defect
recurrent pyogenic infections, granuloma formation
trmt: antibiotic prophylaxis

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6
Q

Function of eosinophils

A

kill parasites + hypersensitivity rxns

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7
Q

What is the significance of decreased eosinophils?

What is the significance of increased eosinophils?

What is the common cause worldwide? developed countries

A

low: not clinically significant
high: eosinophilia

worldwide: parasitic infections
developed countries: atopic allergic disease (asthma, eczema)

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8
Q

What are the causes of eosinophilia? (differentiate between 1˚ and 2˚

A

1˚ = Neoplasm (Hodgkins, Lymphoma, CML, primary eosinophilic disorders

2˚ = Allergies (drugs, environmental), Asthma, Collagen vascular diseases, Parasitic infections

mnemonic: NAACP

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9
Q

What is the function of basophils?

A

hypersensitivity reactions (release histamine/leukotrienes)

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10
Q

What are the first cells seen in hematologic recovery post chemotherapy?

A

monocytes

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11
Q

What are the roles of monocytes? (2 main)

A

APC, release granules to kill MOs

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12
Q

How does CML/AML and MDS differ in terms of monocyte number?

A

CML/AML has high monocytes (monocytosis) due to neoplastic proliferation of mature myeloid cells

MDS has low monocytes (monocytopenia) due to the fact that cells can divide, but not mature (remain in blast stage)

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13
Q

What causes monocytosis?

What causes monocytopenia?

A

monocytosis - anything that increases monocyte number:
infections
bone marrow recovery
autoimmune diseases (ulcerative colitis, lupus)
CML/AML
Hodgkins Lymphoma

monocytopenia - anything that decreases monocyte number:
sepsis
MDS
aplastic anemia
hairy cell leukemia
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14
Q

What are smudge cells?

A

artifacts of tissue processing

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15
Q

What are characteristic markers of B cells?

How do you establish clonality?

A

CD19, CD20

clonality established via light chain restriction: indicative that cells came from the “same population”

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16
Q

What are characteristic markers of T cells?

How do you establish clonality?

A

none specifically (maybe CD3)

cells do not have an easily discernale surface marker

clonality established via PCR/western blot of the T cell receptor,

17
Q

Pancytopenia can occur as a result of these 4 general processes:

A

1) bone marrow failure (myelodysplastic syndrome), leukemia (AML/CML), or aplastic anemia
2) bone marrow infiltration (malignancy, sarcoidosis, tuberculosis)
3) Ineffective myelopoiesis (B12 or folate deficiency)
4) hypersplenism - removes the blood cells too early and too quickly.

18
Q

What is the short-hand for CBC?

A

WBC Hb/Hct Plt

19
Q

What is the normal values of WBC?

A

4-10K cells / µL

20
Q

What is the normal values of Hgb? Hct?

A

Hgb:
Female: 11-16
Males: 14-17

Hct:
Females: 35-45
Males: 40-51

21
Q

What is the normal values for platelets?

A

150-375K

22
Q

What is the ANC? How is the ANC calculated?

A

Absolute Neutrophil Count (ANC) - used to determine if the % from the automated reading is truly abnormal or if it is a relative increase/decrease %.

= WBC * ((% segs + % bands)/100)

23
Q

What’s the difference between storage pool, circulating pool and marginal pool of neutrophils?

A

storage pool = bone marrow; waiting to respond to an infection or stress

circulating pool = blood; either responds to infection or removed by the reticuloendothelial system (spleen)

marginal pool = blood vessel wall; demarginates and enters the circulation in the event of an infection or “stressor”

24
Q

What growth factor governs myelopoiesis?

A

G-CSF (granulocyte colony stimulating factor)

25
Q

What are 4 main acquired disorders of neutrophil function?

A

1) MDS
2) Alcoholism
3) metabolic disorders (diabetes, uremia, malnutrition)
4) HIV infection

26
Q

What is a L shift?

A

increase band cells in the peripheral circulation; typically associated with bacterial infection

27
Q

What is shift neutrophilia? In what conditions is this normally observed?

A

demargination of marginal pool into circulating pool.

seen with steroids, epi injection, exercise, seizures

28
Q

What is the Leukemoid reaction?

A

Demargination AND marrow proliferation into periphery

seen with infection, inflammation, metastatic cancer, G-CSF

29
Q

What is the leukoerythroblastic reaction?

What are some pathological findings one would expect in the peripheral blood smear

A

damaged bone marrow (fibrosis or infiltration) that promotes EARLY WBC + RBC release

PB smear: L shift, early forms of RBC (reticulocyte + nucleated RBC), tear drop RBCs

30
Q

Generally speaking, what is leukemia?

A

acute: increase in abnormal/young forms (blasts) that take over the marrow and are the ones that are released
chronic: profound L shift

Heme (3 decks)

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