Neutrophils (Exam 1) Flashcards
What state are the chromatin in mature neutrophils?
condensed
What are neutrophils also called?
PMNs (poly-morpho nuclei)
What dye do neutrophil granules pick up?
both acidic and basic dyes
What is band neutrophil? Where can it be found?
immature neutrophil with a band-shaped nucleus (not multi-lobed yet) | circulation (its ok) and BM
What does a high band-neutrophil count indicate?
body is recruiting a lot of PMNs to fight off a current infection
What does a high band-neutrophil in circulation suggest about bone marrow activity?
BM = hyperactive
What are “band neutrophils” also called? Why?
left-shifted | precursor to mature neutrophil
What does neutrophilic leukocytosis indicate?
indicates bacterial infection
What can band neutrophils tell you?
how recent a bacterial infection is
What do sputum and pus consist of?
dead neutrophils
What is sputum indicative of?
bacterial infection
What are the 5 differential diagnoses associated with neutrophilic leukocytosis? (in order)
bacterial infection | metabolic/drug intoxication | necrosis | hemorrhage | malignancies
Which of the 5 differential diagnoses is most common?
bacterial infection
Which bacterial strain is most commonly associated with neutrophilic leukocytosis? What are the other 2 strains?
S. aureus | Strep hemolyticus | Diplococcus pneumoniae
What are 2 diagnostic methods/tests to rule out bacterial infection causing neutrophilic leukocytosis?
blood culture and antibody (Ab) test
What is the diagnostic methods/tests to rule out metabolic/drug intoxication causing neutrophilic leukocytosis?
talking to patient | toxicology screening of blood sample/urine test
What is necrosis causing neutrophilic leukocytosis due to?
myocardial infarctions (heart attacks), extensive burns, degeneration of benign neoplasms
How would you be able to diagnose that necrosis would be causing the neutrophilic leukocytosis?
talk to the patients if they have had a heart attack | will be able to see burns
What does hemorrhage mean? What are hemorrhoids?
Hemorrhage = loss of blood | hemorrhoids = accumulation go blood around anus
Type of people that commonly get hemorrhoids?
geriatrics and pregnant women
How would you be able to diagnose that hemorrhage would be causing the neutrophilic leukocytosis?
talk to patient
What does leukemia mean?
proliferation of WBCs
How would you be able to diagnose that neutrophilic leukemia would be causing the neutrophilic leukocytosis?
blood smear = all WBCs look the same
What are the 3 diagnostic steps with neutrophilic leukocytosis cases?
talk to patient | blood culture/toxicology screenings | blood smears
What are the 4 common causes of neutropenia?
infections | hematopoietic disorders | chemical agents or drugs | physical agents
Why do infections induce neutropenia?
stimulates lymphocytosis = reduced production of neutrophils
What hematopoietic disorders are associated with neutropenia?
leukemia of lymphocytic type
What are some examples (2) of drugs/chemical agents that can induce neutropenia? Why?
penicillin and streptomycin | due to side-effects such as drug-resistant bacteria
What is a physical agent that can induce neutropenia?
ionizing radiation (only affects nucleated cells)
What are the 2 types of granules in PMNs and what is the main difference between them?
primary (azurophilic) and secondary (more specific) | differ in shape
What are the 3 substances in the primary granules of PMNs? What type of substances are they?
anti-bacterial substances | peroxidase (myeloperoxidase) | acid hydrolyses | lysosome
What are the 2 enzymes within the secondary granules of PMNs?
lysozyme | alkaline phosphatase
What do the substances in the PMN granules control?
bacterial proliferation
What is the lifespan of neutrophils in the BM and peripheral blood?
BM = 4-6 days | peripheral blood = 4-6 hours
What are the 3 functions that neutrophils carry out?
chemotaxis | phagocytosis | intracellular killing
What is chemotaxis?
response to stimuli = migrate to site of infection | dictated by presence of antigen
What is phagocytosis?
forms a phagosome = intakes pathogens
What are the 4 enzymes involved in neutrophil intracellular killing?
hydrolytic enzymes (lysozymes) | acidic pH | hydrogen peroxide | myeloperoxidase
What are the pus-forming organisms?
gram (+) and gram (-) bacteria
What 2 gram (+) bacteria are part of the pus-forming organisms?
staphylococcus | streptococcus
What 3 gram (+) bacteria are part of the pus-forming organisms?
pseudomonas | E.coli | proteus
What occurs if there is a defect in one of the neutrophil functions?
neutrophil cannot do its job = needs ALL of its functions to work | leads to infection from pus-forming organisms
What may a recurrent infection be due to?
problem with neutrophil function
What are the 4 neutrophil genetic defects?
Chronic Granulomatous Disease (CGD) | Lazy leukocyte Syndrome | Diabetes Mellitus | Myeloperoxidase Deficiency
What is Chronic Granulomatous Disease?
neutrophils cannot induce intracellular killing
What is Lazy Leukocyte Syndrome?
neutrophils cannot respond to chemotaxis
How can Diabetes Mellitus play a role in neutrophil defects?
neutrophils cannot phagocytose
What is Myeloperoxidase Deficiency?
neutrophils cannot intracellular kill because cannot produce myeloperoxidase
Which genetic disease causing neutrophil defect is the worst? Why?
CGD = neutrophil keeps bacteria in and doesn’t kill it »_space;> protects it from other immune cells killing it since neutrophils aren’t targeted by other immune cells = allows bacteria to multiply and eventually lyse neutrophil to escape = more bacteria = recurrent infection
How to distinguish if patient has CGD or myeloperoxidase deficiency? (2 approaches)
family history | lyse neutrophils to detect presence/absence of myeloperoxidase
