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Hematology > Neutrophils (Exam 1) > Flashcards

Neutrophils (Exam 1) Flashcards

1
Q

What state are the chromatin in mature neutrophils?

A

condensed

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2
Q

What are neutrophils also called?

A

PMNs (poly-morpho nuclei)

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3
Q

What dye do neutrophil granules pick up?

A

both acidic and basic dyes

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4
Q

What is band neutrophil? Where can it be found?

A

immature neutrophil with a band-shaped nucleus (not multi-lobed yet) | circulation (its ok) and BM

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5
Q

What does a high band-neutrophil count indicate?

A

body is recruiting a lot of PMNs to fight off a current infection

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6
Q

What does a high band-neutrophil in circulation suggest about bone marrow activity?

A

BM = hyperactive

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7
Q

What are “band neutrophils” also called? Why?

A

left-shifted | precursor to mature neutrophil

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8
Q

What does neutrophilic leukocytosis indicate?

A

indicates bacterial infection

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9
Q

What can band neutrophils tell you?

A

how recent a bacterial infection is

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10
Q

What do sputum and pus consist of?

A

dead neutrophils

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11
Q

What is sputum indicative of?

A

bacterial infection

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12
Q

What are the 5 differential diagnoses associated with neutrophilic leukocytosis? (in order)

A

bacterial infection | metabolic/drug intoxication | necrosis | hemorrhage | malignancies

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13
Q

Which of the 5 differential diagnoses is most common?

A

bacterial infection

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14
Q

Which bacterial strain is most commonly associated with neutrophilic leukocytosis? What are the other 2 strains?

A

S. aureus | Strep hemolyticus | Diplococcus pneumoniae

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15
Q

What are 2 diagnostic methods/tests to rule out bacterial infection causing neutrophilic leukocytosis?

A

blood culture and antibody (Ab) test

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16
Q

What is the diagnostic methods/tests to rule out metabolic/drug intoxication causing neutrophilic leukocytosis?

A

talking to patient | toxicology screening of blood sample/urine test

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17
Q

What is necrosis causing neutrophilic leukocytosis due to?

A

myocardial infarctions (heart attacks), extensive burns, degeneration of benign neoplasms

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18
Q

How would you be able to diagnose that necrosis would be causing the neutrophilic leukocytosis?

A

talk to the patients if they have had a heart attack | will be able to see burns

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19
Q

What does hemorrhage mean? What are hemorrhoids?

A

Hemorrhage = loss of blood | hemorrhoids = accumulation go blood around anus

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20
Q

Type of people that commonly get hemorrhoids?

A

geriatrics and pregnant women

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21
Q

How would you be able to diagnose that hemorrhage would be causing the neutrophilic leukocytosis?

A

talk to patient

22
Q

What does leukemia mean?

A

proliferation of WBCs

23
Q

How would you be able to diagnose that neutrophilic leukemia would be causing the neutrophilic leukocytosis?

A

blood smear = all WBCs look the same

24
Q

What are the 3 diagnostic steps with neutrophilic leukocytosis cases?

A

talk to patient | blood culture/toxicology screenings | blood smears

25
Q

What are the 4 common causes of neutropenia?

A

infections | hematopoietic disorders | chemical agents or drugs | physical agents

26
Q

Why do infections induce neutropenia?

A

stimulates lymphocytosis = reduced production of neutrophils

27
Q

What hematopoietic disorders are associated with neutropenia?

A

leukemia of lymphocytic type

28
Q

What are some examples (2) of drugs/chemical agents that can induce neutropenia? Why?

A

penicillin and streptomycin | due to side-effects such as drug-resistant bacteria

29
Q

What is a physical agent that can induce neutropenia?

A

ionizing radiation (only affects nucleated cells)

30
Q

What are the 2 types of granules in PMNs and what is the main difference between them?

A

primary (azurophilic) and secondary (more specific) | differ in shape

31
Q

What are the 3 substances in the primary granules of PMNs? What type of substances are they?

A

anti-bacterial substances | peroxidase (myeloperoxidase) | acid hydrolyses | lysosome

32
Q

What are the 2 enzymes within the secondary granules of PMNs?

A

lysozyme | alkaline phosphatase

33
Q

What do the substances in the PMN granules control?

A

bacterial proliferation

34
Q

What is the lifespan of neutrophils in the BM and peripheral blood?

A

BM = 4-6 days | peripheral blood = 4-6 hours

35
Q

What are the 3 functions that neutrophils carry out?

A

chemotaxis | phagocytosis | intracellular killing

36
Q

What is chemotaxis?

A

response to stimuli = migrate to site of infection | dictated by presence of antigen

37
Q

What is phagocytosis?

A

forms a phagosome = intakes pathogens

38
Q

What are the 4 enzymes involved in neutrophil intracellular killing?

A

hydrolytic enzymes (lysozymes) | acidic pH | hydrogen peroxide | myeloperoxidase

39
Q

What are the pus-forming organisms?

A

gram (+) and gram (-) bacteria

40
Q

What 2 gram (+) bacteria are part of the pus-forming organisms?

A

staphylococcus | streptococcus

41
Q

What 3 gram (+) bacteria are part of the pus-forming organisms?

A

pseudomonas | E.coli | proteus

42
Q

What occurs if there is a defect in one of the neutrophil functions?

A

neutrophil cannot do its job = needs ALL of its functions to work | leads to infection from pus-forming organisms

43
Q

What may a recurrent infection be due to?

A

problem with neutrophil function

44
Q

What are the 4 neutrophil genetic defects?

A

Chronic Granulomatous Disease (CGD) | Lazy leukocyte Syndrome | Diabetes Mellitus | Myeloperoxidase Deficiency

45
Q

What is Chronic Granulomatous Disease?

A

neutrophils cannot induce intracellular killing

46
Q

What is Lazy Leukocyte Syndrome?

A

neutrophils cannot respond to chemotaxis

47
Q

How can Diabetes Mellitus play a role in neutrophil defects?

A

neutrophils cannot phagocytose

48
Q

What is Myeloperoxidase Deficiency?

A

neutrophils cannot intracellular kill because cannot produce myeloperoxidase

49
Q

Which genetic disease causing neutrophil defect is the worst? Why?

A

CGD = neutrophil keeps bacteria in and doesn’t kill it &raquo_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

50
Q

How to distinguish if patient has CGD or myeloperoxidase deficiency? (2 approaches)

A

family history | lyse neutrophils to detect presence/absence of myeloperoxidase

Hematology (20 decks)

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