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Liz's Hematology Module 2 > Qualitative WBC Abnormalities > Flashcards

Qualitative WBC Abnormalities Flashcards

1
Q

When do primary granules appear?

A

Promyelocyte

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2
Q

What is the composition of a neutrophil’s secondary granule?

A

Leukocyte alkaline Phosphatase

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3
Q

What cell is this based on

  • Dawn of neutrophilia (2’ granules)
  • Flattened side of the nucleus
  • Perinuclear clearing (hof area)
A

Myelocyte

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4
Q

What are the different types of alterations found in neutrophils?

A
  • Toxic changes
  • Leukemic inclusions
  • Anomalies
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5
Q

What are some of the toxic changes found in neutrophils?

A
  • Toxic granulation
  • Doehle bodies
  • Degranulation/Agranulation
  • Vacuolization
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6
Q

What is the leukemic inclusion found in neutrophils?

A

Auer rods

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7
Q

What anomalies are found in neutrophils?

A
  • May-Hegglin
  • Alder Reilly
  • Chediak-Higashi
  • Pelger-Huet
  • Hypersegmentation
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8
Q

Toxic granulation causes…

A
  • Infections
  • Poisons that affect BM (including chemo)
  • Cytokine administration
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9
Q

Dark blue/purple cytoplasmic granules in metas, bands, or neutrophils; peroxidase positive (primary granules); Accelerated proliferation; CRP and ___ are in correlation w/ inflammation

A

Toxic granulation

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10
Q

Small oval, pale blue inclusions in the peripheral cytplasm of bands and seg; may be single or in multiples; asynchronous cytoplasmic maturation

A

Doehle bodies

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11
Q

Doehle bodies are made of _____

A

RNA

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12
Q

Doehle bodies cause…

A
  • Infection
  • Burns
  • Trauma
  • Pregnancy
  • Tumors
  • Post GM-csf
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13
Q

Absent or decreased number of granules in neutrophils that can be caused “naturally”

A

Hypogranulation/agranulation

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14
Q

This is caused by fusion of cytoplasmic granules w/ phagosome

A

Hypogranulation/agranulation

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15
Q

This is caused by asynchronous maturation due to accelerated proliferation

A

Hypogranulation/agranulation

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16
Q

Additional causes linked to chromosomal abnormalities in hypogranulation/agranulation

A
  • MDS

- Leukemia

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17
Q

Toxic change in the cytoplasm of neutrophils; primarily caused septicemia and bacterial infections; other important causes include prolonged exposure to EDTA and acute alcoholism

A

Vacuolization/vacuolation

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18
Q

What 3 comrades are often seen together in infections?

A

Vacuoles, toxic granulation, Doehle bodies

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19
Q

Red staining rods or bodies found in the cytoplasm of malignant immature myeloid cells (myeloblasts and promyelocytes); found in Faggot cells; bundle of sticks

A

Auer rods

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20
Q

Auer rods are composed of fused ____ granules

A

Primary

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21
Q

Where are Auer rods seen in?

A
  • Acute myeloid leukemia (AML)
  • Acute promyelocytic Leukemia (APL)
  • Acute myelomonocytic leukemia (AMML)
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22
Q

Inclusions in neutrophils that resemble Doehle bodies; found in all mature myeloid cells

A

May-Hegglin anomaly

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23
Q

May-Hegglin anomalies are composed ____

A

RNA

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24
Q

These are associated w/ thrombocytopenia and giant platelets

A

May-Hegglin anomalies

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25
Q

Prominant azurphilic granules (resembles toxic granulation); the granules are formed by the accumulation of partially degraded mucopolysaccharides in lysosomes

A

Alder-reilly anomaly

26
Q

Alder-Reilly anomalies are autosomal ____

A

Recessive

27
Q

May-Hegglin anomalies are rare autosomal ____ traits

A

Dominant

28
Q

Lysosomal organelles affected; large azurophilic granules; red granules predominant in LYMPHOCYTES; grey/blue seen in neutrophils; neutropenia, causes impaired chemotaxis and defective granulation and abnormal membranes of abnormal lysosomes

A

Chediak-Higashi anomaly

29
Q

Chediak-Higashi anomalies are rare and autosomal ____

A

Recessive

30
Q

Anomaly caused by failure of segmentation of granulocyte nuclei; band form with two lobes, dumbbell, bikini top, peanut

A

Pelger-Huet anomaly

31
Q

Pelger-Huet anomalies are autosomal ____; and > ____ of neutrophils are affected

A

Dominant; 80%

32
Q

Is heterozygous or homozygous more common in Pelger-Huet anomalies? Why?

A

Heterozygous; asymptomatic

33
Q

In acquired Pelger-Huet, when < 50% of neutrophils are affected, the most common disease is ____ _____

A

MDS

34
Q

> 5 lobes or ≥ 6 polys w/ 5 lobes

A

Hypersegmentation

35
Q

3 different disorders demonstrating hypersegs

A
  • Autosomal dominant (no known clinical abnormalities)
  • Acquired (megaloblastic anemia w/ vitamin B12 or folate deficiency)
  • Autosomal dominant (myelokathexis w/ neutropenia and pyknotic cells)
36
Q

Cytoplasm is basophilic and can be indented by RBCs/ballerina skirt; chromatin is less clumped than normal lymph; normal changes in response to antigenic stimulus

A

Reactive lymphocyte

37
Q

Most common viral infections that lead to reactive lymphs

A

Infectious mononucleosis, EBV, and CMV

38
Q

Can confirm mono vs. CMV w/ what test?

A

Monospot

39
Q

Infectious mononucleosis primarily infects what kind of cells?

A

B-cells

40
Q

Common age group affected by mono?

A

Ages 17-25

41
Q

2 complications of infectious mono

A
  • Cold agglutinins

- Hemolytic anemia

42
Q

Are granules more common in reactive or normal lymphs?

A

Reactive lymphs

43
Q

Nuclear remnant of lymphocyte; no discernable cytoplasm; aka basket cells

A

Smudge cells

44
Q

What disease is most common seen w/ smudge cells?

A

Chronic lymphocytic leukemia (CLL)

45
Q

If more than ____% smudge cells are present, what do you do?

A

10%; remake smear using 1 drop of albumin and 10 drops of blood

46
Q

After remaking smudge cell slide w/ albumin how do you report it?

A

Differential is reported from the albumin smear but everything else is reported from the original smear (because you are diluting by 10% when you add ALB); occasional=10% or more than 5 remake this slide

47
Q

Degeneration of a cell; may be seen in any nucleated cell as a result of aging and degeneration; nuclear chromatin condenses to a solid or structure-less mass

A

Pyknosis/necrosis

48
Q

How do you report reactive lymphs?

A

Count reactive and non-reactive lymphs on separate keys and report % of each; for absolute lymph count, use the TOTAL percentage

49
Q

How do you report Pelger-Huet?

A

Count as segs and make notation that Pelger-Huet like cells are present

50
Q

How are toxic granulation, Doehle bodies, hypersegs, hypo- or agranulation, and Auer rods reported?

A

Report as present

51
Q

Smudge cells and megakaryocytes are not reported in the 100 cell diff but are included in the _____ _______

A

WBC estimate

52
Q

Fungus that is prevalent in OH and Mississippi River valleys; seen in cytoplasm of leukocytes

A

Histoplasma capsulatum

53
Q

Obligate intracellular gram negative bacteria creates a morulae; usually Zoonotic, but it has been transferred to humans by ticks

A

Anaplasma phagocytophilum

54
Q

filarial nematode that is most common in AFRICA and India

A

Loa loa

55
Q

Protozoan parasite that is the cause of MALARIA; presents in peripheral blood as rings and as crescent shaped gametocytes

A

Plasmodium falciparum

56
Q

Protozoan blood parasite that appears similar to malaria on a blood smear but crescent gametocytes are absent

A

Babesia (Babesiosis)

57
Q

Linked to African Sleeping Sickness

A

Trypanosoma gambiense

58
Q

Describe what homozygous Pelger-Huet looks like in a patient

A
  • In the PB, round or oval nuclei

- Patient exhibits congnitive impairment, skeletal abnormalities, and heart defects

59
Q

Describe patients w/ Chediak-Higashi anomalies

A
  • Partial albinism, splenomegaly, hepatomegaly

- Early death from infections

60
Q

A differential w/ appropximately 10% bi-lobed neutrophils is most characteristic of what condition?

A

Acquired Pelger-Huet anomaly

Liz's Hematology Module 2 (13 decks)

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