WBC Flashcards

1
Q

• Affects both cellular and humoral immunity
• Patients exhibits : ⇣ T cells, poorly functioning B cells,
hypogammaglobulinemia
• Gamma chain deficiency : mutations in IL2RG gene
(IL 2,4,7,9,15,21)

A

Severe Combined Immunodeficiency disorder (SCID)

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2
Q

• X linked disease

A

➢Wiskott-Aldrich Syndrome (WAS)

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3
Q

Caused by one of 400 mutations in the WAS gene : (⇣ levels of
WASp proteins)

A

➢Wiskott-Aldrich Syndrome (WAS)

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4
Q

⇣ B cells, T, NK cells, neutrophils, monocytes are dysfunctional

A

Wiskott-Aldrich Syndrome (WAS)

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5
Q

• Absence or decreased size of thymus
• Low number of T lymphocytes

A

22q11 Syndromes

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6
Q

✓DiGeorge Syndrome
✓Sedlackova syndrome

A

22q11 Syndromes

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7
Q

✓Caylor cardiofacial syndrome
✓Shprintzen syndrome
✓Conotruncal anomaly face syndrome

A

22q11 Syndromes

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8
Q

• Antibody deficiency

A

Bruton tyrosine kinase Deficiency

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9
Q

mutation in the CHS1 LYST gene on chromosome 1q42.1-2 that encodes
for a protein that regulates the morphology and function of LYSOSOME-related organelles.

A

Chédiak – Higashi Syndrome

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10
Q

Inclusions that resembles the fused lysosomal granules in CHS

A

Pseudo Chédiak – Higashi

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11
Q

Congenital neutropenia (CN)
Low neutrophil count

A

Congenital defects of phagocytes

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12
Q

• defects of motility
• inability of neutrophils and monocytes to move from circulation to the site of inflammation (called extravasation)

A

Leukocyte Adhesion Disorders

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13
Q

only curative
treatment of Leukocyte Adhesion Disorders

A

Hematopoietic stem cell transplant

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14
Q

Types of Leukocyte Adhesion Disorders:

A

LAD I, II, III, SDS

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15
Q

Defects of respiratory burst

A

Chronic Granulomatous disease (CGD)

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16
Q

• caused by mutations in genes responsible for proteins
that make up the reduced form of (NADPH) oxidase
• patients experience life-threatening catalase-positive bacterial and fungal infections

A

Chronic Granulomatous disease (CGD)

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17
Q

warts, hypogammaglobulinemia, infections, and myelokathexis syndrome

A

WHIM syndrome

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18
Q

patients experience recurrent bacterial infections and are highly susceptible to human papillomavirus (HPV) infection, which leads to NEVER, which can be widespread and resistant
to treatmen

A

WHIM syndrome

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19
Q

characteristic spectacle-like (“pince-nez”) morphology with
the nuclei attached by a thin
filament

A

Pelger-Huët Anomaly

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20
Q

• decreased nuclear segmentation and distinctive coarse chromatin clumping pattern
• affects ALL leukocytes
• mutation in the lamin beta-
receptor gene.

A

Pelger-Huët Anomaly

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21
Q

• associated with severe bacterial infections, HIV, tuberculosis, and mycoplasma pneumonia

A

Pseudo- or Acquired Pelger-Huët Anomaly

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22
Q

NUMBER OFCELLS AFFECTED>68%TYPES OF WBC AFFECTED
: ALL WBC LINEAGES

A

(TRUE) Pelger Huët Anomaly

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23
Q

NUMBER OF
CELLS AFFECTED:
<35
TYPES OF WBC AFFECTED:
Neutrophil only

A

PSEUDO PHA

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24
Q

granulocytes with large, darkly
staining metachromatic cytoplasmic
granules (large azurophilic granules)

A

Alder-Reilly Anomaly

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25
T/F: Leukocyte function is affected in Alder-Reilly
FALSE; NOT
26
characterized by variable: •thrombocytopenia •giant platelets •large Döhle body-like inclusions in neutrophils, eosinophils, basophils, and monocytes
May-Hegglin Anomaly
27
What gene is mutated in chromosome mutation in the on chromosome 22q12-13.3
MYH9 gene
28
Enumerate Lysosomal Storage Disorders
Mucopolysaccharides, Gaucher's disease, Niemann Pick Disease
29
deficient activity of an enzyme necessary for the deg- radation of dermatan sulfate, heparan sulfate, keratan sulfate, and/or chondroitin sulfate
Mucopolysaccharidoses
30
the most common of the lysosomal lipid storage diseases?
Gaucher's Disease
31
defect or deficiency in the catabolic enzyme beta-glucocerebrosidase
Gaucher's Disease
32
Gaucher Disease has three subtypes. What is the most common subtype?
Subtype 1
33
deficiency of lysosomal hydrolase enzyme acid SPHINGOMYELINASE
Niemann-Pick Disease
34
neutrophils GREATER than ______ in adults or ____ in children
7.0x10^9/L and 8.5x10^9/L - Neutrophilia
35
a decrease in the Absolute Neutrophil Count to less than ____ in white adults or ____ in black adults
2.0x10^9/L or 1.3x10^9/L -Neutropenia
36
Neutrophilia is can occur as a result of ______ shift in neutrophils
catecholamine-induced
37
Give the diagnostic values of the following: Eosinophilia, and Eosinopenia
greater than 0.4x10^9/L less than 0.09x10^9/L
38
What WBC is increased when a patient has chronic myeloid leukemia, allergic rhinitis, hypersensitivity to drugs or food, chronic infections, hypothyroidism, chronic inflammatory conditions, radiation therapy, and bee stings?
Basophils
39
Basophilia is suspected when absolute basophil count greater than _____?
0.15x10^9/L
40
Diagnostic value for Monocytosis and Monocytopenia?
Monocytosis: greater than 1.0x10^9/L in adults and greater than 3.53x10^9/L in neonate Monocytopenia: absolute monocyte count of less than 0.2x10^9/L
41
Lymphocytosis vs Lymphocytopenia
Lymphocytosis: CHILDREN- greater than 10.0x10^9/L, whereas in ADULTS it is defined as a count greater than 5.0x10^9/L Lymphocytopenia: less than 2.0 x10^9/L, whereas in adults it is de- fined as a count less than 1.0x10^9/L
42
Lymphocytosis vs Lymphocytopenia
Lymphocytosis: CHILDREN- greater than 10.0x10^9/L, whereas in ADULTS it is defined as a count greater than 5.0x10^9/L Lymphocytopenia: less than 2.0 x10^9/L, whereas in adults it is de- fined as a count less than 1.0x10^9/L
43
first sign of recovery after myelosuppression
Monocytosis
44
contagious illness caused by a virus called Epstein-Barr virus (EBV) also called as "kissing disease"
Infectious Mononucleosis
45
In Epstein-Barr virus (EBV) infection, there is typically an increase in the number of white blood cells called _____, specifically _____.
lymphocytes specifically B lymphocytes
46
General characteristics of Myelogenous leukemia (non-lymphocytic leukemia)
• Myeloperoxidase : positive (+) • Sudan Black B : positive (+)
47
Presence of Auer rods • Most common type of leukemia in adults
Acute Myelogenous Leukemias (AML)
48
• Based on CYTOGENETICS and Molecular studies • At least 20% blasts in bone marrow to diagnose AML
WHO
49
• Based on MORPHOLOGY and cytochemistry • Based on Romanowsky-Stained smears • Pseudo-pelger-huet cells in the granulocytic cell line • Auer rods
French-American-British
50
(AML, Minimally Differentiated)
MO
51
● Blasts having CD13, CD33, CD34 and CD117 ● NO EVIDENCE OF CELLULAR MATURATION of Blasts ● Auer Rods (-), Myeloperoxidase (-), Sudan Black B (-) ● Less than 5% of All AML ● Patients are usually infants or older adults
M0 (AML, Minimally Differentiated)
52
M1
(AML, Without Maturation)
53
● Blasts having CD13, CD33, CD34 and CD117 similar with those of M0 ● 90% of Cells in BM are BLASTS ● Found in All Age Groups with Highest Incidence in Adults ● Has No Male or Female Predominance
M1 (AML, Without Maturation)
54
● Nuclear:Cytoplasmic Maturational Asynchrony ○ Morphologically - Nucleus appears more immature than Cytoplasm ○ Functionally - Leukemic Blasts exhibits Phagocytosis w/c is a property only of a Mature WBC
M1 (AML, Without Maturation)
55
● Auer Rods (+), Myeloperoxidase (+), Sudan Black B (+) ● Chloroacetate Esterase (+), Acetate Esterase (-)
M1 (AML, Without Maturation)
56
● Greater than 20% Type I and II Blasts in Bone Marrow ○ At least 10% Granulocyte @ Various Stages of Maturation ● Distinguished from M1 by Presence of Granulocytic Cells At or Beyond the Promyelocytic Stage of Maturation ● Characteristic GINGIVAL BLEEDING
M2 (AML, With Maturation)
57
● Pseudo-Pelger-Huet (+) - Rod-Shaped or Dumbbell-Shaped or Nonsegmented Nuclei ● Hypogranular Neutrophils (+) - Leads to Deficient Phagocytosis, Deficient Microbial Killing and Deficient Chemotaxis ● Auer Rods (+), MPO (+) and SBB (+) ● Aspects of DYSPLASIA are present
M2 (AML, With Maturation)
58
● AKA Hypergranular PROmyelocytic Leukemia ● Found in all age groups similar to M1 and M2 ● Greater Predilection for Males
M3 (Acute Promyelocytic Leukemia) APL
59
● Frequently more associated with Disseminated intravascular coagulopathy (DIC) ● Abnormal Promyelocytes with Heavy Granulation ● Presents with LEUKOPENIA ● Auer Rods (+) and Intensely Positive for MPO and SBB ● Faggot Cells (+) ● RENIFORM or Bilobed Nuclei
M3 (Acute Promyelocytic Leukemia)
60
(Microgranular Promyelocytic Leukemia)
M3m
61
● numerous granules present but can only be detected by electron microscopy hence the term “MICROGRANULAR” ● Has WORSE Prognosis than M3 due to Initial High Blast Counts
M3m (Microgranular PROmyelocytic Leukemia)
62
M3m (Microgranular Promyelocytic Leukemia) is caused by a ________
Chromosomal Translocation t(15;17)
63
M4 (Acute Myelomonocytic Leukemia) AKA
Naegeli Monocytic Leukemia
64
● Positive for Myeloid Antigens - CD13 and CD33 ● Auer Rods (+), MPO (+), SBB (+), Specific and Non-Specific Esterases (+)
M4 (Acute Myelomonocytic Leukemia)
65
M4 (Acute Myelomonocytic Leukemia) are POSITIVE for Monocytic Antigens - GIVE THE 6 ANTIGENS
CD4, 11b, 11c, 14, 36, 64
66
● Lysozyme - Muramidase > contained in LARGER amounts in Monocytes > excreted in large amounts in URINE when there is what kind of leukemia?
M4 (Acute Myelomonocytic Leukemia)
67
Diagnostically Important for M4 Leukemia - 3x the Upper Limit is Significant
Serum or Urine Lysozyme
68
● Caused by a Problem in Chromosome 16
M4 (Acute Myelomonocytic Leukemia)
69
M4eo specific name
(Acute Myelomonocytic Leukemia w/ Eosinophilia)
70
● Increased Marrow Eosinophils ● Cells exhibit Large Basophilic Granules mixed with Smaller Eosinophilic Granules
M4eo (Acute Myelomonocytic Leukemia w/ Eosinophilia)
71
● Uniquely exhibits Distinct Chloroacetate Esterase (+) and PAS (+) which differentiates it from normal eosinophils
M4eo
72
M4eo Chloroacetate Esterase +/- PAS +/-
BOTH POSITIVE
73
● AKA Schilling Leukemia
M5 (Acute Monocytic Leukemia)
74
● Presents w/ Highest Incidence of Organomegaly and Organ Involvement of all AMLs ● Greater than 80% of Marrow Cells are Monoblasts, Promonocytes or Monocytes
M5 (Acute Monocytic Leukemia)
75
● Auer Rods (+), MPO (-), SBB (-), Specific Esterase (-) Associated with problems in Chromosome 11, t(9;11)
M5 (Acute Monocytic Leukemia)
76
M5a vs M5b
M5a (Poorly Differentiated) and M5b (Well Differentiated)
77
● Characterized by Large Blast Cells with Delicate, Lacy Chromatin in both blood and bone marrow ○ 1-3 Large, Prominent Vesicular Nucleoli are present ○ Voluminous Cytoplasm with 1 or More Pseudopods
M5a (Acute Monocytic Leukemia, Poorly Differentiated)
78
● More than 80% of Monocytic Compartment Predominance are BLASTS
M5a
79
● Characterized by Presence of ALL STAGES OF MONOCYTE DEVELOPMENT (Monoblasts, Promonocytes and Monocytes)
M5b
80
● Associated with DIFFUSE ERYTHEMATOUS SKIN RASH
M5b
81
● Predominant Cell in BM in M5b
Promonocyte
82
DiGuglielmo’s syndrome
M6 (Acute Erythroleukemia)
83
● Variable WBC Count and Pancytopenia occurs ● Presence of Numerous Nucleated RBCs ● Mixed Populations of HYPOchromic and NORMOchromic RBCs
M6 (Acute Erythroleukemia)
84
frequently progresses to M1, M2 or M4 Leukemia
M6
85
● Alpha-Naphthyl Acetate Esterase (+) ● Auer Rods (+) Defect in Chromosome 5 and 7
M6
86
Distinct Feature of M7
Myelosclerosis
87
(Acute MEGAakaryocytic Leukemia)
M7
88
● MPO (-), SBB (-) and Esterase (-) ● Alpha-Naphthyl Acetate Esterase (+) ●Alpha-Naphthyl Butyrate Esterase (-)
M7 (Acute Megakaryocytic Leukemia)
89
● Unique Cytochemistry for MEGAkaryoblasts ● PAS (+)
M7
90
● CD41, CD42b and CD61 ● Defect in Chromosome 21
M7