WBC Flashcards
Predominant WBC in adults
Neutrophils
Predominant WBC in children <4 yrs old
Lymphocyte
On determining WBC maturity, MOST valuable and reliable criterion is
Nuclear chromatin pattern
Examples of granulocytes and polymorphonuclears
Basophil
Eosinophil
Neutrophil
Examples of agranulocyte and mononuclears
Lymphocytes
Monocytes
Examples of phagocytes
Basophilic
Eosinophil
Neutrophil
Monocytes
Example of immunocyte
Lymphocyte
As granulocytes mature, the overall size decreases (true or false )
True
Most recognizable granulocytic precursor using light microscope
Myeloblast
Type of myeloblast that shows the presence of dispersed primary granules in the cytoplasm
Type II myeloblast
The synthesis of primary granules begins in the
Type II myeloblast or PROMYELOCYTE (BEST))
Last stage capable of mitosis ; synthesis of secondary granules begins
Myelocyte
Patches of grainy pale pink cytoplasm representing secondary start to become obvious in the area of the Golgi apparatus
Dawn of neutrophilia
Synthesis of tertiary granules begins ; JUVENILE CELL ; first stage of nuclear indention ; PEANUT/KIDNEY bean shaped
Metamyelocyte
STAB CELL/STAFF CELL ; YOUNGEST GRANULOCYTIC PRECURSOS to normally appear ; SAUSAGE NUCLEUS - 1/2 of the nuclear width
BAND
Drugs associated with Extreme neutropenia
Amidopyrine and Cephalosphorin (<0.5x109/L)
Predominant type of lymphocyte (normal adult blood) ; composed of mostly nucleus , scanty cytoplasm
Small lymphocyte
Size of small lymphocyte
7-10 um
Size of medium lymphocyte
10-12 um
Size of large lymphocyte
11-25 um
Final maturation of stage of b-lymphocyte
Plasma cell
Nucleus is “TORTOISE SHELL” CARTWHEEL” or “CLOCK FACE” appearance
PLASMA CELL
Cytoplasm is dark blue, SEA BLUE, CORNFLOWER in color
Plasma cell
Cytoplasm of plasma cell may contain round, discrete globules called _______ that contain immunoglobulins
RUSSEL BODIES
Most common malignant disease of plasma cells
Plasma cell myeloma
Most abundant cells in the body
Macrophages
This is produced by macrophages that is cytotoxic against viruses, bacteria, fungi, Protozoa, helminths, and tumor cells
Nitric oxide
Released by the macrophages that stimulates T lymphocytes
Interleukin 1
Produced by macrophages that acts as the primary transport factor for vitamin b12
Transcobalamin II
Liver macrophage
Kupffer cells
Lungs macrophage
Alveolar macrophage / dust cells
Kidneys macrophage
Mesangial cells
Brain macrophage
Microglial cells
Skin macrophage
Langerhans cells
Spleen macrophage
Littoral cell
Synovial tissue macrophage
Type A cells
Bone macrophage
Osteoclast
Placenta macrophage
Hoffbauer cells
Lobes of neutrophil
3-5 lobes
Movement of neutrophil in normal condition
Zigzag manner
Neutrophils share a common progenitor with montocytes which is:
Granulocyte Monocyte Progenitor
Major stimulatory cytokines for neutrophil production
G-CSF
Half life of neutrophils in the blood is relatively short (approximately _____)
7 hours
Extracellular threadlike structures thought to represent chains of nucleosomes from unfolded nuclear
Neutrophil Extracellular Traps (NETs)
Order of formation of neutrophil granules
Primary > Secondary > Tertiary > Seecretory
Order of degranulation of neutrophil granules
Secretory > tertiary > secondary > Primary
Primary granules contents of Neutrophil
Myeloperoxidase
Acid B-glycerophosphatase
Lysozyme
Cathepsins
Defensins
Elastase
Proteinase-3
Secondary granules contents of Neutrophil
B2-microglobulin
Collagenase
Gelatin are
Lactoferrin
Neutrophil gelatinase-associated lipocalin
Transcobalamin I
Lysozyme
Lysozyme that is anti microbial
Muramidase
Tertiary (gelatinase granules) contents of Neutrophil
Gelatinase
Collagenase
Lysozyme
Acetyltransferase
B2-microglobulin
Formed during the band and segmented neutrophil stages
Secretory granules
Secretory granules contents of Neutrophil
Cd11b/CD18
Vesicle-associated membrane-2
CD10, CD13, CD14, CD16
Cytochrome b558
Complement 1q receptor
Alkaline phosphates
Complement receptor-1
A CD that contributes to tight stationary binding between neutro and endothelial cells
CD11b/CD18
Only WBC that has ALP activity
NEUTROPHIL
Promotes terminal maturation, functional activation, and prevention of apoptosis of eosinophil
IL-5
Causes mast cell degranulation and cytokine production
Major Basic Protein
Survival time of eosinophil in human tissues
2-5 days
Eosinophil Primary Granules contents
Charcot-Leyden Crystals
Eosinophil secondary granules contents
Major basic protein
Eosinophil cationic protein (matrix)
Lysozyme
Catalase
Eosinophil small lysosomal granule contents
Acid phosphatase
Catalase
Elastase
Eosinophil lipid bodies contents
Cyclooxygenase
Eosinophil peroxidase
Esterase
Carry proteins from secondary granules to be released into the extracellular medium
Secretory vesicles
Basophil granules
Histamine
Interleukin-4
Interleukin-13
Chondroitin sulfates (heparin)
A dye that can bind with acid mucopolysaccharides in blood cells to form metachromatic complexes
Toluidine blue
Histochemically defined as a reaction product color that is considerably different from the color of the dye itself
Metachromasia
Least common WBC in normal peripheral blood
Eosinophil
Have IgE receptors on their surface membrane ; induces B cells to synthesize IgE ; involved in the control of helminth infections
Basophil
Connective tissue cell that has large basophilic granules containing heparin, serotonin, bradykinin, and histamine
Mast cell
Round horse-shoe shaped or lobulated m usually with some degree of folding or convulsions ; chromatin: lace-like or stringy
Monocytes
Cytoplasm blue-gray contains fine indistinct granules called AZURE DUST (GROUND GLASS appearance) ; small pseudopods or bled may be observed
Monocytes
This WBC is said to be rich in muramidase
Monocytes
Cytoplasm isi sky blue or “Robin egg” blue
Lymphocytes
Cells for adaptive immunity
T and B cells
Cells for innate immunity
NK cells
LYMPHOCYTE TYPE: Plasmacytoid lymphocyte, Turk’s irritation ; seen in German measles
TYPE 1
LYMPHOCYTE TYPE: seen in Downey infection mononucleosis cell ; aka infectious mononucleosis ; “flared skirt” or “fried egg” appearance
Type II
LYMPHOCYTE TYPE: nucleus finally reticulated nuclear chromatin pattern
Type III
Most common counting chamber (hemacytometer/hemocytometer)
Levy chamber with improved neubauer ruling
The 4 corner large squares of the Nuebauer counting chamber is used for
Manual WBC count
The middle square square of the Nuebauer counting chamber is used for
Manual RBC count
Markings of RBC Thomas Pipet
0.5, 1, 101
Markings of WBC Thomas pipet
0.5, 1, 111
color of the bead of RBC Thoma pipet
Red
color of the bead of WBC pipet
White or colorless
RBC Thoma pipet volume (bulb)
100
WBC Thoma pipet volume (bulb)
10
WBCs diluting fluids
1% ammonium oxalate
3% acetic acid
1% hydrochloric acid
Diluting fluids for platelets
1% ammonium oxalate
RBC diluting fluid
Isotonic saline
Dilution and Area counted for WBC
1:20 (4 mm^2)
1:100 (9 mm^2)
Allow the dilution to sit for _____ mins to ensure that the RBCs have lysed ; WBC counts should be performed within ___ hrs of dilution
10 mins ; 3 hours
Charge both sides of the hemacytometer by holding the microhematocrit tube at ____ degree angle
45 degree
After charging the hemocytometer, place it in a ______ for ____ mins before counting the cells to give them the time to settle
Moist chamber ; 10 mins
WBCs read using what objective
Low power 10x
For a 1:20 dilution, count all of the cells in the ______ squares
4 corner squares
Cells touching the TOP and LEFT lines must be?
Counted
Cells touching the bottom and right lines must be ??
Ignored
WBC count formula
No. Of cells/ul = cells ctd x df / area (mm2) x depth (0.1)
Percentage difference formula
V1-V2 / (V1 + V2 / 2) X 100
This is performed if there are >5 NRBCs seen in 100 WBCs
Corrected WBC count
CORRECTED WBC COUNT FORMULA
Uncorrected WBC ct x 100 / (100 + NRBCs)
Routinely performed wbc diff count
100-cell differential
WBC diff count that performed in instances when the EBC count is >40x10^9/L to increase accuracy fo results ; results are then divided by 2
200-cell differential
200-cell differential may also be performed in cases when?
> 10% eosinophil, basophil
11% monocytes
More lymphocytes than neutrophils (except for children)
WBC diff count that is performed in instances when the WBC count is >100 x 10^9/L to increase accuracy of results
300 or 400 - cell differential
WBC differential that is performed in instances when the WBC count is <1.0 x 10^9/L ; performed using a buff coat smear ; results are multiplied by 2 to get a percentage
50-cell differential
Gives the number of specific WBC type per 100 WBCs ; not as informative as the absolute count
Relative count
Relative WBC ct formula
(# of specific WBC type per/100 WBCs counted) x 100
Relative count Reference range for neutrophil
51% to 67%
Relative count Reference range for lymphocyte
25% to 33%
Relative count Reference range for monocyte
2% to 6%
Relative count Reference range for basophil
0% to 1%
Gives the number of specific WBC type per cubic millimeter of blood ; more informative than the relative count
Absolute count
WBC Absolute count formula
Relative count (%) x WBC count = /mm^3 of blood
Absolute count Reference range for neutrophil
1,600/uL to 7,260/uL
Absolute count Reference range for lymphocyte
960/uL to 4,400/uL
Absolute count Reference range for monocyte
180/uL to 880/uL
Absolute count Reference range for eosinophil
45/uL to 440/uL
Absolute count Reference range for basophil
45/uL to 110/uL
What shift is it when there is an increase in the number of young forms (usually neutrophils)
Shift to the left
What shift is it when there is an increase in the number of old forms (e.g. pernicious anemia)
Shift to the right ( OLD PEOPLE ARE ALWAYS RIGHT)
A shift to the left in which there is an increase in the number of young forms with NORMAL or LOW WBC count (e.g. tuberculosis)
Degenerative shift to the left
A shift to the left in which there is an increase in the number of young forms with HIGH WBC count (e.g. appendicitis)
Regenerative shift to the left
A non specific reaction but provides important evidence of underlying disease or stress the hematopoietic compartment
Leukoerythroblastic reaction
This is strongly associated with primary myelofibrosis
Leukoerythroblastic reaction
Leukoerythroblastic reaction is present on a blood smear of
Immature of neutrophil
Nucleated rbc
Teardrop cell
Observed in conditions involving the presence of space occupying lesion in the marrow (myelophthisis) such as metastatic tumor, fibrosis, lymphoma, leukemia
Striking and sustained Leukoerythroblastic reactions
Observed in hemolytic anemia, severe infections, cardiac failure, uremia, megalosblastic anemia
Mild and transitory Leukoerythroblastic reactions
Nuclear remnants of lymphocytes ; appearance similar to thumb print ; structureless chromatin
Smudge cell
Nuclear remnants of granulocytic cells ; netlike chromatin pattern
Basket cells
Granulocytic cells with pyknotic nuclei and an agranular cytoplasm
Necrotic cells
Neutrophils that have engulfed foreign bodies like bacteria and fungi
Phagocytic cell
Large cells which line the veins ; stretched and ovoid in appearance ; with single nucleus with dense chromatin and no nucleoli ; abundant cytoplasm which appears translucent ; found at the feathered edge
Endothelial cells
NUDE nuclei that stain dark purple
Megakaryocyte fragments
May be associated with chronic lymphocytic leukemia ; may be found normally in few numbers
Smudge cells
Found when prolonged exposure to EDTA ; chemotherapy (rarely)
Necrotic cells
Considered a contaminant of venipunctrue ; must not be confused with clumps of malignant cells
Endothelial cells
May be found in newborns ; may be found also in aberrant platelet production, myelofibrosis, essential thrombocythemia
Megakaryocyte fragments
May be found in newborns ; may be found also in aberrant platelet production, myelofibrosis, essential thrombocythemia
Megakaryocyte fragments
Resembles hand mirror ; seen in ALL, AML, IM
Hand mirror lymphocytes
Benign ; mild symptoms ;
Myeloperoxidase deficiency
