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Hematology 430 > WBC > Flashcards

WBC Flashcards

1
Q

Pelger-Huet anomaly morphology

A

Look: Decrease nuclear segmentation, Bilobed forms
coarse chromatin, Round nuclei
Gene: Lamin-beta-receptor gene

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2
Q

Alder-Reilly anomally

A

Look: Granules with large, dark staining —> Incomplete degration of lipids
Mutation at: a-L-iduronodase

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3
Q

Chediak-Higashi syndrom

A

Look: Abnormal fusion of granules, giant lysosomal granules
Caused by: Lysosomal traffic regulation protein defect.
Affect: Decrease phagocytosis, Increase infection
Gene: CHS1 LYST gene

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4
Q

May-Hegglin anomaly

A

Look: Large Dohle body-like inclusion.
Caused by: Precipitated myosin heavy chain
Affect: Megakaryocyte maturation
Gene: MYH9

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5
Q

Chronic granulomatous disease

A

Look: normal
Caused by: Decrease ability to produce superoxide, reactive oxygen
Affect: Increase bacterial, fungal infection
Mutation: NADPH oxidase complex: X-link, autosomal recessive

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6
Q

Gaucher disease

A

Look: normal or Crinkled paper
Caused by: Accumulation of unmetabolized sphingolipid
Affect: Increase serum phosphatase, thrombocytopenia, Anemia
Mutation: beta- glucocerebrosidase

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7
Q

During exercise/adrenaline, which pool has more neutrophils?

A

Circulation

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8
Q

During infection/endotoxin/steroids, which pools has more Neutrophils?

A

Marginated pool

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9
Q

What hormone stimulate PMN from BM to PB?

A

G-CSF

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10
Q

A function of secretory granules of PMN?

A

Strengthen PMN

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11
Q

Function and examples of tertiary granules?

A

Movement through collagen

Activate IL-8 for recruits other PMN.

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12
Q

Function of Neutrophils

A

Fastest response to bacteria

  • Release lysozymes
  • Release defensin protein (~ antibiotic and poke a hole)
  • Release strong oxidants
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13
Q

Function of myeloperoxidase in PMN?

A

NADH in phagosomal —> Hypochlorite

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14
Q

What enzyme convert reactive oxygens to hypochlorite

A

Myeloperoxidase

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15
Q

What forms bactericidal molecules

A

Primary and secondary granules

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16
Q

Function of primary and secondary granules

A

Fuse to membrane and release to act as chemotactic agents:

  • attract macrophage
  • attract other PMN
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17
Q

Side effect of a fusion of 1st and 2nd granules

A

damage tissue

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18
Q

Cytokines of Eosinophils

A

GM-CSF, IL3, IL5

Transcription factor: GATA-1

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19
Q

Eosinophils degranulationa

A

Classical exocytosis
Compound exocytosis
Piecemeal degranulation
Cytolysis

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20
Q

Function of Eosinophils

A

Control helminth infection through:
MBP
Cationic proteins
Reactive oxygen species

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21
Q

Function of basophils in immunity

A

IgE synthesis induction
Allergic inflammation
Regulate Th2
Parasite infection

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22
Q

Function of Basophils in blood vessel

A

Angiogenesis

through VEGF

23
Q

Mast cell

A

12-25 um, elliptical shape
Chromatin condense
N:C = 1:5
No nucleoli, division

24
Q

Life span of Mast cell

A

MCP in BM and spleen
Precursor in PB and then move to tissue
Prominent in lung and intestine

25
Q

Function of Mast cell

A

Allergic reaction effector cell
Inflammatory reaction
APC
Anti-inflammatory and immunosuppressive

26
Q

Monocyte function

A 
TLR trigger phagocytes
Synthesis NO to kill organism
Fc & complement recceptor
—
APC
—
Pick up debris and recycle RBC
—
Synthesis proteins
Aid EPO
27
Q

Two type of DC

A
  1. Conventional: secrete IL-12, found on skin/mucosal, migrate to lymp
  2. Plasmacytoid: secrete IFN, found on lymphoid tissue
28
Q

Lymphocytes

A 
8-15um
Nu: oval, perinuclear zone
Chromatin: coarse
N:C = 2:1 (or 1:1)
Cytoplasm: darkly basophilic, no granules
29
Q

Incidence of B cells and T cells

A

BM: 0.2-2.8% B cells
PB: Rare B cells, mostly T cells

30
Q

Pelger-Huet anomaly - gene affected

A

Autosomal

Mutation in Lamin-b- receptor gene

31
Q

How many PMN get affected in Pelger-Huet Anomaly

A

Homo: all
Hete: 55-93% neutrophils

32
Q

How many PMN get affected in pseudo PHA

A

Less than 38%

33
Q

How much BM accounts for body weight?

A

3.4% - 5.9%

34
Q

what cells in yellow marrow

A

Adipocytes

35
Q

Function of Red marrow

A

Primary source of hematopoiesis

Produce 6 bil Blood cells/kg/day

36
Q

Cytopenia

A

Decrease of cells

37
Q

Cytosis

A

Increase of cells

38
Q

Normal range of MCV

A

80-100 fL

39
Q

Ref. range of MCH

A

26-32 pg

40
Q

Ref. range of MCHC

A

32-36 g/dL

41
Q

Rules of Three

A

Hgb x 3 = HCT +/- 3

42
Q

Preparation for BM sample collection

A

CBC and differential < 24 hrs

Fasting at least 6 hrs

43
Q

BM specimen collection site

A

Posterior super iliac crest

2nd favorite is Sternum

44
Q

BM Aspirate for making smear

A

Wright stain: morphology, differential, M:E ration

Prussian blue: Iron study

45
Q

BM Aspirate for tube collection

A
  1. EDTA: flow cytometry, molecular
  2. Heparin: cytogenetics
  3. Culture
  4. 10% formalin: histologic examination
46
Q

Advantage of BM Aspirate

A

Make smear immediately
Easy stained
M:E ration calculating

47
Q

Disadvantage of BM Aspirate

A

Small sample
Dry taps
Cellularity estimate is not correct (100% - the pt’s age)

48
Q

Dry tap?

A

Fibrotic, acellular, or packed with leukemic cells marrow

—> Collect BM biopsy if dry tap

49
Q

BM core biopsy

A

Cylindrical core of tissue

50
Q

BM core biopsy standard:

A

Length: 1.5 cm

Fit in 10% formalin for histologic examination

51
Q

Prepare BM biopsy if dry tap

A
  1. Make touch prep slides

2. Cut into 3 pieces: 1 in 10% formalin, 2 in RPMI medium

52
Q

advantage of BM biopsy

A

No dry tap
Good for cellularity
Minimal sampling error

53
Q

Disadvantage of BM’s biopsy

A

Loss morphological features
Complicated process
Hard to stain (too thick)

54
Q

Hematoxylyn and eosin stain

A

Standard dye for core biopsy

Evaluate cellularity and hematopoietic cell distribution

Hematology 430 (3 decks)

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