WBC Abnormalities Flashcards
0
Q
Increases risk of infection from host organisms
A
Agranulocytosis
1
Q
Major causes of neutrophilia
A
1 Infection
2 Inflammation
3 Malignancy
2
Q
Released in response to acute infection, trauma or inflammation
A
Colony-stimulating factor
3
Q
Causes of leukopenia
A
1 Viral infections
2 Overwhelming bacterial infections
3 Bone marrow disorders
4 Certain drugs (barbiturates, neurologic drugs, certain antibiotics, anticonvulsants)
4
Q
What are leukemoid reactions?
A
Reactive leukocytosis seen in leukemia characterized by blasts, promyelocytes, myelocytes, and metamyelocytes
5
Q
Presence of nucleated RBCs and immature neutrophils
A
Leukoerythroblastic reaction
6
Q
Physiologic cause of neutrophilia
A
Response to therapy
7
Q
Causes of leukoerythroblastic reactions
A
Damage to marrow and extramedullary hematopoiesis (tumor, fibrosis, lymphoma or leukemia)
8
Q
Neutrophilia is associated with
A
1 Acute inflammation 2 Acute stress 3 Myelocytic leukemia 4 Eclampsia 5 Gout 6 Autoimmune diseases (rheumatoid arthritis, thyroiditis) 7 Trauma
9
Q
Two kinds of neutrophilia
A
Acute shift
Chronic stimulation
10
Q
Basophilic leukocytosis
A
Basophilia
11
Q
Causes of neutropenia
A
1 Increased neutrophil destruction (overwhelming infection; bacteria such as Typhoid, Paratyphoid, Brucellosis; viruses such as measles, yellow fever, Hepatitis A, IM, Rubella; immune reactions such as isoimmune, autoimmune or drug-induced; other mechanisms such as sequestration, pseudoneutropenia, malignant myeloproliferative disorders)
2 Decreased neutrophil production
12
Q
Excess cytokine stimulates proliferative pool
A
Chronic stimulation
13
Q
Pathologic causes of neutrophilia
A
1 Infections (pyogenic bacteria, rabies, variola, herpes zoster, chicken pox, Actinomyces fungi, some spirochetal and rickettsial organisms) 2 Inflammatory responses to tissue destruction (serosal, visceral, blood destruction, posttraumatic, thermal injury, chemicals, drugs, venoms, parasitic invasions, autoimmune disorders) 3 Other inflammatory responses (neoplastic growth, metabolic disorders, acute hemorrhage) 4 Drugs (corticosteroids, lithium)
14
Q
Abnormally low number of neutrophils
A
Neutropenia
15
Q
Usually occurs secondary to viral infection
A
Leukopenia
16
Q
Presence of precursor granulocytes in the peripheral blood
A
Shift to the left
17
Q
T or F. There is an increased total WBC count in acute shift neutrophilia
A
F. Only measured WBC is increased
18
Q
Neutropenia is associated with
A
1 Aplastic anemia 2 Chemotherapy 3 Radiation therapy or exposure 4 Viral infection 5 Widespread severe bacterial infection
19
Q
Acquired causes of decreased neutrophil production
A
1 Chemical toxicity due to chemotherapy (ionizing radiation, benzene)
2 Marrow replacement
3 Nutritional deficiency
4 Cytotoxic drugs
20
Q
Dominance of immature forms of neutrophils in the blood
A
Left shift
21
Q
Common in myelofibrosis
A
Severe disruption of the marrow
22
Q
Causes of chronic stimulation
A
1 Infection 2 Down's syndrome 3 Pregnancy/eclampsia 4 Chemotherapy recovery 5 Myeloproliferative disorders 6 Marrow metastasis
23
Q
Monocytic leukocytosis
A
Monocytosis
24
Eosinophilic leukocytosis
Eosinophilia
25
Two types of causes of decreased neutrophil production
1 Inherited
| 2 Acquired
26
Inherited causes of decreased neutrophil production
1 Defective stem cell development (reticular dysgenesis, cyclic neutropenia, infantile agranulocytosis, Fanconi's syndrome)
2 Genetic disorders of the immune system
3 Disorders of cellular development (Chediak-Higashi syndrome, Lazy leukocyte syndrome)
27
Presence of bilobed neutrophils with more condensed chromatin
Pseudo-Pelger Huet Anomaly
28
Affects platelets
May-Heggelin Anomaly
29
Immunologic neutropenia
Drug-induced
30
Classification of neutrophil morphologic abnormalities
1 Cytoplasmic morphologic abnormalities
| 2 Nuclear morphologic abnormalities
31
Cytoplasmic morphologic abnormalities of neutrophils
```
1 Toxic granules
2 Dohle bodies
3 May-Heggelin Anomaly
4 Cytoplasmic vacuolation
5 Pseudopods
6 Auer rods
```
32
Neutrophilia quantitative abnormalities
Neutrophilia
| Neutropenia
33
Found in segmented and band neutrophils
Dohle bodies
34
Nuclear morphologic abnormalities of neutrophils
```
1 Pyknotic nuclei
2 Hypersegmented nuclei
3 Toxic nuclear projections
4 Ringed nuclei
5 Chediak-Higashi syndrome
```
35
Most common cause of leukopenia
Neutropenia
36
Cause of toxic granules
Stimulation by antigens
38
Produces vacuoles that are large and unevenly distributed
Phagocytosis of extracellular material
39
Pseudo-Pelger Huet Anomaly is found in
```
1 Inherited myelodysplastic syndrome
2 Idiopathic myelofibrosis
3 Chronic granulocytic leukemia
4 Therapy with colchicine
5 Ibuprofen infectious mononucleosis
6 Malaria
7 Myxedema
8 Chronic lymphocytic leukemia
```
40
Characteristics of dohle bodies
1 Pale blue
2 Round or elongated bodies
3 1-5 mcm located near cell membranes
41
Inherited condition that causes large Dohle-like inclusion bodies present primarily in neutrophils
May-Heggelin Anomaly
42
Indicates sluggish neutrophil locomotion
Pseudopods
43
WBC < 4,000
Leukopenia
44
Neutrophilia qualitative abnormalities
1 Shift to the left
2 Pelger-Huet
3 Pseudo-Pelger Huet Anomaly
45
Produces vacuoles that are small and evenly distributed
Autophagocytosis
46
Characteristics of toxic granules
1 Large
2 Dark blue-black
3 Clustering within the cell
47
Temporary or transient leukocytosis
Leukemoid reaction
48
What are dohle bodies?
Cytoplasmic inclusions consisting of rRNA in parallel rows
50
Chediak-Higashi Syndrome affects
Neutrophils
Monocytes
Lymohocytes
51
Shift to the left is found in
1 Pregnant women or neonates
2 Infections
3 Bone marrow fibrosis
4 Bone marrow infiltration by malignancies
52
What are pseudopods?
Granule-free protrusions of cytoplasm
53
Causes of autophagocytosis
Sulfonamides and chloroquine
| Prolonged storage of cells
54
Increased proportion of toxic granules is associated with
Poor prognosis
56
Degranulation on exposure to toxins and high dose radiation
Autophagocytosis
57
Altered primary granules
Toxic granules
59
Neutrophilic leukocytosis
Neutrophilia
60
Acute shift from ___ to ____
Marginating
| Circulating pool
61
Types of cytoplasmic vacuolation
1 Autophagocytosis
| 2 Phagocytosis of extracellular material
62
Auer rods are found in
Acute myeloblastic leukemia
| Myelodysplastic syndrome
64
Anomaly in which most neutrophils have round or bilobed nuclei
Pelger-huet
65
Toxic nuclear projections are seen in
Metastatic carcinoma
| Irradiation
66
Lymphocytic leukocytosis
Lymphocytosis
68
Abnormally high number of neutrophils
Neutrophilia
69
Best indicator of severity of infection
Ratio of nonsegmented and segmented neutrophils
70
WBC > 10,000
Leukocytosis
71
Causes of acute shift
```
1 Steroid treatment
2 Exercise
3 Epinephrine
4 Hypoxia
5 Seizures
6 Other stress
```
72
Associated with toxic granules and seen in sepsis
Phagocytosis of extracellular material
73
Small azurophil rods in the cytoplasm of myeloblasts and promyelocytes; sometimes found in mature neutrophils
Auer rods
73
Not lobed or not segmented neutrophils
Ringed nuclei
74
Caused by prolonged specimen storage in EDTA
Pseudopods
76
Toxic nuclear projections are seen in
the inner side of band forms facing the centriole
79
Shrunken and dense nuclei
Pyknotic nuclei
79
Causes of pyknotic nuclei
Poor staining or preparation
| Acute myeloid leukemia (AML)
80
Pyknotic nuclei are seen in
sepsis
81
Rare fatal hereditary disorder found in children making them prone to infections
Chediak-Higashi Syndrome
82
Eosinophil quantitative abnormalities
Left shift eosinophilia
| Eosinopenia
83
High count of eosinophil which may be inherited, malignant or reactive
Eosinophilia
84
Association of eosinophil count and parasitic death
Reactive eosinophilia
85
Persistent and extreme eosinophilia (parasitic, allergic, malignant, idiopathic)
Hypereosinophilic syndrome
86
Morphology of left shift eosinophilia
Eosinophil metamyelocyte in peripheral blood
86
Left shift eosinophilia is seen in
1 Reactive eosinophilia
2 Myeloproliferative disorders
3 Acute myeloid leukemia
87
Low count of eosinophils
Eosinopenia
87
Causes of eosinopenia
1 Production abnormalities
| 2 Adenocorticotropic hormone (ACTH) administration
88
Seen in acute bacterial infections due to sequestration, margination, and chemotaxis
Eosinopenia
89
Eosinophil qualitative abnormalities
1 Degranulation
2 Vacuolation
3 Hypersegmentation
90
Most prominent eosinophil alteration
Degranulation
91
Requirement to obtain absolute vacuole
1000-cell differential counts
92
Allows identification of basophils in > 10,000 WBCs
Flow cytometer
93
Basophil quantitative abnormalities
Basophilia
| Basopenia
94
Causes of basopenia
1 Acute infections
2 Stress
3 Hypothyroidism
4 Increased glucocorticoids
95
Seen in conditions caused by eosinophilia
Basophilia
96
Basophilia in newborns
Transient
97
Cause of Chediak-Higashi Syndrome
Impaired neutrophil function (impaired lysosome degranulation with phagosomes leading to decrease in phagocytosis)
98
Causes of monocytopenia
Administration of glucocorticoids
| Overwhelming infections
99
Self-limited, lymphoproliferative responses
Nonmalignant, reactive disorders
100
Hypersegmented nuclei are seen in
long term infections
101
Hypersegmented nuclei are found in
```
1 Megaloblastic anemia
2 Iron deficiency
3 Chronic infection
4 Liver disease
5 Uremia
```
101
Leukemia that occurs mainly in adults
Chronic myeloid/myelogenous leukemia (CML)
102
Causes of basophil qualitative abnormalities
Ingestion of fatty meal
| Antigen-related stimulation
103
Basophil qualitative abnormality
Degranulation
104
Functionally immunocompetent lymphocyte
Type I
105
Hairlike projections
Toxic nuclear projections
106
Proliferation of cytotoxic T cells are seen during the second week
Infectious mononucleosis
107
Monocyte quantitative abnormalities
Monocytosis
| Monocytopenia
108
Causes of lymphopenia
```
1 Immunodeficiency syndrome
2 Corticosteroid therapy
3 Neoplasia
4 Radiation therapy
5 Chemotherapy
```
110
Accompanies neutrophilia
Monocytosis
112
Basis of classification of leukemia
Duration
| Type of blood cell affected
113
Plasmacytoid lymphocyte and Turk's irritation cell
Type I
114
Causes of monocytosis
```
1 Chronic bacterial infection (bacterial endocarditis, malaria, TB, typhoid)
2 Chronic inflammation (collagen vascular diseases, SLE, rheumatoid arthritis, ulcerative colitis, sarcoidosis)
3 Malignant (AML, CA myelodysplastic syndrome, Hodgkin's disease)
4 Others (post splenectomy, chronic neutropenia)
```
115
Monocyte qualitative abnormality
Response to stimuli
117
Most common type of leukemia in young children
Acute lymphocytic leukemia (ALL)
118
Cancer of the lymph nodes
Lymphoma
120
Transformed or reticular lymphocytes
Type III
121
Malignant proliferation of immature forms of WBC in the peripheral circulation and in the lymph nodes
Leukemia
123
Benign disorders
(Review)
125
What happens in monocyte qualitative abnormality?
1 Immature monocytes
2 Transformation into histiocytes, macrophages
3 Alteration of nucleus into long thin band-like shape
127
Morphology of reactive lymphocytes
Type I
Type II
Type III
128
Lymphocyte abnormalities
```
1 Nonmalignant reactive disorders
2 Lymphocytosis
3 Reactive lymphocytes
4 Infectious mononucleosis
5 Autoimmune lymphoproliferative syndrome
```
129
Leukemia that occurs in both adults and children
Acute myeloid/myelogenous leukemia (AML)
| Acute non-lymphocytic leukemia
131
Leukemia that affects adults over the age of 55
Chronic lymphocytic leukemia (CLL)
132
Fried egg or flared skirt appearance of a lymphocyte
Type II
133
Malignant proliferation of plasma cells
Myeloma
134
Infectious mononucleosis cell
Type II
137
Examples of lymphoma
Non-hodgkin's lymphoma
| Hodgkin's disease
138
Neoplastic disorders of WBC
Myeloproliferative disorders
Lymphoproliferative disorders
Immunoproliferative disorders
139
Reactive lymphocyte of B-cell origin
Type I
140
Basophilia caused by Type I hypersensitivity reactions, long-term foreign antigen stimulation, hypothyroidism, ulcerative colitis, estrogen therapy
Reactive Basophilia
142
Derived from a single precursor cell with all the affected cells (progeny) showing features of deviation from the precursor cell
Neoplastic disorders of WBC
145
Diagram of classifications of leukemia
(Review)
146
Lymphocyte abnormality that occurs most frequently during viral infections
Lymphocytosis
147
Absolute lymphocytosis
Increase in the number of circulating lymphocytes (lymphocytes in the peripheral blood increase in the marginal and circulating pool)
151
Relative lymphocytosis
Increase in the percentage of circulating lymphocytes
152
Other terms for reactive lymphocyte
1 Atypical
2 Variant
3 Downey cell
153
Ringed nuclei are found in
Toxic and malignant myeloproliferative states
