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Clinical Microscopy 2 > WBC Abnormalities > Flashcards

WBC Abnormalities Flashcards

0
Q

Increases risk of infection from host organisms

A

Agranulocytosis

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1
Q

Major causes of neutrophilia

A

1 Infection
2 Inflammation
3 Malignancy

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2
Q

Released in response to acute infection, trauma or inflammation

A

Colony-stimulating factor

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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)

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4
Q

What are leukemoid reactions?

A

Reactive leukocytosis seen in leukemia characterized by blasts, promyelocytes, myelocytes, and metamyelocytes

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5
Q

Presence of nucleated RBCs and immature neutrophils

A

Leukoerythroblastic reaction

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6
Q

Physiologic cause of neutrophilia

A

Response to therapy

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7
Q

Causes of leukoerythroblastic reactions

A

Damage to marrow and extramedullary hematopoiesis (tumor, fibrosis, lymphoma or leukemia)

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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
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9
Q

Two kinds of neutrophilia

A

Acute shift

Chronic stimulation

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10
Q

Basophilic leukocytosis

A

Basophilia

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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

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12
Q

Excess cytokine stimulates proliferative pool

A

Chronic stimulation

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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)
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14
Q

Abnormally low number of neutrophils

A

Neutropenia

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15
Q

Usually occurs secondary to viral infection

A

Leukopenia

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16
Q

Presence of precursor granulocytes in the peripheral blood

A

Shift to the left

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17
Q

T or F. There is an increased total WBC count in acute shift neutrophilia

A

F. Only measured WBC is increased

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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
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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

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20
Q

Dominance of immature forms of neutrophils in the blood

A

Left shift

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21
Q

Common in myelofibrosis

A

Severe disruption of the marrow

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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
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23
Q

Monocytic leukocytosis

A

Monocytosis

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24
Q

Eosinophilic leukocytosis

A

Eosinophilia

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25
Q

Two types of causes of decreased neutrophil production

A

1 Inherited

2 Acquired

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26
Q

Inherited causes of decreased neutrophil production

A

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)

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27
Q

Presence of bilobed neutrophils with more condensed chromatin

A

Pseudo-Pelger Huet Anomaly

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28
Q

Affects platelets

A

May-Heggelin Anomaly

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29
Q

Immunologic neutropenia

A

Drug-induced

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30
Q

Classification of neutrophil morphologic abnormalities

A

1 Cytoplasmic morphologic abnormalities

2 Nuclear morphologic abnormalities

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31
Q

Cytoplasmic morphologic abnormalities of neutrophils

A 
1 Toxic granules
2 Dohle bodies
3 May-Heggelin Anomaly
4 Cytoplasmic vacuolation
5 Pseudopods
6 Auer rods
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32
Q

Neutrophilia quantitative abnormalities

A

Neutrophilia

Neutropenia

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33
Q

Found in segmented and band neutrophils

A

Dohle bodies

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34
Q

Nuclear morphologic abnormalities of neutrophils

A 
1 Pyknotic nuclei
2 Hypersegmented nuclei
3 Toxic nuclear projections
4 Ringed nuclei
5 Chediak-Higashi syndrome
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35
Q

Most common cause of leukopenia

A

Neutropenia

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36
Q

Cause of toxic granules

A

Stimulation by antigens

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38
Q

Produces vacuoles that are large and unevenly distributed

A

Phagocytosis of extracellular material

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39
Q

Pseudo-Pelger Huet Anomaly is found in

A 
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
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40
Q

Characteristics of dohle bodies

A

1 Pale blue
2 Round or elongated bodies
3 1-5 mcm located near cell membranes

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41
Q

Inherited condition that causes large Dohle-like inclusion bodies present primarily in neutrophils

A

May-Heggelin Anomaly

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42
Q

Indicates sluggish neutrophil locomotion

A

Pseudopods

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43
Q

WBC < 4,000

A

Leukopenia

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44
Q

Neutrophilia qualitative abnormalities

A

1 Shift to the left
2 Pelger-Huet
3 Pseudo-Pelger Huet Anomaly

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45
Q

Produces vacuoles that are small and evenly distributed

A

Autophagocytosis

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46
Q

Characteristics of toxic granules

A

1 Large
2 Dark blue-black
3 Clustering within the cell

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47
Q

Temporary or transient leukocytosis

A

Leukemoid reaction

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48
Q

What are dohle bodies?

A

Cytoplasmic inclusions consisting of rRNA in parallel rows

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50
Q

Chediak-Higashi Syndrome affects

A

Neutrophils
Monocytes
Lymohocytes

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51
Q

Shift to the left is found in

A

1 Pregnant women or neonates
2 Infections
3 Bone marrow fibrosis
4 Bone marrow infiltration by malignancies

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52
Q

What are pseudopods?

A

Granule-free protrusions of cytoplasm

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53
Q

Causes of autophagocytosis

A

Sulfonamides and chloroquine

Prolonged storage of cells

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54
Q

Increased proportion of toxic granules is associated with

A

Poor prognosis

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56
Q

Degranulation on exposure to toxins and high dose radiation

A

Autophagocytosis

57
Q

Altered primary granules

A

Toxic granules

59
Q

Neutrophilic leukocytosis

A

Neutrophilia

60
Q

Acute shift from ___ to ____

A

Marginating

Circulating pool

61
Q

Types of cytoplasmic vacuolation

A

1 Autophagocytosis

2 Phagocytosis of extracellular material

62
Q

Auer rods are found in

A

Acute myeloblastic leukemia

Myelodysplastic syndrome

64
Q

Anomaly in which most neutrophils have round or bilobed nuclei

A

Pelger-huet

65
Q

Toxic nuclear projections are seen in

A

Metastatic carcinoma

Irradiation

66
Q

Lymphocytic leukocytosis

A

Lymphocytosis

68
Q

Abnormally high number of neutrophils

A

Neutrophilia

69
Q

Best indicator of severity of infection

A

Ratio of nonsegmented and segmented neutrophils

70
Q

WBC > 10,000

A

Leukocytosis

71
Q

Causes of acute shift

A 
1 Steroid treatment
2 Exercise
3 Epinephrine
4 Hypoxia
5 Seizures
6 Other stress
72
Q

Associated with toxic granules and seen in sepsis

A

Phagocytosis of extracellular material

73
Q

Small azurophil rods in the cytoplasm of myeloblasts and promyelocytes; sometimes found in mature neutrophils

73
Q

Not lobed or not segmented neutrophils

A

Ringed nuclei

74
Q

Caused by prolonged specimen storage in EDTA

A

Pseudopods

76
Q

Toxic nuclear projections are seen in

A

the inner side of band forms facing the centriole

79
Q

Shrunken and dense nuclei

A

Pyknotic nuclei

79
Q

Causes of pyknotic nuclei

A

Poor staining or preparation

Acute myeloid leukemia (AML)

80
Q

Pyknotic nuclei are seen in

81
Q

Rare fatal hereditary disorder found in children making them prone to infections

A

Chediak-Higashi Syndrome

82
Q

Eosinophil quantitative abnormalities

A

Left shift eosinophilia

Eosinopenia

83
Q

High count of eosinophil which may be inherited, malignant or reactive

A

Eosinophilia

84
Q

Association of eosinophil count and parasitic death

A

Reactive eosinophilia

85
Q

Persistent and extreme eosinophilia (parasitic, allergic, malignant, idiopathic)

A

Hypereosinophilic syndrome

86
Q

Morphology of left shift eosinophilia

A

Eosinophil metamyelocyte in peripheral blood

86
Q

Left shift eosinophilia is seen in

A

1 Reactive eosinophilia
2 Myeloproliferative disorders
3 Acute myeloid leukemia

87
Q

Low count of eosinophils

A

Eosinopenia

87
Q

Causes of eosinopenia

A

1 Production abnormalities

2 Adenocorticotropic hormone (ACTH) administration

88
Q

Seen in acute bacterial infections due to sequestration, margination, and chemotaxis

A

Eosinopenia

89
Q

Eosinophil qualitative abnormalities

A

1 Degranulation
2 Vacuolation
3 Hypersegmentation

90
Q

Most prominent eosinophil alteration

A

Degranulation

91
Q

Requirement to obtain absolute vacuole

A

1000-cell differential counts

92
Q

Allows identification of basophils in > 10,000 WBCs

A

Flow cytometer

93
Q

Basophil quantitative abnormalities

A

Basophilia

Basopenia

94
Q

Causes of basopenia

A

1 Acute infections
2 Stress
3 Hypothyroidism
4 Increased glucocorticoids

95
Q

Seen in conditions caused by eosinophilia

A

Basophilia

96
Q

Basophilia in newborns

97
Q

Cause of Chediak-Higashi Syndrome

A

Impaired neutrophil function (impaired lysosome degranulation with phagosomes leading to decrease in phagocytosis)

98
Q

Causes of monocytopenia

A

Administration of glucocorticoids

Overwhelming infections

99
Q

Self-limited, lymphoproliferative responses

A

Nonmalignant, reactive disorders

100
Q

Hypersegmented nuclei are seen in

A

long term infections

101
Q

Hypersegmented nuclei are found in

A 
1 Megaloblastic anemia
2 Iron deficiency
3 Chronic infection
4 Liver disease
5 Uremia
101
Q

Leukemia that occurs mainly in adults

A

Chronic myeloid/myelogenous leukemia (CML)

102
Q

Causes of basophil qualitative abnormalities

A

Ingestion of fatty meal

Antigen-related stimulation

103
Q

Basophil qualitative abnormality

A

Degranulation

104
Q

Functionally immunocompetent lymphocyte

105
Q

Hairlike projections

A

Toxic nuclear projections

106
Q

Proliferation of cytotoxic T cells are seen during the second week

A

Infectious mononucleosis

107
Q

Monocyte quantitative abnormalities

A

Monocytosis

Monocytopenia

108
Q

Causes of lymphopenia

A 
1 Immunodeficiency syndrome
2 Corticosteroid therapy
3 Neoplasia
4 Radiation therapy
5 Chemotherapy
110
Q

Accompanies neutrophilia

A

Monocytosis

112
Q

Basis of classification of leukemia

A

Duration

Type of blood cell affected

113
Q

Plasmacytoid lymphocyte and Turk’s irritation cell

114
Q

Causes of monocytosis

A 
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
Q

Monocyte qualitative abnormality

A

Response to stimuli

117
Q

Most common type of leukemia in young children

A

Acute lymphocytic leukemia (ALL)

118
Q

Cancer of the lymph nodes

120
Q

Transformed or reticular lymphocytes

121
Q

Malignant proliferation of immature forms of WBC in the peripheral circulation and in the lymph nodes

123
Q

Benign disorders

125
Q

What happens in monocyte qualitative abnormality?

A

1 Immature monocytes
2 Transformation into histiocytes, macrophages
3 Alteration of nucleus into long thin band-like shape

127
Q

Morphology of reactive lymphocytes

A

Type I
Type II
Type III

128
Q

Lymphocyte abnormalities

A 
1 Nonmalignant reactive disorders
2 Lymphocytosis
3 Reactive lymphocytes
4 Infectious mononucleosis
5 Autoimmune lymphoproliferative syndrome
129
Q

Leukemia that occurs in both adults and children

A

Acute myeloid/myelogenous leukemia (AML)

Acute non-lymphocytic leukemia

131
Q

Leukemia that affects adults over the age of 55

A

Chronic lymphocytic leukemia (CLL)

132
Q

Fried egg or flared skirt appearance of a lymphocyte

133
Q

Malignant proliferation of plasma cells

134
Q

Infectious mononucleosis cell

137
Q

Examples of lymphoma

A

Non-hodgkin’s lymphoma

Hodgkin’s disease

138
Q

Neoplastic disorders of WBC

A

Myeloproliferative disorders
Lymphoproliferative disorders
Immunoproliferative disorders

139
Q

Reactive lymphocyte of B-cell origin

140
Q

Basophilia caused by Type I hypersensitivity reactions, long-term foreign antigen stimulation, hypothyroidism, ulcerative colitis, estrogen therapy

A

Reactive Basophilia

142
Q

Derived from a single precursor cell with all the affected cells (progeny) showing features of deviation from the precursor cell

A

Neoplastic disorders of WBC

145
Q

Diagram of classifications of leukemia

146
Q

Lymphocyte abnormality that occurs most frequently during viral infections

A

Lymphocytosis

147
Q

Absolute lymphocytosis

A

Increase in the number of circulating lymphocytes (lymphocytes in the peripheral blood increase in the marginal and circulating pool)

151
Q

Relative lymphocytosis

A

Increase in the percentage of circulating lymphocytes

152
Q

Other terms for reactive lymphocyte

A

1 Atypical
2 Variant
3 Downey cell

153
Q

Ringed nuclei are found in

A

Toxic and malignant myeloproliferative states

Clinical Microscopy 2 (5 decks)

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