WBC Disorders Flashcards
most common cause of luekopenia is __________.
most common reactive cause of leukocytosis _______.
neutropenia
neutrophilia
lab investigation of WBC disorders
CBC w/ differential
- detects luekopenia or leukocytosis
- detects anemia if it is present
- PLT counts vary
- differential: predominant cell type affected
increased # and toxic neutrophils (toxic granulation, Dohle bodies, vacuoles) . . . response to ______________.
bacterial infection or inflammation
increased # and reactive lymphocytes . . . response to _________.
viral stimuli
T/F You should suspect malignancy if blasts are present.
True - blasts are always abnormal
Neutrophilia is associated with:
acute bacterial infection
Neutropenia is associated with:
overwhelming infections, viral infection
Lymphocytosis is associated with:
viral infections
Pseudo neutrophilia
physical or emotional stimuli cause redistribution of blood pools . . . marginating -> circulating
short term increase in WBC count but NO left shift
increase in WBC and left shift is present
Pathologic Neutrophilia
- neutrophils leave blood in response to tissue damage
causes of pathologic neutrohilia
acute and chronic bacterial infections
tissue destruction, metabolic disorders, drugs, chronic inflammatory disorders, following hemorrhage or hemolysis
features of pathologic neutrophilia
increase WBC
increased # neutrophils
presence of toxic neutrophils (toxic granules, Dohle bodies, vacuoles)
increased ESR
causes of absolute neutropenia
defects in bone marrow production
overwhelming infection
immune destruction
hypersplenism
causes of absolute eosinophila
control of parasites
allergic states
skin and pulmonary disorders, drugs
causes of absolute basophilia
chronic allergies or immediate hypersensitivity
malignancy
causes of absolute monocytosis
chronic infections (tuberculosis)
chronic inflammatory disorders
recovery from acute bacterial infection
causes of absolute lymphocytosis
response to VIRAL infection - presence of reactive lymphs
need to rule out malignancy
Leukemia
proliferation of malignant cells in bone marrow, often involves blood
may infiltrate liver, spleen, lymph nodes, CNS or skin
initially SYSTEMIC
Lymphoma
proliferation of malignant lymphoid tissue cells in solid tissues . . . lymph nodes, spleen, GI tract
initially LOCALIZED
Etiology of Malignant WBC Disorders
viral theory radiation/chemical damage genetic factors and mutated oncogenes environmental immune dysfunction
Diagnosis for Malignant WBC Disorders
bone marrow exam or tissue biopsy
Acute or Chronic Leukemia?
young age, sudden onset
ACUTE - sudden onset, young age
Chronic - insidious, adults
Acute or Chronic Leukemia?
mature cells
CHRONIC - maturing or mature cells
Acute - immature/blast cells
Acute or Chronic Leukemia?
High WBC count
CHRONIC
Acute - variable
Acute or Chronic Leukemia?
Neutropenia
ACUTE
Acute or Chronic Leukemia?
Mild to severe anemia
ACUTE
Chronic - mild anemia if it is even present
Acute or Chronic Leukemia?
Normal to high platelets
CHRONIC
Acute - low platelets
Acute Myeloid Leukemia
infants and adults
WBC count normal to 100K - meyoblasts
Acute Lymphoid Leukemia
ages 2-10
WBC count normal to 100 K - lymphoblasts
Chronic Meylocytic Leukemia
25-60 years old
WBC 50-300K granulocyte proliferation
oncogene mutation - Philadelphia Chromosome; BCR/ABL
Gleevec
Acute Meylocytic Leukemia
over 50 years old
males 2x > females
WBC 20-200K small mature lymphocytes
5-10 year survival; control symptoms
Hodgkin’s Lymphoma
associated with EBV
enlarged lymph nodes
staged to demonstrate diagnostic cell type and determine prognosis
ESR abnormally increased
Non-Hodgkin’s Lymphoma
enlarged lymph nodes, GI tumors
commonly spread to marrow and blood
biopsies to determine B or T/NK cell lineage
Multiple Myeloma
proliferation of a malignant clone of plasma cells in the bone marrow
plasma cells produce one immunoglobulin type (monoclonal spike, red cell rouleaux, increased ESR)
