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MedClinPath > wbc disorders > Flashcards

wbc disorders Flashcards

1
Q

broad groups of wbcs

A

phagocytes (granulo and mono)

immunocytes (lympho and plasma)

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2
Q

2 pools in the bloodstream

A

ciculating

marginating

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3
Q

wbc kinetics

A

6-10 hrs in circu

4-5 days in tissues

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4
Q

factors that can modify degree of neutro response

A

age
virulence
hematinic deficiency

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5
Q

NV wbc count: adult

A

4-11 x 10^9/L

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6
Q

NV wbc count: neonates

A

10-25 x 10^9/L

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7
Q

NV wbc count: 1 yr

A

6-18 x 10^9/L

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8
Q

NV wbc count: 4-7 yrs

A

6-15 x 10^9/L

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9
Q

NV wbc count: 8-12 yrs

A

4.5-13.5 x 10^9/L

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10
Q

NV in diff count: neutro

A

37-80

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11
Q

NV in diff count: lympho

A

10-50

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12
Q

NV in diff count: mono

A

0-12

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13
Q

NV in diff count: eosino

A

0-9.5

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14
Q

NV in diff count: basophils

A

0-2.5

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15
Q

NV in absolute count (in x10^9/L): neutro

A

1.8-7

1-8.5

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16
Q

NV in absolute count (in x10^9/L): lympho

A
  1. 5-4

1. 5-8.8

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17
Q

NV in absolute count (in x10^9/L): monocyte

A

.03-.9

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18
Q

NV in absolute count (in x10^9/L): eosino

A

0-.67

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19
Q

NV in absolute count (in x10^9/L): baso

A

0-.20

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20
Q

increase in WBC count above upper limit of NV for age and sex

A

leukocytosis with lymphocytosis/neutrophilia/monocytosis/eosinophils/basophilia

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21
Q

decrease in total wbc count below the lower limit of nv for age and sex

A

leukopenia with neutropenia/lymphocytopenia

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22
Q

increase in any wbc type maybe clinically significant but decrease is usually only for _____

A

neutrophils

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23
Q

absolute count of >7.5 bands and nuetrophils

A

neutrophilic luekocytosis

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24
Q

pathophysio mecahnisms for neutrophilic leukocytosis

A

inc. prod
inc. released from marrow
shift from marginal to circu pool
dec. egress of neutro to tissue
combination

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25
Q

increased production and peripheral survival of neutrophils is seen in

A

CML

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26
Q

increased shift from margianl pool of neutro is seen in

A 
stress
intoxication
hypoxia
exercise
adrenalin
inf
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27
Q

decreased egress from circulating is seen in

A

corticosteroids

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28
Q

neoplasms that may lead to neutrophilia

A

solid tumor

MPD

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29
Q

seen when there’s an increase in immature peripheral blood granulocytes usually in acute infection

A

shift to the left

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30
Q

reactive and excessive leukocytosis usually characterized by release of immature cells

A

leukemoid rxns

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31
Q

lab picture of leukemoid rxn

A

WBC ct. >50 x 10^9/L w/ shift to the left

high LAP score

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32
Q

leukemoid is seen in

A

severe and chronic inf
severe hemolysis
metastatic CA

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33
Q

absolute neutro count of <1.5 x 10^9/L

A

neutropenia

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34
Q

levels of neutropenia

A

> 1500/uL normal
1k-1.5k mild
500-1000 moderate
<500 severe

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35
Q

3 factors that determine risk of infection

A

ANC
neutrophil reserve in the marrow
duration

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36
Q

absolute lympho count of >4 x 10^/L

A

lymphocytosis

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37
Q

lymphocytes seen in CLL

A

smudge cells

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38
Q

lymphocytosis may be categorized as

A

monoclonal or polyclonal

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39
Q

examples of dse that causes monoclonal lymphocytosis

A

lymphoproliferative disorder
CLL
non-Hodgkin’s lymphoma
ALL

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40
Q

secondary to stimulation or rxn to factors extrinsic to the lymphocyte

A

polyclonal lymphocytosis

41
Q

absolute lympho count of < 1 (adult) or <2 (children)

A

lymphocytopenia

42
Q

absolute monocyte count of > 0.8 x 10^9/L

A

monocytosis

43
Q

monocytosis causes

A

50% of hema disorder
10% of inflamm and immune disorders
8% malignant disorders

44
Q

causes of monocytosis

A

TB SBE syphilis proptozoan rickettsia leukemia lymphomas multiple myeloma CMML
solid tumors
immune thrombocytopenic purpura
sarcoidosis

45
Q

causes of lymphocytopenia

A 
radiation
chemo
corticosteroids
starvation
aplastic anemia
terminal cancer
HIV
TB
viral hepa
typhoid
Wiskott-Aldrich syndrome
46
Q

most common cause of eosinophilia

A

parasitism

allergic dse

47
Q

levels of eosiphilia

A

<1500 mild
1.5k-5k moderate
>5k severe

48
Q

causes of eosinophilia

A 
allergic
parasitic
recovery from acute inf
skin dse
inflamm
respi
neoplastic
idiopathoc hypereosinophilic syndrome
49
Q

skin dse that causes eosinophilia

A

psoriasis
urticaria
angioedema

50
Q

> 1500 eosinophils/uL for more than 6 months

A

primary hypereosinophilic syndrome

51
Q

affected organs in primary hypereosinophilic syndrome

A

skin
heart
nervous system

52
Q

absence of underlying cause of eosinophilia despite extensive evaluation

A

primary hypereosinophilic syndrome

53
Q

absolute basophil count of > 0.2 x 10^9/L

A

basophilia

54
Q

group of disorders characterized by the accumulation of malignant wbcs in the bone marrow and blood

A

leukemia

55
Q

classifications of leukemia

A

AML
ALL
CML
CLL

56
Q

presence of >20% blasts in blood and marrow

accumulatoion of malignant white cells (blasts) in the blood and marrow

A

acute leukemias

57
Q

lab pic of acute leukemia

A

anemia
thrombocytopenia
leukocyte count (high low or nomal, <5k, absolute lymphocytosis, high wbc ct with high lympho%)

pancytopneia minsan

58
Q

classification of acute leukemia

A

myelogenous

lymphocytic

59
Q

antibodies labelled with different flurochromes recognize the pattern and intensity of expression of the different antigens on the surface of normal and leukemic cells

A

immunophenotyping by flow cytometry

60
Q

direct morphological analysis of chromosomes from tumor cells under the microscope

A

karyotype analysis

61
Q

karyotypeing samples require the tumor cells to be

A

in metaphase

62
Q

clonal disorder of a pluripotent stem cell

A

chronic myelogenous leukemia

63
Q

seen in CML

A

philadelphia chromosome

64
Q

Ph chromosome results to

A

chimeric BCR-ABL gene which codes for fusion protein with a tyrosine kinase actiity

65
Q

clinical features of CML

A 
hypermetab
splenomegaly 
features of anemia and abn. plt. fx
gout or renal impairment caused by hyperuricemia
visual disturbance, priaprism
leukocytosis
complete spectrum of myeloid cells in PBS
basophilia
normo-normo anemia
low LAP
66
Q

most common leukemia in Western but rare in far east

A

CLL

67
Q

clinical features of CLL

A 
occurs in elderly
2:1 male to female
symmertrical enlargement of nodes
anemia and thrombocytopenia
splenomegaly, hepatomegaly
immunosuppression
68
Q

lab pic of CLL

A 
absolute lymphocytosis (monoclonal B cells)
anemia or thrombocytopenia
35% (+) Coombs
pre red cell aplasia
hypogammaglobulinemia
hyper/normocellular marrow
69
Q

BCR-ABL negative myeloproliferative meoplasia or non-leukemic myeloproliferative neoplasias include

A

polycythemia vera
essential thrombocythemia/cytosis
myelofribrosis

70
Q

transmits info from outside the cell through the cell membrane and into the gene promoters on the DNA inside the nucleus

A

JAK-STAT signalling pathway

71
Q

components of the JAK-STAT signalling pathway

A

receptor
JANUS kinase
signal transducer and activator transcription

72
Q

nonreceptor tyrosine kinase that is essential for growth factor signalling

A

JAK2

73
Q

inc. hgb/hct above upper limit for age and sex

A

polycythemia

74
Q

2 subdivisions of polycythemia

A

absolute (primary vs secodnary)

relative/pseudopolycythemia

75
Q

rbc volume normal but plasma is dec.

A

pseudopolycyhtemia

76
Q

red cell mass >125% of that expected for body mass and gender

A

absolute polycythemia

77
Q

polycythemia due to enhanced response of eythroid progenitor cells to cytokines

A

primary

78
Q

polycythemia driven by factors outside erythroid compartment

A

secondary

79
Q

acquired causes of secondary erythrocytosis

A

erythropoietin mediated
local hypoxia
drug associated
pathologic epo prodn

80
Q

clonal stem cell disorder with trilineage myeloid involvement

A

poly vera

81
Q

characterized by idneoendent eryhtrough proliferation resulting to markedly increased red cell mass

A

poly vera

82
Q

present in over 95% of poly vera cases

A

JAK2 mutation

83
Q

major criteria by the poly vear study groups

A

A1 rcm inc.
A2 normal O2 satn
A3 splenomegaly

84
Q

minor criteria by the poly vear study groups

A

B1 PC > 400
B2 WBC count >12
B3 LAP score >100
B4 serum B12 >900

85
Q

how to diagnose polycythemia vera by study group

A

A123

A12 + 2 of B

86
Q

major criteria for poly vera by WHO

A

inc. rbc volume

JAK2 mutatuion

87
Q

minor criteria for poly vera by WHO

A

hypercell marrow
serum Epo dec
endogenous erythroid colony formation in vitro

88
Q

how to diagnose poly vera by WHO

A

2 major + 1 minor

first major + 2 minor

89
Q

lab pic of poly vera

A 
inc hgb hct rbc rcv
neutrophilic and basophilic leukocytosis
jak2 mut
hypercell marrow with panbmyelosis
dec epo
inc UA
90
Q

clinical features in poly vera

A 
hyperviscous hypervolemia hypermetab
headache dyspnea pruritis
cyanosis
splenomegaly
htn
gout
91
Q

median survival of poly vera cases

A

10-16 yrs

92
Q

30% of poly vera cases transform to

A

MF spent phase

93
Q

5% of poly vera cases transform to

A

acute leukemia

94
Q

causes of thrombocytosis

A

reactive

clonal/endogenous

95
Q

persistent plt count of >450 x 10^9/L

A

essential thrombocytosis/thrombocythemia

96
Q

essential thrombocyrtosis is caused by

A

megakaryocyte proliferation and overpod’n

97
Q

clonal dse characterized by progressive generalized reactive marrow fibrosis with extramedullary hematopoiesis in the liver and spleen

A

primary myelofribrosis

98
Q

primary myelofibrosis to simply put it is

A

myelofibrosis with myeloid metaplasia

99
Q

findings in myelofibrosis

A 
anemia
splenomegaly
immature granulo erythro, dacryocytes
marrow fibrosis
osteosclerosis

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