wbc disorders Flashcards
1
Q
broad groups of wbcs
A
phagocytes (granulo and mono)
immunocytes (lympho and plasma)
2
Q
2 pools in the bloodstream
A
ciculating
marginating
3
Q
wbc kinetics
A
6-10 hrs in circu
4-5 days in tissues
4
Q
factors that can modify degree of neutro response
A
age
virulence
hematinic deficiency
5
Q
NV wbc count: adult
A
4-11 x 10^9/L
6
Q
NV wbc count: neonates
A
10-25 x 10^9/L
7
Q
NV wbc count: 1 yr
A
6-18 x 10^9/L
8
Q
NV wbc count: 4-7 yrs
A
6-15 x 10^9/L
9
Q
NV wbc count: 8-12 yrs
A
4.5-13.5 x 10^9/L
10
Q
NV in diff count: neutro
A
37-80
11
Q
NV in diff count: lympho
A
10-50
12
Q
NV in diff count: mono
A
0-12
13
Q
NV in diff count: eosino
A
0-9.5
14
Q
NV in diff count: basophils
A
0-2.5
15
Q
NV in absolute count (in x10^9/L): neutro
A
1.8-7
1-8.5
16
Q
NV in absolute count (in x10^9/L): lympho
A
- 5-4
1. 5-8.8
17
Q
NV in absolute count (in x10^9/L): monocyte
A
.03-.9
18
Q
NV in absolute count (in x10^9/L): eosino
A
0-.67
19
Q
NV in absolute count (in x10^9/L): baso
A
0-.20
20
Q
increase in WBC count above upper limit of NV for age and sex
A
leukocytosis with lymphocytosis/neutrophilia/monocytosis/eosinophils/basophilia
21
Q
decrease in total wbc count below the lower limit of nv for age and sex
A
leukopenia with neutropenia/lymphocytopenia
22
Q
increase in any wbc type maybe clinically significant but decrease is usually only for _____
A
neutrophils
23
Q
absolute count of >7.5 bands and nuetrophils
A
neutrophilic luekocytosis
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
25
increased production and peripheral survival of neutrophils is seen in
CML
26
increased shift from margianl pool of neutro is seen in
```
stress
intoxication
hypoxia
exercise
adrenalin
inf
```
27
decreased egress from circulating is seen in
corticosteroids
28
neoplasms that may lead to neutrophilia
solid tumor
| MPD
29
seen when there's an increase in immature peripheral blood granulocytes usually in acute infection
shift to the left
30
reactive and excessive leukocytosis usually characterized by release of immature cells
leukemoid rxns
31
lab picture of leukemoid rxn
WBC ct. >50 x 10^9/L w/ shift to the left
| high LAP score
32
leukemoid is seen in
severe and chronic inf
severe hemolysis
metastatic CA
33
absolute neutro count of <1.5 x 10^9/L
neutropenia
34
levels of neutropenia
>1500/uL normal
1k-1.5k mild
500-1000 moderate
<500 severe
35
3 factors that determine risk of infection
ANC
neutrophil reserve in the marrow
duration
36
absolute lympho count of >4 x 10^/L
lymphocytosis
37
lymphocytes seen in CLL
smudge cells
38
lymphocytosis may be categorized as
monoclonal or polyclonal
39
examples of dse that causes monoclonal lymphocytosis
lymphoproliferative disorder
CLL
non-Hodgkin's lymphoma
ALL
40
secondary to stimulation or rxn to factors extrinsic to the lymphocyte
polyclonal lymphocytosis
41
absolute lympho count of < 1 (adult) or <2 (children)
lymphocytopenia
42
absolute monocyte count of > 0.8 x 10^9/L
monocytosis
43
monocytosis causes
50% of hema disorder
10% of inflamm and immune disorders
8% malignant disorders
44
causes of monocytosis
TB SBE syphilis proptozoan rickettsia leukemia lymphomas multiple myeloma CMML
solid tumors
immune thrombocytopenic purpura
sarcoidosis
45
causes of lymphocytopenia
```
radiation
chemo
corticosteroids
starvation
aplastic anemia
terminal cancer
HIV
TB
viral hepa
typhoid
Wiskott-Aldrich syndrome
```
46
most common cause of eosinophilia
parasitism
| allergic dse
47
levels of eosiphilia
<1500 mild
1.5k-5k moderate
>5k severe
48
causes of eosinophilia
```
allergic
parasitic
recovery from acute inf
skin dse
inflamm
respi
neoplastic
idiopathoc hypereosinophilic syndrome
```
49
skin dse that causes eosinophilia
psoriasis
urticaria
angioedema
50
>1500 eosinophils/uL for more than 6 months
primary hypereosinophilic syndrome
51
affected organs in primary hypereosinophilic syndrome
skin
heart
nervous system
52
absence of underlying cause of eosinophilia despite extensive evaluation
primary hypereosinophilic syndrome
53
absolute basophil count of > 0.2 x 10^9/L
basophilia
54
group of disorders characterized by the accumulation of malignant wbcs in the bone marrow and blood
leukemia
55
classifications of leukemia
AML
ALL
CML
CLL
56
presence of >20% blasts in blood and marrow
| accumulatoion of malignant white cells (blasts) in the blood and marrow
acute leukemias
57
lab pic of acute leukemia
anemia
thrombocytopenia
leukocyte count (high low or nomal, <5k, absolute lymphocytosis, high wbc ct with high lympho%)
pancytopneia minsan
58
classification of acute leukemia
myelogenous
| lymphocytic
59
antibodies labelled with different flurochromes recognize the pattern and intensity of expression of the different antigens on the surface of normal and leukemic cells
immunophenotyping by flow cytometry
60
direct morphological analysis of chromosomes from tumor cells under the microscope
karyotype analysis
61
karyotypeing samples require the tumor cells to be
in metaphase
62
clonal disorder of a pluripotent stem cell
chronic myelogenous leukemia
63
seen in CML
philadelphia chromosome
64
Ph chromosome results to
chimeric BCR-ABL gene which codes for fusion protein with a tyrosine kinase actiity
65
clinical features of CML
```
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
most common leukemia in Western but rare in far east
CLL
67
clinical features of CLL
```
occurs in elderly
2:1 male to female
symmertrical enlargement of nodes
anemia and thrombocytopenia
splenomegaly, hepatomegaly
immunosuppression
```
68
lab pic of CLL
```
absolute lymphocytosis (monoclonal B cells)
anemia or thrombocytopenia
35% (+) Coombs
pre red cell aplasia
hypogammaglobulinemia
hyper/normocellular marrow
```
69
BCR-ABL negative myeloproliferative meoplasia or non-leukemic myeloproliferative neoplasias include
polycythemia vera
essential thrombocythemia/cytosis
myelofribrosis
70
transmits info from outside the cell through the cell membrane and into the gene promoters on the DNA inside the nucleus
JAK-STAT signalling pathway
71
components of the JAK-STAT signalling pathway
receptor
JANUS kinase
signal transducer and activator transcription
72
nonreceptor tyrosine kinase that is essential for growth factor signalling
JAK2
73
inc. hgb/hct above upper limit for age and sex
polycythemia
74
2 subdivisions of polycythemia
absolute (primary vs secodnary)
| relative/pseudopolycythemia
75
rbc volume normal but plasma is dec.
pseudopolycyhtemia
76
red cell mass >125% of that expected for body mass and gender
absolute polycythemia
77
polycythemia due to enhanced response of eythroid progenitor cells to cytokines
primary
78
polycythemia driven by factors outside erythroid compartment
secondary
79
acquired causes of secondary erythrocytosis
erythropoietin mediated
local hypoxia
drug associated
pathologic epo prodn
80
clonal stem cell disorder with trilineage myeloid involvement
poly vera
81
characterized by idneoendent eryhtrough proliferation resulting to markedly increased red cell mass
poly vera
82
present in over 95% of poly vera cases
JAK2 mutation
83
major criteria by the poly vear study groups
A1 rcm inc.
A2 normal O2 satn
A3 splenomegaly
84
minor criteria by the poly vear study groups
B1 PC > 400
B2 WBC count >12
B3 LAP score >100
B4 serum B12 >900
85
how to diagnose polycythemia vera by study group
A123
| A12 + 2 of B
86
major criteria for poly vera by WHO
inc. rbc volume
| JAK2 mutatuion
87
minor criteria for poly vera by WHO
hypercell marrow
serum Epo dec
endogenous erythroid colony formation in vitro
88
how to diagnose poly vera by WHO
2 major + 1 minor
| first major + 2 minor
89
lab pic of poly vera
```
inc hgb hct rbc rcv
neutrophilic and basophilic leukocytosis
jak2 mut
hypercell marrow with panbmyelosis
dec epo
inc UA
```
90
clinical features in poly vera
```
hyperviscous hypervolemia hypermetab
headache dyspnea pruritis
cyanosis
splenomegaly
htn
gout
```
91
median survival of poly vera cases
10-16 yrs
92
30% of poly vera cases transform to
MF spent phase
93
5% of poly vera cases transform to
acute leukemia
94
causes of thrombocytosis
reactive
| clonal/endogenous
95
persistent plt count of >450 x 10^9/L
essential thrombocytosis/thrombocythemia
96
essential thrombocyrtosis is caused by
megakaryocyte proliferation and overpod'n
97
clonal dse characterized by progressive generalized reactive marrow fibrosis with extramedullary hematopoiesis in the liver and spleen
primary myelofribrosis
98
primary myelofibrosis to simply put it is
myelofibrosis with myeloid metaplasia
99
findings in myelofibrosis
```
anemia
splenomegaly
immature granulo erythro, dacryocytes
marrow fibrosis
osteosclerosis
```
