WBC I - puthoff Flashcards
normal level of wbc
5 .0 to 10.0 (x10^3/ uL)
5 to 10 million
how many lobes does a normal neutrophil have
2-5 lobes
what is serum
clear yellow liquid after blood has been allowed to clot
serum is plasma with diminished fibringoen and other clotting factors
reference range of hematocrit in males and females
males 45 +/- 7
females 42 +/- 7
what is the most common cause of agranulocytosis/neutropenia
what is common consequence
drug toxicity
infections are comon consequence
ulcerating necrotizing lesions of gingiva, floor of mouth, buccal mucosa, pharynx and oral cavity characteristic
lymphocytes in peripheral blood adults
t helper is 32-56
t cell cytotoxic is 17-40
-so t cells make up 80% of lymphocytes in peripheral blood
B cells is 4-20%
NK cells is 4-18%
eosinophilic leukocytosis (eosinophilia) caused by what
allergies
parastitic infcetion
hodgkin and some non hodkind lymphomas
atheroembolic disease
familial forms of HLH
from CD8 and NK cells not forming properly and forming granules, cannot keep immune system in check by lysing antigen bearing dentric cells or activated macrophages
high levels of inflam mediators
are blasts in the peripheral blood normal?
no, always abnormal and must be investigated
what type of neutrophils would you get in sepsis or severe inflammatory disorders like kawaski disease
toxic granules which are darker
dohle bodies appear as sky blue cytoplasmic puddles which are patches of dilated ER
clinical features of HLH
febrile illness with HSM
anemia
thrombocytopenia
high level of plasma ferritin and soluble IL-2 receptor
elevated liver enzymes and TGs
may show DIC
if untreated, then organ failure, shock, death
- use immunosupp drugs
- die in 2 months with familial form without treatment
- with treatment 1/2 pts survive but can have renal damage in adults and mental retardation in children
what are reticulocytes
immature erythrocytes with remnant ER and ribosomes that form reiculum within RBC cytoplasm
20-30% larger than mature RBC and circulate for 2-3 days before all remnants
do you use metastatic in blood cancers?
no
erythrocyte precursors
proerythroblast basophilic erythroblast polychromatophilic erythroblast normoblast nucleated red cells
PB PNN
which white cell cancer is staging useful in
hodgkin lymphoma
which bacterial infections cause lymphocytic proliferation
mycobacteria
what is plasma
plasma is fluid acellular poriton of blood
9% molecules (proteins, organic and inorganic)
91% water
normal granulocyutes percentage vs lymphocytes
40-70%
normal platelet number (X10^3)
150-450
what is the most common trigger of HLH
EBV
the two major determinants of differentiation are
neoplastic cell nuclei and cytoplasm
architectural relationship of the neoplastic cells to other neoplastic cells and non neoplastic stroma
what kind of proliferation occurs in rickets, malaria, SLE and IBD
monocytosis
hemoglobin above ___ gm/dL, then EPO is released at a constant rate in response to decrease in red cell mass
what is normal
what happens if falls below the first number
10, normal is 15 in males and 14 in females
if below 10 then EPO increased logarithmically
what often accompanies lymphocytosis and in what
monocytosis in viral infections
in a left shift during ___ what cells would you see
with a left shift in infections
metamyelocyte is a juvenile granulocyte
band has a horseshoe nuclues
hemophagocytic lymphohistiocytosis (HLH)
pathogenesis
cytopenias
systemic activation of macrophages and CD8+ t cells
-macrophages phagocytize blood cell progenitors in marrow and formed elements in peripheral tissue
-mediators from macrophages and t cells suppress hematopoeisis and produce systemic inflmmation, cytopenia, and shock like picture (cytokine storm)
basophilia cause
myeloproliferative diseases (CML) chronic myelogneous leukemia
neoplastic disorders of myeloid progenitor cells originate in the ____ but secondarily involve the
bone marrow
spleen
which of the following is normally seen in peripheral blood
myeloblast
promyelocyte
myelocyte
none
where is EPO created
peritubular capillary lining cells of kidney (90%) and liver (10%)
normal RBC (x10^6/uL)
- 3-5 in men
3. 5-5 in women
