WBC I - puthoff

Question 1

normal level of wbc

Answer 1

5 .0 to 10.0 (x10^3/ uL)

5 to 10 million

Question 2

how many lobes does a normal neutrophil have

Answer 2

2-5 lobes

Question 3

what is serum

Answer 3

clear yellow liquid after blood has been allowed to clot

serum is plasma with diminished fibringoen and other clotting factors

Question 4

reference range of hematocrit in males and females

Answer 4

males 45 +/- 7

females 42 +/- 7

Question 5

what is the most common cause of agranulocytosis/neutropenia

what is common consequence

Answer 5

drug toxicity

infections are comon consequence
ulcerating necrotizing lesions of gingiva, floor of mouth, buccal mucosa, pharynx and oral cavity characteristic

Question 6

lymphocytes in peripheral blood adults

Answer 6

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%

Question 7

eosinophilic leukocytosis (eosinophilia) caused by what

Answer 7

allergies
parastitic infcetion
hodgkin and some non hodkind lymphomas
atheroembolic disease

Question 8

familial forms of HLH

Answer 8

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

Question 9

are blasts in the peripheral blood normal?

Answer 9

no, always abnormal and must be investigated

Question 10

what type of neutrophils would you get in sepsis or severe inflammatory disorders like kawaski disease

Answer 10

toxic granules which are darker

dohle bodies appear as sky blue cytoplasmic puddles which are patches of dilated ER

Question 11

clinical features of HLH

Answer 11

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

Question 12

what are reticulocytes

Answer 12

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

Question 13

do you use metastatic in blood cancers?

Answer 13

no

Question 14

erythrocyte precursors

Answer 14

proerythroblast
basophilic erythroblast
polychromatophilic erythroblast
normoblast
nucleated red cells

PB PNN

Question 15

which white cell cancer is staging useful in

Answer 15

hodgkin lymphoma

Question 16

which bacterial infections cause lymphocytic proliferation

Answer 16

mycobacteria

Question 17

what is plasma

Answer 17

plasma is fluid acellular poriton of blood
9% molecules (proteins, organic and inorganic)

91% water

Question 18

normal granulocyutes percentage vs lymphocytes

Answer 18

40-70%

Question 19

normal platelet number (X10^3)

Answer 19

150-450

Question 20

what is the most common trigger of HLH

Answer 20

EBV

Question 21

the two major determinants of differentiation are

Answer 21

neoplastic cell nuclei and cytoplasm

architectural relationship of the neoplastic cells to other neoplastic cells and non neoplastic stroma

Question 22

what kind of proliferation occurs in rickets, malaria, SLE and IBD

Answer 22

monocytosis

Question 23

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

Answer 23

10, normal is 15 in males and 14 in females

if below 10 then EPO increased logarithmically

Question 24

what often accompanies lymphocytosis and in what

Answer 24

monocytosis in viral infections

Question 25

in a left shift during ___ what cells would you see

Answer 25

with a left shift in infections
metamyelocyte is a juvenile granulocyte
band has a horseshoe nuclues

Question 26

hemophagocytic lymphohistiocytosis (HLH)

pathogenesis

Answer 26

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)

Question 27

basophilia cause

Answer 27

myeloproliferative diseases (CML) chronic myelogneous leukemia

Question 28

neoplastic disorders of myeloid progenitor cells originate in the ____ but secondarily involve the

Answer 28

bone marrow

spleen

Question 29

which of the following is normally seen in peripheral blood

myeloblast
promyelocyte
myelocyte

Answer 29

none

Question 30

where is EPO created

Answer 30

peritubular capillary lining cells of kidney (90%) and liver (10%)

Question 31

normal RBC (x10^6/uL)

Answer 31

4. 3-5 in men

3. 5-5 in women