WBC intro Flashcards
neutrophil percentage and characteristics
- 35-70%
- multi segmented nucleus
- faint granules
- “segs” “PMNs”
bands
- 1-5%
- increased in infection
- immature neutrophil with curved but not yet segmented nucleus
monocytes
- 4-8%
- act like neutrophils in terms of phagocytosis and microorganism killing
- indented nucleus, cytoplasmic vacuoles
eosinophils
- 0-7%
- bilobed nucleus
- red cytoplasmic granules
- in hyper sensitivity reactions
basophils
- 1-2%
- polysegmented nucleus
- large purple granules
- releases leukotrienes
WBC suffixes
- penia - means too few
- philia or cytosis - too many
define leukocytosis and explain use of modifiers
- total WBC count above two standard deviations
- when due to specific cell such as neutrophils, it would be neutrophilic leukocytosis
what is a left shift?
- increase in band cells
- also called “bandemia”
what is the absolute neutrophil count (ANC)?
ANC = WBC x [(% segs + % bands)/100]
circulating vs marginal pool
available neutrophils split approximately in half, one have circulates for 6-8 hours before being cleared or entering tissues, the other half remains on periphery of small blood vessels and “demarginates” in response to stressor
neutrophils vs monocytes
- neutrophils dominate in the first 8-24 hours of inflammation, and then monocytes take over, so monocytes play a bigger role in chronic infections
cyclic neutropenia
- 21 day cycle of neutropenia with infections recurring
- AD
- ELA2 gene
severe congenital neutropenia
- constant neutropenia
- AD
- ELA2 gene
Kostmann Syndrome
- Infantile agranulocytosis presenting with multiple severe infections
- AR
- HAX1 gene
infections is greatly increased if ANC falls below…
1000 cells/uL
what type of infections carry the worst prognosis in neutropenia?
- gram negative infections
- followed by mycoses and fungi
- viruses and parasites are generally not at added risk with isolated neutropenia
measure of mild, moderate, severe neutropenia
mild - 1000-1500
moderate - 500-1000
severe - under 500
define neutrophilia
counter greater than the upper level of normal, generally greater than 7000
hyperimmunoglobulin E syndrome (congenital neutrophil function)
- high IgE and IgD
- dermatitis, mental status, staph, candida, pulm infections
- CHEMOTAXIS
leukocyte adhesion deficiency (congenital neutrophil function)
- ADHESION AND ROLLING
- bacterial infections from birth
- neutrophilia but no pus
Chediak-Higashi sydrome
- DEGRANULATION
- abnormal granules, slow killing of bacteria
- partial albinism
- giant inclusion bodies
chronic granulomatous disease
- MICROBIAL ACTIVITY
some causes of acquired neutrophil disfunction
- myelodysplasia
- alcoholism
- metabolic disorders
- HIV infection
what is the primary function of the eosinophil?
- kill parasites via phagocytosis
definition of eosinophilia
greater than 1500 cells/uL for greater than 6 weeks
causes of eosinophilia
secondary - to infection, allergy, asthma, meds etc
primary - eosinophilic leukemia, hypereosinophilic syndrome
idiopathic - diagnosis of exclusion
what is the NAACP mnemonic?
causes of eosinophilia Neoplasm Allergies Asthma Collagen vascular diseases Parasites
monocytes are precursors to…..
macrophages, histiocytes, and dendritic cells
normal monocyte count
300-700 cells/uL
define lymphopenia
absolute lymphocyte count less than 1000
causes of lymphopenia
1 - infection, HIV 2 - congenital - wiscott aldrich 3 - medications such as corticosteroids 4 - lymphomas 5 - nutritional
define lymphocytosis
absolute lymphocyte count greater than 4000
causes of lymphocytosis
- non-malignant - such as viral infections
- malignant - lymphoproliferative disorders
what is pancytopenia?
- low WBC but also anemia and thrombocytopenia
general causes of pancytopenia
1 - primary bone marrow replacement or failure
2 - secondary bone marrow replacement or failure
3 - ineffective myelopoiesis
4 - hypersplenism
