WBCs Flashcards
The basic function of blood leukocytes is as a defense system against infectious foreign invaders and non-infectious challenge. This is divided into two separate, but interconnected events, what are they?
– Phagocytosis
– Development of a specific immune response
What is the basic function of blood leukocytes?
A defense system against infectious foreign invaders and non-infectious challenge
Phagocytosis involves which type of WBCs?
granulocytes and monocytes
Development of a specific immune response involves which type of WBCs?
monocytes (macrophages) and lymphocytes
The vascular system is only a temporary residence for leukocytes. The main function of the vasculature with respect to WBCs is to do what?
transport the leukocytes to body tissues
Where is the production site for all hematopoiesis (cells that comprise blood)?
Bone Marrow
What are the two types of marrow?
red and yellow
Majority of RBCs, WBCs and platelets are formed where?
in red marrow
Pluripotent: pluri = more + potential = power, refers to the ability of a cell to do what?
become many different types of cells
What are the 2 types of stem cells in bone marrow?
– Mesenchymal
– Hematopoietic
Mesenchymal stems cells make up which 3 types of cells?
- connective tissue
- blood vessels
- lymphatic tissue
Hematopoietic stem cells make up which 3 types of cells?
- RBCs
- WBCs
- platelets
Leukocytes are differentiated from each other by which 2 characteristics?
- nuclear
- cytoplasmic
The granules in eosinophils have affinity for which part of the Wright’s stain, which ultimately stains them which color?
- the acid part
- orange-pink
The granules of basophils have affinity for which part of the stain and what color do they stain?
- the basic part
- bluish-black
The granules of neutrophils have an affinity for which part of the stain and what color do they stain?
- both acid and basic parts
- pinkish-blue
Monocytes are usually large or small? What is the shape of their nucleus?
- large
- horseshoe shaped
T/F: Lymphocytes may be small (non-reactive) with a large nuclear to cytoplasmic ratio or large (reactive) with a smaller nuclear to cytoplasmic ratio.
True
The nucleus of a lymphocyte is usually which 2 sizes and shapes?
- round (small lymphs)
- slightly indented (large lymphs)
Leukocytes differentiate into mature cells from what?
pluripotential stem cell in the bone marrow
In the general maturation scheme in direction of LESS mature ⇒ MORE mature, what are the first 4 characteristics that apply to WBC (and RBC) development?
- Cytoplasm: More basophilia ⇒ less basophilia
- Large nucleus ⇒ smaller nucleus
- Large nucleoli ⇒ Small nucleoli ⇒ then absent
- Large cell size ⇒ smaller cell size
What is the 5th characteristic of the general maturation scheme for WBC granulocytes only?
nucleus large & round ⇒ smaller & segmented
What are the six general stages of maturation following commitment of stem cell in bone marrow:
- Myeloblast
- Promyelocyte
- Myelocyte
- Metamyelocyte
- Band
- Segmented cell
What are 2 characteristics of a myeloblast?
- non-granular cytoplasm
- red nucleus
What is a characteristic of a promyelocyte?
distinct granules
What is a characteristic of a myelocyte?
[cell division possible through this stage] granules differentiate enough to be identified n/e/b
What is a characteristic of a metamyelocyte?
slightly indented nucleus
What is a characteristic of a band cell?
Indentation > ½ Width hypothetical round nucleus
Which condition would you suspect if you found myeloblasts, promyelocytes, myelocyte, and/or metamyelocytes in a blood smear?
blood pathology like leukemia
In the assessment of circulating WBCs, the total white blood cell count (WBC) and differential are measured in an automated counter. WBC reflects what of myeloid and lymphoid cells?
the circulating pool
For WBCs, what are numbers for panic low and panic high?
Panic Low: less than 500 per mm3
Panic High: greater than 30,000
Which group of people has the highest normal WBC rate?
Newborns
The following conditions are examples of which type of WBC issue?
• Infections • Leukemic neoplasia • Other malignancy • Trauma, stress, hemorrhage • Tissue necrosis • Inflammation • Dehydration • Thyroid storm • Steroid drugs • Post Splenectomy
Leukocytosis
The following conditions are examples of which type of WBC issue?
• Drug toxicity • Bone marrow depression/ failure • Severe infections • Dietary deficiencies • Marrow aplasia • Marrow infiltration • Autoimmune disease • Hypersplenism • Chemotherapy
Leukopenia
An increase or decrease in WBC count may be caused by what?
an alteration of all WBC cell lines, but more commonly results from an alteration of only one type of WBC
Most variations in the leukocyte count are due to increases or decreases in the number of _________ since by percentage they are the most numerous.
neutrophils
T/F: Cell structures with basic groups bind the acidic dye & appear blue. Cell structures with acidic groups bind the basic dye & appear various shades of pink or red-orange.
FALSE!!! Cell structures with acidic groups bind the basic dye & appear blue. Cell structures with basic groups bind the acidic dye & appear various shades of pink or red-orange.
60-30-6-3-0, Never Let Motor Engines Blow is the mneumonic for order what?
WBCs to include their percentage ratio of how they present in the blood
“Absolute” (ABS) number of cell type is important for determining what?
if patient has a sufficient # cells of a specific type
What are the most common PMN (polymorphonuclear leukocytes) & are primary defense against microbial invasion?
Neutrophils
Neutrophils are stored in bone marrow for __-__ days (mature neutrophil reserve). Circulate in blood for about __ hours. And live in tissue for __ more before they apoptose.
- 5-7 days
- 7 hours
- 2 hours
Which 3 things stimulate neutrophil production leading to increased total WBC count?
- acute bacterial infection
- inflammation
- trauma
Granules contain what component?
leukocyte alkaline phosphatase (LAP)
Cytoplasm may show __________ during active phagocytosis.
vacuoles
Dark purple granules in cytoplasm due to severe infections, burn pts. is referred to as what?
Toxic granulation
With a shift to the left, increases in band neutrophils in peripheral circulation is a response to which type of infection?
bacterial
The nucleus of a neutrophil becomes hypersegmented with which types of deficiency?
- vitamin B12
- folic acid
Toxic granulation is found in severe inflammatory states. The toxic granules are azurophilic, and is thought to be due to what?
impaired cytoplasmic maturation in the effort to rapidly generate large #’s of granulocytes
More that 3 cells (per 100) with 5 lobes or one with 6 lobes is evidence of what?
hypersegmentation
The following characteristics are indicative of what neutrophil condition? • Acute infection • Trauma • Physical/emotional stress • Inflammatory disorders • Metabolic disorders • Myelocytic leukemia • Cushing’s syndrome
Neutrophilia = increase
The following characteristics are indicative of what neutrophil condition? • Overwhelming bacterial infection • Viral infections • Aplastic anemia • Radiation therapy • Addison’s disease • Chemotherapy • Dietary deficiency
Neutropenia = decrease
What are the 4 proteins in eosinophils that help eliminate parasites:
- peroxidase
- major basic protein
- eosinophil cationic protein
- eosinophil-derived neurotoxin
What can suppress eosinophils?
increased cortisol levels
Increased eosinophils in nasal smear aid in diagnosis of which condition?
allergic rhinitis
The following conditions are indicative of which eosinophil term? • Parasitic infections • Allergic reactions • Asthma, hay fever • Hodgkin’s Disease • Eosinophil Myalgia Syndrome • Eczema • Leukemia • Autoimmune disease • Ovarian Cancer
Eosinophilia (>5%) = increase
The following conditions are indicative of which eosinophil term?
• Cushing Syndrome • Endogenous or exogenous cortisol excess • Stress (shock, severe burns, severe infections)
Eosinopenia = decrease
Which type of cell is similar to mast cells and is capable of phagocytosis of immune complexes?
Basophils
Basophil granules contain which 3 things?
- heparin
- histamine
- serotonin
Basophils and mast cells degranulate during _________ reactions, releasing ________ (among other things)…
- allergic
- histamine
The following conditions are indicative of which basophil term?
• Myleoproliferative diseases: Polycythemia • Granulocytic leukemia • Chronic Myelocytic Leukemia (CML) • Hodgkin’s Lymphoma
Basophilia >50/mm3 increase
The following conditions are indicative of which basophil term?
• Acute phase of infection • Hyperthryoidism • Stress reactions • Prolonged steroid therapy
Basopenia <20/mm3 = decrease
What are the 3 types of lymphocytes?
- T cells: Mature in thymus. Involved in cellular mediated immunity: T-suppressor cells (CD8) T-Helper cells (CD4)
- B cells (CD19, CD20): Mature in bone marrow. Participate in humoral immunity, as plasma cells they produce antibodies.
- NK -Natural killer cells (CD56, CD57)
Which cells arise from the fixed tissue reticulum cell in the bone marrow?
Lymphocytes
Where do B lymphocytes mature? T lymphocytes?
- bone marrow
- thymus
What are B lymphocytes that are committed to active production of antibodies?
Plasma cells
Atypical lymphocytes are seen in which type of conditions?
some viral infections, e.g. infectious mononucleosis
The following conditions are indicative of which lymphocyte term?
• Viral infections: CMV, HIV • Some bacterial infections (pertussis,TB) • Lymphocytic leukemia • Multiple myeloma (plasma cell proliferation) • Infectious mononucleosis/EBV • Infectious hepatitis • Hypoadrenalism (Addison’s Disease)
Lymphocytosis >4000/mm3
The following conditions are indicative of which lymphocyte term?
• Non-lymphocytic leukemia’s (dt relative shift) • Hodgkin’s Disease • Sepsis • Immunodeficiency diseases • SLE /Lupus • Drug therapies – adrenocorticosteroids, chemotherapy • Radiation therapy
Lymphopenia
Which cells arise in bone marrow from a common progenitor cell with the granulocytes, can be produced rapidly as needed, and spend longer time in circulation?
Monocytes
T/F: Monocytes function as phagocytes, much the same as neutrophils do by engulfing bacteria and removing necrotic debris from blood
True
What are 3 classic characteristics of a monocyte?
- large
- deeply indented nucleus
- large amount of cytoplasm
The following conditions are indicative of which monocyte term?
• Some viral infections, • infectious mono=EBV • Chronic bacterial inf. • Tuberculosis • Subacute Bacterial Endocarditis SBE • Syphilis • Chronic ulcerative colitis • Parasites, e.g. malaria • Monocytic leukemia
Monocytosis (>500/mm3) increase
The following conditions are indicative of which monocyte term?
• Prednisone • HIV • Hairy Cell Leukemia • Aplastic Anemia
Monocytopenia (<100/mm3) decrease
An increased # of WBCs released from bone marrow pool, an increase production from myelocyte stage in bone marrow via cell division, immature cell types are released from bone marrow are indications of what?
WBC response to infection
Band cells are most common and equal what type of shift?
left shift
T/F: • Severe infections may see occasional metamyelocyte
True
