White Blood Cell Conditions Flashcards
What does neutropenia mean?
Not enough neutrophils
What does neutrophilia mean?
Too many neutrophils
What does lymphocytosis mean?
Too many lymphocytes
Describe the different pathways of haematopoeisis (broadly).
Start with stem cell which then divides into myeloid cells or lymphoid cells (both types of WBC). They go down different pathways. Lymphoid becomes lymphocytes (T cells or B cells) or NK cells. B cells make plasma cells. Myeloid can form platelets, red cells etc.
What are the causes of neutrophilia? (5)
Infection (especially bacterial, rather than viral)
Inflammation (e.g. flare of inflammatory bowel disease, rheumatoid arthritis, or lupus)
Trauma
Active cancer
Myeloproliferative conditions (e.g. chronic myeloid leukaemia, myelofibrosis)
A 20 year old male was admitted with sudden onset of left-sided chest pain and a productive cough with purulent sputum. High WBC count – neutrophils and monocytes.
What is the diagnosis and how should he be treated?
Bacterial pneumonia
Give oral antibiotics
A 25 year old woman was admitted via the Casualty Department with increasing difficulty with breathing, dry cough, and wheeze. High eosinophil count.
What is the diagnosis?
Eosinophils suggest allergy/atopy. This is an exacerbation of asthma.
What are the causes for eosinophilia? (6)
Allergy/atopy Parasitic infections Drugs Haematological disorders Connective tissue disorders Hyper-eosinophilic syndrome
An 18 year old female presented to her general practitioner with a sore-throat and general malaise.
On examination she had cervical lymphadenopathy and an inflamed throat. Temperature is 39°C. High lymphocyte count. Blood film shows reactive lymphocytes.
What is the diagnosis?
Glandular fever (infectious mononucleosis) – can be caused by Epstein Barr virus.
A 62 year old male was admitted for the repair of an inguinal hernia. On examination he was found to have mild generalised lymphadenopathy. High white cell count (high lymphocyte) and low Hb.
What is the diagnosis?
Chronic lymphocytic leukaemia
What are the four main types of leukaemia?
Chronic lymphocytic leukaemia (CLL)
Chronic myeloid leukaemia (CML)
Acute lymphocytic leukaemia (ALL)
Acute myeloid leukaemia (AML)
A 45 year old man presented with general malaise, night sweats and discomfort in the left hypochondrium. On examination he had an enlarged spleen. White cell count high and lots of different cells found on the blood screen.
What is the diagnosis?
Chronic myeloid leukaemia
What is chronic myeloid leukaemia always caused by?
Genetic translocation between chromosome 9 and 22 (Philadelphia translocation).
What is the Philadelphia translocation and how does it lead to the symptoms/signs in CML?
Puts BCR-ABL genes next to each other – fusion gene codes for abnormal tyrosine kinase protein, which drives the proliferation we see in CML. Leads to systemic symptoms and spleen overproducing cells, leading to heightened rate of metabolism.
How is CML treated?
Drugs that specifically inhibit the abnormal tyrosine kinase protein (imatinib).
