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LOCOMOTOR 2 > White Blood Cell Conditions > Flashcards

White Blood Cell Conditions Flashcards

1
Q

Describe the appearance of neutrophils and their function

A

2-3 lobes of the nuclei, light staining with lobed nucleus. Involved in responding to BACTERIAL infections

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2
Q

Describe the appearance of eosinophils and their function

A

Have a red brick colour staining with two nuclei and are involved in responding to PARASITES (e.g. helminths)

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3
Q

Describe the appearance of basophils and their function

A

Rarely seen in blood film but cytoplasm is highly granular and is involved in allergies as it’s the equivalent to mast cels in the blood

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4
Q

Describe the appearance of monocytes and their function

A

Largest of the granulocytes with a kidney-bean shaped nucleus, and matures in tissues to become a macrophage

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5
Q

Describe the appearance of lymphocytes and their function

A

Large nucleus: cytoplasm ratio (very little cytoplasm visible) and involved in adaptive immunity

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6
Q

What are macrocytes and what may cause this?

A

Red cells with an increased MCV, due to liver disease or B12/folate deficiency

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7
Q

What are target cells and what may cause this?

A

Red cells with a ‘target-like’ appearance due to liver disease, haemoglobinopathies or iron deficiency

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8
Q

What are pencil cells and what may cause this?

A

These are where the red cells appear thin and pencil-shaped due to iron-deficiency

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9
Q

What are ecchinocytes and what may cause this?

A

These are star-shaped red cells due to liver disease

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10
Q

What are microcytes and what may cause this?

A

Red cells with a reduced MCV due to iron-deficiency or thalassaemia

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11
Q

What are spherocytes and what may cause this?

A

Spherical red cells due to hereditary spherocytosis, or autoimmune haemolytic anaemia.

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12
Q

What may the presence of red cell fragments in a blood film represent?

A

Diffuse intravascular coagulation (DIC) or cardiac prosthetic valves

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13
Q

What are elliptocytes and what may cause this?

A

Thicker versions of pencil cells present due to hereditary elliptocytosis

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14
Q

What are tear drop poikilocytes are what may cause this?

A

These are red cells that are tear-drop shaped due to myelofibrosis

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15
Q

What are Howell-Jolly bodies and what may cause this?

A

Remnant of DNA in red cell due to hyposplenism or post-splenectomy

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16
Q

How would a malarial parasite present in a blood film?

A

Look’s similar to an engagement ring within the red blood cells.

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17
Q

What is the mode of inheritance for hereditary ellpitocytosis?

A

Autosomal dominant

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18
Q

What is hereditary elliptocytosis?

A

Where there is a defect leading to failure of spectrum heterodimers to self-associate into heterotetramers so the normal bi-concave disc doesn’t form.

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19
Q

How does the genetic profile affect the severity of hereditary elliptocytosis?

A

Homozygous (or doubly heterozygous) have severe haemolytic anaemia, whereas those who are heterozygous tend to have no ill effects until discovered under routine examination

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20
Q

What is immune thrombocytopenia purpura (ITP)?

A

Usually appears as spontaneous skin purport and mucosal bleeding that tends to affect women 15-50 and bone marrow has increased levels of megakaryocytes.

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21
Q

In a 23-year-old woman with easy bruising, heavy periods, petechial haemorrhages around her ankles and microcytic anaemia, what is the likely cause?

A

Iron-deficiency anaemia due to chronic blood loss and immune thrombocytopenia purport for the petechial haemorrhages and easy bruising.

22
Q

What are the characteristic blood film signs post-splenectomy or with hyposplenism?

A

Irregularly contacted red cells, target cells, Howell-Jolly bodies

23
Q

Why does whooping cough cause a lymphocytosis in children instead of a neutrophilia?

A

Whooping cough is caused by Bordetella pertussis bacteria which would cause a neutrophilia in adults but lymphocytosis often occurs in response to bacterial infections in children.

24
Q

A one-year-old boy presented with a recent respiratory tract infection. This had now developed into severe paroxysms of coughing. He has a normocytic anaemia with lymphocytosis. What is the likely diagnosis?

A

Whooping cough with bordetella pertussis, as bacterial infections in young children often lead to a lymphocytosis instead of a neutrophilia

25
Q

What are the histological characteristics of chronic lymphocytic leukaemia?

A

Polychromasia (reticulocytosis) and normocytic anaemia with lymphocytosis

26
Q

Outline the underlying pathophysiology of chronic lymphocytic leukaemia

A

There is clonal expansion of B-cells and the bone marrow is infiltrated by lymphocytes leading to it’s failure and subsequently the development of anaemia, neutropenia and thrombocytopenia.

27
Q

What are promyelocytes?

A

Early granulocyte precursors characterised by bi-lobed nuclei and cytoplasmic granulation

28
Q

What is acute promyelocytic leukaemia?

A

A type of acute myeloid leukaemia characterised by the presence of a t(15:17) translocation and the presence of DIC (disseminated intravascular coagulation)

29
Q

Which form of leukaemia is a t(15:17) translocation and DIC characteristic of?

A

Acute promyelocytic leukaemia

30
Q

Why does treatment of acute promyelocytic leukaemia with chemotherapy have to be done with care?

A

Chemotherapy aggravates the DIC ad therefore multiple platelet transfusions and replacement of clotting factors with fresh frozen plasma have to be used.

31
Q

How would acute pro-myelocytic leukaemia appear on a full blood count?

A

Normocytic anaemia (due to bone marrow infiltration), reduced leucocytes generally with increased pro-myelocytes, decreased platelets (due to DIC and marrow infiltration) and increased clotting and reduced availability of factors.

32
Q

What is myelofibrosis?

A

Extensive scarring of the bone marrow which affects the production of blood cells

33
Q

A 64-year-old woman presented with tiredness and left-sided abdominal discomfort. On examination she had an enlarged live and massive splenomegaly. There were occasional granulocyte precursors and a circulating erythroblast in the blood film. What is the likely diagnosis?

A

Primary myelofibrosis with extramedullary haemaopoiesis

34
Q

What are the characteristic features of primary myelofibrosis?

A

Leucoerythroblastic anaemia with massive splenomegaly

35
Q

What mutation is associated with primary myelofibrosis?

A

JAK 2 in the haematopoietic precursor cells.

36
Q

What is ‘multiple myeloma’?

A

A form of cancer where there is clonal proliferation of plasma cells in the bone marrow with presence of monoclonal antibodies or light chains in the serum-urine with associated tissue damage.

37
Q

What are the characteristic signs of a multiple myeloma?

A

Rouleaux formation, background staining and macrocyclic anaemia with monoclonal antibodies (paraproteins)

38
Q

A 20-year-old male was admitted with sudden onset of left-sided chest pain and a productive cough with purulent sputum.

They had neutrophilia, increased monocytes and reduced lymphocytes. What is the likely diagnosis?

A

There is neutrophilia, which is likely to be indicative of a bacterial infection, as well as infiltration of monocytes and reduction in lymphocytes, therefore the diagnosis will be bacterial, and is therefore bacterial pneumonia.

39
Q

25-year-old woman was admitted via the Casualty Department with increasing difficulty with breathing.

She had increased neutrophils and eosinophils. What is the likely diagnosis?

A

Eosinophilia is more pronounced and therefore it is likely she is having an acute asthma attack

40
Q

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 with a temperature of 39°C.

They have increase neutrophils and increased reactive and non-reactive lymphocytes. What is the likely diagnosis?

A

This patient has lymphocytosis and their diagnosis would be infectious mononucleosis.

41
Q

A 62-year-old male was admitted for the repair of an inguinal hernia. On examination he was found to have mild generalised lymphadenopathy.

He has a normocytic anaemia, reduced platelets and neutrophils with increased levels of lymphocytes. What is the likely diagnosis?

A

The patient has lymphocytosis, normocytic anaemia, mild neutropenia and thrombocytopenia and this leads to a diagnosis of chronic lymphocytic leukaemia.

42
Q

What are the characteristic signs of chronic lymphocytic leukaemia (CLL)?

A

Lymphocytosis, normocytic anaemia, mild neutropenia and thrombocytopenia.

43
Q

What are the characteristics of chronic myeloid leukaemia?

A

Granulocytosis, normocytic anaemia and mild thrombocytosis

44
Q

A 45-year-old man presented with general malaise, night sweats and discomfort in the left hypochondrium. On examination he had palpable liver and spleen.

He had a increased granulocytes, lymphocytes and reduced platelets. What is the likely diagnosis?

A

Chronic myeloid leukaemia

45
Q

A 12-year-old girl presented with increasing tiredness and easy bruising.

She has normocytic anaemia, reduced platelets and increased blast cells (leucocytosis). What is the likely diagnosis?

A

Acute lymphoblastic leukaemia

46
Q

What are the characteristics of acute lymphoblastic leukaemia (ALL)?

A

Normocytic anaemia, thrombocytopenia and leucocytosis (increased blasts)

47
Q

What are the characteristics of acute myeloid leukaemia?

A

Macrocytic anaemia, thrombocytopenia and leucocytosis (increased blasts)

48
Q

A 65-year-old woman presented with increasing breathlessness, spontaneous bleeding from her gums and easy bruising.

They had macrocyclic anaemia, thrombocytopenia and leucocytosis. What is the likely diagnosis?

A

Acute myeloid leukaemia

49
Q

What are the characteristics of sickle cell disease/anaemia?

A

Polychromasia (reticulocytosis), sickle cells and splenic atrophy features

50
Q

A 26-year-old black woman was admitted with severe pain in her hip.

She has normocytic anaemia and increased platelets. What is the likely diagnosis?

A

Sickle cell anaemia

51
Q

Which form of leukaemia is associated with the philadelphia chromosome?

A

Chronic myeloid leukaemia

52
Q

What is the philadelphia chromosome?

A

Genetic abnormality of chromosome 22

LOCOMOTOR 2 (28 decks)

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