White Blood Cell Disorders

Question 1

Causes of Neutropenia?

Answer 1

Drug Toxicity

Infection

Question 2

Causes of Lymphopenia

Answer 2

Immunodeficiency: DiGeorge
High Cortisol State: cortisol induce apoptosis in lymphocytes, Cushings
Autoimmune destruction: Lupus
Whole Body Radiation

Question 3

Neutrophilic Leukocytosis causes (high levels of circulating leukocytes)

Answer 3

Bacterial Infection
Tissue Necrosis
High Cortisol State

Question 4

HY Left shift indicates immature neutrophils. The cells have decreased ____Receptors

Answer 4

Fc

Question 5

HYWhat is the marker that is decreased for the left shift immature neutrophils

Answer 5

CD16HY

Question 6

why does cortisol cause neutrophilic leukocytosis?

Answer 6

cortisol disrupts adhesion of marginated neutrophils and the neutrophils fall into the blood stream

Question 7

Monocytosis (increasing the WBC)

Answer 7

chronic inflammatory states

malignancy

Question 8

Eosinophilia causes and the important HY association

Answer 8

Allergic Reactions and Parasitic Infection

HY Hodgkin Lymphoma via increased IL-5 prodn

Question 9

cytokine responsible for eosinophilia in Hodgkin Lymphoma is

Answer 9

IL-5 secreted by Th2 cells

Question 10

Basophilia is HY classically associated with

Answer 10

Chronic myeloid Leukemia

Question 11

Lymphocytic Leukocytosis seen in viral infections because

Answer 11

Viral infections are fought by CD8 cells which recruit lymphocytes?

Question 12

HYBordetella pertussis can cause what sort of Leukocytosis (we’d expect to see neutrophils but we see…)

Answer 12

Lymphocytic leukocytosis because of the Lymphocytosis Promoting Factor which blocks lymphocytes from leaving the blood and entering the lymph node

Question 13

Infectious Mononucleosis causes Lymphocytic leukocytosis comprised of reactive CD8 cells. Which virus is more common?

Answer 13

EBV more common

CMV less common

Question 14

Where does EBV of infectious mononucleosis typically infect?

Answer 14

Oropharynx
Liver
B Cells

Question 15

HYCD8 T cell response will result in Lymphadenopathy w/ what area of the lymph node being enlarged?

Answer 15

Hyperplasia of the paracortex

Question 16

Why is splenomegaly seen in CD8 T-cell response (seen in for example infectious mononucleosis?

Answer 16

T cell area (the periarterial lymphatic sheath PALS)

Question 17

Atypical lymphocytes seen in infectious mononucleosis. What does the monospot test detect?

Answer 17

IgM heterophile antibodies

Question 18

What drug would precipitate a rash in someone infected with infectious mononucleosis?

Answer 18

Penicillin

Question 19

*HY** Acute Lymphoid Leukemia (both T and B) will have positive nuclear staining for what DNA polymerase?

Answer 19

TdT

Question 20

Acute Lymphoid Leukemia is associated with what syndrome after the age of 5

Answer 20

Down Syndrome

Question 21

Cell surface markers of B-Acute Lymphoid Leukemia?

Answer 21

CD10, CD19, CD20

Question 22

B-ALL has excellent response to chemo but needs prophylaxis to what 2 areas?

Answer 22

Scrotum and CSF

Question 23

Good and Bad prognosis of B-ALL translocations

Answer 23

t(12;21) good prognosis seen in kids

t(9;22) poor prognosis commonly seen in Adults (also the translocation for CML)

Question 24

T-ALL presents as a mass where?

Answer 24

Thymic mediastinal mass

Question 25

Mediastinal mass in teenager could be?

Answer 25

Acute Lymphoblastic Lymphoma

Question 26

Acute Myeloid Leukemia classically presents with what histological findings?

Answer 26

Auer rods in the cytoplasm (aggregate of Myeloperoxidase) punched out nucleus

Question 27

Classic translocation seen in Acute promyelocytic Leukemia?

Answer 27

t(15;17) which disrupts Retinoic Acid Receptor-alpha

Question 28

Acute monocytic Leukemia is a proliferation of monoblasts that characteristically infiltrate the

Answer 28

Gums

Question 29

Acute megakaryoblastic leukemia lacks MPO and is associated with Down Syndrome before age of 5 unlike _______ which is associated after the age of 5

Answer 29

Acute Lymphocytic Leukemia

Question 30

Acute megakaryoblastic leukemia tend to develop what type of syndrome?

Answer 30

Myelodysplastic syndromes

Question 31

Hematopoeitic stem cell surface marker

Answer 31

CD34+

Question 32

**HY**Chronic lymphocytic leukemia coexpress what cell surface markers?

Answer 32

CD5 and CD20

Question 33

Chronic lymphocytic leukemia is the neoplastic proliferation of which cells and you see what histologically??

Answer 33

Naive B-cells Smudge cells

Question 34

When Chronic lymphocytic leukemia go in to the lymph nodes, this is called

Answer 34

small lymphocytic lymphoma

Question 35

Infection is a common cause of death in patients with Chronic Lymphocytic leukemia because a complication is _________ as the naive B cells that lack capability of great Igs crowd out the functioning B cells.

Answer 35

Hypogammaglobulinemia

Question 36

Chronic Lymphocytic Leukemia create naive B cells that don't produce many antibodies, but when they do create antibodies it attacks the

Answer 36

Red blood cells (autoimmune hemolytic anemia)

Question 37

Unlike Chronic lymphocytic leukemia which is a proliferation of naive B cells, which leukemia is a proliferation of mature B cells and are positive for Tartrate Resistant Acid Phosphatase

Answer 37

Hairy Cell Leukemia (have hairy processes) do a TRAP stain

Question 38

Clinical features of Hairy cell leukemia

Answer 38

Splenomegaly (due to expansion of the red pulp)**HY** Usually no Lymphadenopathy Dry Tap w/ bone marrow aspiration

Question 39

Adult T cell Lymphoma presents in a similar way to Multiple Myeloma in that there are lytic bone lesions and hypercalcemia. How does ATCL present though that can clue you into that dx

Answer 39

presents with a rash caused by HTLV which is associated with IV drug use affects people in Japan and Caribbean