White Blood Cells Flashcards
Which white blood cells are produced from the common myeloid progenitor?
Granulocytes - neutrophils, basophils and eosinophils
What is the difference between monocytes and macrophages?
Monocytes are in the blood whilst macrophages are in tissue
What are the main functions of neutrophil granulocytes?
Chemotaxis, phagocytosis and killing of phagocytosed bacteria
What are the main functions of basophils granulocytes?
Chemotaxis, phagocytosis, killing of phagocytosed bacteria, medication of immediate type hypersensitivity, modulates inflammation responses by releasing heparin
What is the main functions of eosinophils
Chemotaxis, phagocytosis, killing of phagocytosed bacteria, defense against parasitic infection
What is left shift?
When there is a presence of earlier forms of neutrophils eg band forms
How many lobes is normal for a neutrophil?
3-5
What is it called when there are more than 5 lobes in a neutrophil
Hyper segmented neutrophil
What are the steps of chemotaxis?
MARDi MP
Migration Adhesion Rolling Diapediesis Migration Phagocytosis
What is diapedesis?
When white blood cells migrate across the blood vessel wall
How many lobes do eosinophils contains?
2
What is contained within the granules of basophils?
Heparin, histamine and proteolytic enzymes
How do you identify basophils?
They have many granules in their cytoplasm
What do monocytes do?
Present antigens to lymphoid cells
How are macrophages related to iron?
They store and release iron
What white blood cells derive from the common lymphoid progenitor?
T cell, B cells and NK cells
What do B lymphocytes produce?
Antibodies
What do NK Cells do?
Part of innate immunity - kill tumour and virus infected cells
What is leucocytosis?
To many white blood cells of any type
What is meant by neutrophilia , basophilia and eosinophillia?
Too many of each type of white blood cell
What is leucopenia?
Too little of any type of white blood cell
What is the most abundant type of white blood cell?
Neutrophils
What color of eosinophils appear when stained?
Red granules and two lobes
What can cause too many neutrophils?
NICE PreT
Neoplasm Infection Corticosteroids Exercise Pregnancy Tissue damage
How does exercise increase the number of neutrophils?
Exercise causes a rapid shift of neutrophils from marginated pool to circulating pool
What might neutrophilia be accompanied with?
Left shift and toxic changes
What is toxic granulation of neutrophils?
Heavy course granulation of neutrophils
What causes neutropenia?
BRAID
Benign ethnic neutropenia - people of African descent
Radiotherapy
Autoimmune disorders
Infections - severe viral and bacterial infections
Drugs - eg chemotherapy
What is considered a low neutrophil count?
<0.5 x 10^9/L
What is lymphocytosis?
Too many lymphocytes
How to recognize lymphocytosis from a blood film?
Find atypical lymphocytes eg in Epstein Barr Virus infection
Basophillic cytoplasm
Scalloped margins of WBC
What condition in children causes lymphocytosis?
Whopping cough
What is a cause of lymphopenia?
HIV infection
Also: chemotherapy, radiotherapy, corticosteroid
What causes monocytosis?
Infection or chronic inflammation
What causes eosinophilia?
Due to allergy or parasitic infection, asthma, eczema
What causes basophillia?
Leukemia
A 6-year old child is diagnosed with acute lymphoblastic leukaemia. The doctor warns the parents that their child is more susceptible to infections. Why is this the case?
The childs bone marrow cells are not infiltrated with cancer cells
How do macrophages form?
Myeloid stem cells can give rise to monocytes
Monocytes migrate to tissue where they develop into macrophages
Which white blood cell stores and releases iron?
Macrophages
What do B lymphocytes mature into?
Plasma cells which secrete antibodies
What is meant by Reactive or Secondary changes?
Occur when a normal or healthy bone marrow responds to an external stimulus such as Infection, inflammation or infarction
What is a primary blood cell disorder?
The leukocyte count or morphology is abnormal due to acquired somatic DNA damage affecting a haematopoietic precursor cell giving rise to blood cancers such as leukaemia, lymphoma, myeloma or myeloproliferative disorders
What are causes of neutrophillia?
infection (particularly bacterial infection), inflammation, infarction or other tissue damage,
What lifestyle factors could cause neurophilli?
Pregnancy
Exercise
Corticosteroids
When might toxic granulation be seen?
During pregnancy
What is meant by left shft in terms of neutrophillia?
There is an increase in non-segmented neutrophils in the blood (these are known as band forms)
What causes chronic myeloid leukaemia?
CML results from a translocation (exchange of material) between chromosomes 9 and 22, occurring in a single haemopoietic stem cell, resulting in the formation of a fusion gene, ABL:BCR
Why does the fusion gene BCR:ABL cause CML?
The fusion protein has constitutive tyrosine kinase activity which drives autonomous blood cell proliferation
What happens to the spleen in CML?
Enlarged spleen
What causes too many monocytes?
infection (particularly chronic bacterial infection) or chronic inflammation
What might lymphocytes due to a viral infection look like?
Intensely basophilic cytoplasm, scalloped margins and hugging of the surrounding red blood cells
What cell type is characteristic of chronic myeloid leukaemia?
Smudge cells
What are some haematological features of acute lymphoblastic leukaemia?
Leukocytosis with lymphoblasts in the blood
Anaemia (normocytic, normochromic)
Neutropenia
Thrombocytopenia (low platelet count)
Replacement of normal bone marrow cells by lymphoblasts
Why might a child with acute lymphoblastic leukaemia have bruising and be pale?
Bruising is due to lack of platelets
Pale is due to anaemia
both these occur due to the replacement of normal bone marrow cells with lymphoblasts
What are the treatment options for ALL?
Supportive Red cells Platelets Antibiotics Systemic chemotherapy Intrathecal chemotherapy
What are the causes of lymphopenia?
HIV infection
Chemotherapy
Radiotherapy
Corticosteroids
