White Blood Cells

Question 1

Granulocytes

Answer 1

Neutrophils eosinophils and basophils which have granules in the cytoplasm
MHSC-myeloblast-granulocyte/monocyte

Question 2

Myeloid growth factors

Answer 2

G-CSF-granulocyte colony stimulating factor
M-CSF-macrophage colony stimulating factor
GM-CSF-granulocyte macrophage colony stimulating factor
These are important in proliferation and survival of myeloid cells

Question 3

Neutrophil

Answer 3

Myeloid stem cell-myeloblast-neutrophil
Lasts 7-10 hours in circulation before migrating to tissues
Lobulated nucleus
1)chemotaxis
2)phagocytosis following cytokine priming
Migration into tissues:marginating,adhesion,rolling,diapedesis,migration

Question 4

Chemotaxis

Answer 4

Directed migration of a cell in response to a chemical stimulus

Question 5

Eosinophil

Answer 5

Myeloid stem cell-myeloblast-eosinophil
Circulates for a few hours
Bilobed nucleus
1)chemotaxis
2)phagocytosis
3)Defends against parasitic infection

Question 6

High eosinophil count means

Answer 6

Parasitic infection

Question 7

Basophil

Answer 7

Myeloid stem cell-myeloblast-basophil
Bilobed nucleus
Granules which contain histamine heparin and proteolytic enzymes
1)chemotaxis
2)phagocytosis
3)mediation in IgE mediated hypersensitivity reactions
4)modulation in inflammatory responses by releasing heparin and proteases
Involve in helminth destruction

Question 8

Monocyte

Answer 8

Myeloid stem cell-monocyte precursor-monocyte
Circulates several days
1)chemotaxis
2)phagocytosis
3)Antigen presentation to lymphoid cells
Monocytes develop into macrophages (histocytes)
Macrophages store iron

Question 9

B and T lymphocytes

Answer 9

B: made in bone marrow and mature into plasma cells to make antibodies
T: travel from fetal liver to thymus and mature in thymus.Involved in cell mediated immunity

Question 10

Natural killer cells

Answer 10

Made in bone marrow
Part of innate immune system
Can kill tumor cells and virus infected cells

Question 11

Primary blood disorder

Answer 11

Leukocyte count or morphology is abnormal due to acquired somatic DNA damage affecting haematopoietic precursor cell, giving rise to blood cancers

Question 12

Reactive or secondary changes

Answer 12

Occur when normal or healthy bone marrow responds to an external stimulus such as infection, inflammation or infarction

Question 13

Leukocytosis

Answer 13

Increase in total number of WBC

• Neutrophilia
• Eosinophilia
• Basophilia
• Lymphocytosis
• Monocytosis

Question 14

Leukopenia

Answer 14

Decrease in total number of WBC

• Neutropenia
• Lymphopenia

Question 15

Neutrophilia

Answer 15

Too many neutrophils

• Primary causesChronic myeloid leukaemia (CML)
• Secondary causesInfection (particularly bacterial), inflammation, infarction
  Can also be seen in pregnancy or after exercise or administration of corticosteroids

Question 16

What toxic changes occur due to neutrophilia

Answer 16

Left shift: Presence of less mature myeloid cells due to depletion of bone marrow stores
Toxic granulation: Course granulation due to sever infection inflammation or pregnancy

Question 17

Eosinophilia

Answer 17

Too many eosinophils
Primary cause by chronic myeloid leukemia
Secondary cause by allergy eg asthma or parasitic infection

Question 18

Basophilia

Answer 18

Too many basophils
Very uncommon and usually due to leukemia

Question 19

Monocytosis

Answer 19

Too many monocytes
Caused by infection or chronic inflammation or leukemia

Question 20

Lymphocytosis

Answer 20

Primary cause by lymphoproliferative disorders
Secondary causes by viral or bacterial infections

Question 21

Neutropenia

Answer 21

Too few neutrophils

Can occur due to:

• chemotherapy/radiotherapy
• Autoimmune disorders
• Severe bacterial infections
• Certain viral infections
• Drugs - e.g. anticonvulsant and antipsychotic

Patients with very low neutrophil count are at risk of serious infections

Question 22

Lymphopenia

Answer 22

Caused by HIV leukaemia or chemotherapy or corticosteroids

Question 23

Acute vs chronic

Answer 23

Acute are severe and sudden in onset
Chronic occurs for a long time

Question 24

Chronic lymphocytic leukaemia

Answer 24

Lymphoproliferative disorder
Increased lymphocytes are mature
Lymphocytes are squashed
Common in elderly

Question 25

Chronic myeloid leukaemia

Answer 25

Increase in all granulocytes
No increase in number of lymphocytes
Observation of granulocytes at various stages of development including band forms
Occurs due to abnormal chromosome 22 Philadelphia chromosome
Protein BRC-ABL1 has tyrosine kinase activity take tyrosine kinase inhibitors for treatment
Splenomegaly

Question 26

Megaloblastic anaemia

Answer 26

Hypersegmentation of nucleus observed
B12 or folate deficiency
More than 5 lobes

Question 27

Chronic lymphocytic leukemia

Answer 27

Squashed lymphocytes
Occurs in eledery

Question 28

Acute lymphoblastic leukemia

Answer 28

Increase in lymphoblasts
Bone marrow is infiltrated by lymphoblasts affecting haemopoiesis
Has neutropenia,thrombocytopenia(low platelets count),anemia and leukocytosis of lymphoblasts
Pale skin and bruising
Need red cell transfusions platelet transfusion and antibiotics

Question 29

Neutrophil hypersegmentation

Answer 29

More than 5 lobes
Due to vitamin b12 or folic acid deficiency