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1.2 POM Haematology > White Blood Cells > Flashcards

White Blood Cells Flashcards

1
Q

What are granulocytes?

A

Leukocytes with granules in cytoplasm
(contain agents for microbicidal function)

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2
Q

What are the 4 types of granulocyte?

A
  1. Neutrophil
  2. Basophil
  3. Eosinophil
  4. Monocytes
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3
Q

What are the 3 myeloid growth factors?

A
  1. G-CSF (granulocyte-CSF)
  2. M-CSF (macrophage-CSF)
  3. GM-CSF
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4
Q

How do myeloblasts turn into granulocytes?

A

-Cell division to myelocyte
- Differentiation to band form then granulocyte

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5
Q

What is the lifespan of a neutrophil?

A

7-10 hours

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6
Q

How can neutrophils be identified on a blood film?

A

Segmentend nucleus (3-5 lobes)

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7
Q

What is the function of neutrophils?

A

Phagocytoses and kills microorganisms

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8
Q

What are the 6 steps of neutrophil chemotaxis?

A
  1. Adhesion - to vessel lumen
  2. Margination
  3. Rolling
  4. Diapedesis - squeezes through cell gaps in endothelium
  5. Migration - in tissue to microorganism
  6. Phagocytosis
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9
Q

What must happen to a neutrophils for phagocytosis to occur?

A

Cytokine-priming

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10
Q

What is the lifespan of an eosinophil?

A

<Neutrophil

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11
Q

What is the function of eosinophils?

A

Fight parasitic infections (eg. helminths)

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12
Q

Why are eosinophils important in hypersensitivity?

A

Regulate Type 1 hypersensitivity reactions
- Inactivate histamine and leukotrienes from basophils/mast cells

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13
Q

How are eosinophils identified on a blood film?

A

-Red
-Many granules
-Bilobed nucleus

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14
Q

What 3 things do basophil granules store?

A
  1. Histamine
  2. Heparin
  3. Proteolytic enzymes
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15
Q

What is the function of basophils?

A

Immune and inflammatory responses

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16
Q

What are the 2 reactions basophils influence and how?

A
  1. Type 1 hypersensitivity —> IgE-coated basophils release histamine and leukotrienes
  2. Inflammatory response —> release heparin and proteases
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17
Q

How are basophils identified on a blood film?

A
  • Blue
  • Packed with granules
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18
Q

What are mast cells?

A

Tissue-resident cells involved in hypersensitivity reactions

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19
Q

What is the circulation time of a monocyte?

A

Several days

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20
Q

Where do monocytes go when they leave circulation?

A

Reside in tissue —> macrophages

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21
Q

What are the 3 functions of monocytes?

A
  1. Phagocytosis of antibody and complement-coated micoorganisms
  2. Phagocytosis of bacteria/fungi
  3. Antigen presentation to immune cells
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22
Q

What is the 2 function of macrophages?

A
  1. Phagocytosis
  2. Store and release iron
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23
Q

How are macrophages arranged in the bone marrow?

A

Each encircled by erythrocytes —> delivers iron to them

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24
Q

What 3 cells to lymphoid progenitor cells give rise to?

A
  1. B lymphocytes
  2. T lymphocytes
  3. NK cells
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25
Q

Where do lymphocytes circulate?

A
  • Recirculate to lymph nodes and tissues
  • Then back to bloodstream
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26
Q

How are B and T lymphocytes identified on a blood film?

A
  • Small
  • Mostly nucleus
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27
Q

How in an NK cell identified on a blood film?

A
  • Larger
  • Granules
  • Clumped nucleus
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28
Q

Where do B lymphocytes originate? (2)

A
  • Fetal liver
  • Bone marrow
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29
Q

Where do B lymphocytes mature?

A

Bone marrow

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30
Q

How do B lymphocytes acquire surface antibodies?

A

Ig heavy and light chain gene rearrangements

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31
Q

How do B lymphocytes develop further in the lymphatic system?

A
  • Exposed to other antigens
  • Mature to recognise non-self antigens
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32
Q

Where do T lymphocytes originate?

A

Fetal liver

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33
Q

Where do T lymphocytes mature?

A

Thymus

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34
Q

What is the function of T lymphocytes?

A

Cell-mediated immunity

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35
Q

What is the function of B lymphocytes?

A

Humoral immunity

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36
Q

What is the function of NK lymphocytes?

A

Innate immunity
- kill tumour cells
- kill virus-infected cells

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37
Q

What is the cause of transient leukocytosis?

A

Reactive cause
- Infection/inflammation/infarction
- Bone marrow responding to external stimulus

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38
Q

What is the cause of persistent leukocytosis?

A

Primary blood cell disorders
- Leukaemia/lymphoma/myeloma
- DNA damaged —> affects haemopoietic precursor cells

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39
Q

What is leukocytosis?

A

Too many white blood cells

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40
Q

What are the 5 types of leukocytosis?

A
  1. Neutrophilia
  2. Eosinophilia
  3. Basophilia
  4. Lymphocytosis
  5. Monocytosis
41
Q

What is leukopenia?

A

Too few white blood cells

42
Q

What are the 2 types of leukopenia?

A
  1. Neutropenia
  2. Lymphopenia
43
Q

Why may those with leukopenia need isolation?

A

Very weak immune system

44
Q

What is neutrophilia?

A

Too many neutrophils

45
Q

What are the 3 causes of neutrophilia?

A
  1. Infection
  2. Inflammation
  3. Tissue damage
46
Q

What 3 things is neutrophilia also a normal response to?

A
  1. Pregnancy
  2. Exercise
  3. Corticosteroids
47
Q

What 2 things may accompany neutrophilia?

A
  1. ‘Left-shift’ —> presence of non-segmented neutrophils or neutrophil precursors
  2. Toxic granulation
48
Q

What is chronic myeloid leukaemia? (CML)

A

Primary blood cancer
- Myeloproliferative

49
Q

What 3 things can be identified on the blood film of a CML patient?

A
  1. Neutrophilia
  2. Basophilia
  3. Left-shift
50
Q

What is neutropenia?

A

Too few neutrophils

51
Q

Which 2 therapies can cause neutropenia?

A
  1. Chemotherapy
  2. Radiotherapy
52
Q

What are the 5 causes of neutropenia?

A
  1. Autoimmune disorder
  2. Severe bacterial infection
  3. Viral infections (some)
  4. Drugs
  5. Thrombocytopenia
53
Q

Which ethnicities may have a blood film wrongly suggesting neutropenia and why?

A

African/Afro-Caribbean —> benign ethnic neutropenia
- More neutrophils parked in vasculature (not actually less neutrophils)

54
Q

What is the biggest risk of neutropenia and how is this combatted?

A

Serious infection
- urgent intravenous antibiotics

55
Q

How many lobes does the nucleus of a normal neutrophil have?

A

3-5

56
Q

What is neutrophil hypersegmentation?

A

Increased number of lobes in neutrophil nuclei
- ‘Right-shift’

57
Q

What causes neutrophil hypersegmentation?

A

Megaloblastic anaemia
- vit B12/folic acid deficiency — >affect DNA replication —> nuclei lobes keep dividing

58
Q

What are the 3 neutrophil abnormalities?

A
  1. Neutrophilia
  2. Neutropenia
  3. Neutrophil hypersegmentation
59
Q

What is ‘right shift’ and ‘left shift’ in neutrophils?

A
  1. Right-shift = too many nucleus lobes (overdeveloped)
  2. Left-shift = unsegmented nucleus or neutrophil precursors present in blood (underdeveloped)
60
Q

What is eosinophilia?

A

Too many eosinophils

61
Q

What are the 2 causes of eosinophilia?

A
  1. Allergy (asthma, eczema, drugs)
  2. Parasitic infection
62
Q

Which type of leukaemia can present eosinophilia?

A

CML

63
Q

What is basophilia?

A

Too many basophils

64
Q

What is the cause of basophilia?

A

Leukaemia - eg. CML

65
Q

Which leukocytosis is uncommon?

A

Basophilia

66
Q

What are band forms?

A

Immature neutrophils

67
Q

How can band forms be identified on a blood film?

A
  • Snake-like nucleus (unsegmented)
  • Granules
68
Q

How can myelocytes be identified on a blood film?

A
  • Rounded ‘triangle’ nucleus
69
Q

What is monocytosis?

A

Too many monocytes

70
Q

What are the 3 causes of monocytosis?

A
  1. Infection
  2. Inflammation
  3. Leukaemia (some)
71
Q

What is lymphocytosis?

A

Too many lymphocytes

72
Q

What is the cause of transient lymphocytosis?

A

Viral infection

73
Q

What is the cause of persistent lymphocytosis?

A

Lymphoproliferative disorder - eg. CLL

74
Q

What are the 4 symptoms of chronic lymphocytic leukaemia (CLL)?

A
  1. Weight loss
  2. Fevers
  3. Night sweats
  4. Straw-coloured blood
75
Q

What is lymphopenia?

A

Too few lymphocytes

76
Q

What are the 4 causes of lymphopenia?

A
  1. HIV
  2. Chemotherapy
  3. Radiotherapy
  4. Corticosteroids
77
Q

Which patients may develop transient lymphopenia?

A

Severe infection

78
Q

What is leukaemia?

A

Blood cancer

79
Q

What are the 2 classes of leukaemia?

A
  1. Myeloid
  2. Lymphoid
80
Q

Which cells do leukaemic cells replace?

A

Normal HSCs

81
Q

What proportion of cancers are leukaemias?

A

5%

82
Q

How do leukaemic cells enter the blood?

A

Clone —> replace normal bone marrow cells —> spill into blood

83
Q

Where do most leukaemias originate?

A

Bone marrow

84
Q

How does leukaemia occur?

A

Somatic mutations in a usually oncogenes

85
Q

Why may leukaemic clones replace normal cells? (3)

A

Growth or survival advantage
1. Don’t need usual growth factors
2. Disturbance in proliferation or maturation
3. Failure of apoptosis

86
Q

What is important about the life expectancy of patients with leukaemia?

A

Shortest of all cancer

87
Q

Why do the terms malignant and benign not apply to leukaemias?

A

Leukaemias will circulate in the bloodstream and migrate to other tissues (no solid tumour)

88
Q

What 4 types of leukaemia?

A
  1. ALL - acute lymphoblastic leukaemia
  2. AML - acute myeloid leukaemia
  3. CLL - chronic leukocytic leukaemia
  4. CML - chronic myeloid leukaemia
89
Q

What is the difference between the maturity of cells affected by acute vs chronic leukaemias?

A
  • ALL/AML —> blast cells affected
  • CLL/CML —> mature cells affected
90
Q

Which age group does ALL usually affect and why?

A

Children
- mutations in utero

91
Q

Which age group does CLL usually affect?

A

Elderly

92
Q

Why does CML occur?

A

Fusion protein BCR-ABL1 —> activates signalling pathways

93
Q

Why does CLL occur?

A

Steady expansion of leukaemic clone —> gradually replace normal cells
(B —> mutation usually in TF gene —> B won’t mature —> accumulation of blast cells)

94
Q

What are the 4 consequences of leukaemia?

A
  1. Accumulation of abnormal cells
  2. Metabolic effects
  3. Crowding out of normal haemopoiesis
  4. Lose T and B lymphocyte function (CLL)
95
Q

What are the 7 consequences of accumulation of abnormal cells in leukaemia?
(Leukaemia Stops Happiness Because Tumours Stop Life)

A
  1. Leukocytosis
  2. Splenomegaly
  3. Hepatomegaly
  4. Bone pain (ALL/AML)
  5. Thymic enlargement (T-ALL/T-CLL)
  6. Skin infiltration
  7. Lymphadenopathy (ALL/CLL)
96
Q

What are the 4 consequences of metabolic effects of leukaemia?

A
  1. Renal failure —> hyperuriacaemia
  2. Weight loss
  3. Fever (low-grade)
  4. Sweating
97
Q

What are the 3 consequences of crowding out of normal haemopoiesis in leukaemia?

A
  1. Anaemia - fatigue, lethargy, pallor, breathlessness
  2. Neutropenia - fever
  3. Thrombocytopenia - bruising, petechiae, bleeding
98
Q

What is the consequence of loss of T and B lymphocyte function in leukaemia?

A

Weak immune system (CLL)

1.2 POM Haematology (7 decks)

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