WHITE BLOOD CELLS MORPHOLOGY ,FUNCTIONS

Question 1

NEUTROPHILS morphology

Answer 1

➢Main defence of the body against bacteria infection.
➢Normal neutrophil has a diameter of about 13µm.
➢Has segmented nucleus of 3-5 lobes.
➢Cytoplasm usually stained pink / orange with fine granulation except in bacteria infection when the granules appear coarse and deeply stained (toxic granulation)

Question 2

EOSINOPHILS

Answer 2

●Usually about 12-17µm in diameter.
●They usually have two nuclear segment.
●Usually have eosinophilic granules.
* fight parasitic worms
* functions is allergic reactions such as asthma

Question 3

Basophils

Answer 3

:
●Nuclear segments tend to fold up on each other resembling a closed lotus flower.
●Cytoplasm usually have large dark blue or purple granules which often obscure the nucleus.

Question 4

Monocyte

Answer 4

:
•The largest of the circulating leucocytes.
•About 15-18µm in diameter.
•Have bluish-grey cytoplasm that contains fine reddish granules.
•The nucleus is large,folded or curled without segmentation.

Question 5

Lymphocyte

Answer 5

●Mononuclear cell with thin rim of pale blue cytoplasm.
●Usually about 9µm in diameter.
●Occasionally contains scanty granules.
●About 85% of the circulating lymphocytes are T cells or natural killer cells.

Question 6

NEUTROPENIA

Answer 6

•Viral infections
•Drugs : i) Anti-inflammatory ,Phenylbutazone.
ii) Antibacterial e.g Chloramphenicol, Cotrimoxazole.
iii)Anticonvulsants e.g Phenytoin.
iv)Antithyroid e.g Carbimazole.
v) Hypoglycaemic e.g Tolbutamide
•Hypersplenism
•Bone marrow failure

Question 7

CAUSES NEUTROPHILIA

Answer 7

•Bacterial infections
•Inflammation e.g Myocardial infarction
•Myeloproliferative disorders: e.g CML
•Drugs e.g steroid
•Disseminated malignancy
•Stress e.g trauma, surgery, burns.
•Metabolic disorders e.g uraemia,gout

Question 8

LYMPHOCYTOSIS

Answer 8

•Acute viral infection
•Chronic infection e.g TB, hepatitis, syphilis
•Leukemia and lymphomas esp CLL

Question 9

LYMPHOPENIA

Answer 9

•Steroid therapy
•Systemic Lupus erythematosis
•Uraemia
•HIV
•Marrow infiltration
•Post chemotherapy or radiotherapy

Question 10

EOSINOPHILIA

Answer 10

•Drug reactions e.g Erythema multiforme
•Allergies: Brochial asthma,food sensitivity ,urticaria
•Parasitic infestations: helminthiasis…Amoebiasis,Hookworm, Ascariasis
•Skin disease: Psoriasis, dermatitis herpetiformis.
•Hodgkin’s disease.
•Hypereosinophilic syndrome

Question 11

EOSINOPENIA

Answer 11

•Acute inflammation
•Drugs: steroid , catecholamines

Question 12

MONOCYTOSIS

Answer 12

•Chronic bacteria infections: Tuberculosis, Typhoid fever.
•Acute myeloid Leukaemia
•Hodgkin’s disease
•Myelodyplasia
• Malaria

Question 13

BASOPHILIA

Answer 13

•Myeloproliferative disease
•Viral infection
•IgE-mediated hypersensitivity reactions e.g urticaria
•Inflammatory disorder e.g Rheumatoid arthritis

Question 14

Döhle Bodies

Answer 14

•Small round or oval pale blue structures usually found at the periphery of the neutrophil.
•Consist of ribososmes and endoplasmic reticulum.
•Seen in severe bacteria infections.

Question 15

Toxic granulations

Answer 15

Presence of Coarse red-purple granules in the neutrophils.
Seen in septicaemia.

Question 16

Left shift

Answer 16

Presence of immature white cells in the peripheral blood. E.g band forms and metamyelocytes.
Less than 3 lobes in nucleus

Question 17

THE LEUKAEMOID REACTION

Answer 17

A reactive and excessive leucocytosis characterized by the presence of immature white cells in the peripheral blood …..Myeloblast,promyelocyte, Myelocytes, metamyelocytes,band forms.
Usually seen in severe infections.

Question 18

What is Right shift /Hypersegmentation and where can you see it?

Answer 18

Neutrophils with more than five nuclear lobes segments.
Seen in megaloblastic anaemia, uraemia and post chemotherapy especially methotrexate.

Question 19

What is Pelger Huët Anomaly?

Answer 19

Benign inherited anomaly in which neutrophil nuclei fail to segment properly . Majority of the neutrophils have only two discrete equal sized lobes connected by a thin chromatin bridge.
Seen in Myelodysplastic syndrome and Acute myeloid Leukaemia.

Question 20

Myeloperoxidase deficiency

Answer 20

This is the most common qualitative disorder of phagocytes .
Usually due to mutations of the MPO gene inherited in an autosomal recessive fashion.
This usually affects the polymorphonuclear microbicidal activity.

Question 21

Leukocyte adhesion deficiency

Answer 21

A rare disorder manifested by delayed wound healing ,recurrent bacterial infections and neutrophilia.
Usually results in severe impaired neutrophil chemotaxis and emigration to the site of infection.

Question 22

Chediak – Higashi syndrome

Answer 22

Inherited in an autosomal recessive fashion .
Characterized by: i)Presence of giant granules in the neutrophils,eosinophils, monocytes and lymphocytes.
ii) Neutropaenia and thrombocytopaenia
iii) Marked hepatosplenomegaly.

Question 23

May –Hegglin anomaly.

Answer 23

Inherited in an autosomal dominant manner.
Characterized by:
i) Basophilic cytoplasmic inclusions of RNA in the neutrophils.
ii) Mild thrombocytopaenia with giant platelets.

Question 24

Types of WBC

Answer 24

Granulocytes have visible granules or grains inside the cells that have different cell functions. Types of granulocytes include basophils, neutrophils, and eosinophils.

•Agranulocytes are free of visible grains under the microscope and include lymphocytes and monocytes.
•Together, they coordinate with one another to fight off things like cancer, cellular damage, and infectious diseases.