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34 Cards in this Set
- Front
- Back
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Series of cells in PMN development
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Myeloblast
Promyelocyte Myelocyte Metamyelocyte Band Neutrophil Segmented Neutrophil |
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Progression of nuclear shape (PMN development)
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Round or oval (2 steps)
Indented (2 steps) Elongated band (1 step) 2-5 distinct nuclear lobes (1 step) |
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Progression of nuclear chromatin (PMN development)
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No aggregation
Slight aggregation Aggregated/Granular Basi- / oxyphilic easily distinguished Coarsely granular Granular |
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Progression of nucleoli (PMN development)
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1-5 (2 steps)
None (4 steps) Nucleoli are LOST with maturity |
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Progression of cytoplasm (PMN development)
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Basophilic, scant (2 steps)
Bluish pink, moderate (2 steps) Pink, abundant (2 steps) Cytoplasm increases and becomes pinker with maturity |
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Progression of granules (PMN development)
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Absent
Present, NON-specific, fine azurophilic (reddish) Present, specific, azurophilic Present, specific eosinophilic Present, specific, violet/pink Specific, fine, violet/pink Granularity is GAINED with maturity |
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Neutrophils
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2-5 lobed nucleus
Clumped chromatin, granules in cytoplasm Life span of days Normal differential 30-75% Increased in acute bacterial infections |
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Basophils
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Bilobed nucleus
Dark purple granules (stimulated by IgE, C5a, C3) Note: granules contain heparin, histamine, etc. Life span of 2 weeks Normal differential 0-2% Secrete IL4 Increased in myeloproliferative disorders, menses, diabetes, etc. |
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Eosinophils
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2-3 segmented nucleus
Orange-red granules (stimulated by IgA, E, G, substance P, etc.) Life span of days Normal differential 0-6% Secrete IL3, 5, 6, 8 Increased in drug interactions, parasitic infections, allergic conditions, Hodgkins, etc. |
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Lymphocytes
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Cytoplasm is scant - abundant (shades of blue)
Life span of days - years Normal differential 20 - 45% Increased in inflammation, viral infections, drug reactions, etc. Decreased in (auto)immune disorders, acute infections ("left shift"), radiation, etc |
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Monocytes
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Abundant, blue-grey cytoplasm, containing vacuoles
Life span of days Stimulated by INF-g, IL-2, 4, M-CSF Normal differential 0-10% Increased in chronic infections, CVDs, IBD, myeloproliferative disorders |
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Platelets
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Anucleate
Fine, blue-purple granules Life span of 8-10 days Normal # 150 - 450 billion Increased in iron deficiency Decreased in viral infections, acute leukemia, radiation, etc. |
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Neutropenia level
Level where infection fighting is compromised Agranulocytosis |
< 1.5 x 10e9
< 1.0 x 10e9 < 0.5 x 10e9 |
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Breakdown of platelet distribution
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2/3 in circulation
1/3 pooled for storage |
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Cyclic neutropenia
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Autosomal dominant disorder
3-6 days of neutropenia every 21-30 days |
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Symptoms of neutropenia
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Begin after 1-3 days
Malaise, chills, sore throat, fever Later come fatigability, weakness |
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Causes of eosinopenia
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Cushing's syndrome
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Causes of basopenia
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Hyperthyroidism
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Monocytopenia
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Seen in first few hours after prednisone
Returns to normal by 12 hours |
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Causes of lymphocytopenia
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CORTICOSTEROIDs (lymphocytes are very sensitive)
Chemo, radiation Hodgkin's HIV Chronic diseases |
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"Left Shift"
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Due to shifting of reserves into blood following stimulus
BM production is increased Immature neutrophils are released Usually, is a sign of an acute process |
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Leukemoid reactions
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Presence of circulating blasts
May be secondary to benign/malignant conditions |
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Lymphocytosis
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> 4x10e9 (adults) > 9x10e9 (kids)
Can be caused by: Pertussis (mostly in kids) Toxoplasmosis, brucellosis, syphilis (all atypical) Infectious Mononucleosis (EBV infection of B-cells) CMV (may follow blood transufsions) HLTV-1 (transient) |
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Infectious lymphocytosis
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Benign problem
Seen mostly in children Characterized by small lymphocytes Related to Coxsackie A or B6, echovirus, or adenovirus 12 Almost never presents with splenomegaly or lymphadenopathy |
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This can inactivate IgE mediated reactions
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Eosinophilia
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One of first signs of megaloblastic anemia
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Hypersegmentation
Sometimes referred to as "right shift" Normal PMNs ALWAYS have less than 5 lobes |
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Concomitant MPO deficiency and diabetes may develop in this
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Candidiasis
Note: MPO deficiency is autosomal recessive |
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Pelger-Huet anomaly
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Autosomal dominant disorder
Failure of nuclei to segment properly Homozygous -- round nuclei Heterozygous -- bi-lobed nuclei Note: BENIGN, function is normal Note: ACQUIRED Pelger-Huet may be a sign of MDS |
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Dohle bodies
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Blue cytoplasmic inclusions
Remnants of RER Associated with "left shifts" Often seen in conjunction with toxic granulation |
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May-Hegglin Anomaly
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Autosomal dominant
Large basophilic inclusions, giant platelets, and thrombocytopenia Inclusions appear to be altered RNA Note: BENIGN, but may be assoc. with bleeding Note: inclusions look like large Dohle bodies |
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Chediak-Higashi Syndrome
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Autosomal recessive
Abnormally large leukocyte granules (lysozyme fusion) Platelet function is abnormal (lack granules) Chemotaxis and phagocytosis is defective Giant melanosomes -- HYPOpigmentation |
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Alder-Reilly Anomaly
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Autosomal Dominant
Lysozymal enzymes are lacking Dense granules seen in ALL leukocytes (resembles toxic gran.) Note: lymphocytes have metachromatic granules surrounded by clear zone |
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Changes during maturation of lymphocytes
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Loss of red-purple parachromatin
Change in cytoplasmic color (basophilic -- sky blue) |
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Changes during maturation of monocytes
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Homogenous chromatin to reticular pattern
Change from dark cytoplasm to pale grey |
