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99 Cards in this Set
- Front
- Back
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What do white blood cells do?
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Directly destroy invading bacteria/virus/toxins via phagocytosis - ie granulocytes, and monocytes
and Form antibodies with go on to destroy or inactivate the microorganism - Lymphocytes |
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What are Leukocytes?
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White Blood Cells - mobile unitis of the bodies protective system
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Where are leukocytes formed?
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Bone marrow (franulocytes, monocytes and some lymphocytes
Lymph Tissue lymphocytes/plasma cells |
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What are the three major classifications of WBC?
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-Granlocytes (or polys d/t the multiple nuclei lobules)
-Monocytes -Lymphocytes |
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What do granulocytes do?
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They circulate and phagocytoize forgin bodies - they also secreate psytokines to increase a immune reaction (but in small doses)
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Name the three types of granulocytes or "polys"
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polymorphonuclear neutraphils
polymorphonuclear eosinophils polymorphnuclear basophils |
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What do monocytes do?
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they circulate and become inbedded in certin types of tussue there they embed and become macrophages, the macrophages are then able to become phagocytosis. Monocytes them selves are the unattached, circulating form of macrophages that are UNABLE to preform phagocytosis
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What are three types of lymphocytes
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T lymphocytes
B lymphocytes plasma cell lines |
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Which type of lymphocytes can "eat" and which create antibodies?
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T-lymphocytes eat
B- lymphocytes and plasma cell lines scerate/make antibodies |
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What is a normal newborns WBC count?
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30,000 - 40,000
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What lab values will you see with a septic neonate?
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a decrease in WBC -they become neutropenic
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What lab values do you monitor for neonates concerning infection?
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CRP
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Where do WBC's come from?
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The WBC fairy, duh. Kidding. From pluripotential hematopoetic stem cells.
PHCS become LCS (lymphoid stem cells) or CFU-S LCS become the t and b lymphocytes CFU-S become CFU-GM and CFU-M which mature into the granulocytes and nonocytes |
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Myelocytic-myeloblasts become what?
Where are they formed? |
Granulocytes and nonocytes and are formed in the bone marrow
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Lymphocytic-lymphoblasts become what?
Where are they formed? |
lymphocytes and plasma cells
The lymph tissue |
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If your lab results are high in myeloblasts where in the body does the problem orginate from? What BIG question sould you ask yourself?
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The problem is in the bone marrow.
What is causing the bone marrow to spill immature WBC's in circulation |
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If your lab results are high in lymphoblasts, where in the body does the problem orginate from? What BIG question should you ask yourself?
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Lymph tissue.
What is causing the overreation of the lymph tissue |
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WBC's differ from RBC's in their fuction, and structure. How do mature WBC's appear in a blood smear, as apposed to RBC's?
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WBC's have a multilobular, condensed nucleus.
RBC's have no neuclus. |
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True or Faluse:
The dergree of nuclei segmentation increases as the cells mature? |
True!
Mautre WBC's - nutrophils, eosinophils, basophils all have segmented nuclei! The degree of nuclei segmenation increses as the cells mature. |
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What is the first type of WBC that leaves the bone marrow and is in circulation.
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Blasts
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If you have a infection, what type form of leukocytes will increase in circulation?
a.) Myeloblasts b.) Promyelocytes c.) myelocytes d.) metamyelocytes e.) Bands |
Bands
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What form of leukocytes should cause a Penn Graduate to suspect leukemia, and what will you see when you smear the blood sample.
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Myeloblasts!
These cells should NEVER EVER EVER be in peripheral blood, they are a red flag for leukemia! In a blood smear they have one large round/oval nuclei |
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What is the sequence in leukocyte maturation
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Myeloblasts
Promyelocytes Myelocytes Metamyelocytes Bands Segmented Neutrophils |
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What do promyelocytes look like? When would you see them in your lab work?
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THey are larger than myeloblasts, but have a smaller nuclei. They are often seen when a pt. is getting steriods, or when a pt is receiving CFU-S inorder to recover a pt who is suffering from a leukopenia type response to chem.
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What do myelocytes look like? When are they seen in peripheral blood?
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THey are smaller than promyelocytes - a trained eye can now differeniate the classification of the cell line - meaning, they know if its a neut, eos, or baso
Normally not seen in the peripheral blood, but may be present with marros hyper-activity! |
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What do metamyelocytes look like?
When are they seen? |
Smaller than myelocytes, with a kidney shaped nuclei. They are in the Pre-band form. They make up 0-1% or peripheral blood WBC's. May or maynot be seen in a healthy pt.
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What do bands look like. When do you see them?
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have a U shaped nuclues. Able to tell specific granules at this time primarluy neuo or baso.
They increase when there in an infection the marrow is responding to. |
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What type of leukocytes are seen during the first stages of an infection?
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Neutrophil bands
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What form of leukocytes will you see with cancer. Why?
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Blasts. The cancer is inhibiting the cells abilty to carry out the normal DNA encripped maturation process. The cells are not able to convert int the mature phase of the life cycle.
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What is the final mature leukocyte called. What does it look like?
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Segmented neutrophils. Called segs, or PMN leukocytes due to the segmented nuclei, with filaments joing the lobes
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What cells increase during a anti-bacterial response by the immune system
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Neutrophils.
They have major phagocytic abilities. You will see an increase in neutriphil bands during an early stage of infection. |
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What is a monocyte, what does it do?
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The monocyte circulates in the blood system, until it does into the tissue it is assigned to and becomes a macrophage. Once it is a macrophage, the cell is able to eat the debrie, and necrotic tissue. It comes to clean up. It is the french maid of the immune system. Like all good maids. these cells come after the party, or acute infection. A increase in monocytes means the infection is in the LATER stages.
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You have just recieve lab work on a pt, with incresed monocytes. What can you suspect with these lab results?
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THat some one is in the later stages of the infection.
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When are basophils increased? What is their function?
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They are made due to an inflmmation or allergy. They contrubute to allergic resposes to antigens. They relases histamine, heprin, bradykinin, serotoinin, and slow reasaing substances of anaphylaxis. They cause local vasodilation, capillary leak with eythema and edema
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When are eosinophil's increased?
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when there is a parasitic infection or allergic reactions. They have anti-helminth and allergy/tonin properties.
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What leukocytes are produced during during a anti-helminth reaction?
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Eosinophils
anti-helminth = parasite |
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Which leukocytes are produced during an anti-viral response?
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Lymphocytes
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How long do granulocytes live?
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Blood - 4 to 8 hours
Tissue 4-5 days |
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How long do monocytes live?
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10-20 hours in the blood
Tissue Macrophages surive for moths |
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How long do lymphocytes live? Where are they located?
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In the lymph tissue and can pass in and out of blood. Can surivie weeks to months.
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Where do mature Neutrophils live?
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in circulating blood, ready to fight infection - they destroy invading microorganisms via phagocytosis
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Where to macrophages live?
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In tissue. They were monocytes but they have enbedded into tissue and incraed the number of lysosomes they have. This enables them to preform phagocytosis. Monocytes have little ability to fight invasers.
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What controls the WBC response?
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Cytokines
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Why would someone be giveing a pt. G-CSF (granulocyte stimulating factor)
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To incrase the WBC count in all the cell lines. Give the drug if someone is neutropenic.
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What forms cytokines?
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Activated macrophages, fibrolasts, and lymphocytes, and endothelial cells
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What do cytokines do?
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THey accentuate the inflammatory response. They allow the WBC where ith einfection is and calls the WBC's to the site - they make the cite attractive to WBC's They incrase capillary membrane permability so WBCs can leave the blood and do into the tissue and vasodialate to incrase the profussion of an infected area.
They induced local cellular chages that help eridicate and minimize spread of the pathogen. |
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What do chemotaxis factors do?
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attract neutrophils and monocytes to a site of injury.
Its a nonspecific response Incrse the capillary membrane permebility and vasodilation to facilate movmente of the WBC's from the blood into affected tissue |
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T or F
Toxins are a cheotaxis factor |
True
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Name the cheotaxis factors that react to a nonspecific inflammatory response
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Toxins
Cytokines Complement proteins Clotting proteins |
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Why would you want clotting factors to serve as a chemotaxis factor?
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If you cut your finger, you have exposed the underlining vasculature to blood vessles - you want to a.) stop the bleeding, and b.) prevent the spred of the infection
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Which leukocytes prefrom phagocytosis
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neutrophils and macrophages
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How does a body know to react to an offending agent? What makes an agent offensive?
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Rough surface membrane (body tissue have smoooth cell membranes)
Lack of protein coat (healthy tissues have protein coats that repel phagocytes, dead and foreign materials do not) Antoboides - produced by lymphocytes coat the pathogens and then make recongnizable to neutrophils and macrophages |
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A cheootaxin response has happened in the body, what must also occur for the leukocytes (neutrophils) to be useful?
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THere must be adhesion to the site. The WBC's must recognize the the complementary adhesion molecutes on the other leukocytes, endothelial surfaces, and cytokies.
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Which of the following is not a adheasion receptor?
a.) selectins b.) immunoglobin superfamlies c) intergrins d.) mucin-like glycoproteins e.) all of the above |
E) all of the above
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If little baby Suzie is missing the immunoglobulin superfamily - a adhesion recepor, what can you assume about little baby Suzie?
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She is ummunocompromised - she is unable to get nurtrophils to stick to one site. The infection then can not be contined, so she will have a systemic infection d/t a local invader
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What happenes when a leukocyte encounters a pathogen?
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- Extends pseudopdia, to attach and encirlce the pathogen.
- Lysomes fuse with the phagosome and realse digestive and bactericidal enzymes into the phagosome |
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What is a digestive vesicle?
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A pagosome + lysosomes that creates a digestive vesicle whicth inactivates the offending agesnt to a nonreactive state
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What is a phagosome?
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A engulfed substance that a lysosome ate and is now in the cytoplasm
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What is a lysosome?
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A intracellular vessecle that has digestive enzymes
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What are the phagocytic chemicals in the lysosome?
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Protease, lipases, and bactericidal agents.
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What do proteases do
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Break down proteins
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What do lipases do
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Break down lipids and phosphilids
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What do bactericidal agents do
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Kill bacteria when enzymes fall to digest them
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What are peroxisomes?
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Peroxisomes are ubiquitous organelles in eukaryotes that participate in the metabolism of fatty acids and other metabolites. Peroxisomes have enzymes that rid the cell of toxic peroxides. They have a single lipid bilayer membrane that separates their contents from the cytosol (the internal fluid of the cell) and contain membrane proteins critical for various functions, such as importing proteins into the organelles and aiding in proliferation. Like lysosomes, peroxisomes are part of the secretory pathway of a cell, but they are much more dynamic and can replicate by enlarging and then dividing.
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What are the oxidizing agents from peroxisomes?
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Superoxide anion
hyfrogen peroxide hydroxyl ions |
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What does myeloperoxisase do?
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catilizes h202 and chloride to form hypoclorite.
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What are the four oxodizing agents?
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Superoxide anion
hydrogen peroxide hydroxyl ions hypochlorite |
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If you are missing myeloperoxidase what can you assume about the immune system?
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Cant make hypochlorite (meyleoperoxidase catalyzes h2o2 and chloride to form hypochlorite)
When you lack any of the oxidizing agesnts you are suspetiable to systamatic infections |
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What chemcial is resposiable for making all reactive oxygen intermediates?
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NADPH oxidase.
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If you are have NADPH defency what can we assume about your immune system?
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You have profound immune deficancy. You cant start the events that lead to the sequence of events that result in profuction of an oxidizing agent.
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What does NADPH oxidase do?
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it oxidizes NADPH (reduced nicotinamide-adenine dinucleotide phosphate) and in the process REDUCES O2 to superoxidise anion.
Superoxide is then converted into hyfrogen peroxide (H2O2) and hyfrogen perodise can be futher reduced into hyfrocyl radical (OH) |
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What is pus
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Dead tissue cells, neutrophils, and macrophases comdined with intersitial fluid
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What happens if pus is not reabsorbed?
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Abscess
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What is the reticuloendothelial system
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Monocyte-macrophage system
Monocytes, fixted tissue macrophates, mobile macrophates, and specizlized endothelial cells in the bond marros spleen and lymph nodes |
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Why will you see a increase number circulating neutrophils in the blood steam before an increae in the moncyte/macrophage line?
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There is a delay in immdeiate response to infection because fixed tissue macrophage will breatk away and move with a strong chemotaxis signal - the neutrophils help add to the signal
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Where in the body are macrophages?
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Lymph nodes
Spleen Bone Marros Skin, subq tissue Brain Liver Lungs |
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How do lymph nodes assist in keeping infections local?
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THe lymph nodes are linied with macrophages, so when an pathogen enger the lymp node it is destroyed before entering into veouns blood. Lymphy systems irritiates bacteria/toxins before entering into systeic blood supply
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What happens if a pathogens does surpass the lymp nodes, or if the microorganism enters into the blood stream?
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It becoems entrapped by a reticular meshwork of the spleen or bone marrow.
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What effect does the skin and sub q tissue have on macrophages?
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When the tissue is breached, and exposed to the external enviroment histiocytes divide in response to local inflammation
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What is a histiocyte?
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A macrophage of the skin.
Their cytoplasm is eosinophilic and contains variable amounts of lysosomes. They bear membrane receptors for opsonins, such as IgG and the fragment C3b of complement. They express LCAs (leucocyte common antigens) CD45, CD14, CD33 and CD4 (also expressed by T Helper Cells). |
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Where are micrioglial cells?
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In the brain. They are macrophages that live in the brain.
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What are Kupffer Cells?
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Macrophages of the liver sinusoids.
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How does the liver help in preventing the spread of systemic infections?
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The Kupffer Cells are interlaced with the epitheal cells in the liver. Bacteria in the venous blood must go through protal circularion before entering into systemic circulation.
Some bacteria that breaks away from the gut will be filtered via the portal system |
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When you see some one in liver failuer why do they develop bacteremia.
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becouse their kupffer cells are destroyed
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Can over wellming sepsis of the gut surpass the liver's ability to filter?
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Yes
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Why do we feed sick children?
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To keep the integrity of the intestinal cilla to keep from necrosisn and greaking down, translocating the bactera into the blood.
Intact gut - entact bacteria |
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Where are the macrophages of the lungs at? What happens after they are phagocytized?
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the alveolar wall tissue. after digesion of a pathogen, alvolar macrophages dump end products into lumph system
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What is a "giant cell"
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A term used when a pathogen is difficult to digest and the macrophages have grouped together, and digegets the pathogen over time - comon in TB and inhaled irritants such as silica.
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What do eosinophils do?
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eridicate a parasitic infecion, and are used in allergic reactions.
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How do eosinophils eradicate parasitic infections?
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They attach to the parasite via surface moleclues.
Secreate toxic substances into the parasite (these are hyfrolytic enxymes realesed by granules or modified lysomes) |
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What are the two hydrolic enxymes released by granules or modified lysomes when an eosinophil eradicated a parasitic infection?
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Larvicidal polypeptie - which ia a major basic protein
Oxygen ree radicals |
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Why are esionophils called to a site of allergic reaction?
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The mast cells and basophils relase eosiniphil cheomtactic factors that attract and stimulate eosinphils - thats why you see a increased eosinophil count.
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When do you see an increase in the eosinphil count?
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asthma
milk allergy tape worm |
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What is the major chemical reasealed by basophils in response to an allergic reaction?
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Histamine
thats why you have local vascular reactions with allergies - vasodilation, capillary leak, erythema, and edema. Heprin, bradykinin, serotonin, and slow reaslong rubstance of anaphlyaxix are also relased. |
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What do mast cells do? Where are they?
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Lie outsite the capillaires and are like stationary basophils - create allergic responses
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What are IgE type antibodies?
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Antibodies that become attached to basophils and mast cells as part of the trigger for an allergic respose. It attaches to the agigen calling basophills to the sige
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Name the chemical substances in the bood that attach to and destroy microorganisms but are not WBC's
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lysozomes, basic polypeptited, complement complex, natural killer lymphoxytes.
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What are all the ways that the body destroys non-specific micororganisms?
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- phagocotosis by netrophils and macrophages
- HCL in the stomach and digestive enzymes -skins resistance -chemocal substances in the glood that attach to and destroy microorganisms. |
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If some one is shifted to the left, what does that mean? what change in the CBC will you see?
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bacteria infection - ususally or an acute infection, the bands and neuts are elevated.
BNLMEB |
