Pathoma - Leukopenia And Leukocytosis - Fundamentals Of Pathology

Front 1

What CD is positive in hematopoietic stem cells?

Back 1

CD34+

Front 2

Draw a chart over the lineage of cells.

Back 2

Front 3

Normal WBC count is?

Back 3

4000-10,000/μL (4.0-10 x 10^9/L)

Front 4

Low WBC is called ____________, high WBC is called _____________.

Back 4

leukopenia; leukocytosis

Front 5

Neutropenia is clasically seen with _____________.

Back 5

drug toxicity and severe infection (most neutrophils are out of blood and in the tissue)

Front 6

Neutropenia could be treated with a ________ or a ________.

Back 6

G-CSF; GM-CSF

Front 7

Lymphopenia is classically seen in?

Back 7

(1) Immunodeficiency (DiGeorge for example)
(2) High cortisol states (apoptosis)
(3) Autoimmune destruction (lupus)
(4) Whole body radiation

Front 8

The most sensitive cell in the human body to radiation are the _____________.

Back 8

lymphocytes

Front 9

What cell count would you look at to screen for radiation exposure in a patient?

Back 9

Lymphocytes, looking for lymphopenia

Front 10

What are causes of neutrophilic leukocytosis?

Back 10

(1) Bacterial infection
(2) Tissue necrosis

In these two, marrow will release slightly immature cells. This is called a left shift.

(3) High cortisol state

Front 11

A man has an infection. Immature neutrophils are liberated into the blood. These immature cells are characterized by what? (In comparison to mature cells)

Back 11

Decreased fc receptors

Front 12

What is the marker for fc receptors?

Back 12

CD16

Front 13

High cortisol would ___________ (decrease/increase) neutrophils and ____________ (decrease/increase) lymphocytes.

Back 13

increase neutrophils (from marginating pool); decrease lymphocytes

Front 14

Cortisol decreases expression of adhesion receptors on ________.

Back 14

neutrophils.

Produces neutrophilic leukocytosis.

Front 15

When could we see a monocytosis?

Back 15

(1) Chronic inflammatory states
(2) Malignancy

Front 16

Eosinophilia is seen with?

Back 16

(1) Allergic reactions
(2) Parasitic infections
(3) Hodkin lymphoma

Front 17

The mechanism by which eosinophilia occurs in Hodkin lymphoma is increased _________.

Back 17

IL-5

Front 18

CML is the only leukemia with ______________.

Back 18

thrombocytosis

Front 19

Basophilia may be seen with?

Back 19

CML

Front 20

Lymphocytic leukocytosis is seen in?

Back 20

(1) Viral infections
(2) Bordetella pertussis
- Produces lymphocytosis promoting factor (LPF). It blocks lymphocytes from leaving the blood and entering the lymph nodes (they can't learn how to get stimulated to be able to fight infection).

Front 21

Infectious mononucleosis is an _______ infection (most commonly). Less common cause?

Back 21

EBV

Less common is CMV.

Front 22

EBV infection results in what?

Back 22

Lymphocytic leukocytosis comprised of reactive CD8+ T cells

Front 23

EBV is transmitted via ________ and is classically seen in _________.

Back 23

saliva; teenagers

Front 24

EBV primarily infects ______, _______ and _______.

Back 24

oropharynx; liver; B-cells

Front 25

Which area of the lymph node will be enlarged in EBV infection?

Back 25

Paracortex

Front 26

What do we see clinically and on smear in EBV infection?

Back 26

(1) Generalized LAD
(2) Splenomegaly (PALS)
(3) High WBC count with atypical lymphocytes

Front 27

Regarding lymph nodes, the cortex is where the ____-cells live and the paracortex is where the ____-cells live.

Back 27

B-cells; T-cells

Front 28

What is it?

Back 28

Atypical lymphocyte

Front 29

Why is it called infectious mononucleosis?

Back 29

Atypical lymphocytes look like monocytes. They thought it was monocytes.

Front 30

How do you screen for mononucleosis?

Back 30

Monospot testing.

Front 31

Monospot test detects what?

Back 31

IgM heterophile antibodies.

Front 32

Why are IgM heterophile antibodies called heterophile?

Back 32

They bind RBCs from another animal (hetero - other)

Front 33

Monospot test usually turns positive within ____________ after infection.

Back 33

1 week

Front 34

Negative monospot test suggests what?

Back 34

CMV as the cause

Front 35

Definitive diagnosis of mononucleosis is made by?

Back 35

Testing for EBV viral capsid antigen

Front 36

Complications of infectious mononucleosis?

Back 36

(1) Increased risk for splenic rupture (avoid all contact sports for the next year)
(2) Rash if exposed to penicillin
(3) Dormancy of virus in B-cells (increases risk for recurrence of mononucleosis, risk for future lymphoma development especially in immunodeficiency)