2-08 Exam 12 Leukocytes

Front 1

describe LYMPHOCYTES and their function; give examples

Back 1

Lymphocytes-responsible for antibody production and cellular immunity

occur in blood, lymphatic circulation, spleen
T-cells
B-cells
Natural killer cells

Front 2

describe PHAGOCYTES and their function; give examples

Back 2

Two main classes of phagocytes:

Monocytes
Granulocytes
--Neutrophils-first response, pus
--Eosinophils-allergic rxn, parasites
--Basophils-allergic and antigen response, histamine prod = inflam

Front 3

describe AGRANULOCYTES and their function; give examples

Back 3

Agranulocytes: Agranulocytes are a category of white blood cells characterised by the absence of granules in their cytoplasm; they include: Lymphocytes
Monocytes

Front 4

describe MONOCYTES and their function

Back 4

Monocytes which migrate from the bloodstream to other tissues will then differentiate into tissue resident macrophages or dendritic cells

Front 5

describe the (3) types GRANULOCYTES and their function; give examples

Back 5

Neutrophil:
-First responders
-motile (attracted by cytokines)
-hallmark of acute infections
-phagocytic (killing by “respiratory burst”: highly reactive oxygen species in phagolysosome)
in PUS
-Granules:
Primary (promyelocytic stage) and secondary (predominant in mature neutrophil: collagenase, lactoferrin, lysozyme)

Basophils: only occasionally seen in peripheral blood
-allergic and antigen response via histamine causing inflammation.

-Granules: contain heparin (anticoagulant) and histamine (vasodilation)

Eosinophils:
special role in allergic response, defense against parasites (helminths), removal of fibrin formed during inflammation

Acidic granules contain: peroxidase, RNase, DNases, lipase, plasminogen
Degranulation is toxic to invaders but also to host

Front 6

Understand the naming and staining pattern of the granulocytes.

Back 6

Neutrophils - Neutral PINK color

Basophils - DARK BLUE cellular components, stain with the basic dye hematoxylin

Eosinophils - Bright RED cellular components, stain with eosin

Front 7

Know which of the leukocytes are more common.

Back 7

N > E > B
"ben backwards'

Front 8

Draw the "tree" of leukocytes to sort out which is which, annotate it as necessary for understanding and which types are most/least common.

Back 8

Front 9

Draw the "tree" of leukocytes to sort out which is which, annotate it as necessary for understanding and which types are most/least common.

Back 9

Front 10

Understand what band and segs are and their importance for clinical diagnosis.

Back 10

Band neutrophils (stabs): immature neutrophils (immature rod-like nucleus) (increased in patients with infections/inflammations)

Segmented neutrophils: mature neutrophils (segmented nucleus)

Front 11

Know what monocytes and macrophages are and their tissue distribution.

Back 11

Monocytes are present in blood and mature to macrophages in tissues (tissue-specific macrophages)

Front 12

Describe the (3) types of lymphocytes

Back 12

T-cells: develop from cells that have migrated to thymus, cellular immune response

B-cells: antibody producing cells (humoral immune response), mature in bone marrow, circulate in peripheral blood & lymphatic circulation until recognition of antigen

Natural killer cells:Kill tumors and virus-infected cells by releasing contents of granules (induce apoptosis)

Front 13

Know what reticuloendothelial system stands for.

Back 13

The phagocytic system of the body, including the macrophages of tissues, liver and spleen, primarily monocytes and macrophages

Front 14

Understand the two important functions of the spleen as a ____ ____ and as part of the ____ system.

Back 14

blood filter , immune

Front 15

Know what the red pulp and white pulp are responsible for.

Back 15

Red pulp: 75% of spleen, Red blood cell monitor

White pulp: Lymphocytes, macrophages, dendritic cells

Front 16

Remember that the ____ and ____ can become hematopoietic (extramedullary) in extreme circumstances.

Back 16

Spleen, liver

Front 17

Be able to briefly define splenomegaly and hypersplenism.

Back 17

Splenomegaly - ENLARGEMENT of spleen due to a large variety of conditionsHypersplenism -Increased spleen FUNCTION

Front 18

Know what leukopenia and leukocytosis mean (understand the suffix –penia and –cytosis) and be able to rationalize what conditions could lead to those.

Back 18

Leukopenia - low WBC from:
-Bone marrow failure (for example, due to infection, tumor, or abnormal scarring)
-Collagen-vascular diseases (such as lupus rythematosus)
-Disease of the liver or spleen
-Radiation

Leukocytosis - high WBC from:
-Anemia
-Infectious diseases-Inflammatory disease (such as rheumatoid arthritis or allergy)-Leukemia
-Severe emotional or physical stress
-Tissue damage (for example, burns)

Front 19

What is respiratory burst?

Back 19

rapid release of reactive oxygen species (superoxide radical and hydrogen peroxide) from different types of cells.

Front 20

Be familiar with the terminology of the different assays in the complete blood count. In other words look over these and make sure you understand them:

White blood cell count
White blood cell differential (distinguishes between the different types of white blood cells)
Red blood cell count
Hemoglobin
Hematocrit
Mean corpuscular volume (MCV)
Mean corpuscular hemoglobin (MCH)
Mean corpuscular hemoglobin concentration (MCHC)
Platelet count

Back 20

na

Front 21

Be able to define leukemia, lymphoma, and myeloma.

Back 21

Leukemia: Overproduction of immature cancerous white blood cell precursors, originating in bone marrow (causes bone marrow failure, neutropenia, anemia, infiltration of other organs), causes neutropenia b/c crowd out other cells

Myeloma:Cancer of plasma cells (B cells) in bone marrow (decreased immune function, eventually myeloma cells invade other parts of body)

Lymphoma: Cancer of lymphocytes in lymph nodes (occasionally entering bloodstream)

Front 22

Be able to briefly outline the general progression of leukemia.

Back 22

Disease originates in bone marrow-> spleen, lymph nodes and liver

Front 23

What is chronic leukemia?

Back 23

Chronic - Aggressively proliferating malignant blast cells (hematopoietic stem cell)

CLL: chronic lymphoid leukemia
-several disorders affecting B- or T-cells
-most common type of leukemia
-no cure, but often slow progression

CML: chronic myeloid (myelogenous) leukemia
-WBC cancer caused by philadelphia chromosome translocation

Front 24

What is acute leukemia?

Back 24

Acute - rapidly proliferating malignant blast cells, curable

Front 25

What is lymphotic leukemia?

Back 25

Lymphocytic
Cancer where lymphocytes proliferate abnormally

Accumulation of white cells in the lymph nodes (only occasionally entering blood or extra-lymphoid tissue in later “leukemic phase”)lym-

-Hodgkins = involves the Reed-Sternberg cells (giant B cells), Epstein Bar virus, high cure rate (60-90%)

-non-Hodgkins = No Reed-Sternberg cells involved , B or T -cell involved

Front 26

What is myeloid leukemia?

Back 26

Cancer of plasma cells in bone marrow (decreased immune function, eventually myeloma cells invade other parts of body)

Front 27

Be able to define Hodgkin’s and non-Hodgkin's lymphoma. Know what a Reed-Sternberg cell is.

Back 27

-Hodgkins = involves the Reed-Sternberg cells (giant B cells), Epstein Bar virus, high cure rate (60-90%)

-non-Hodgkins = No Reed-Sternberg cells involved , B or T -cell involved

Front 28

What are the most common leukocytes?

Back 28

Neutrophils

Front 29

Are leukocytes derived from the lymphoid and/or myeloid cell lineage?

Back 29

Both lymphoid (T&B) and Myeloid (Eos, basophils, macrophages, monocytes, neutrophils)

Front 30

What are the phagocytic cells?

Back 30

Neutrophils and macrophages

Front 31

You suspect a patient has leukemia. Considering where the cancer originates, which laboratory test would you perform to confirm the diagnosis?

Back 31

Bone marrow sample will be needed: aspiration/core biopsy

Front 32

Which of the following cell types are granulocytes?

1. Basophil
2. Lymphocytes
3. Red blood cell
4. Monocytes

Back 32

choose the best answer as not all leukocytes are granulocytes!

Basophil

Front 33

What do neutrophils and macrophages have in common?

1. They are leukocytes
2. They are part of the immune system
3. They can phagocytose foreign microorganisms
4. All of the above

Back 33

all of the above, remember that the granulocytes are all phagocytic as well

Front 34

An increased amount of band neutrophils indicates:

1. Lack of hematopoiesis
2. Increased lymphocyte count
3. Inflammation or infection
4. Increased expression of erythropoietin

Back 34

Inflammation or infection

Front 35

Lymphocytes are derived from stem cells of:

1. the thymus.
2. the bone marrow.
3. the lymph nodes.
4. the blood.

Back 35

bone marrow

Front 36

Hypersplenism can be caused by:

1. aplastic anemia.
2. pancytopenia.
3. surgical removal of the spleen.
4. splenomegaly.
5. All of the above

Back 36

aplastic anemia

remember megaly is a large spleen not a high functioning one.

Front 37

Leukopenia can be caused by:

1. Infections
2. Lymphoma
3. Aplastic anemia
4. Hyposplenism

Back 37

aplastic anemia also cuaed by leukemia

note that the other choices all result in leukocytosis = incr in leukocytes

Front 38

A cancer of the white blood cells originating in the bone marrow is called:

1. Erythrocytosis
2. Hodgkin's lymphoma
3. Lymphoma
4. Leukemia

Back 38

leukemia

Front 39

ALL (acute lymphocytic leukemia) can involve which of the following cells?

1. Red blood cells
2. Platelets
3. Monocyes
4. T-cell precursors

Back 39

T-cell precursors

Front 40

Reed-Sternberg cells are:

1. Neutrophils with segmented nuclei
2. Megaloblastic red blood cells
3. Giant white blood cells in the bone marrow
4. Giant cells derived from B-cells

Back 40

Giant cells derived from B-cells

Front 41

The term thrombocytes refers to:

Back 41

Platelets

Front 42

What are the roles of ADP and thromboxane A2?

1. They are platelet activating factors
2. They convert fibrinogen to fibrin
3. They stimulate tissue factor expression
4. They inhibit blood clot formation

Back 42

They are platelet activating factors

Front 43

Which of the following factors is a component of the common pathway (coagulation cascade)?

1. Factor VIIa
2. Factor X
3. Christmas factor (factor IX)
4. Tissue factor
5. All of the above

Back 43

Factor X

Front 44

The Prothrombin time (PT) test is specific for:

1. Only the common pathway
2. The intrinsic and common pathway
3. The extrinsic and common pathway
4. The extrinsic, intrinsic and common pathway

Back 44

The extrinsic and common pathway

Front 45

Several blood tests have been performed for a patient. The platelet count, platelet function tests and thrombin time are normal but the Activated Partial Thromboplastin Time (PTT or aPTT) is very slow. Which disease do you suspect?

1. Hemophilia A
2. Anemia
3. Sideroblastic anemia
4. Von Willebrand disease

Back 45

Hemophilia A

Front 46

Plasmin, derived from plasminogen, is responsible for:

1. Activation of thrombinogen
2. Activation of fibrinogen
3. Degradation of fibrin
4. Platelet aggregation

Back 46

Degradation of fibrin

Front 47

A deficiency in von Willebrand factor would lead to:

1. Thrombocytopenia
2. Risk of thrombosis
3. Myeloproliferative disease
4. Increased bleeding

Back 47

bleeding

Front 48

What is VWF and what does it do?

Back 48

Its primary function is binding to other proteins, particularly Factor VIII and it is important in platelet adhesion to wound sites

vWF appears to play a major role in blood coagulation. vWF deficiency or dysfunction (von Willebrand disease) therefore leads to a bleeding tendency