Bisc 341 - Hematology - Test 3

Front 1

Term used to indicate a general increase in the number of white blood cells

Back 1

Leukocytosis

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Indicates a decrease in white blood cells

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Leukocytopenia

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Increase in the number of white cells in peripherial blood (neutrophils, eosinophils, basophils, monocytes, lymphocytes)

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Lymphocytosis

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Blood does not have enough white blood cells

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Lymphocytopenia

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What may cause an INCREASE in neutrophils? (Neutrophilia)

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-Inflammatory conditions
-Infection
-Physical stimuli (hot or cold)
-Surgery
-Burns
-Stress
-Some drugs and hormones
-Some types of leukemia

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What may cause an INCREASE in eosinophils? (Eosinophilia)

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-Active allergic disorders (asthma, hay fever)
-Dermatoses
-Non-parasitic infections
-Some forms of leukemia
-Parasitic infections (non-protozoan)

**May include Charcot-Leyden crystals***

Front 7

What may cause an INCREASE in basophils? (Basophilia)

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-Ulcearative Colitis
-Hyperlipidemia
-Smallpox and chickenpox
-Chronic sinusitis
-Chronic myelogenous leukemia
-Polycythemia Vera

Front 8

What may cause an INCREASE in monocytes? (Monocytosis)

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-Infections (TB; bacterial endocarditis)
-Fever of unknown origin
-Inflammatory bowel disease
-Rheumatoid arthritis
-Hematological disorders (anemia)

Front 9

What may cause a DECREASE in neutrophils? (Neutropenia)

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-Bone marrow injury or infiltration
-Starvation
-Anorexia
-Cyclic neutropenia
-Increased destruction or utilization
-Entrapment of the spleen

Front 10

What can cause a DECREASE in eosinophils? (Eosinopenia)

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-Glucocorticosteroid hormones
-Acute bacterial or viral inflammation

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What can cause a DECREASE in basophils? (Basopenia)

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-Hormones (corticotropin and progesterone)
-During ovulation
-Thyrotoxicosis

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What can cause a DECREASE in monocytes?

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No known conditions

Front 13

What cells are these?

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Neutrophils

Front 14

What cells are these?

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Eosinophils

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Basophils

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What cells are these?

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Lymphocytes

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What cells are these?

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Monocytes

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These are found in neutrophils but can also be found in monocytes and lymphocytes. They can be cause by viral infections, drugs, and burns. They can also be seen in May-Heggin.

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Dohle Bodies

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These are red/purple particles seen in neutrophils, basophils, and eosinophils. They can resemble toxic granulation.

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Alder Reilly

Front 20

These are Dohle-like bodies in neutrophils. They are surrounded by abnormally large and poorly granulated platelets with thrombocytopenia.

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May-Hegglin Inclusion

Front 21

This is an abnormality seen in mature granulocytes. Frequently seen in infectious states as well as burns, malignancies, and drug therapy.

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Toxic Granulation

Front 22

Neutrophils with more than five lobes. Found in Vitamin B12 deficiency or folic acid deficiency

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Hypersegmentation

Front 23

How do you calculate absolute lymphocyte count?

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WBC * Relative % lymphocytes

Normal range = 22-40% or 1.1-4.4 * 10^9

Less than normal = lymphocytopenia
Higher than normal = lymphocytosis

Front 24

Calculate white blood cell/platelet count using hemocytometer

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White cell count: 1/(4*1*1*.01); cells counted * dilution factor * volume factor

Front 25

Characterize/differentiate between refractory anemias.

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???

Front 26

Indicate laboratory results present in cases of inflammation.

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-WBC greater than 10.5 * 10^9
-Bands may be increased (11%)

-Shift to the left
-The ESR is increased in inflammation

Front 27

Describe in detail the stages of phagocytosis.

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Front 28

This type of leukemia lasts for weeks to months. Symptoms have a short duration. Many immature cells form in bone marrow and peripheral blood. WBC is elevated.

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Acute Leukemia

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This type of leukemia lasts for months to years. The symptoms have a long duration. Mostly mature cells form in bone marrow and blood. WBC range is elevated to lower than normal.

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Chronic Leukemia

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This type of leukemia is characterized by an increase in the number of immature cells in the bone marrow and arrest in their maturation. Consists of undifferentiated myeloid blasts. It is minimally differentiated.

The only way to tell if the blasts are myeloid is from immune markers. Evidence of bone marrow failure seen by anemia, thrombocytopenia, and neutrophenia. Leukocytosis with significant increase in blasts.

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M0; Acute myelogenous leukemia

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This type of leukemia has no maturation. Most common type of leukemia in children younger than 18 months but typically occurs in middle aged adults

Characterized by sudden onset that looks like an acute infection. History of fever, infections, fatigue and bleeding. Physical exam may reveal tenderness of the bones (ribs and sternum), ulcerated mucous membranes, petechiae, and pupura

Anemia and thrombocytopenia. Leukocytosis > 100. Peripheral blood and bome marrow show myeloblasts. Regular cytoplasmic outline and auer rods. Three to five nucleoli.

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M1; Acute Myelogenous Leukemia

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This type of leukemia HAS maturation. Easy bruising, epistaxis, gingival bleeding, petechiae. Anemia and thrombocytopenia.

Leukocytosis can exceed 300. Myeloblasts predominate on smear. Nuclei are round or oval with one or more ucleoli. Basophilic cytoplasm with azurophilic granules.

Aeur rods are common.

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M2; Acute myelogenous leukemia

Front 33

Fatigue and bleeding. Lab similar to M2. Anemia and thrombocytopenia. Promyelocytes are predominant. Promyelocytes may be hypergranular, microgranular, or hypogranular.

Nuclear chromatin is finely reticular and cells lack nucleoli. Auer rods may be seen. Increased DIC.

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M3; Acute Prolmyelocytic Leukemia

Front 34

Similar to other acute leukemias. Proliferation of granulocytes and monocytes. Anemia and thrombocytopenia. Blasts may be indented and have convoluted nuclei.

3-5 nucleoli. Auer rods. Promelocytes there but not dominating. Reduced platelets.

Vacuoles

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M4; Acute Myelomonocytic Leukemia

Front 35

Pure monocytic; onset is dramatic with headaches and fevers. Anemia and thrombocytopenia. Lots of blasts.

Monocytes make up 75%. Blasts have muddy or smoggy blue-gray cytoplasm with tiny granules. Reticular granular chromatin with 1-5 large nucleoli. Lots of vacuoles

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M5; Acute Monocytic Leukemia

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Acute erythroid leukemia. Also called Diguglielmo leukemia. Graulocytic and erythrocytic cells.

Blasts of erythroid and myelogeous origin found in marrow. Irregular outline with high c/n radio. Intense blue color. Auer rods.

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M6; Eryrthroleukemia

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50% of blasts are megakaryoctes. Thrombocytopenia is present. Dysplastic features. Huge and crazy looking cells.

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M7; Megakaryoblastic Leukemia

Front 38

This type of anemia is divided into L1, L2, L3. 90% of childhood leukemias are this. Peaks at 3-5 yrs and 65 yrs. Increased leukocytes, lots of blasts, 100% lymphoblasts, lymphocytes, smudges.

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Acute Lymphoblastic Leukemia

Front 39

This type of stain produces black color in positive reactions associated with granulocytic leukocytes. Differentiates ALL from AML. Neutrophils, basophils, eosinophils stain positive; lymphocytes and monocytes stain negative.

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Sudan Black

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Black precipitate for positive.

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Myeloperoxidase

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Indicates glycogen and other carbs. Mature neutrophils contain lots of glycogen. Strong positive in neutrophilic granulocytes, immature and mature platelets and erythrocytes. Weird dotted looking results. Distinguished myeloblasts and monoblasts

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Periodic Acid-Schiff Stain

Front 42

Used in leukocytes to differentiate neutrophilic granulocytes and earlier forms. Positive is seen in granulocytic line and negative in monocytic line.

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Esterase stains

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This is used to recognize cells of monocytic origin. Strongly positive for monocytes. Big black smudges

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Nonspecific esterase/alpha-napthyl acetate and butyrate esterate

Front 44

Positive stain is maroon. Leukocytes stain positive. Monocytes are more intense positive than neutrophils.

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Acid phosphate stains

Front 45

What are the primary lymphoid tissues?

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Thymus and bone marrow

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What are secondary lymphoid tissues?

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Lymph nodes, spleen, peyer's patches of intestines

Front 47

This condition is a malignant plasma cell disease. Onset is 40-70. Peak is in 70s. Bone pain, weakness, fatigue. Abnormal bleeding. Bone marrow fails. Anemia. Rouleaux. Bence Jones is in urine. Bleeding is common. Electrophoresis of serum and urine reveal tall, sharp peaks.

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Multiple Myeloma

Front 48

Onset in 25-35 yrs in males. WBC is normal, disease progresses and neutrophils develop. Eosinophils and monocytes increase. Develop lymphocytopenia and thrombocytopenia. Reed-Sternberg cells in lymph nodes.

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Hodgkins Lymphoma

Front 49

Most frequent type is a diffuse large b cell lymphoma. Occurs around age 60. Reed-Sternbergs are not present.

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Non-Hodgkin's Lymphoma