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Hematology Exam 3
Development of WBCs and PLTs, Lec 9
| Term | Definition |
|---|---|
| ______ cells have Lymphocytes and Monocytes. ________ have Neutrophils, Eosinophils, and Basophils. | Mononuclear cells, Granulocytes |
| T or F: Mature lymphs are the smallest circulating cells. | True |
| What are the two types of Lymph cells? | B cells and T cells |
| What do B cells do? | Make Abs as part of immune response and present Ag to cells |
| What do T cells do? | Direct the immune response and add cytotoxicity to kill infected/abnormal cells |
| What are monocytes precursors for, and where do they reside? | The are precursors for Dendritic Cells or Macrophages, and reside in the tissues. They digest garbage and turn it into other things |
| How are granulocytes differentiated? | Their granules are different which gives them different fucntions. |
| The granules in ___________ contain enzymes that kill bacteria and help with clot lysis. | Neutrophil |
| The granules in _________ help kill Helminth parasites. | Eosinophils |
| The granules in _________ help mediate the allergic response. | Basophils |
| How do WBCs develop? | Pluripotent stem cells give rise to different mature lineages which are determined by Colony Stimulating factors. They come from the Bone Marrow. |
| When evaluating BM at 20x, the normal ratio of Marrow to Fat is ____, Hypercellular is _____, and Hypocellular is ____ | 1:1, >4:1, <1:4 |
| When evaluating BM at 100x, the normal ratio of Myeloid to Erythroid is _____. You also look for other cells unique to marrow, such as ____, ____, and _____. | 2:1, Macrophages Osteoblasts and Osteoclasts |
| What are the normal values of Erythroblasts and Neutrophils? | 20% and 57% |
| What is hyperplasia and how do you know which one you have? | INFECTION: the Marrow to Fat is 5:1. The lymphs and neutrophils are expanding DYSPLASIA: abnormal growth and there is greater than normal #s of precursors present with abnormal morphology. |
| Besides infection and dysplasia, how else can you have Hyperplasia? | if you have Leukemia or Lymphoma |
| What are causes of Hypoplasia? | Old age, BM taken from the cortex, Aplastic Anemia, or Reticular fibrosis |
| What are the 4 myeloid precursors? | Myeloblast, Promyelocyte, Myelocyte, and Metamyelocyte |
| What are the 3 Mature Myeloid Cells? | Neutrophils, Eosinophils, and Basophils |
| What are the 2 Monocytic precursors? | Monoblasts and Promonocytes |
| What makes a mature monocyte different from lymphs? | Their cytoplasm is more grey, nucleus is folded, and the cytoplasm does not "bend" around RBCs. |
| What are the two megakaryocytes? | Megakaryoblasts and Promegakaryocytes |
| _________ are 40-100microns, can have 1:1 or 1:12 nucleus to cytoplasm ratio, have no nucleoli and pinkish blue cytoplasm & granules | Megakaryocytes |
| ________ are 1-4microns and are small granular nuclear cells | Platelets |
| What are the 2 lymphocytic precursors? | Lymphoblasts and Prolymphocytes |
| What are the 2 mature lymphocytes? | Tcells/Bcells and Plasma cells |
| Profile MYELOBLASTS | Size: 15-20 microns N:C ratio – 7:1-4:1 round nucleus with delicate disbursed chromatin, 2-3 nucleoli – pale blue cytoplasm with varying amounts of granules |
| Profile PROMYELOCYTES | Size: 18-25 microns N:C ratio – 2:1-5:1 round or oval nucleus with 2-3 nucleoli – blue cytoplasm with few to many dark blue granules (primary granules) |
| Profile MYELOCYTES | Size:12-18 microns N:C ratio – 3:1-3:2 Coarser chromatin with few to no nucleoli – cytoplasm is pinkish blue with primary and secondary (specific) granules present |
| Profile METAMYELOCYTES | Size: 10-15 microns N:C ratio – 7:3 – 1:1 Kidney shaped or indented nucleus with course chromatin and no nucleoli – pink-blue cytoplasm with pinkish to reddish-blue granules |
| Profile NEUTROPHILS | Size: 10-16 microns N:C ratio 1:3-1:5 dark purple nucleus with heavily clumped chromatin – pink cytoplasm with pink to rose-violet granules |
| Profile EOSINOPHILS | Size: 10-16 microns N:C ratio 1:3 – 1:5 dark purple nucleus with heavily clumped chromatin – pink cytoplasm with red-orange granules |
| Profile BASOPHILS | Size: 10-16 microns N:C ratio 1:3 – 1:5dark purple nucleus with heavily clumped chromatin – pink cytoplasm with blue-black granules |
| Profile MONOBLASTS | Size: 14-20 microns N:C ratio – 3:1 – 1:1 round to oval nucleus with fine distinct chromatin and 1-5 nucleoli – cytoplasm is blue-grey with no granules |
| Profile PROMONOCYTES | Size: - 14-20 N:C ratio – 2:1 – 1:1 Oval or indented nucleus with fine reticular chromatin and 1-3 nucleoli – cytoplasm is glue-grey, finely granular (ground glass) and may have occasional vacuoles |
| Profile MONOCYTES | Size: 14-21 microns N:C ratio 1:1 Horseshoe shaped or indented nucleus with folding, fine delicate linear strands of chromatin – many fine dust like granules, occasional vacuole and blunt pseudopods |
| Profile MEGAKARYOBLASTS | Size: 20-50 microns N:C ratio – 5:1 – 3:1 round or oval nucleus with fine distinct strands to dense chromatin with distinct nucleoli – cytoplasm is moderate to dark blue with some to no fine granules |
| Profile PROMEGAKARYOCYTES | Size: 20-80 microns N:C ratio – 1:1 Irregular indented nucleus with 2-4 lobes |
| Profile LYMPHOBLASTS | Size: 10-22 microns N:C ratio – 7:1-4:1 Round or oval central or eccentric nucleus with fine lacy chromatin and 1-2 prominent nucleoli – cytoplasm is dark blue and smooth, without granules |
| Profile PROLYMPHOCYTES | Size: 10-15 microns N:C ratio – 3:1-4:1 round centrally placed nucleus that is reddish purple with coarse clumped chromatin (ginger snap) – abundant light to medium blue cytoplasm |
| Profile Tcells/Bcells | Size: 7-15 microns N:C ratio – 3:1 ratio round or slightly indented nucleus with course clumped chromatin and no visible nucleoli - sky blue to deep blue cytoplasm |
| Profile PLASMA CELLS | Size: 9-20 microns Dark purple nucleus is ovoid and eccentrically placed with no nucleoli – cytoplasm is abundant and deep blue with clear area near the nucleus |
| What are the 10 cytochemical stains? | Acid Phos, TRAP, Alk Phos, Non-specific esterase, Specific esterase, Peroxidase, Sudan Black B, Iron Stain, TdT, and PAS |
| Acid Phos does focal staining in ______ | T cells |
| TRAP is ______ in hairy cell leukemia bc AP is non inhibited by ________. | Positive, Tartrate |
| Alk Phos is present in ________. | Neutrophils |
| What is the Leukocyte alkaline phosphatase score used for? | To differentiate between Leukamoid reaction (high score) and Leukemia (low score) |
| What does Specific esterase stain for? | Neutrophils and mast cells |
| What does Non-Specific esterase stain for? | Monocytes, Megakaryocytes, and Plasma Cells |
| Peroxidases stain ______ granules black and ________ reddish brown. | Neutrophils, Eosinophils |
| Sudan Black B stain _______ in granulocytes and monocytes, but __________ in lymphocytes. | Positive, Negative |
| What does the Iron Stain look for? | Blue/green granules in Erythroid precursors and Ringed Sideroblasts |
| TdT is strongly positive in _________. | Lymphocytes |
| PAS distinguishes ______ from ____________, and looks for ____________. | Gaucher's, Neiman Pick, Erythroid leukemia |
| Megaloblastic anemia creates characteristic changes in the ________ cells of the marrow. | Precursor |
| ____________ causes morphololigical changes such as hypersegmentation, discontinuity of nuclear/cytoplasmic development, and giant megakaryocytes. | Megaloblastic anemia |
| __________ is associated with infection or activation of neutrophils, with dark purple granules in the cytoplasm. | Toxic granulation |
| _________ are Rough ER remnants, and are associated with stress or infection. | Dohle Bodies |
| __________ are associated with Infectious Mono, make "large lymphocytes", and have BENT cytoplasms surrounding RBCS | Reactive Lymphocytes |
| _____ Disorder has bi-lobed or unlobed neutrophils and may be interpreted as immature cells. There are no symptoms or treatment needed. | Pelger-Huet |
| _________ has lipids in the cytoplasm of most cells, Alder-Reilly bodies, and looks like granulation. Hunter's Disease is associated with this. | Alder-Reilly Anomaly |
| _____________ has giant fused granules in neutrophils and lymphs. Cells engulf but don't kill microbes, skin hypopigmentation, silvery hair, photophobia, and lymphadenopathy/hepatosplenomegaly | Chediak-Higashi Syndrome |
| ____________ is Autosomal Dominant, has Blue Dohle-like inclusions in all granulocytes, and Giant platelets. Cells function normally, and variable thrombocytopenia may lead to bleeding. | May-Hegglin Anomaly |
| ___________ has a normal Wright's Stain and NBT is negative. Cells cannot kill bacteria, and it is treated with prophlylactic antibiotics. | Chronic Granulomatous Disease |
| __________ have swirly cytoplasms of their macrophages and accumulate glucocerebroside. Symptoms are enlarged spleen/liver, increased serum phosphatase and is treated by a BM transplant or enzyme supplementation. | Gaucher's Disease |
| ____________ is Autosomal Recessive and has macrophages with foamy cytoplasm due to an accumulation of sphingomyelinase. It is fatal by 3 yrs of age, and there is no treatment. | Niemann-Pick Disease |
| HTLV would infect _________ cell types, diagnosed using __________, it is an STD usually found in old asian men, and treatment is __________. | T cells, Western blot, no treatment |
| HIV infects ____ cells, diagnosed by ______, symptoms include _________, and treatment is _________. | T helper/CD4+, nucleic acid test by 2nd week OR P23 Ags after 4 weeks OR the Ab test, none, lots of medication |
| Infectious Mononucleosis infects ___________, diagnosed by _________, symptoms include ___________, and treatment is ___________. | B cells, look for Ab's typically prodeced by B cells (Heterophile Ab) OR look for lots of active lymphocytes, fatigue and swollen lymph nodes and enlarged spleen, to suppress the immune response |
| ________ is spread by the sand fly and is found in the tissues and BM. It infects ___________. | Leishmania, Macrophages |
| What are the two forms of Leishmania? | Visceral and Cutaneous |
| _____ has a large nucleus/open chromatin/little cytoplasm. _____ has MORE cyto/MORE condencsed nucleus/clear aread where protien is produce ________ has verycondensed chromatin/very little cytoplasm. | Blast, Plasma cell, Lymphocyte |
| Why are white cells called "white" cells? | bc the buffy coat where they are located is full of WBCs |
| What are the types of cells found in the buffy coat? | white blood cells and platelets |
Created by:
Hamncheese52
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