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Phils hemo WBCS
| Question | Answer |
|---|---|
| Five white blood cells | Neutrophil, Eosinophil, basophil, monocyte, lymphocyte |
| Granulocytic maturation series | myeloblast, promyelocyte, myelocyte, metamyelocyte, band, seg |
| This stage in granulocytic maturation is characterized by small amount of pale blue cytoplasm, no granules, nucleus has delicate chromatin with nucleoli | myeloblast |
| This stage in granulocytic maturation is similar to myeloblast but has primary nonspecific granules | promyelocyte |
| this stage in granulocytic maturation is characterized by the presence of secondary specific granules it is also the last stage to divide (blue muddy gray) | myelocyte |
| this stage of granulocytic maturation is characterized by the nucleus beginning to indent | metamyelocyte |
| This stage in granulocytic maturation is characterized by nuclear indention is more than half of the width | band |
| This stage in granulocytic maturation is characterized by 2-5 nuclear lobes connected by thin strand of chromatin | Seg |
| What are primary granules made of | myeloperoxidase |
| What are secondary granules made of | peroxidase to destroy bacteria |
| 10-15 um, segmented 2-5 lobs connected by chromatin filament, with pinkish tan cytoplasm neutrophilic granules | Neutrophil |
| Reference range for neutrophils | 50-70% |
| When are neutrophils seen | bacterial infection |
| 12-16 um band shaped or segmented into two lobes with large red granules | eosinophils |
| Reference range for eosinophils | 1-3% |
| 10-14 um usually dificult to see because of overlying granules, dark purple granules | basophil |
| Reference range for basos | 0-1% |
| 12-22 um round horse shaped nucleus or lobulated, convoluted loose strans of vchromatin, gray blue cytoplasma with indistinct azure granuals, vacuoles and pseudopods | Monocytes |
| Reference range for monos | 2-8% |
| when are monos seen | post infection |
| 6-8 um with a round or oval nucleus with dence blocks of chromatin indistinct chromatin/parachromatin separation, cytoplasm sparce to abundant, sky blue | lymphocytes |
| Reference range for lymphocytes | 20-40% |
| What is another name for the leukomoid reaction | shift to the left |
| This is often seen in bacterial infections and inflamation, with the presence of immature granulocytes in the blood | shift to the left |
| This is often seen in infection or inflammation with dark staining granules in cytoplasm of neutrophils | toxic granulation |
| this is often seen in infections and burns with light blue patches in cytoplasm of neutrophils | dohle bodies |
| These are often seen in septicemia, drugs, toxins, and radiation with phagocytic vacuoles in cytoplasm of neutrophils | vacuolization |
| This is one cign of pernicious anemia, with more than 5% of segs with more than 5 lobes | hypersegmentation |
| this is an inherited disorder with no clinical effect may be misinterpreted as a shift to the left, most neutrophils have round or bilobed nuclei | pelger-huet anomaly |
| This is seen in AML (ANLL) and has red needles in cytoplasm of leukemic myeloblasts and monoblasts | Auer rods |
| These are seen in viral infections, and one or more of the following, large size, elongated indented nucleus, immature chromatin, increased parachromatin, nucleoli, increased cytoplasm, dark blue or very pale cytoplasm | varient lymph, or atypical or reactive |
| What condition is associated with bacterial infection, inflammation, hemorrhage, hemolysis and stress | neutrophilia |
| what condition is associated with acute infection antibodies, drugs, chemicals, and radiation | neutropenia |
| what condition is associated with infections mono, cytomegalovirus, whooping cough, actue infectious lymphocytosis | lymphocytosis |
| what condition is associated with convalescence from viral infections, chronic infections, TB, subacute bacterial endocarditis, parasitic infections, rickettsial infections | Monocytosis |
| What condition is associated with allergies, skin diseases, parasitic infections | Eosinophilia |
| What condition is associated with chronic myelogenous leukemia and plycythemia vera | basophilia |
| This leukemia occurs suddenly in children and young adults, with a median survival of 3 months, Increased to normal WBC, low platelets, many blasts, normo/normo anemia | Acute Leukemia |
| This leukemia normally affects middle aged to elderly with an insidious onset and survival time of 2-6 years, an increased WBC normal to increased platelets, more mature cells, and no anemia until late stages | Chronic |
| AML (M0) | Acute myeloblastic Leukemia w/o mat. |
| ANLL | acute nonlymphocytic leukemia |
| this leukemia has undifferentiated blasts | AML (M0) |
| Acute myeloblastic leukemia w/min mat | AML (M1) |
| this leukemia there is a predominance of myeloblasts with min. maturation, some promyelocytes may be present. auer rods may be present, pseudo pelger huet anomaly may be present | AML (M1) |
| acute myeloblastic leukemia w/mat | AML (M2) |
| this leukemia has myeloblasts predominate wome maturation to or beyond promyelocyte stage, auer rods are common. most common type of AML | AML (M2) |
| Acute promyeloblastic leukemia | AML (ALP) (M3) |
| This leukemia the promyelocyte is predominant cell. myeloblasts and myelocytes may be present. Auer rods are common. high incidence in DIc uncommon type | AML (ALP) (M3) |
| AMML (M4) | acute myelogenous monocytic leukemia |
| Eearly myelogenous cells predominate with app. 20% monocytic cells. Blasm pay be indented and convoluted nuclei. Auer rods may be present. Second most common type | AMML (M4) |
| AMoL (M5) | Acute monoblastic leukemia |
| M5a has a predominance of monoblasts, M5b has a predominance of promonocytes and monocytes as well uncommon type | AMoL |
| EL (M6) | Acute erythroblastic leukemia |
| Erythroblasts with megaloblastoid changes and other dysplastic features, myeloblasts and promyelocytes. Auer rods may be present | EL (M6) |
| MegL (M7) | Acute Megakaryoblastic Leukemia |
| Proliferation of megakaryoblast and atypical megakaryocytes. Megakaryocytic fragments may be seen in the peripheral blood uncommon type | MegL (M7) |
| Two types of ALL | L1 (small cell homo) L2 (large cell hetero) |
| L1 | small cell homo |
| L2 | large cell hetero |
| uniform population of small lymphoblasts with scanty cytoplasm, round nuclei with occ. cleftin, homogeneous chromatin, inconspicuous nucleoli associated with children | L1 |
| heterogeneous population of large pleomorphic lymphoblasts with nuclear clefting and inindentation older children and adults | L2 |
| ALL | Acute lymphoblastic leukemia |
| This stain detects peroxidase found in primary granules and auer rods | myeloperoxidase |
| this stain is used to differentiate AML M1, M2, and M3 (pos) from ALL (neg) | myeloperoxidase |
| This stain detects lipids in primary and secondary granules of granulocytes | sudan black |
| this stain can be used to differentiate AML M1, M2, M3 (pos) from ALL (neg) | sudan black |
| this stain detects glycogen | periodic acid Schiff (PAS) |
| RBC precursors stain intensely, normal RBC are neg. Large coarse clumps in lymphoblasts in ALL | PAS |
| Detects esterase in primary granules of myeloid cells | Napthol ASD chloracetat esterase |
| Differenciates AML M1, M2, and M3 pos and ALL neg | naptholl ASD |
| stains nonspecific esterase in moncytic precursors | alpha naphthyl acetate esterase or alpha naphthyl butyrate esterase |
| Strong positive in monocytic cells positive in M4 and M5 neg in ALL | pha naphthyl acetate esterase or alpha naphthyl butyrate esterase |
| stains Esterase enzymes in myeloid and monocytic cells | combined esterase |
| used to evaluate the ratio of myelocytic and monocytic cells | combined esterase |
| detects primitive lymphoid cells | Tdt |
| this stain's activity is elevated in L1 and L2 | Tdt |
| Chronic myelogenous leukemia (CML) aka | Chronic granulocytic leukemia |
| marked leukocytosis with an increase in mature and immature cells of the granulocytic series, thrombocytosis is common, philadelphia chromosome may be found in malignant cells. anemia | chronic myelogenous leukemia |
| Four chronic myeloproliferative disorders | CML, AMM, PV, ET |
| Agnogenic myeloid metaplasia (AMM) aka | idiopathic myelofibrosis |
| bone marrow fibrosis. extramedullary hematopoiesis. all stages of myeloid maturation including eos and basos. Nucleated RBCs and TEARDROP RBCs defective platelets | Agnogenic myeloid metaplasia |
| Polycythemia vera (PV) ak | primary polycythemia erythremia |
| increas in all cellular bone marrow elements, increased hemoglobin and hematocrit and increased LAP | Polycythemia vera |
| Plateles >1000 x 10^9 / L marked platelet anisocytosis. Occasional megakaryocytes fragments | essential thrombocythemia |
| in this situation there is a high WBC count, anemia is absent, the peripheral blood smear shows a shift to the left with rare blasts, toxic gran and dohle bodies, LAP score is high and Philly chromosome is neg | Leukemoid reaction |
| In this situation, WBC coutn is high, anemia is present, there is a shift to the left with blasts, eosinophilia and basophilia with a low LAP score, and a positive Philly chromo | CML |
| What does the LAP stain do | look at the granules inside the cells |
| CLL is | chronic lymphocytic leukemia |
| Chronic lymphoproliferative disorders are | CLL and Hair cell leukemia |
| this is the most common leukemia in adults. BCLL is most common, Lymphocytosis with relatively mature lymphocytes, smudge cells, may be accompanied by anemia, thrombocytopenia, and production of autoantibodies | chronic lymphocytic leukemia |
| hairy cells-scant abundant agranular light grayish blue cytoplasm with irregular hair like projections round to oval nuclei with loose chromatin. Pancytopenia. WBC low | hair cell leukemia |
| three plasma cell disorders | Multiple meyloma, plasma cell leukemia, waldenstrom's macroglobulinemia |
| Multiple myeloma involves what immunnoglobulin | IgG |
| Waldenstrom's macrogloulinemia involves what immunoglobulin | IgM |
| abnormal plasma cells in peripheral blood, pancytopenia, rouleaux monoclonal gammopathy | plasma cell leukemia |
| malignant plasma cells in marrow. Rare abnormal plasma cell on peripheral smear, normo normo anemia. rouleux on blood smear elevated ESR due to increased globulins. M spike on serum protein electrophoresis may have bence jones proteinure. lytic bone | multiple myeloma |
| monoclonal gammopathy due to increased IgM rare plasmacytoid lymphocytes or plasma cells on peripheral smear. rouleaux may have bence jones proteinuria and cryoglobulins | waldenstrom's macroblobulinemia |
Created by:
jnwells03
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