Exam 1 : WBC

myelopoiesis (granulopoiesis)

growth and development of granulocytic and monotocytic cells in the bone marrow (WBCs)

WBC maturation takes

7-11 days

granulocytes vs agranulocytes

granulocytes can digest microorganisms; agranulaocytes cannot

Granulocytes

neutrophils, eosinophils, basophils

Agranulocytes

monocytes and lymphocytes

lymphocytes

immune response

granulocytes and monocytes are responsible for

phagocytosis

phagocytosis

ingest bacteria and dispose of dead matter

chemotaxis

movement by a cell or organism in reaction to a chemical stimulus

neutrophils

most abundant; phagocytosis; bands/segments; typically 3-5 segments

-increased in bacterial infection!!!

eosinophils

phagocytic; pink; two nuclei; 12-17um

destroy parasitic worms!!

basophils

phagocytic; all purple; granular; one nuclei

response in allergic reactions!!

-increase inflammation

lymphocytes

immune response; B and T cells

-increased in viral infections!!

monocytes

can differentiate into macrophages and phagocytize debris; >20um; largest; large monocyte

platelets features

made from megakaryocytes; tiny pink; no nucleus

erythrocyte features

round pink; light middle

lymphocyte features

light purple with dark purple middle

-B all purple no bands/segments

-T smaller all purple; mostly nuclei

neutrophil maturation

myeloblast, promyelocyte, myelocyte, metamyelocyte, band, seg

erythrocyte maturation

rubriblast-->prorubicyte-->rubricyte-->metarubicyte-->polychromatophilic erythrocyte-->mature erythrocyte

-blast

baby

monocyte maturation

Myeloid stem cells -> monoblasts -> promonocytes -> monocytes

lymphoid: plasma maturation

lymphoid stem cell -> pre B -> B lymphoblast -> B cell -> plasma cell

lymphoid: T cell maturation

lymphoid stem cell -> bone marrow to thymus -> prothymocyte -> t lymphoblast -> T cell

hypersegmention

neutrophils with nuclei that have 6 or more lobes

-B12 and folate deficiencies

Hyposegmentation

(Pelger-Huet anomaly) when neutrophils are bilobed/dumbell shaped

T/F it only takes one cell to diagnose hyper/hypo segmentation

F must be several abnormal cells present

neutrophil cytoplasmic inclusions

-bacterial/acute infections

toxic granulation

accentuation of normal cytoplasmic granules. Granules become more numerous, larger and stain a deeper blue-black color

vacuolization

vacuoles appear as "holes" in the cytoplasm

Dohle bodies

large, gray blue structure is neutrophil cytoplasm

-typically near the border

reactive lymphoctyes

increased size, may be round, elongated, or lobulated

-viral infections!! ex mono

-cytoplasm is "soft" and indented by RBCs

ineffective granulopoiesis

increase number of WBC precursor and decreased mature WBC in peripheral blood

ineffective granulopoiesis: secondary problem

signal is sent but stem stems cannot get to WBC

ineffective granulopoiesis: primary problem

no stem cells

megakaryopoiesis

platelet production

platelet maturation

stem cell, megakaryoblast, promegakaryocyte, megakaryocyte, thrombocyte

megakaryocytic splinter to create

platelets; occurs in the red bone marrow -> enter the peripheral blood circulation

platelet life span

5-9 days

what organs remove old platelets

spleen and liver

ineffective thrombopoiesis

Increased abnormal megakaryocytes in the bone marrow

Thrombocytopenia in peripheral blood

CBC requires

lavender tube : EDTA

WBC differential requires _ stain

Wright's stain

WBC differential reports on

neutrophils, lymphocytes, monocytes, eosinophils, basophils

(Never, Let, Monkeys, East, Bananas)

WBC differential ranges

Neutrophils: 60

Lymph: 40

Monocytes: 10

Eosinophils: 2

Basophils: 0

left shift

increase in the number of immature neutrophils

-typically an early response to infection

-"bandemia"

platelet range

150-400

-worry when it comes to bleeding

-too low: prolonged bleeding

-too high: clots

reticulocyte count

they are seen in peripheral samples!!

von Willebrand's disease

bleeding disorder

factor deficiency anemia

-cancer and sickle cell

erythrocyte sedimentation rate

detects inflammatory conditions

-very non specific!!!

-auto immune diseases

changes in the ESR are

result of changes in plasma protein levels

following an acute inflammatory process or acute injury protein levels will

increase

ESR

measures sedimentation rate of red blood cells; indicates inflammation; how fast it fills

G6PD deficiency

deficient enzyme activity

-whole blood anticoagulated w/ EDTA or heparin

several G6PD enzyme variants exists with what populations

greek, Italian, jewish

bone marrow studies are used to diagnose

polycythemia vera, acute and chronic leukemia, myelodysplastic syndrome, aplastic anemia

bone marrow tissue sample

drawn from the pelvis