Clin Med L3 CBC - WBC portion

What are Granulocytes? Give Examples

cells that digest microorganisms

ex: Neutrophils, Eosinophils, and Basophils

What are Agranulocytes? Give Examples

cells that cannot digest microorganisms

ex: Monocytes and Lymphocytes.

What is the function of WBCs in host defense?

Phagocytosis (granulocytes and monocytes)

Immune response (lymphocytes).

What is the function of Neutrophils?

phagocytize and destroy microbes, increased in bacterial infection

what is the function of Eosinophils?

combat the effects of histamine in allergic reactions, destroy certain parasitic worms

what is the function of Basophils?

release heparin, histamine, and serotonin to intensify the inflammatory response in allergic reactions

what is the function of Lymphocytes?

essential component of the immune defense system, interact with antigens and mount an immune response (T and B lymphocytes), increased in viral infections

What is the function of Monocytes?

differentiate into macrophages and phagocytize debris and microbes

strep is what kind of infection?

mono is what kind of infection?

bacterial

viral

what type of WBC fights parasitic worms?

eosinophils

what type of WBC fights viral infections?

lymphocytes

• blue cytoplasma

what type of WBC deals with inflammatory allergic reactions?

basophils

what type of WBC fights bacterial infections?

neutrophils

what type of WBC deals with histaminic allergic reactions?

eosinophils

What is the difference between Neutrophils and Eosinophils?

Eosinophils are larger and richer in color when stained, and typically are bi-segmented unlike neutrophils

R: Neutrophil L: Eosinophil

neutrophils have how many segments?

color?

more than 2 segments

pale

eosinphils have how many segments?

color?

only 2 segments

vibrant

identify all these WBC

top R

middle R

bottom R

top L

middle L

bottom L

top R: neutrophil with band

middle R: T cell

bottom R: plasma B cell (lymphocyte)

top L: eosinophil

middle L: neutrophil

bottom L: basophil

what is hypersegmentation?

what anemia do we see this in?

neutrophils with MORE than 6 segments

• commonly seen in

  • megaloblastic anemias (B12 and folate deficiencies)

what is hyposegmentation (Pelger-Huet anomaly) ?

neutrophil has 2 segments or LESS

• congenital or acquired (ex. CML).

What is Toxic Granulation?

more inclusions in the cytoplasm of WBC seen as darker staining of neutrophils

What is Vacuolization?

Commonly seen in?

“holes” in the cytoplasm; frequently seen in association with toxic granules

• Commonly seen in acute infections – usually bacterial.

what WBC can have hypersegmentation, hyposegmentation, toxic granulation and vacuolization?

neutrophils

What are Döhle Bodies?

What do they indicate?

Seen as large, gray-blue structures in cytoplasm, often located next to the cytoplasmic border

Structures are aggregates of rough endoplasmic reticulum

Indicate rapid cell maturation

What are Reactive Lymphocytes?

large lymphocytes

• nucleus appears elongated

• cytoplasm is abundant, pale blue, and often staining unevenly

what illness do we see reactive lymphocytes in?

viral infections

What information does the WBC Count provide?

provides a count of the number of WBCs

• does NOT tell you why they are elevated

is the WBC count specific or non-specific?

non-specific

What is a WBC Differential?

tells you different counts of the different WBC

What does 'Shift to the Left' mean in the context of WBCs?

Indicates that the neutrophils present in the blood are at a slightly earlier stage of maturation than usual

results in an increased number of band neutrophils

what does a left shift indicate?

bacterial infection; also known as “bandemia”

• early response to infection

What does a WBC count of 100,000 – 400,000 indicate?

a new onset WBC of 100,000 – 400,000 indicates acute or acute on chronic leukemia

What does a Reticulocyte Count indicate?

how well your bone marrow is producing RBCs

• how well the body is compensating while having anemia

what usually causes an increase in Retic Count?

any disease that is destroying your RBCs that forces the body to make more RBC

When would you see an Increased Retic Count?

Hemolytic anemias

Acute or chronic bleeding

Following treatments for iron def anemia or factor def anemia

what does a Decreased Rectic count mean?

ineffective production of RBCs in the bone marrow

• aka body CANNOT make RBCs well (erythropoiesis)

When would you see a Decreased Retic Count?

aplastic anemia

other various types of deficiency anemias

• Thalassemia

when you have a Decreased Retic Count what is the next diagnostic test you will order?

bone marrow biopsy

What is Bone Marrow Biopsy?

Examination of bone marrow tissue to diagnose

• Polycythemia vera

• Acute and chronic leukemias

• Myelodysplastic syndromes

• Aplastic anemia

What is Erythrocyte Sedimentation Rate (ESR)?

means of detecting any inflammatory conditions

is the ESR specific or non-specific?

non-specific

How do increased protein levels affect ESR?

the increased protein levels decrease the tendency of RBCs to repel each other and enhances rouleaux formation

• stacked RBC

What is G6PD Deficiency?

genetic abnormalities which cause decreased in G6PD activity

• G6PD protect RBC

when is G6PD deficiency tested?

patient with symptoms or risks of hemolytic anemia without any other cause