t2

Define "right-shift"

An increase in the segmentation of the Neutrophilic nucleus.

Describe the function of the Neutrophil in the Immune System.

Neutrophils perform phagocytosis to stop the action of foreign material or infectious agents, Chemotaxis increases the concentration of chemotactic substances, and have amoeboid moments of Neutrophils of diapedesis

Define the term diapedesis and its relationship to neutrophils.

Diapedesis allows movement through capillary walls into tissues, thus granting Neutrophils the ability to enter tissues to fight infections.

Describe the function of Basophils in the Immune System.

Basophils immediate Hypersensitivity reactions because of the release of the granular contents.

Identify the contents found in the granules of basophils.

Heparin and Histamine.

Describe the function (s) of the eosinophil in the immune system.

Mediate tissue inflammation of infections like parasite infections and helminth infections. Also mediates allergic reactions and antihistamine effects.

Differentiate between leukemia and leukocytosis.

Leukemia is a malignant disease that is a progressive abnormal proliferation of a particular cell line(s). Leukocytosis is just increased white blood cells.

Differentiate between physiological neutrophilic leukocytosis and pathological neutrophilic leukocytosis, and identify the conditions representative of each

Physiological neutrophilic leukocytosis is movement of the Neutrophils from the marginal pool into the circulating pool. Caused by strenuous exercise, emotional stress, labor or childbirth, or newborns (growth).

Pathological neutrophilic leukocytosis is a disease which causes the movement of the neutrophils from the marginal pool into the circulating pool, causing early release from the bone marrow. Caused by bacterial infections, appendicitis, inflammatory conditions, or chronic myelogenous leukemia (CML).

Define the term leukopenia

Decrease in total white blood cell count.

Define neutropenia and identify those conditions representative of it.

Is a decrease in Neutrophils, caused by radiation/ chemotherapy, megaloblastic anemia, Aplastic Anemia, or a viral disease.

Describe the function of the B-Lymphocyte, including the line of defense it provides.

Is the 3rd line of defense. Aids in Humoral Immunity by producing antibodies. Forms memory cells.

Identify the type of cell that B-Lymphocytes become when stimulated by antigen.

B-Lymphocytes become plasma cells when stimulated by antigen

Describe the function of T-Cells in the Immune System.

T-Lymphocytes are responsible for cellular immunity and form immunologic memory cells.

Differentiate between CD4 and CD8 Cells in relationship to their roles in immunity

CD4 Cells release cytokines chemokines to activate other immune cells (B-Cells). CD8 Cells suppress other immune cells.

Describe the characteristics of the Natural Killer Cell and its role in immunity.

Is neither T nor B Cells, its role in immunity is against viral and tumor cells and it doesn't require antigen recognition.

Describe the role of the plasma cell in immunity and identify the line of defense it is associated with.

Plasma cells are associated with the synthesis of proteins (antibodies) to fight infections. And are part of the 3rd line of the defense

Identify the location of plasma cells in the body.

Plasma cells are normally found in the Bone Marrow and abnormality found in peripheral blood.

Differentiate between humoral and cellular immunity and identify the white cells associated with each.

Humoral immunity uses antibodies (B-Lymphocytes) to target and neutralize extracellular pathogens like bacteria, while cellular immunity uses T cells (T lymphocytes) to directly destroy infected or cancerous cells.

Explain whether secondary lymphoid tissue is antigen dependent or independent and explain why.

Secondary lymphoid tissue is antigen dependent because antigenic stimulation increases the secondary lymphoid tissue proliferation of B-Lymphocytes and T-Lymphocytes.

Differentiate between physiological lymphocytosis and pathological lymphocytosis and identify the conditions associated with each.

Physiological lymphocytosis has a higher lymphocyte count, found in infants to young children.

Pathological lymphocytosis is an absolute increase in the number of lymphocytes in peripheral blood circulation. Found in viral infections, whooping cough, mumps, viral pneumonia, infectious mononucleosis, and lymphocytic leukemia.

Define Pathological Plasmacytic Leukocytosis and state those conditions associated with it.

Pathological Plasmacytic Leukocytosis is the presence of plasma cells in peripheral blood. Found in severe childhood infection, multiple myeloma, and plasma cell leukemia.

Correctly spell the names of the cells in the monocytic line.

Monoblast, Promonocyte, and Mature Monocyte.

Identify the name given to monocytes in the tissues.

Macrophages.

Describe the various specific functions of Monocytes in the Immune System and identify the line of defense associated with them.

Monocytes perform phagocytosis, stimulate inflammation reactions, and are an antigen presenting cell. Last on the scene and is the 2nd line of defense.

Define Pathogenic Monocytic Leukocytosis and identify those conditions associated with it.

An absolute increase of Monocytes in peripheral blood circulation. Conditions associated with this include tuberculosis, Monocytic Leukemia, fungal infection, recovery from acute bacterial infection, and subacute bacterial endocarditis.

Explain how a differential is performed and identify the stain that is used to identify the cells.

A blood smear is made and stained by a Wright's stain. 100 WBCs are counted and classified according to the type of white cell seen. Finally the differential is reported in a percent.

Describe the clinical significance for performing a differential.

In certain physiological or pathologic states, a special type of white cell may be increased or decreased. Inclusions or anomalies may help identify certain disease conditions.

Differentiate relative counts from absolute counts.

Relative counts are a percentage of each type of WBC. Absolute counts are the number of each type of WBC/L.

State the normal reference values for relative differential counts.

Metamyelocyte: 0-1%

Banded Neutrophil: 2-6%

Segmented Neutrophil: 50-70%

Lymphocyte: 18-42%

Monocyte: 2-11%

Eosinophil: 1-3%

Basophil: 0-2%

Calculate the absolute differential leukocyte values for the patient sample when given the relative differential count and total white blood cell count.

Relative counts differential X Total WBC count = Absolute counts.

Calculate the normal absolute differential leukocyte reference range for each cell type by recalling the relative differential reference values and the total white cell reference

(7.1 +/-3.5 x 10⁹/L) X Total white cell reference = range

Identify all of the parts of a complete differential.

RBC Morphology: Anisocytosis (size variation), poikilocytosis (shape variation), polychromasia, inclusions, Rouleaux (coin stacking), hemoglobin color.

WBC Morphology: estimate number, White Blood Cell Differentiation, white cell abnormality.

Platelet Morphology: platelet morphology, platelet clumps, estimate number.

Calculate the corrected white blood cell count when given the uncorrected white count and the number of nucleated red blood cells found when performing a differential and report the count in the correct units.

Uncorrected count X 100 / 100 + 25 = corrected WBC.

List the signs of severe infection.

Left Shift (Bands), vacuous in the cytoplasm of Neutrophils, Döhle Bodies, toxic granulation, intracellular organisms.

Describe the pathology in Chédiak-Higashi Syndrome and discuss the prognosis for the patient.

Abnormal lysosomes are formed by the aggregation and fusion of primary and secondary granules, thus unable to be released. Cells cannot kill bacteria.

Define tissue.

A group of similar specialized cells that function together as a unit.

State the various functions of connective tissue.

binds structures together, stores fat, transport substances, protects against disease, helps repair tissue damage.

Explain the two major functions of red blood cells and identify the structure in each that is responsible for the function.

transports gasses (oxygen and carbon dioxide), iron in hemoglobin binds to oxygen. Acts as blood buffer, protein in hemoglobin that acts as blood buffer.

Define "Hypersensitivity" and identify the white cells associated with this function.

inappropriate immune overreactions (Eosinophils and Basophils)

Name the types of white blood cells normally found in peripheral blood.

Granulocytes and Agranulocytes

List the normal reference values for Red Blood Cells, White Blood Cells, and Platelets

RBC M (4.60-6.00 x 10⁶/mm³). RBC F (4.00-5.40 x 10⁶/mm³). WBC (3.6-10.6 x 10³/mm³). Platelets (150-450 x 10³/mm³).

Differentiate between medullary hematopoiesis and extramedullary hematopoiesis.

Medullary hematopoiesis, normal product of blood cells in the bone marrow. Extramedullary hematopoiesis, abnormal production of blood cells outside the bone marrow.

Describe the abnormal conditions that lead to extramedullary hematopoiesis.

Aplastic Anemia, infiltration of malignant cells, and Hemolytic Anemia.

Identify the cell that gives rise to all cell lines and describe its characteristics.

stem cells, capable of self renewal and regenerating the entire hematopoietic system.

Identify the last erythrocyte stage capable of mitosis.

polychromatic normoblast

Identify the first erythrocytic stage where hemoglobin can be recognized and explain why.

Polychromatophilic Normoblast (Rubricyte), first stage where hemoglobin is recognized due to large amount of hemoglobin and decreasing amount of ribosomes.

Define pyknotic nucleus.

dense, homogenous structure that is incapable of DNA synthesis

Define synchronism and asynchronism as it relates to erythropoiesis.

synchronism, cytoplasm and nuclear development occurs together. asynchronous, cytoplasm and nuclear development occurs separately.

Describe the pathology of megaloblastic erythropoiesis.

a nuclear maturation defect that causes the nucleus to develop or mature at a slower rate than the cytoplasm.

Identify the conditions that result in megaloblastic erythropoiesis and explain why they result in this problem.

vitamin B12 deficiency (malabsorption or deficient diet), pernicious anemia (lack of glycoprotein), folic acid deficiency (malabsorption or deficient diet).

Identify those conditions associated with microcytic erythropoiesis and explain why they result in this problem.

iron deficient anemia (malabsorption or deficient diet), Thalassemia (a decrease in normal glowing chain synthesis)

Identify the hormone that regulates erythropoiesis

Erthropoietin

Identify the primary production site of erythropoietin.

kidneys

Identify the factors that will increase erythropoietin levels.

Hypoxia, pituitary hormones, adrenal gland hormones. Testosterone, thyroid hormones.

Describe the changes that occur as a result of increased erythropoietin levels.

increased erythropoiesis, increased red cell number and hemoglobin synthesis, increased mitosis, increased number of reticulocytes and erythrocytes in peripheral circulation.

Identify the primary hematologic test that is used to estimate the rate at which new RBCs are entering the peripheral blood from the bone marrow.

reticulocyte count

Explain why the reticulocyte stains are classified as supravital stains.

stained when cells are alive or living, residual ribosomal RNA is precipitated within the reticulocyte.

Differentiate between a polychromatophilic cell and a reticulocyte noting which stains you find each type of cell.

reticulocyte - new methylene blue, brilliant crystal blue. Polychromatophilic - Wright's stain. Reticulocyte dependant of polychromatophilic.

Identify the components being stained within a reticulocyte.

cytoplasmic DNA, mitochondria, ribosomes.

Calculate the reticulocyte count percentage when given the number of reticulocytes counted out of 1000 red cells counted.

X/1000 x 100 = X%

State the normal adult and neonate reference ranges for reticulocyte counts.

adult (0.5-2.0%), neomates (2.0-6.0%)

Describe the clinical significance of a reticulocyte count by listing the conditions that increase or decrease the count and explain how these conditions affect red cell production.

increase - Hemolytic Anemia, blood loss, Sickle cell anemia, treatment of IDA/folic acid/ vitamin b12 deficiencies. Decrease - Aplastic Anemia, IDA, folic acid, vitamin b12 deficiencies.

Identify the other red blood cell inclusions that may also stain with the supravital stain.

heinz Bodies, Howell-Jolly Bodies, pappenheimer bodies, hemoglobin h

Define the term "poikilocytosis".

variation in the shape of erythrocytes

Identify those cell types that demonstrate an increased or decreased osmotic fragility test.

spherocytes

Define the term anisocytosis.

variation in the size of the erythrocytes

Describe the pathology behind the formation of Spherocytes.

Result of a membrane defect involving spectrum, Ankyrin, and band 4.1

Describe the appearance of hypochromasia in red blood cells

the central pallor area of erythrocytes is larger than normal

Describe the conditions that lead to the formation of hypochromis cells.

iron deficiency anemia and beta thalassemia major

Differentiate between siderocytic granules and pappenheimer bodies.

siderocytic granules is iron that is found through a special stain called prussian blue stain. pappenheimer bodies are violet granules found through Wright stain.

Identify the three types of malaria.

Plasmodium ovale, Plasmodium vivax, and Plasmodium falciparum.

Explain how nucleated red blood cells affect the Total White Blood Cell count.

If nucleated RBCs are present in whole blood, because of their nucleus, they will be counted as WBCs by the automated cell counting instrument.

Explain when it is appropriate to perform a corrected total white blood cell count.

If the number of nucleated RBCs is greater than 5 then you perform a corrected total white blood cell count.

Identify the specific type of tissue associated with blood.

Blood is Connective tissue

Describe the function of platelets in Hemostasis.

acts as plugs and initiate fibrin formation

State the normal amount of blood found in an adult in milliliters.

5-6k

Define Hematocrit

Volume of packed red blood cells

Differentiate between the composition and function of red bone marrow and yellow bone marrow.

Red bone marrow, all red blood cells. Yellow bone marrow, mostly fat (adipose) tissue, acts as a "reserve" system.

Identify the preferred bone marrow aspiration site(s) for young adults-adulthood.

sturnum and iliac crest

Define the prefixes, root words, and suffixes associated with Erythropoiesis and Hematopoiesis.

Erythropoiesis, erythro - red/ poiesis - formation. Hematopoiesis, Hemat/o - blood/ poiesis - formation.

State the name of the stain that is used in distinguishing cellular morphology.

wright stain

Identify the location of the mature erythrocyte.

peripheral blood circulation

Recall the normal life span of the erythrocyte.

120 days

State the approximate size of a mature erythrocyte.

5-8 um.

Describe the pathology of microcytic erythropoiesis.

a cytoplasmic maturation defect that causes the cytoplasm to develop or mature at a slower rate than the nucleus.

Identify the two stains used for reticulocyte counts.

new methylene blue, brilliant crystal blue

Identify the blue material within a stained reticulocyte.

RNA

Define isotonic, hypertonic, and hypotonic and describe the effect of each on the red blood cell.

isotonic is normal, hypertonic is shrinked, hypotonic is inflated.

Differentiate between a platelet lying on top of a red blood cell from the ring form of malaria.

use the focus function of the microscope to see if the artifact is on the cell or in the cell.

Differentiate between primary and secondary granules in relationship to their appearance and cell stage where they are recognizable.

primary granules first appear in promyelocyte stage, has undefined color

secondary granules first appear in myelocyte stage, has defined color

Identify the first stage where there can be differentiation between Neutrophils, Basophils. and Eosinophils.

Myelocyte is the first stage where there can be differentiation between Neutrophils, Basophils. and Eosinophils.

Explain the difference between the circulating pool and the marginating pool and state the percentage of each.

The circulating pool is using neutrophils 50%. The marginating pool is storage, 50%.

Define "left-shift".

An increase in the more immature Neutrophils in peripheral blood.

Define "regenerative change".

an increase in total WBC count.

Define "degenerative change".

A decrease in total WBC count.

Describe the 1st line of defense in the Immune System.

Skin-Epithelial Barriers.

Describe the 2nd line of defense in the Immune System.

Phagocytosis

State the name of the basophil found in tissue.

Mast cell.

Differentiate between the terms "Physiological" and "Pathological".

Physiological is a normal response and is not related to disease. Pathological is disease related.

Identify the three types of mature lymphocytes.

The three types of mature lymphocytes are B-Lymphocytes, T-Lymphocytes, and natural killer cells.