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WBC Introduction and Anemia Lab
Terms in this set (41)
Polymorphonuclear Neutrophils (PMNs)
-Segmented neutrophil (40-70% of WBCs)
-Life span of about 10 days
-Moves from bone marrow to blood to tissues
-Mature more quickly under stressful conditions
-Primary defense for bacterial infections
Neutrophil Main Function
-locate, ingest, and kill bacteria and other foreign invaders
Increase in Neutrophils vs Decrease in Neutrophils
Neutrophils increase when we have...
-Acute Infection/Inflammatory Process
-shift to immaturity, an increase in immature forms.
-Increase in the number of immature WBCs relative to the distribution under normal conditions
-Occurs when we have an Acute Infection/Inflammatory Process
-B-cells, T-cells, and Natural Killer (NK) cells
Lymphocyte Main Function
-antigen recognition and immune response
-can pass back and forth between blood and tissues
-life span is varied (up to two years)
B-Cells are both produced and mature in the...
B-Cells are most effective against...
-Bacteria and their toxins
T-Cell precursors leave the Bone Marrow and mature in the...
-Recognize & destroy body cells gone awry, including virus-infected cells & cancer cells.
NK Cell Function
-cytotoxic cells of innate immune system (non-adaptive).
Monocytes account for ___% of WBCs
-Circulate briefly and then enter tissue
-Differentiate into highly mobile macrophages.
-Crucial in body's defense against viruses and chronic infections such as tuberculosis.
-Important in activating lymphocytes to mount an immune response.
Eosinophils take __ days to develop in the marrow
-circulate for hours before entering tissues.
Eosinophils are very specialized granulocytes containing what unique granule contents?
-Major basic protein (Toxic to cells and parasites)
-Cationic protein (ribonuclease)
Eosinophil colony stimulating factor is postulated to be...
-Abrogate some aspects of Hypersensitivity Reactions, such as neutralizing histamine and inhibiting Mast Cell degranulation.
Basophils Cell Characteristics
-Cytoplasm contains large, coarse, histamine-containing granules that have affinity for basic dye and stain dark purple.
-Histamine is an inflammatory chemical that acts as vasodilator and attracts other WBCs.
An infiltrate of which cells is most characteristic of the earliest stages of acute inflammation?
-Neutrophils. Neutrophils are the most prominent inflammatory cells in foci of acute inflammation during the first several hours.
When describing a WBC differential count, a left shift refers to?
-Increase in the number of immature WBCs relative to the distribution under normal conditions.
.....the term "Left Shift" can be applied to either blood OR bone marrow.
.....may be associated with both reactive (like infection) or neoplastic (like leukemia) disorders.
Laboratory Components for Evaluation of WBCs
-Automated Hematologic Evaluation
.....Complete blood count (CBC)
-Peripheral Blood Smear Evaluation
.....Morphologic Evaluation of WBCs
-Bone marrow biopsy
White Blood Cell (WBC) Count
-Includes all circulating nucleated hematopoietic cells except nucleated red blood cells, if present.
-Critical in the diagnosis and management of patients with hematologic and infectious diseases.
WBC Count can also be used to monitor patients receiving...
...cytotoxic drugs, radiation therapy, and some antimicrobial drugs.
Mnemonic for Normal WBC Differential
Never Let Monkeys Eat Bananas!
The WBC is determine in which tubes?
-EDTA-anticoagulated blood (lavender top tube).
Total WBC Count i s measured by what two methods?
-Light Scatter (Flow Cytometry)
Flow Cytometry: Forward Scatter vs Side Scatter
-Forward Scatter=Cell Size
-Side Scatter=Complexity of the Cell Type
-can involved Laser light scatter or
Fluorescent antibody labeling
Factors That Can Affect CBC (6)
When does a manual evaluation of a peripheral smear need to be performed?
-when abnormal results are detected by the hematology analyzer and the specimen gets "flagged" for a manual peripheral smear evaluation.
WBCs distribute nonrandomly on a smear, with ___ cells at the edge and ___ cells in the middle.
-bigger cells (monocytes) go to the edge
-smaller cells (lymphocytes) go to the middle
WBC Disorders are classified into two broad categories...
-Leukocytosis: Increased WBCs (>10,000)
-Leukopenia: Decreased WBCs (<10,000)
The peripheral blood leukocyte count is influenced by...
-Size of myeloid and lymphoid precursor and storage cell pools in the bone marrow, thymus, circulation, and peripheral tissue.
-Rate of release of cells from the storage pool into circulation.
-Proportion of cells that are adherent to blood vessel walls at any time (marginal pool).
-Rate of extravasation of cells from the blood into tissue.
Bone Marrow Evaluation
-May be required when etiology of abnormal peripheral blood counts is uncertain.
.....Especially if a hematologic malignancy is suspected.
-Evaluation of marrow cellularity and hematopoiesis.
.....Hypercellular or hypocellular
.....Orderly maturation or maturation arrest
-less cellular (more fat) means older individual
Which assessment is done better by manual smear?
-Identification of abnormal, dysplastic features of WBCs
Which assessment(s) are done better by automated analyzer?
Which patients do NOT need a bone marrow biopsy?
-patients with GI bleeding and anemia.
Which patients eventually need a bone marrow biopsy?
-A patient with a persistent anemia with no explanation.
-A patient with no sign of infection and a very high white count.
-A patient with a few circulating blasts on peripheral smear review.
-A patient with unexplained pancytopenia
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