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  1. Describe a myeloblast
    • No cytoplasmic granules
    • Round/oval nucleus with fine reddish-purple staining chromatin
    • Dark blue cytoplasm
    • 2-5 nucleoli
  2. Describe a promyelocyte
    • Cytoplasm has large, nonspecific/primary granules containing myeloperoxidase
    • Round/oval nucleus with slightly carsening chromatin
    • 1-3 nucleoli
  3. Describe a myelocyte
    • Prominent golgi apparatus - clear area located in the cytoplasm next to the nucleus
    • Cytoplasm has specific/secondary granules that contain hydrolytic enzymes, including alkaline phosphatase and lysozyme
  4. What is the first stage where granulocyte types can be differentiated into eosinophil, basophil, or neutrophil?
  5. What granulocyte makes up 13% of the nucleated cells in the bone marrow?
    Neutrophilic myelocyte
  6. Describe a metamyelocyte
    • Nucleus is indented in a kidney bean shap and has coarse, clumped chromatin
    • Nuclear indent is less than half the width of the hypothetical round nucleus
    • Cytoplasm is pink and filled with pale blue to pink specific/secondary granules
  7. What granulocyte makes up 16% of the nucleated cells in the bone marrow?
    Neutrophilic metamyeloctye
  8. Describe the Band neutrophil
    • Nucleus is a "C" or "S" shaped with coarse, clumped chromatin lacking segmentation
    • Nuclear indent is greater than half the width of a hypothetical round nucleus
    • Cytoplasm is pink and filled with pale blue to pink specific/secondary granules
  9. What is the reference range of Band neutrophil?
    • Bone marrow: 12%
    • Peripheral blood: 0-5%
  10. Describe a segmented neutrophil
    • 3-5 lobes
    • Cytoplasm is piink and filled with small, pale blue to pink specific/secondary granules
  11. What is the reference range for a segmented neutrophil?
    • Bone marrow: 12%
    • Peripheral blood: 50-80%
  12. Describe an eosinophil
    Cytoplasm contains large, bright red-orange, secondary granules that contain enzymes and proteins
  13. Describe a basophil
    • Cytoplasm contains large, purple-black, secondary granules that contain heparin and histamine
    • Granules may be numerous and obscure the nucleus, or they may "wash out" in staining
  14. What is the reference range of an eosinophil?
    Peripheral blood: 5%
  15. What is the reference range of a basophil?
    Peripheral blood: 0-1%
  16. Where do blasts, promyelocytes, and myelocytes divide and for how long?
    • In the bone marrow mitotic pool
    • 3-6 days
  17. Where do metamyelocytes, bands, and segmented neutrophils mature, and for how long?
    • In the bone marrow post-mitotic pool
    • 6 Days
  18. What included in the marginating granulocyte pool and what do they do? 
    • Mainly neutrophils
    • Adheres to vessel walls
  19. What do neutrophils do in response to antigenic stimulation?
    Neutrophils diapedese into tissues from the marginating pool in response to antigenic stimulation
  20. What attracts neutrophils to the site of inflammation?
    • Chemotactic factors, which include:
    • Complement
    • Bacterial products
    • Injured tissue
    • Hemostatic components
  21. What helps neutrophils recognize a substance as foreign?
    Opsonins such as IgG and complement component C3b
  22. What involves neutrophil attachment to the foreign object formation of a vacuole around it, and neutrophilic degranulation to release lytic enzymes (respiratory burst) in an effort to kill the organism?
  23. How do blood and tissue cells in the body undergo cell death?
    • Necrosis
    • Apoptosis
  24. How is necrosis induced?
    Induced by extracellular forces such as lethal chemical, biological, or physical events
  25. What is the termed for programmed cell death?
  26. How does apoptosis occur?
    Due to extracellular or intracellular processes that depend on a signal
  27. What are toxic changes in neutrophils associated with?
    • Bacterial infection
    • Growth factor therapy
  28. What are Dohle bodies?
    Small oval inclusions (RNA) located in the cytoplasm that stain light blue
  29. What do eosinophils respond to?
    • Parasitic infections (because they express Fc receptors for IgE)
    • Modulate the allergic response (releasing substances that can neutralize products released by basophils and mast cells)
  30. What do basophils do?
    • Express membrane receptors for IgE
    • Once activated, degranulation releases histamine - initiating the classic signs of immediate hypersensitivity reactions (Type I)
    • Release a chemotactic factor that attracts eosinophils to the site
  31. Which granulocyte initiates the classic signs of immediate hypersensitivity reactions (Type I)?
  32. How can you tell the difference between pseudoneutrophilia and neutrophilia caused by a disease?
    Pseudoneutrophilia has NO toxic changes and NO shift to the left
  33. When bone marrow reserves are released into the blood, how much can the WBC count increase?
    Up to 50 x 109/L
  34. When does the bone marrow release its' reserves to increase the WBC count in the blood?
    • Bacterial infections 
    • Other infections
    • Tissue destruction
    • Drugs
    • Toxins
    • Growth factor
  35. What condition:
    Blood picture mimics chronic myelogenous leukemia
    Benign, extreme response to a specific agent or stimulus
    Neutrophilic leukemoid reaction (NLR)
  36. What condition:
    Presence of immature leukocytes and immature erythrocytes in the blood
    Occurs in marrow replacement disorders, such as myelofibrosis
    Leukoerythroblastic reaction
  37. What is a decrease in the absolute number of neutrophils?
  38. What occurs when neutropenia worsens?
    Risk of infection
  39. What are the causes of neutropenia, when dealing with the bone marrow?
    • Chronic or severe infection depletes available neutrophil reserves - use exceeds bone marrow production
    • Hypersplensim causes neutrophils to be removed from circulation
    • Bone marrow injury (aplastic anemia), bone marrow infiltration (leukemia, myelodysplastic syndromes, or metastatic cancer, bone marrow suppression by chemicals or drugs (chemotherapy)
    • DNA synthesis defects due to vit B12 or folate defeciency
    • Many viral infections are associated neutropenia
  40. What clinical conditions are associated with eosinophilia?
    • Parasitic infections
    • Allergic reactions
    • Chronic inflammation
    • Chronic myelogenous leukemia - including early maturation stages
    • Hodgkin disease
    • Tumors
  41. What clinical conditions are associated with eosinopenia?
    • Acute inflammation
    • Inflammatory reactions that cause release of glucocorticosteroids and epinephrine
  42. What clinical conditions are associated with basophilia?
    • Type I hypersensitivity reactions
    • Chronic myelogenous leukemia, including early maturation stages
    • Polycythemia vera
    • Relative transient basophilia can be seen in patients on hematopoietic growth factors
  43. What clinical conditions are associated with basopenia?
    • Inflammatory states
    • Following immunologic reactions
  44. What condition:
    Both sex-linked and autosomal recessive inheritance with the ratio affected males to females being 6:1
    Morphologically normal, but functionally abnormal because of enzyme deficiency that results in an inability to degranulate, which causes inhibitied bactericidal function
    Fatal early in life
    Chronic granulomatous disease (CGD)
  45. What condition:
    Autosomal recessive disorder causes large, gray-green, peroxidase positive granules in the cytoplasm of leukocytes
    Abnormal fusion of primary and secondary neutrophilic granules
    Both morphologically and functionally abnormal leukocytes
    WBCs unable to degranulate and kill invading bacterial
    Patients will present with photophobia and skin hypopigmentation
    Fatal early in life
    Chediak-Higashi syndrome
  46. What is characterized by 5 or more lobes in the neutrophil?
  47. What clinical conditions are associated with hypersegmentation?
    Megaloblastic anemia due to Vit B12 or folic acid deficiency
  48. What refers to a tendency in neutrophils to have 1 or 2 lobes?
  49. What clinical conditions are associated with hyposegmentation?
    • Pelger-Huet anomaly
    • Psuedo Pelger-Huet
    • May be anomaly or shift to the left
  50. What condition:
    Autosomal dominant inheritance
    Nucleus dumbbell or peanut shaped - referred to as "pine-nez"
    Must differentiate from a left shift to the left associated with an infection 
    This condition has no toxic changes
    Pelger-Huet anomaly
  51. What condition:
    Acquired abnormality associated with myeloproliferative disorders and myelodysplastic syndromes
    Can also be drug induced
    Nucleus is usually round instead of dumbbell shape that is seen in the anomaly
    Frequently accompanied by hypogranulation
    Pseudo Pelger-Huet
  52. What condition:
    Autosomal dominant inheritance
    Large, crystalline, Dohle-like inclusions in the cytoplasm of neutrophils on Wright's stain
    Giant platelets
    Clinical bleeding
    May-Hegglin anomaly
  53. What condition:
    Autosomal recessive inheritance
    Large azurophilic granules appear in the cytoplasm of all or only one cell line, granules contain degraded mucopolysaccharides due to an enzyme defect
    Must differentiate from toxic granulation present in neutrophils only in infectious conditions
    Alder-Reilly anomaly
Card Set:
2013-05-03 03:02:30
Morphology Function Nonmalignant Disorders

Morphology, Function, Nonmalignant Disorders
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