136 Questions
Which type of leukocyte arrives at the site of inflammation after neutrophils and does not die in the process?
Monocytes
What are the primary granules present in myelocytes and metamyelocytes responsible for?
Contain hydrolytic enzymes
What is the main function of T lymphocytes?
Provide cellular immunity
Which leukocyte type produces antibodies needed for humoral immunity?
B lymphocytes
What is the role of basophils in the immune system?
Mediate immediate hypersensitivity reactions
Which leukocyte type destroys tumor cells and cells infected with viruses?
NK lymphocytes
Which leukocyte type modulates the allergic response caused by basophil degranulation?
Eosinophils
What percentage of nucleated cells in the bone marrow do neutrophilic myelocytes make up?
13%
Which leukocyte type represents 80% of lymphocytes in the blood?
T lymphocytes
What is the main function of promyelocytes in the bone marrow?
Phagocytizing foreign bodies
What is the N:C ratio of the band neutrophil?
1:2
What percentage of nucleated cells in the bone marrow does the band neutrophil make up?
12%
What color are the specific/secondary granules in the cytoplasm of the band neutrophil?
Pink
How many lobes does the nucleus of a segmented neutrophil typically have?
3-5
In response to infection or growth factor, which type of granules stain in the cytoplasm of a segmented neutrophil?
Nonspecific/primary granules
What percentage of peripheral white blood cells (WBCs) do band neutrophils make up?
25-40%
What is the shape of the nucleus in a band neutrophil?
"C" or "S"-shaped with coarse, clumped chromatin lacking segmentation
What are the typical characteristics of the cytoplasm in a segmented neutrophil?
"Pink and filled with small, pale blue to pink specific/secondary granules"
What type of granules are present but usually don't stain in a segmented neutrophil unless in response to infection or growth factor?
"Nonspecific/primary granules"
What does N:C ratio stand for in the context of band and segmented neutrophils?
"Nucleus: Cytoplasm ratio"
What is the percentage range of nucleated cells in the bone marrow that segmented neutrophils make up?
15-30%
What is the size range of both band and segmented neutrophils?
10-15 um
What is the size range of eosinophils?
12-16 um
Which leukocyte type makes up less than 1% of the nucleated cells in the bone marrow?
Eosinophils
What do basophil granules contain?
Histamine and heparin
How do neutrophils mature in the bone marrow?
From blasts to segmented form
What causes necrosis in cells?
External forces such as lethal chemicals and physical events
What is the main function of myelocytes in the bone marrow?
Cell division
What distinguishes eosinophils from other leukocytes based on their morphology?
Bright red-orange granules containing enzymes
What condition is characterized by the presence of immature leukocytes and immature (nucleated) erythrocytes in the blood?
Leukoerythroblastic reaction
What condition is associated with a decrease in the absolute number of eosinophils?
Eosinopenia
What condition is characterized by an increase in the absolute number of basophils?
Basophilia
Which condition is caused by a congenital enzymatic defect of NADPH oxidase in granulocytes and monocytes?
Chronic granulomatous disease
What condition is characterized by a tendency in neutrophils to have 1 or 2 lobes in their nucleus?
Hyposegmentation
What rare autosomal recessive immunodeficiency disorder is characterized by abnormal intracellular protein transport?
Chediak-Higashi syndrome
What is characterized by 5 or more lobes in the neutrophil nucleus and is associated with megaloblastic anemia?
Hypersegmentation
What process leads to the rapid and free exchange of neutrophils between the circulating granulocyte pool and marginating granulocyte pool?
Diapedesis
Which type of granules, when stained in the cytoplasm of segmented neutrophils, indicates persistent staining and is responsible for toxic granulation?
Primary granules
What do Doehle bodies, small oval inclusions located in the cytoplasm of neutrophils, contain?
RNA
What characteristic differentiates the regenerative shift to the left from the degenerative shift to the left in neutrophils?
Bone marrow response
Which leukocyte type expresses Fc receptors for IgE and modulates the allergic response caused by basophil degranulation?
Eosinophils
Which factor initiates the classic signs of immediate hypersensitivity reactions (Type I) through histamine release?
Fc receptors for IgE
Which condition causes a short-term increase in the total WBC count and in the absolute number of neutrophils without an actual change in the total blood granulocyte pool or toxic changes to neutrophils?
Physiologic neutrophilia
Which abnormality is characterized by a nucleus that is usually round instead of the dumbbell shape normally seen?
Pseudo Pelger-Huet anomaly
Which anomaly is associated with large, crystalline, Dohle-like inclusions in the neutrophil cytoplasm?
May-Hegglin anomaly
Which anomaly is characterized by large azurophilic granules in the cytoplasm due to an enzyme defect?
Alder-Reilly anomaly
Which type of granules are typically present in the cytoplasm of neutrophils with toxic granulation?
Primary granules
Which anomaly is inherited as an autosomal dominant trait?
May-Hegglin anomaly
Which abnormality is frequently accompanied by hypogranulation?
Pseudo Pelger-Huet anomaly
Which type of leukocyte may have large, crystalline, Dohle-like inclusions on Wright's stain in the presence of a specific anomaly?
Neutrophils
What should be differentiated from the large azurophilic granules seen in Alder-Reilly anomaly?
Toxic granulation present in neutrophils only during infectious conditions
In which cell line can large azurophilic granules appear due to an enzyme defect in Alder-Reilly anomaly?
Neutrophils only
Which of the following statements about monocytes is NOT true?
They kill the ingested material during the phagocytic process
What condition is associated with an increase in the absolute number of monocytes?
Autoimmune disorders like systemic lupus erythematosus
Which of the following is the most common lipid storage disorder with an autosomal recessive inheritance pattern?
Gaucher disease
What is the main function of spleen macrophages?
Remove old/damaged RBCs and conserve iron for recycling
Which of the following diseases is characterized by large azurophilic granules in the cytoplasm due to an enzyme defect?
Alder-Reilly anomaly
What condition is characterized by a decrease in the absolute number of monocytes?
Chronic bacterial infections
What is the function of bone marrow macrophages?
Ingest abnormal RBCs and store and supply iron for hemoglobin synthesis
What is true about prolymphocytes?
They have a N:C ratio of 3:1
What distinguishes reactive lymphocytes from lymphoblasts?
Fine chromatin and nucleoli present in reactive lymphocytes but not in lymphoblasts
What is the enzyme defect in Alder-Reilly anomaly?
Defect in acid phosphatase
Which cell type represents the transitional cell that migrates into the tissue and becomes a fixed or free macrophage?
Monocyte
Which cells are named according to their location in the body?
Monocytes
Which monocyte precursor has a round/oval eccentric nucleus with fine chromatin and no cytoplasmic granules?
Monoblast
Which cells contain lysosomes with hydrolytic enzymes including peroxidase and acid phosphatase?
Monocytes
What is the characteristic nucleus shape of a macrophage?
"Horseshoe" or "kidney-bean" shaped
Which cells are derived from the myeloid progenitor cell, CFU-GM, and are acted on by growth factors and interleukins to form monocytes?
"Peripheral blood monocytes"
Which cells are characterized by blue-gray cytoplasm, fine azurophilic granules, and may have pseudopods and vacuoles?
"Monocytes"
"Kupffer cells" are primarily found in which organ?
Liver
What is the primary function of macrophages in the body?
Phagocytosis of bacteria and cellular debris
Which membrane markers are used to identify T lymphocytes (T cells)?
CD2, CD3
What is the primary function of T suppressor cells (T-s, T8)?
Suppressing activation of B cells by antigens
What is the characteristic morphology associated with reactivity in B lymphocytes?
Transformation into plasma cells
What are natural killer (NK) cells responsible for?
Destroying tumor cells and cells infected with viruses
Which virus infects B lymphocytes and is common in the 14-24 age group?
Epstein-Barr virus (EBV)
Which condition has symptoms similar to infectious mononucleosis and is transmitted by blood transfusions and saliva exchange?
Cytomegalovirus (CMV)
Which condition is associated with adenovirus and coxsackie A virus?
Infectious lymphocytosis
What is the primary difference between the origins of leukemia and lymphoma?
Leukemia originates in the bone marrow and is initially systemic, while lymphoma originates in lymphoid tissue and is initially localized
Which factor is NOT listed as a possible cause for oncogene activation contributing to malignant leukocyte disorders?
Bacterial infections
What is the optimal sample for bone marrow examination?
Both the aspirate and core biopsy specimen
Which chromosome abnormality is diagnostic for acute promyelocytic leukemia?
t(15;17)
What is the predominant cell type in chronic leukemias?
Mature cells
Which testing method may be used for bone marrow examination?
Flow cytometry
What are the characteristics of acute leukemias in terms of survival without treatment?
Survival is weeks to months without treatment
What is the defining characteristic of acute lymphoblastic leukemia (ALL) by the World Health Organization (WHO) classification?
More than 20% bone marrow blasts
What distinguishes small lymphoblasts with homogeneous appearance in acute lymphoblastic leukemia (ALL) by the FAB classification?
Basophilic cytoplasm with vacuoles
What is the defining characteristic of chronic lymphocytic leukemia (CLL) in the laboratory findings?
Presence of smudge cells
What is the defining characteristic of small lymphocyte lymphoma (SLL) which is the lymphoma phase of CLL?
Small, hyperclumped lymphocytes
What distinguishes Burkitt lymphoma from other types of acute lymphoblastic leukemia (ALL)?
Large and uniform lymphoblasts with prominent nucleoli
What are Doehle bodies, small oval inclusions located in the cytoplasm of neutrophils, associated with?
Acute myeloid leukemia (AML)
What is the defining characteristic of chronic myeloid leukemia (CML) in terms of cellularity?
>70% cellularity in bone marrow
In Hodgkin lymphoma, which cell type is typically found in the lymph node biopsy?
Reed-Sternberg (RS) cells
What is the most common subtype of Hodgkin lymphoma based on the WHO classification?
Nodular sclerosis
Which condition presents as a disseminated disease with widespread skin involvement and circulating lymphoma cells?
Mycosis fungoides
What is the enzyme detected by the cytochemical stain myeloperoxidase (MPO)?
Peroxidase
Which stain is used to differentiate blasts of acute myelogenous leukemias (AMLs) from acute lymphoblastic leukemias (ALLs)?
Sudan Black B
Which type of neoplasm is classified by WHO as a T/NK cell neoplasm?
Mycosis fungoides
What does an increased LAP score indicate during active disease?
Granulocytic series abnormalities
Which condition causes skin itching and ulcerative tumors?
$Mycosis fungoides$
$Non-Hodgkin lymphoma$ is usually seen in patients over which age?
$50$ years of age
Which malignancy is characterized by lymphocytosis greater than 100 X 10^9/L and the presence of prolymphocytes?
Prolymphocytic leukemia
Which condition is identified on serum protein electrophoresis by an 'M'-spike in the gamma-globulin region?
Waldenstrom macroglobulinemia
Which malignancy results in dry tap on bone marrow aspiration due to extensive bone marrow involvement?
Hairy cell leukemia
Which condition is associated with marked rouleaux, increased ESR, and a blue background to blood smear?
Multiple myeloma
Which malignancy has the characteristic of being tartrate-resistant acid phosphatase (TRAP) stain positive?
Hairy cell leukemia
Which condition is caused by a monoclonal gammopathy leading to excessive production of IgG or IgA with decreased production of other immunoglobulins?
Multiple myeloma
Which malignancy is characterized by the presence of plasma cells and lymphocytes on a blood smear, in addition to other laboratory findings?
Waldenstrom macroglobulinemia
Which stain is useful in distinguishing acute myeloid leukemias from those that are primarily cells of monocytic origin?
Naphthol AS-D chloroacetate esterase stain
Which stain detects esterase enzyme present in monocytic cells?
Alpha-naphthyl butyrate stain
Which stain is useful in the diagnosis of erythroleukemia and acute lymphoblastic leukemia?
Periodic acid-Schiff stain
Which stain detects alkaline phosphatase enzyme activity in primary granules of neutrophils?
Leukocyte alkaline phosphatase stain
What is the reference range for LAP (Leukocyte alkaline phosphatase) score based on neutrophil grading?
13-130
What type of cells are negative for the Naphthol AS-D chloroacetate esterase stain?
Granulocytic cells
Which cells are positive with the Periodic acid-Schiff (PAS) stain?
Malignant erythroblasts
What does a positive Leukocyte alkaline phosphatase (LAP) stain indicate?
Dark precipitate due to presence of alkaline phosphatase activity
What is the purpose of the LAP score based on neutrophil grading?
Assessment of leukemoid reaction intensity
What does the inability to differentiate chronic myelogenous leukemia (CML) from a neutrophilic leukemoid reaction (NLR) cause?
Misdiagnosis of CML as NLR
What is the color of the precipitate observed in a positive Leukocyte alkaline phosphatase (LAP) stain?
Dependent on dye used
What is the defining characteristic of chronic myelogenous leukemia (CML) in terms of cellularity?
Elevated WBC count and all stages of granulocyte production
Which condition is characterized by inappropriate erythropoiesis despite decreased erythropoietin (EPO)?
Polycythemia Vera
What is the primary distinguishing factor between Secondary Polycythemia and Relative (Pseudo-) Polycythemia?
Appropriate response to increased EPO or tissue hypoxia
Which disorder is characterized by progressive blood cytopenias despite bone marrow hyperplasia?
Myelodysplastic Syndromes
What is the characteristic feature of Chronic Idiopathic Myelofibrosis in terms of laboratory findings?
Anisocytosis and poikilocytosis with teardrop cells
What distinguishes Essential Thrombocythemia from Reactive Thrombocytosis and Polycythemia Vera?
Giant forms of platelets and abnormal platelet function
What distinguishes Polycythemia Vera from other forms of polycythemia based on the laboratory findings?
Increased RBC (>20 g/dL) and hematocrit (>60%)
What is the distinguishing feature of Essential Thrombocythemia in terms of the affected age group?
Found mainly in adults 60 years of age and older
Which condition's accelerated phase ultimately leads to acute leukemia in most patients?
Chronic Myelogenous Leukemia
What differentiates Myelodysplastic Syndromes from other myeloproliferative neoplasms?
Progressive blood cytopenias despite bone marrow hyperplasia
Which disease is most likely to be associated with an increased LAP score?
Polycythemia vera
Which acute myelogenous leukemia (AML) subtype is characterized by proliferation of unipotential stem cell CFU-GM?
M2
What is the defining characteristic of acute monocytic leukemia (AMOL)?
≥80% monoblasts in the bone marrow
Which membrane markers are used to identify megakaryoblasts and atypical megakaryocytes in acute megakaryocytic leukemia (AMegL)?
CD41, CD42, and CD61
What is the primary distinguishing feature of BILINEAGE LEUKEMIAS?
Contain two cell populations with myeloid and lymphoid antigens expressed
What is the implication of JAK2 oncogene in chronic myeloproliferative disorders?
Implicated in all chronic myeloproliferative disorders
What is a distinguishing feature of TARTRATE-RESISTANT ACID PHOSPHATASE STAIN (TRAP) in hairy cell leukemia?
Cells are resistant to inhibition with tartrate
This quiz provides an introduction to leukocytes, focusing on their classification as phagocytes (granulocytes and monocytes) and immunocytes (lymphocytes, plasma cells, and monocytes). It also covers the WBC reference range in SI units and the functions of neutrophils, monocytes, and T lymphocytes.
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