83 Questions
What is the size range of a segmented neutrophil?
10-15 um
Which cell type makes up less than 1% of the nucleated cells in the bone marrow and 5% of peripheral WBCs?
Eosinophil
What is the typical nucleus shape of an eosinophil?
Bilobed
Which type of granules contain heparin and histamine?
Purple-black granules
What is the N:C ratio of a neutrophil?
1:3
What makes up less than 0.1% of the nucleated cells in both the bone marrow and peripheral blood?
Basophil
Which cell type has cytoplasm filled with small, pale blue to pink specific/secondary granules?
Segmented neutrophil
What is the characteristic feature of the nucleus of a segmented neutrophil?
Coarse, clumped chromatin with 3-5 lobes
Which cell type makes up 12% of the nucleated cells in the bone marrow?
Segmented neutrophil
What is the typical size range of a basophil?
10-15 um
What is the main content of the cytoplasmic granules in an eosinophil?
Enzymes and proteins
Which cell type has cytoplasm containing large, purple-black, secondary granules?
Basophil
What recognizable maturation stages are present in an eosinophil?
Myelocyte, metamyelocyte, band, and segmented form
What is the N:C ratio of a neutrophil?
$1:3$
Which pool contains metamyelocytes, bands, and segmented neutrophils in the bone marrow?
Post-mitotic pool
What attracts neutrophils to the site of inflammation?
Complement and bacterial products
Which process involves neutrophil attachment to a foreign object, formation of a vacuole around it, and release of lytic enzymes?
Phagocytosis
What is the fate of neutrophils when they are destroyed in the process of phagocytosis?
They undergo cell death through apoptosis
Where is the rapid and free exchange of neutrophils between different pools observed?
Circulation system
What is the main content of the cytoplasmic granules in a neutrophil?
Myeloperoxidase
What type of granulocyte pool mainly contains neutrophils that adhere to vessel walls?
Marginating granulocyte pool
What releases neutrophils into circulation when they are mature or needed?
Bone marrow
What do opsonins such as IgG and complement component C3b help neutrophils recognize as foreign?
Antigens
Where do neutrophils diapedese into the tissues from in response to antigenic stimulation?
Marginating granulocyte pool
What is indicated by the presence of colorless areas in the cytoplasm of neutrophils?
Toxic vacuolation
What is the most common type of left shift associated with an increased demand for neutrophils?
Regenerative shift to the left
What is indicated by the presence of small oval inclusions (RNA) located in the cytoplasm of neutrophils?
Dohle bodies
What is the appropriate bone marrow response to increased demand for neutrophils?
Regenerative shift to the left
What is associated with an increased number of myelocytes, metamyelocytes, and/or bands in the peripheral blood?
Shift to the left
What change in neutrophils is seen after an overwhelming infection in which bone marrow production cannot keep up with increased need for neutrophils?
Degenerative shift to the left
What change in neutrophils refers to prominent granulation due to persistent staining of primary granules?
Toxic granulation
Which type of cell releases substances that can neutralize products released by basophils and mast cells, and also modulate the allergic response?
Eosinophils
What initiates the classic signs of immediate hypersensitivity reactions (Type I) by releasing histamine upon degranulation?
Basophils
Which type of cell expresses Fc receptors for IgE in response to parasitic infections?
Eosinophils
Which cell type releases a chemotactic factor that attracts eosinophils to the site of inflammation?
Basophils
What is the cause of neutropenia due to chronic or severe infection?
Depletion of available neutrophil reserves
What is a characteristic associated with basophilia?
Type I hypersensitivity reactions
What can cause an increase in eosinophils?
Allergic reactions
What is a potential cause of basopenia?
Inflammatory states
What disorder is associated with the presence of immature leukocytes and immature erythrocytes in the blood?
Myelofibrosis
What can cause a decrease in absolute number of neutrophils?
Vitamin B12 deficiency
What is a potential cause for the decrease in the absolute number of basophils?
Inflammatory states
What can lead to an increase in the absolute number of eosinophils?
Parasitic infections
What can cause neutropenia due to bone marrow production defects?
Bone marrow injury (aplastic anemia)
What is the main difference between physiologic pseudoneutrophilia and pathologic neutrophilia?
Bone marrow reserves are released into the blood in pathologic neutrophilia, but not in physiologic pseudoneutrophilia.
What distinguishes the neutrophilic leukemoid reaction (NLR) from chronic myelogenous leukemia?
NLR is a benign, extreme response to a specific agent or stimulus, while chronic myelogenous leukemia is not.
What differentiates physiologic pseudoneutrophilia from pathologic neutrophilia?
Caused by exercise, stress, pain, pregnancy in physiologic pseudoneutrophilia, but not in pathologic neutrophilia.
What is a distinguishing feature of neutrophilic leukemoid reaction (NLR) compared to physiologic pseudoneutrophilia?
WBC count increase to between 50 and 100 X 109/L in NLR, but not in physiologic pseudoneutrophilia.
What distinguishes pathologic neutrophilia from neutrophilic leukemoid reaction (NLR)?
Bone marrow increases production of neutrophils to replenish reserves in pathologic neutrophilia, but not in NLR.
What sets physiologic pseudoneutrophilia apart from neutrophilic leukemoid reaction (NLR)?
Caused by exercise, stress, pain, pregnancy in physiologic pseudoneutrophilia, but not in NLR.
What differentiates the shift observed in pathologic neutrophilia from that seen in physiologic pseudoneutrophilia?
Bone marrow reserves are released into the blood in pathologic neutrophilia, but not in physiologic pseudoneutrophilia.
What is the underlying cause of chronic granulomatous disease (CGD)?
Congenital enzymatic defect of NADPH oxidase in platelets and monocytes
What is the characteristic feature of Chediak-Higashi syndrome?
Abnormal intracellular protein transport
What is the main cause of hypersegmentation in neutrophils?
Vitamin B12 or folic acid deficiencies
What is the morphological difference between hypersegmentation and hyposegmentation?
5 or more lobes vs 1 or 2 lobes
What is the main consequence of the inability of neutrophils to degranulate in CGD?
Inhibited bactericidal function
What is the genetic basis of Chediak-Higashi syndrome?
Autosomal recessive inheritance
What distinguishes Pelger-Huet anomaly from hypersegmentation?
Hyperclumped nucleus
What is the main concern associated with morphologically normal but functionally abnormal leukocytes?
'Left shift' on blood smear
'Left shift' on blood smear is indicative of:
Increase in immature white blood cells
What differentiates hypersegmentation from hyposegmentation?
5 or more lobes vs 1 or 2 lobes in neutrophils
What is the characteristic associated with Chediak-Higashi syndrome?
Abnormal intracellular protein transport
What is the main difference between MAY-HEGGLIN ANOMALY and ALDER-REILLY ANOMALY?
Presence of large azurophilic granules
Which anomaly is associated with autosomal dominant inheritance?
MAY-HEGGLIN ANOMALY
What is the characteristic feature of ALDER-REILLY ANOMALY?
Degraded mucopolysaccharides in cytoplasmic granules
What distinguishes the cytoplasmic anomalies described in the text from toxic granulation present in neutrophils only in infectious conditions?
Morphological appearance of neutrophils
Which growth factors and interleukins act on the committed progenitor cell, CFU-GM, to form monocytes?
GM-CSF and IL-5
Where in the body do Kupffer cells primarily function?
Liver
What is the name for the macrophages found in the central nervous system?
Microglial cells
What is the characteristic feature of the transition from promonocyte to monocyte?
Transition from indented to round/oval nucleus
What distinguishes the macrophage from the other monocyte precursors?
Blue-gray cytoplasm with many vacuoles
What is the main difference between a monoblast and a promonocyte?
Size and N:C ratio
What distinguishes a monocyte from a promonocyte?
Shape and chromatin density of the nucleus
What is the most likely feature of a macrophage compared to a monoblast?
Increased size and N:C ratio
What is the distinguishing feature of a promonocyte compared to a monocyte?
"Brainlike" convolutions in the nucleus
What is the main function of monocytes/macrophages in the immune response?
Initiating and regulating the immune response
Which cells are known as 'scavenger cells' due to their ability to ingest foreign material?
Monocytes/macrophages
What do blood monocytes ingest, limiting the coagulation response?
Activated clotting factors
Which cells are very efficient phagocytic cells with receptors for IgG or complement-coated organisms?
Monocytes/macrophages
Where do splenic macrophages primarily remove old/damaged red blood cells?
Spleen
What do bone marrow macrophages remove and store for hemoglobin synthesis?
Iron
What do monocytes secrete, in addition to cytokines/interleukins and tumor necrosis factor?
Antibodies
What is the primary function of liver macrophages?
Removing fibrin degradation products
Test your knowledge of neutrophil and eosinophil morphology with this quiz. Explore the characteristics of the nucleus, cytoplasm, and granules of these cells, as well as their distribution in the bone marrow and peripheral blood.
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