White Blood Cell Functions and Hematopoiesis
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Questions and Answers

Which of the following diseases can result in neutrophilia?

  • Hairy cell leukemia
  • Tuberculosis (correct)
  • Rheumatoid arthritis (correct)
  • Aplastic anemia
  • What condition is associated with a lack of leukocyte adhesion proteins, leading to increased susceptibility to infections?

  • Leukocyte Adhesion Deficiency (correct)
  • Pelger-Huet Anomaly
  • Chediak-Higashi Syndrome
  • Chronic Granulomatous Disease
  • In which condition do neutrophils retain the ability to phagocytose but are unable to kill microorganisms?

  • Myelodysplastic Syndrome
  • Chronic Granulomatous Disease (correct)
  • Pelger-Huet Anomaly
  • Chediak-Higashi Syndrome
  • Which of the following is NOT a potential cause of monocytopenia?

    <p>Influenza (B)</p> Signup and view all the answers

    What characteristic shape do neutrophils exhibit in Pelger-Huet Anomaly?

    <p>Bilobed (A)</p> Signup and view all the answers

    Which autoimmune disease is commonly associated with neutrophilia?

    <p>Rheumatoid arthritis (B)</p> Signup and view all the answers

    What type of genetic mutation is associated with Chediak-Higashi Syndrome?

    <p>Inherited genetic mutation (A)</p> Signup and view all the answers

    Which of the following is a characteristic of Chronic Granulomatous Disease?

    <p>Absence of respiratory burst (A)</p> Signup and view all the answers

    Basophilia can be associated with which of the following?

    <p>Surgical complications (B)</p> Signup and view all the answers

    Which is a common treatment for conditions causing monocytopenia?

    <p>Myelotoxic drugs (C)</p> Signup and view all the answers

    What is a common cause of absolute lymphocytosis?

    <p>Acute viral infections (B)</p> Signup and view all the answers

    Which condition is NOT associated with relative lymphocytosis?

    <p>Chronic lymphocytic leukemia (A)</p> Signup and view all the answers

    What does the term neutrophilia refer to?

    <p>Increase in the number of neutrophils (C)</p> Signup and view all the answers

    Infectious mononucleosis is primarily caused by which virus?

    <p>Epstein-Barr virus (B)</p> Signup and view all the answers

    Which clinical feature is characteristic of infectious mononucleosis?

    <p>Diagnostic red spots at the junction of soft and hard palate (B)</p> Signup and view all the answers

    What is the normal range of leukocytes in peripheral circulation?

    <p>4000 to 11,000/μL of blood (D)</p> Signup and view all the answers

    What is the blood picture typically seen in infectious mononucleosis?

    <p>Leucocytosis with an absolute increase in lymphocytes (D)</p> Signup and view all the answers

    Which type of white blood cell is primarily affected in neutrophilia?

    <p>Neutrophils (C)</p> Signup and view all the answers

    Which of the following is a cause of relative lymphocytosis?

    <p>Exercise (C)</p> Signup and view all the answers

    What is a common threshold for defining neutrophilia?

    <p>More than 8000 cells/μL (C)</p> Signup and view all the answers

    Which factor is NOT typically related to absolute lymphocytosis?

    <p>Splenic sequestration (A)</p> Signup and view all the answers

    Which of the following conditions could lead to neutrophilia?

    <p>Bacterial infections (D)</p> Signup and view all the answers

    What is the clinical significance of diagnosing neutrophilia?

    <p>Can signal an underlying inflammatory process (A)</p> Signup and view all the answers

    Which of the following statements about infectious mononucleosis is true?

    <p>It can lead to lifelong immunity after infection. (D)</p> Signup and view all the answers

    Monocytosis is often associated with what condition?

    <p>Chronic inflammation (D)</p> Signup and view all the answers

    Neutrophilia can be associated with which of the following types of leukocyte disorders?

    <p>Leukocytosis (B)</p> Signup and view all the answers

    Which of the following is NOT a cause of absolute lymphocytosis?

    <p>Splenomegaly (A)</p> Signup and view all the answers

    In neutrophilia, which of the following could be a potential diagnostic strategy?

    <p>Bone marrow biopsy (D)</p> Signup and view all the answers

    Which type of leukocytosis specifically involves an increase in neutrophils?

    <p>Neutrophilia (A)</p> Signup and view all the answers

    Which of the following is a severe form of neutropenia?

    <p>Agranulocytosis (D)</p> Signup and view all the answers

    What physiological condition can lead to neutrophilia?

    <p>Pregnancy (B)</p> Signup and view all the answers

    Which drug is known to increase neutrophil release from the bone marrow?

    <p>Corticosteroids (C)</p> Signup and view all the answers

    Which condition is a common cause of reactive neutrophilia?

    <p>Acute bacterial infection (A)</p> Signup and view all the answers

    What is a potential cause of neutrophilia associated with metabolic diseases?

    <p>Acute renal failure (A)</p> Signup and view all the answers

    In which type of leukemia could neutrophilia be frequently observed?

    <p>Chronic myeloid leukemia (A)</p> Signup and view all the answers

    What is a common clinical manifestation seen alongside reactive neutrophilia?

    <p>Deviated leukocyte formula (leukemoid reaction) (A)</p> Signup and view all the answers

    Which of these is NOT a characteristic of physiological neutrophilia?

    <p>Persistent over time (B)</p> Signup and view all the answers

    Which immune response is closely linked to the phenomenon of neutrophilia?

    <p>Increased tissue infiltration (D)</p> Signup and view all the answers

    What condition can cause metabolic disturbances leading to neutrophilia?

    <p>Diabetic ketoacidosis (A)</p> Signup and view all the answers

    Which of the following conditions can be exacerbated by neutrophilia?

    <p>Gout (C)</p> Signup and view all the answers

    Flashcards

    Neutropenia Causes

    A condition with low neutrophil counts, caused by accelerated removal, increased destruction, autoimmune issues, or bone marrow problems.

    Acquired Neutropenia

    Neutropenia developed later in life due to various factors like inflammation, infections, drugs, radiation, or autoimmune disorders.

    Felty's Syndrome

    A form of rheumatoid arthritis where the spleen destroys neutrophils.

    Neutrophilia

    High neutrophil count, often in response to infections or stress.

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    Reactive Neutrophilia

    Increased neutrophil release compensating for tissue needs; often linked with a left-shifted leukocyte formula (leukemoid reaction).

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    Eosinophilia Causes

    High eosinophil count, often related to allergic reactions, parasites, infections, or certain malignancies.

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    Neutropenia Congenital Causes

    Neutropenia present at birth; Kostmann's syndrome is a common example.

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    Neutrophilia Physiological Conditions

    Increased neutrophil count due to normal bodily processes such as pregnancy, labor, postpartum, newborns, or exercise.

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    Eosinophilia Diagnosis

    Diagnosis of exclusion; excluding other reasons for eosinophilia.

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    Neutrophilia - Drug/Toxic Causes

    Increased neutrophil counts due to certain drugs, such as corticosteroids or exposure to toxins.

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    Leukocytosis

    Increased number of white blood cells in the blood.

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    Leukopenia

    Decreased number of white blood cells in the blood.

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    WBC Function

    Protection against disease, primarily outside the bloodstream.

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    Phagocytosis

    Process of engulfing and destroying foreign invaders by cells (like neutrophils and monocytes).

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    Margination

    WBCs sticking to the blood vessel walls.

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    Diapedesis

    WBCs leaving the blood vessels to go to the infection site.

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    Normal WBC Range

    4000-11,000 per microliter of blood.

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    Agranulocytosis

    Severe neutropenia with very low neutrophil count.

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    Monocytopenia Causes

    Conditions like infections, stress, certain cancers (like aplastic anemia and leukemia), and treatments with drugs that impact bone marrow cells lead to a low monocyte count.

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    Basophilia Causes

    Basophilia, an elevated basophil count, can arise from various causes, including surgical complications, specific infections, inflammatory disorders, and certain cancers like leukemia.

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    Pelger-Huet Anomaly

    Inherited genetic mutation causing neutrophils to have unusual shapes (bilobed, etc.). Usually a harmless finding.

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    Chediak-Higashi Syndrome

    Genetic condition causing abnormal neutrophils and impaired lysosomal digestion, leading to issues with pigment and bleeding disorders, especially in children.

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    Chronic Granulomatous Disease (CGD)

    An autosomal recessive disorder causing abnormal neutrophil function. Neutrophils can't effectively kill microorganisms due to a lack of a critical process.

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    Leukocyte Adhesion Deficiency (LAD)

    Genetic disorder affecting white blood cell adhesion. This impacts their ability to migrate and fight infection.

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    Qualitative WBC Disorder

    Problems with the function or structure, rather than the number, of white blood cells.

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    White blood cells

    Cells of the immune system which play a critical role in defending the body against pathogens.

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    Infectious causes of abnormal WBC counts

    Certain infections can cause changes in the numbers and/or functioning certain types of white blood cells.

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    Lymphocytosis causes

    Increased lymphocyte count, due to various infections, chronic conditions, or other factors.

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    Acute Viral Infections

    Infections like infectious mononucleosis, hepatitis, and cytomegalovirus, are associated with lymphocytosis.

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    Chronic intracellular bacterial infections

    Examples are tuberculosis or brucellosis, which are linked to increased lymphocyte count.

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    Chronic lymphocytic leukemia

    A cancer in which there are an abundance of abnormal lymphocytes and is a reason for a condition called lymphocytosis.

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    Relative Lymphocytosis

    Increased lymphocyte count, but not necessarily from illness; this can be linked to age or conditions.

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    Infectious Mononucleosis

    An acute viral infection characterized by symptoms like fever, fatigue, and sore throat. A key factor for increased lymphocytes.

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    Epstein-Barr virus

    A virus causing Infectious mononucleosis.

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    Monocytosis

    Increased monocytes(a type of white blood cells) count, often seen during chronic inflammation.

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    Clinical features of IM

    Symptoms such as fever, malaise, fatigue, sore throat, and potentially splenomegaly (enlarged spleen).

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    Study Notes

    Alterations in White Blood Cells

    • White blood cells (WBCs) are crucial for defending against disease, primarily operating outside the bloodstream.
    • WBCs exhibit key functions including margination, rolling, adhesion, transmigration (diapedesis), and chemotaxis.

    Hematopoiesis

    • Hematopoiesis is the process of blood cell formation.
    • The process begins with a pluripotent stem cell, which differentiates into myeloid and lymphoid stem cells.
    • Myeloid stem cells generate granulocytes, megakaryocytes, and erythrocytes.
    • Lymphoid stem cells generate B cells and T cells which mature into plasma cells and various T-cells.
    • Common Fate Unit (CFU) cells are intermediates in the development process

    Functions of WBCs

    • WBCs primarily function to protect against disease.
    • They actively work outside the bloodstream.
    • WBCs participate in key processes like margination, rolling, and adhesion, and transmigration.
    • WBCs use chemotaxis to navigate toward infection sites.
    • Phagocytosis involves recognition, engulfment, killing, and digestion of pathogens by neutrophils and monocytes (active phagocytes)

    Lysosomal Constituents

    • Lysosomes contain enzymes for breaking down foreign particles.
    • Primary lysosomes (azurophilic, non-specific) contain myeloperoxidase, lysozyme (bacteria targeted), and acid hydrolases.
    • Secondary lysosomes (specific) contain lactoferrin, lysozyme (again bacteria), alkaline phosphatase, and collagenase.

    Benign Disorders of White Blood Cells

    • Benign white blood cell disorders can be categorized as either qualitative (morphological or functional changes) or quantitative (changes in number).

    Quantitative Disorders of White Blood Cells

    • Leukocytosis involves an increased number of white blood cells.
    • The normal range of leukocytes in peripheral blood is 4000 to 11,000/μL.
    • Leukopenia describes a reduced number of white blood cells.
    • Specific types of leukopenia include neutropenia (low neutrophils) and lymphopenia (low lymphocytes).
    • Related terms include leukocytosis, neutrophilia, eosinophilia, basophilia, lymphocytosis, monocytosis and their respective decreased counterparts.

    Neutropenia

    • Neutropenia is specifically a reduced neutrophil count (less than 1500 cells/μL).
    • Agranulocytosis denotes severe neutropenia (neutrophil count less than 200 cells/μL).
    • Neutropenia has congenital (e.g., Kostmann's syndrome) and acquired causes (e.g., accelerated removal, increased destruction, drug-induced granulocytopenia, irradiation, autoimmune disorders, splenomegaly).
    • Acquired neutropenia includes various conditions like Felty's syndrome, neoplasms, alcoholism, and nutritional deficiencies (folate, vitamin B12, iron, copper).
    • Aplastic anemia and idiopathic neutropenia are also included.

    Neutrophilia

    • Physiological causes include newborns, pregnancy, labor, postpartum, and post-exercise.
    • Drug-induced neutrophilia can be caused by corticosteroids.
    • Other causes include acute poisoning with heavy metals (Hg) and some venoms.
    • Reactive neutrophilia results from increased neutrophil release from bone marrow to accommodate high tissue affinity, often accompanied by leukocyte formula deviation ("leukemoid reaction").
    • Metabolic and endocrine diseases (diabetic ketoacidosis, acute renal failure, acute gout) and some malignant hematologic diseases (CGL, PV, CMML) are also potential causes

    Eosinophilia

    • Eosinophilia is an increased blood eosinophil count.
    • Potential causes include allergic diseases (asthma, allergic rhinitis, eczema, atopic dermatitis), parasitic infections, fungal and other infections, tuberculosis, and hematologic and non-hematologic malignancies.

    Lymphocytosis

    • Lymphocytosis is an elevated lymphocyte count.
    • Absolute lymphocytosis has causes like acute viral infections (infectious mononucleosis, hepatitis, cytomegalovirus), other acute infections (pertussis), protozoal infections (toxoplasmosis), and chronic intracellular bacterial infections (tuberculosis, brucellosis), and chronic lymphocytic leukemia.
    • Relative lymphocytosis causes include age less than two years, acute viral infections, connective tissue diseases, splenomegaly with splenic sequestration of granulocytes, exercise, and stress.
    • Infectious mononucleosis, caused by Epstein-Barr virus, is characterized by virus infection of epithelial and B cells; saliva from infected persons is the chief mode of transmission. The condition often does not cause illness in children below age 10 and confers lifelong immunity afterward.

    Monocytosis

    • Monocytosis is an elevated level of monocytes.
    • Chronic inflammation, infections (tuberculosis, brucellosis), autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis), malignancies (Hodgkin's disease, certain leukemias), and recovery from neutropenia or acute infections are frequent causes.

    Monocytopenia

    • Monocytopenia is characterized by low monocyte levels.
    • Potential causes include acute infections, stress, aplastic anemia, hairy cell leukemia, acute myeloid leukemia, treatment with myelotoxic drugs, and treatment with glucocorticoids.

    Basophilia

    • Basophilia, an increased basophil count, could result from a surgery complication (e.g., splenectomy), infectious disorders (Influenza, Chickenpox), infected organ sites (abscesses), inflammatory disorders, and neoplastic disorders (acute myeloid leukemia, Hodgkin's disease).
    • Further causes of basophilia include allergic/collagen autoimmune disorders, congenital/developmental disorders, hereditary/familial/genetic disorders (e.g., spherocytosis), vegetative/autonomic/endocrine disorders (e.g., hypothyroidism), a leukemoid reaction, drug reactions, and foreign protein injection.

    Qualitative Disorders of White Blood Cells

    • Qualitative disorders involve changes in the form or function of white blood cells.
    • Pelger-Huet anomaly is an inherited genetic mutation (sometimes acquired) causing abnormal neutrophil shapes (bilobed, peanut, or dumbbell).
    • Chediak-Higashi syndrome (genetic disorder) presents with abnormal large irregular granules, impaired lysosomal digestion of bacteria, and association with pigment disorders and blood disorders.
    • These abnormalities are usually associated with an increased risk of infection.

    Chronic Granulomatous Disease (CGD)

    • In Chronic granulomatous disease (CGD), abnormal neutrophils phagocytose microorganisms but cannot kill them due to a lack of respiratory burst and peroxidase production.

    Leukocyte Adhesion Deficiency (LAD)

    • Leukocyte adhesion deficiency (LAD) is an autosomal recessive disorder impacting leukocyte cell-surface adhesion proteins (integrins), specifically the CD11/CD18 complex.
    • Defective adhesion to endothelial cells, chemotaxis, C3bi-mediated phagocytosis, particle-triggered respiratory burst activation, and degranulation are characteristic of this condition.
    • Common clinical features include frequent bacterial and fungal infections, lack of pus formation, and delayed umbilical cord separation, along with persistent leukocytosis. Diagnosis involves flow cytometry analysis of neutrophil CD11/CD18 levels.

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