1What are the 2 kinds of leukocytes
Myeloid (granulocytes)
Mononuclear
2What cells are considered granulocytes?
neutrophils
eosinophils
basophils
3What cells are considered mononuclear cells?
monocytes
lymphocytes
4What are the subdivisions of common myeloid progenitor?
granulocyte-monocyte progenitor
eosinophil basophil progenitor
megakaryocyte-erythrocyte progenitor
Mast Cells
5What results from granulocyte-monocyte progenitor?
neutrophil
monocyte → mq
6What results from eosinophil basophil progenitor?
eosinophil
basophil
7What results from megakaryocyte erythrocyte progenitor?
RBCs
megakaryocytes → platelets
8What are the subdivisions of common lymphoid progenitor?
dendritic cell
Pre-B
Pre-T
NK
9What is the progression from Pre B to plasma?
Pre-B > B lymphoblast > B cell > Plasma
10What is the progression from Pre T to T cell?
Pre-T > T lymphoblast > T cell
11What is the progression of myelopoiesis?
hematopoietic stem cell > CMP > GMP > Myeloblast > Promyelocyte > myelocyte > metamyelocyte > band > neutrophil
12What cytokines progress CMP to GMP?
IL-3
GM-CSF
13What cytokines progress GMP to myeloblast?
Il-3
GM-CSF
G-CSF
14What stages are part of the proliferation (mitotic) pool?
CMP, GMP, myeloblast,
promyelocyte, myelocyte
15What stages are in the maturation (storage) pool?
metamyelocyte,
band, neutrophil
16What are the most common pluripotent stem cell markers?
C34
17What stem cells are involved in myelopoiesis?
pluripotent stem cell
myeloid stem cell
colony-forming unit granulocyte-erythroid-mq-megakaryocyte (CFU-GEMM)
18What kind of pools are seen in myeloid lineage?
BM pool
circulating pool
margination pool
tissue pool
19What are the two branches of bone marrow stem cells?
myelocytic cells
lymphocytic cells
20What features should be checked for myeloid maturation?
nuclear features
cytoplasmic features
N:C
size
21What nuclear features change during myeloid maturation?
chromatin condensation
nucleoli
shape
22What cytoplasmic features change during myeloid maturation?
granulation
color
23In general, what features are common in immature cells?
less cytoplasm
large nucleus
N:C high
cell size: large
24What is the first maturation stage to be identifiable?
myeloblast
25What cell markers are present in myeloblast?
CD34, Tdt, CD117, HLA-DR
26What are the cell features of myeloblast?
Size: Large
Chromatin diffused
Nucleoli present, round nucleus
Basophilic, agranular cytoplasm
N:C large
27What are the features of promyelocyte?
Primary granules present
basophilic cytoplasm
Round nucleus
28What are the features of myelocyte?
Cytoplasm increasing, has pink region (secondary granules)
Nucleus round
N:C decreasing
29What are the features of metamyelocyte?
Nucleus kidney shaped/horshoe
Cytoplasm: pink expanding
Bulky nucleus
No proliferation!!!
30What are the features of band?
More horshoe than previous
Pinkish cytoplasm
31What are the features of segmented polymorphonuclear neutrophils (PMN)?
segmentation of nucleus into 3-4
chromatin dense
no longer dividing
granular
32Describe eosinophil appearance
large orange granules with 2 segment nucleus
33What is the main content of eosinophil granules?
major basic protein (MBP) released to kill foreign invaders
34How much eosinophils are normally present in peripheral blood?
1-2%
35What is the main content of basophil granules?
proteins: histamine (Allergic rxns)
cytokines: inflam rxns
36What is the progenitor cell of monoblasts?
CFU-GEMM
37What is the stimulating factor for monoblast?
M-CSF
38What are the cell markers for monoblasts?
CD34+
CD117+
39What are the nuclear features of promonocyte?
convoluted nucleus (folded looking)
prominent nucleolus
40What are the cytoplasmic features of promonocyte?
clear basophilic
41What are the granular contents in promonocyte?
none
42What are the nuclear features of monocyte?
chromatin open
irregular shape, distorted
43What are the cytoplasmic features of monocyte?
abundant
44Where are monocytes found?
in peripheral blood for 3-5 days, then enter tissue becoming mq
45Where are mq found?
in tissues
46What is the function of macrophages?
RES/ MMS: get rid of old RBC
bilirubin metab
immune sys → ag presenting cell
47What are the 2 categories of macrophages?
free (dynamic fxn)
fixed (ex. Kupffer cells)
48Where is the site of development of lymphopoiesis?
BM → B cell
thymus → T cell
then move to secondary organs
49What are the stages of maturation for lymphopoiesis?
lymphoblast
prolymphocyte
lymphocyte
50What are the percent of total leukocytes for <1 yr old?
up to 60%
51What are the percent of total leukocytes for 1-4 years old?
decrease to 50%
52What are the 3 kinds of lymphocytes?
B lymphocytes (20%)
T lymphocytes (85%)
NK
53What are the subtypes of T lymphocytes?
CD4+ helper
CD8+ cytotoxic
54What happens to CD4:CD8 ratio in HIV patients?
decreases (more CD8)
55What are the main features of lymphocytes during lymphopoiesis?
halo around nucleus
deeply basophilic nucleus
56What kind of cells are lymphocytes?
memory cells
plasma cells
57What kind of morphology is seen in infectious mononucleosis?
increase reactive lymphs
broad cytoplasm
LGL granules in cytoplasm
hugging RBCs (deform around RBC)
nucleoli present, chromatin loose
increased transaminase
58What are the different kind of abnormalities of leukocyte disorders?
nuclear abnormalities
cytoplasmic abnormalities
functional leukocyte abnormalities
59What type of alterations do reactive or stress-related leukocyte disorders cause?
quantitative alteration
qualitative alterations (morphology)
60What causes Pelger-Huet anomaly?
dominantly inherited defect of terminal neutrophil differentiation due to mutations in lamin B receptor gene
61What is hereditary hypersegmentation?
hypersegmented neutrophils in patients with benign hereditary hypersegmentation (NOT from MA)
Problem: DNA replication
62What are the 2 kinds of monocyte/ mq lipid storage diseases?
Gaucher disease
Niemen-Pick disease
63What causes monocyte/ mq lipid storage diseases?
deficiency in enzyme responsible for break down of polysaccharides
64What kind of cell does Gaucher and Niemann-Pick disease affect?
macrophages
65What enzyme is responsible for Gaucher disease?
Beta-glucocerebrosidase
66What enzyme is responsible for Niemann-Pick disease?
acid sphingomyelinase
67What is the appearance of Niemann-Pick cell?
foamy due to accumulated of lipid metabolism
68What is the appearance of Gaucher cell?
fibrillar structure due to abnormally functioning mq
69What are the 3 kinds of cytoplasmic/ morphologic alterations of granulocytes?
1. Alder-Reilly anomaly
2. Chediak-Higashi syndrome
3. May-Hegglin anomaly
70What causes Alder-Reilly anomaly?
rare autosomal recessive disorder in which basic defect involves protein-carb complexes called mucopolysaccharides
71What happens in Alder-Reilly?
accumulation of degraded mucopolysaccharides within the lysosomes account for large purple staining inclusions seen on ALL WBCs
72What is typically seen in Chediak-Higashi syndrome?
giant lysosomal granules in granulocytes, monocytes, and lymphocytes
73What causes Chediak Higashi syndrome?
leukocyte dysfunction
granules fuse with each other and make huge granules making them less effective to kill pathogens;
high risk of infections
74What are the symptoms of Chediak Higashi?
Bleeding (abnormal dense granules in plt)
death before 10 yo
75What is the problems with neutrophils in Chediak Higashi?
Neutrophils are deficient in chemotactic and bactericidal activities
76What is May-Hegglin anomaly?
rare inherited blood platelet disorder
characterized by abnormally large and misshapen platelets (giant platelets)
and inclusions in neutrophils known as Dohle-like bodies
77What does toxic granulation affect?
neutrophils (only)
see: neutrophilia and increase WBC
78When does toxic granulation happen?
in bacterial infections (usually during active infection)
79Where are Dohle bodies typically found?
in granulocytes
cytoplasm
80What are stimulating factors for non-malignant morpho alterations of lymphocytes?
reactive lymphocytes
viral infections the stim dev of reactive lymphs
Ex. Infectious mononucleosis
81What virus causes infectious mononucleosis?
EBV
82What are the general features of non-malignant morph alterations of lymphocytes?
abundant cytoplasm
vacuoles
nucleoli
open chromatin