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Hematology Internship Section 2
Part B: WBC Disorders
47
Biology
Undergraduate 4
10/05/2015

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Term
A patient has a WBC of 7.0 x 10^3 / microliter. The manual differential has 60% neutrophils. Which of the following is correct for the number of neutrophils.
A. Relative - neutrophilia, Absolute - Normal
B. Relative - neutropenia, Absolute - Normal
C. Relative - Normal, Absolute - Neutrophilia
D. Relative - Normal, Absolute - Normal
Definition
D. Relative - Normal, Absolute - Normal
Term
How can Pelger-Huet be distinguished from a left shift?
Definition
Pelger-Huet shows no toxic changes, granulation, Dohle bodies, or vaculation. WBC would not be elevated.
Term
At what cell stage can eosinophil be differentiated?
Definition
Myelocyte
Term
Match the following stain results with the corresponding condition:
M1
[image]
Definition
C. Peroxidase +, S. E. +, N. E. =, PAS =
Term
Match the following stain results with the corresponding condition:
M4
[image]
Definition
D. Peroxidase +, S. E. +, N. E. +, PAS =
Term
Match the following stain results with the corresponding condition:
M5
[image]
Definition
A. Peroxidase =, S. E. =, N. E. +, PAS =
Term
Match the following stain results with the corresponding condition:
ALL
[image]
Definition
B. Peroxidase =, S. E. =, N. E. =, PAS +
Term
Match the following stain results with the corresponding condition:
CML
[image]
Definition
E. LAP of 5
Term
Match the following myeloproliferative conditions with the correct description:

Platelet count over 1,000,000 / microliter with large and bizarre forms
Definition
Thombocythemia
Term
Match the following myeloproliferative conditions with the correct description:

Leukoerythroblastosis and tear drops; + silver or reticulin stain
Definition
Myelofibrosis
Term
Match the following myeloproliferative conditions with the correct description:

+Philadelphia chromosome; Left Shift and Increased Eos and Basos
Definition
CML
Term
Match the following myeloproliferative conditions with the correct description:

All cell lines Increased & Increased RBC Mass
Definition
Polycythemia Vera
Term
Describe a mott cell.
Definition
Plasma cell with large vacuoles comprised of immunoglobulins.
Term
When are mott cells seen?
Definition
Seen in Multiple Myeloma cases
Term
How can Polycythemia vera be distinguished from secondary polycythemia (erythrocytosis) using lab tests?
Definition
Secondary seen in COPH or lung problems; has Increased Erythropoietin and Decreased O2 Saturation; Normal RBC Mass;
Other cells lines are NOT affected
Term
Match the following lymphoproliferatives with their descriptions:

Increased WBC; Increased Relative & Absolute Lymphs; Smudge Cells
Definition
CLL
Term
Match the following lymphoproliferatives with their descriptions:

Cutaneous T cell disorder with large, convoluted, folded PAS + Cells
Definition
Sezary cell Lymphoma
Term
Match the following lymphoproliferatives with their descriptions:

Cells with projections that are TRAP +
Definition
Hairy Cell Leukemia
Term
Match the following lymphoproliferatives with their descriptions:

Reed Sternberg cells in the bone marrow and or lymph nodes
Definition
Hodgkin's Lymphoma
Term
Match the following lymphoproliferatives with their descriptions:

Abnormal or immature lymphs in blood/BM and lymph nodes - NO Reed Sternberg cells
Definition
Non-Hodgkin's Lymphoma
Term
Match the following WBC Disorders with their descriptions:

Bi-lobed clumped cells with NO toxic changes; Patient NOT sick
Definition
Pelger-Huet
Term
Match the following WBC Disorders with their descriptions:

WBC Normal or Low; Occasional reactive lymph; Cultures negative
Definition
Viral Infection
Term
Match the following WBC Disorders with their descriptions:

WBC High Normal; 80% lymphs, many reactive; Young Adult
Definition
Infectious Mono
Term
Match the following WBC Disorders with their descriptions:

Increased IgM; Plasmacytoid lymphs and hyperviscosity syndrome
Definition
Waldenstrom's Macroglobulinemia
Term
Match the following WBC Disorders with their descriptions:

Increased WBC; Left shift; Dohle bodies, vacuoles, and toxic granulation
Definition
Bacterial Infection
Term
Match the following WBC Disorders with their descriptions:

Toxic changes of WBCs with ingested ovoid organisms in the segs
Definition
Fungal Infection
Term
Which of the following would NOT be an appropriate use of a buffy coat peripheral smear?
A. Extremely low WBC count
B. Looking for parasites
C. Looking for sickle cells
D. Performing cytochemical stains from a "dry tap" marrow patient
Definition
C. Looking for sickle cells
Term
A differential on 3 year-old has 63% lymphs. What is the correct interpretation?
Definition
Report results - this is normal
Term
What is the absolute lymphocyte count of the following:
WBC 11,000 / microliter
61% Segs
30% Lymphs
6% Monos
2% Eos
1% Baso
Definition
3,300 / microliter
Term
For infection mononucleosis, what is the WBC range?
Definition
11-20 x 10^3 / microliter
Term
For infection mononucleosis, what is the relative and absolute counts for both neutrophils and lymphocytes
Definition
Relative neutropenia with relative & absolute lymphocytosis
Term
For infection mononucleosis, what is the definitive test for diagnosis?
Definition
EBV or IgM & IgG ABYs
Term
A woman who just had a baby has a WBC count of 15,300 / microliter. What is the correct interpretation?
Definition
Report results - this is normal
Term
A newborn has a WBC count of 12,000 / microliter, with 12 NRBCs. What is the corrected WBC count?
Definition
10,700 / microliter
Term
A newborn has a WBC count of 12,000 / microliter, with 12 NRBCs. Are these results normal or abnormal for this patient?
Definition
Normal for a newborn
Term
The patient has a high WBC count and a SEVERE Left Shift.

What is the best test to distinguish bacterial infection from CML?
Definition
LAP
Term
The patient has a high WBC count and a SEVERE Left Shift.

What would be the expected LAP results for a bacterial infection?
Definition
INCREASED LAP
Term
The patient has a high WBC count and a SEVERE Left Shift.

What would be the expected LAP results for a CML?
Definition
DECREASED LAP
Term
The patient has a high WBC count and a SEVERE Left Shift.

Which myeloproliferative disorder has an ELEVATED LAP?
Definition
Polycythemia Vera
Term
Which leukemia is most likely in young children?
Definition
ALL
Term
A 19-year-old with a fever and sore throat has 70% lymphs; most are reactive. The next test should be _____.
Definition
Mono-Spot
Term
Which of the following typically presents with pancytopenia, slightly INCREASED MCV, and monocytosis?
A. Myelodysplasia
B. AML
C. CLL
D. Myelofibrosis
Definition
A. Myelodysplasia
Term
A differential was performed on a 37 year-old male in for treatment of an allergic reaction. Which cell line would be expected to be increased?
Definition
Eosinophils
Term
A 20 year-old entered the hospital with a history of severe bruises and shortness of breath. Lab results include:
INCREASED WBC
DECREASED Plt
40% Blasts with Auer Rods
What is the most likely condition?
Definition
AML
Term
An inherited, benign WBC Disorder in which the neutrophils have 2 lobes (dumbbells, eyeglasses) is:
Definition
Pelger-Huet
Term
The WBC count is 13,000 / microliter and on the differential 70 neutrophils are counted. What is the absolute count?
Definition
9,100 / microliter
Term
Which of the following are MOST typically associated with Multiple Myeloma (MM)?
A. Increased Ca, Decreased Plasma cells in bone marrow, Rouleaux
B. Increased Ca, Increased IgM, Increase Lymph in BM
C. Increased Ca, Decreased IgM, Decreased Lymphs in BM,
D. Increased Ca, Rouleaux, Increased IgG, Plasma cells in BM
Definition
D. Increased Ca, Rouleaux, Increased IgG, Plasma cells in BM
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