Deck 18: Nonmalignant Granulocyte and Monocyte Disorders

Question 1

How does immediate neutrophilia differ from acute neutrophilia?

A)Immediate neutrophilia ccurs within 4-5 hours of stimulus while acute neutrophilia occurs within 30 minutes.
B)Immediate neutrophilia lasts 20-30 minutes while acute neutrophilia lasts hours to days.
C)In immediate neutrophilia circulating neutrophils show an increase in early neutrophil precursors while in acute neutrophilia the neutrophils are mature.
D)In immediate neutrophilia the leukocytes return to normal as the bone marrow production increases while in acute neutrophilia the neutrophils are mature.

Answer 1

Immediate neutrophilia lasts 20-30 minutes while acute neutrophilia lasts hours to days.

Question 2

A patient presents with neutrophilia of 50 x 109/L with many circulating immature cells.The blood contains many bands, metamyelocytes, myelocytes, promyelocytes, and a rare blast.There are no nucleated erythrocytes present.What disease state is most likely with these results?

A)Leukoerythroblastosis
B)Hypersensitivity reaction
C)Tissue damage due to burns
D)Neutrophilic leukemoid reaction

Answer 2

Neutrophilic leukemoid reaction

Question 3

What disease state correlates highly with the presence of cytoplasmic vacuoles in freshly drawn blood?

A)Ehrlichia sp.infection
B)Septicemia
C)HIV infection
D)Malaria

Answer 3

Septicemia

Question 4

A peripheral blood smear examination shows many WBCs with many blue-staining round inclusions present.There is thrombocytopenia with giant platelets present.What autosomal dominant disease is associated with these findings?

A)May-Hegglin anomaly
B)Alder-Reilly anomaly
C)Chédiak-Higashi anomaly
D)Megaloblastic anemia

Question 5

A patient has a WBC count of > 50 x 109/L with many circulating leukocyte precursors and a normal RBC count.What can be concluded from these findings?

A)The patient has CML.
B)The patient is having a leukemoid reaction.
C)The patient has reactive chronic neutrophilia.
D)There is not enough information to draw an accurate conclusion.

Question 6

A patient presents with larger-than-normal neutrophils with hypersegmentation, macro- ovalocytes, and pancytopenia.This may be an indicator of:

A)Pelger-Huët anomaly.
B)Myeloproliferative disorder.
C)Megaloblastic anemia.
D)Infection.

Question 7

A patient presents with splenomegaly and bone pain.Laboratory findings reveal large macrophages with small eccentric nuclei, and cytoplasm with a wrinkled appearance.
Further testing shows leukopenia, thrombocytopenia, and anemia.What is the probable
Cause?

A)Niemann-Pick disease
B)Gaucher's disease
C)Tay-Sachs disease
D)Sandhoff's disease

Question 8

Interpret the following results: WBC count 1.4 x 10⁹/L; bone marrow shows myeloid hypoplasia with a decreased M:E ratio of 1:1.There is no history of medications or drug
Exposure.What can be concluded from this?

A)The patient has a pseudoneutropenia.
B)The patient has a neutropenia due to decreased production.
C)The patient has a neutropenia due to increased loss in circulation.
D)The patient has a neutropenia due to toxin exposure.

Question 9

Which of the following characteristics is associated with the neutrophilia that accompanies bacterial infection?

A)A left shift
B)Toxic granulation
C)Döhle bodies
D)All of the above

Question 10

A technologist is scanning a blood smear and notices that many of the neutrophils have more than six lobes.Which of the following would be consistent with that finding?

A)A decreased vitamin B₁₂ level
B)An increased serum iron level
C)A positive DAT result
D)Decreased serum iron

Question 11

What must be done when blood is drawn in EDTA and the neutrophils adhere to erythrocytes?

A)Draw the blood in heparin anticoagulant.
B)Recollect the blood from a finger stick and make manual dilutions.
C)Draw the blood in citrate anticoagulant.
D)Draw the blood in a plain red top tube.

Question 12

In the identification of Pelger-Huët cells, what nuclear characteristic other than the dumbbell shape aids in differentiating these cells from bands?

A)Excessive coarse clumping of chromatin
B)Lack of primary granules
C)Presence of Döhle bodies
D)Toxic granules present

Question 13

Define leukoerythroblastosis, and name a condition in which this is seen.

Question 14

A patient has a high fever, leukopenia, thrombocytopenia, and elevated liver enzymes.A blood smear shows WBCs with large basophilic, spherical cellular inclusions.What could be
The cause?

A)Toxic drugs
B)Ehrlichia sp.infection
C)Severe burns
D)Malaria infection

Question 15

Which of the following disorders is characterized by a defect in sphingomyelinase, which results in macrophages with a foamy appearance?

A)Gaucher's disease
B)Fabry's disease
C)Tay-Sachs disease
D)Niemann-Pick disease

Question 16

A patient's smear shows clumping of neutrophils.The ANC shows a neutropenia. What can be done to obtain a reliable neutrophil count?

A)Draw the patient at a more appropriate time.
B)Delay testing the blood sample until you can rerun it on another instrument.
C)Draw the sample in another type of tube and rerun the sample using warm diluent.
D)Perform a fingerstick and make manual dilutions and blood smears

Question 17

Acute infection, inflammatory reaction, and administration of glucocorticosteroids may result in:

A)Basophilia.
B)Eosinopenia.
C)Mastocytosis.
D)Histiocytosis.

Question 18

A 45-year-old male goes to his physician for a routine checkup.His ANC (absolute neutrophil count) result comes back as 8.5 x 10⁹/L.Which of the following conditions could explain these results?

A) Neutrophilia
B) Intermediate neutrophilia
C) Acute lymphocytosis
D) Neutropenia

Question 19

A 45-year-old female came back from a trip abroad having had nausea and diarrhea, and then later muscle aches, fever, and chills.She is admitted to a local hospital, and is diagnosed
With trichinosis.Which of the following is most consistent with this disease?

A)Eosinophilia
B)Basophilia
C)Basopenia
D)Monocytosis

Question 20

A patient presents with a leukocyte count of 120 x 10⁹/L and splenomegaly.The blood smear reveals a shift to the left with promyelocytes and blasts.The platelets are increased, and the LAP is decreased.Which condition is associated with these results?

A)Bacterial infection
B)Reactive chronic neutrophilia
C)Leukemoid reaction
D)CML

Question 21

Name a type of condition which might cause the following alterations in morphology.

A)Toxic granulation
B)Vacuolization
C)Morulae
D)Eosinophilia

Question 22

List three laboratory results that can distinguish a leukemoid reaction from CML.

Question 23

What causes sea-blue histiocytosis, and how is the sea-blue histiocyte identified?