Lymphocyte Concentration/Morphology

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What is the lymphatic system composed of? 3 things: Primary/secondary lymphoid TISSUES

lymph NODES

lymphatic VESSELS parallel circ system
what is lymph? how does it circulate?: yellow fluid derived from tissue fluid.

via lymph vessels, through nodes to recieve macrophages/lymphocytes/Iglblns

- the trash flow
What are the primary lymphoid organs? (2 adult we normally think of, 1 fetal): bone marrow and thymus

fetal = liver
what are the secondary lymph organs? 3: nodes, spleen, MALT.
What differentiates lymphocytes?: CD markers - cluster designation
3 types of lymph cells: T
B
NK
what percent of lymphs are B cells? how long do they live? what is their function?: 15% to 35%;

short lived;

function to produce antibody
what is an end-stage B cell?: a PLASMA CELL with capability of remembering antigens and making antibody later.
what percent of circ lymphs are T cells? whats their function? what are the 2 subsets: 65-85%

regulators and effectors of immunity

Thelpers
Tsuppressors
what is it called when red cells form around a lymph?: Spontaneous sheep erythrocyte rosetting
what are the 2 ways NK cells kill?: 1. ADCC - antibody dependent cell-mediated cytotoxicity

2. Instructional model - cells w/out CD4 lack the inhibitory signal, so NK cells are directed to kill them.
What is lymphocytosis?: increase
When is lymphocytosis seen? (7 diseases): Viral infection
Bordatella pertussis
EBV - mono
Cytomegalovirus
TB
Toxoplasma gondii
Malignancies
7 diseases lymphocytopenia is seen:: -Aplastic anemia
Immunodeficiency
TB
Radiation therapy
Chemotherapy/immunotherapy
Glucocorticoid release
Platelet apheresis
Based on granules, how do you know a lymph is not a monocyte?: If you can count the granules, it's not a monocyte.
contrast chromatin in large lymphs and reactive:: large = fine, homogenous
reactive: clumps, diffused throughout the nucleus instead of clumped at periphery.
In what cells do you see a perinuclear halo? What is it?: Plasma cells - endstage B cells.

The Golgi apparatus for making antibody
what is the cyanmethemoglobin reaction?: 1. Ferricyanide oxidizes Hgb to Methemoglobin in alkaline med.
2. Methgb +Cyanide = Cynmethgb
Cyanmethgb absorbs at 540 nm
what are 4 potential sources of a falsely elevated Hgb?: -Gross lipemia
-Leukocytosis
-Sickle-resistant red cells
-Macroglobulinemia
How do you correct a lipemic hgb measurement that is falsely elevated?: -Spin blood; dilute plasma in 5 ml cyanmethgb.
Amount to use = (1-Hct)x20uL
Measure OD and subtract from original Hgb msmnt.
How do you correct a leukemic Hgb msmnt?: Do a normal hgb; then spin the cyanmethgb and read OD of supernat = correct HgB conc.
When would you dilute a spcimen for Hgb in half with water?: incomplete lysis due to:
-Sickle cell anemia
-Thalassemia
-Bilirubin
For hgb msmnts greater than 18g/dl, what should be done?: Dilute the sample further,then multiply the result by the dilution factor.
What are 4 potential sources of hematocrit error?: -Poorly mixed blood
-Partially clotted blood
-Inadequetely sealed tube
-Inadequete speed/force/duration of spin
Why would a Hct be falsely decreased?: If the sample was spun too hard.
What is the principle of the erythrocyte sedimentation rate?: Big, formed elements settle faster because they are more dense. These are increasd in infection, and cause RBCs to form rouleaux and settle faster.
Why do you do an ESR?: to evaluate the extent of infection, inflammation, hyperviscous syndrome, and degenerative states.
What is carboxyhemoglobin? Methgb? Sulfhgb? What is the result of each?: Carboxy = hgb + CO; no O2 transfer.
Meth = ferric iron; doesn't carry O2 well.
Sulf = hgb + sulfur
What color results from Carboxyhgb methgb sulfhgb: Carboxy = bright cherry red
Meth = brown
Sulf = lavender.
what are the limitations on specimen usage in the ESR?: must use blood 2 hrs after draw
or refrig up to 12 hrs
-must be room temp
how long does the ESR go?: 1 hr; can be read +/- five min
What are 6 uses for a particle manual count?: -spinal fluid
-synovial fluid
-pleural fluid
-peritoneal fluid
-total eosin
-problem platelets
what is used to dilute RBCs for a manual particle count?: Hayam's gower normal saline
what is used to dilute WBC for a manual particle count?: Acetic acid
Turk's HCL
what do the diluents for WBC do?: lyse RBCs.
what are the precision limitations of the particle count?: chambers must agree w/in 10%
squares must agree w/in 8 cells
Count must be within 1000cells/ul of the predetermined count.
An overly blue peripheral smear indicates what? Overly red?: Blue = too much alkaline buffer.
Red = too acidic of buffer.
What does methylene blue stian? what does eosin stain?: methylene blue stains acidic components; nucleic acid, basophilic granules.
eosin stains basic components; major basic protein, azurophilic granules.
what 4 reasons would make you repeat a diff?: -noting abnormal cells
-nRBCs present
-immature cells
-Agranulocytosis
which cell in RBC maturation is the first production of Hgb seen in?: the first one; rubriblast.
which cell is the last one capable of division?: third - rubricyte/polychromatophilic normoblast
which cell is the last one w/ a nucleus? what is the cell often called?: metarubricyte/orthochromic normoblast;

aka, nRBC.
what cell is a retic? what charactizes it?: diffusely basophilic erythrocyte/polychromatic erythrocyte; no nucleus, so just dots of RNA that condense with new methylene blue
what is the function of a retic?: -to mature in the bmarrow.
-to synthesize 45% of Hgb
What is the chemical makeup of a retic?: -Mitochondria
-Protein machinery
-No nucleus
What does an RPI of greater than three in an anemic individual indicate?: hemolytic anemia
what does an RPI of greater than 2 but less than 3 in an anemic individual indicate?: the bone marrow is responding to treatment

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