Hematology MediaLab

What is the most common early abnormality observed in the lymph nodes of AIDS patients? Reactive lymphadenopathy Mantel cell lymphoma Classic type Hodgkin lymphoma B lymphoblastic leukemia with t(9;22) translocation

"Lymphadenopathy syndrome" has been used to describe the first symptomatic stage of HIV progression, preceding a diagnosis of AIDS. Generalized lymphadenopathy is an early sign of infection with human immunodeficiency virus (HIV). Follicular hyperplasia is the most common form of reactive lymphadenopathies occurring in infections such as HIV infection. Mantle cell lymphoma is a type of lymphoma, and is not associated with HIV infection. Classic Hodgkin lymphoma is a type of lymphoma where Reed-Sternberg cells are seen, but it is not associated with HIV infection. B lymphoblastic leukemia with t(9;22) translocation is a Philadelphia positive ALL, and not associated with HIV infection.

Which of the following is characteristic of Alder-Reilly anomaly? Giant, dysfunctional lysosomal cytoplasmic granules Döhle body-like inclusions composed of precipitated myosin heavy chains Large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides Decreased nuclear segmentation and coarse chromatin in leukocytes

Alder-Reilly anomaly is characterized by large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides. These granules resemble toxic granulation in neutrophils, but findings commonly associated with toxic granulation, such as Döhle bodies, neutrophilia, and a left shift, are absent in Alder-Reilly anomaly. The granules of Alder-Reilly anomaly may also be found in lymphocytes and monocytes; toxic granulation is exclusive to neutrophils. Leukocyte function is normal in Alder-Reilly anomaly. Giant, dysfunctional lysosomal cytoplasmic granules are seen in Chédiak-Higashi syndrome. These granules are seen in granulocytes, monocytes, and lymphocytes. Leukocyte dysfunction leads to recurrent pyogenic infection and early death. Döhle body-like inclusions composed of precipitated myosin heavy chains are seen in May-Hegglin anomaly, along with variable thrombocytopenia and giant platelets. These inclusions are seen in granulocytes and monocytes. Decreased nuclear segmentation and coarse chromatin in leukocytes is seen in Pelger-Huët anomaly (PHA). Morphologic changes are most obvious in mature neutrophils.

A 1:20 dilution is made for a manual WBC count. The four corner squares on both sides of a hemocytometer are counted. A TOTAL of 100 cells are counted (eight total squares). What is the white blood cell count in terms of a liter?

First, determine the number of WBC's from the hemocytometer as follows: WBC count = (dilution ratio x # of cells counted x 10) / (# mm2 area counted) Then: WBC count = (20 x 100 x 10) / (8) = 2500 WBC/mm3 (or 2500 WBC/µL or 2.5 x 103 WBC/µL) To find the WBC count per liter, multiply the WBC count/µL by the number of µL/L (there are 106 µL/L) So: (2.5 x 103 WBC/µL) x (106 µL/L) = 2.5 x 109 WBC/L

Treatment of "sequestration crisis," often seen in infants and young children with sickle cell disease, involves which of the following? Exchange transfusions, and/or splenectomy. Bone marrow transplantation. Antibiotic treatment, for example with penicillin. Treatment with hydroxyurea (hydroxy carbamide).

Treatment of sequestration crisis may include chronic transfusion, exchange transfusion, and/or splenectomy, depending on the patient's age and the severity of the sequestration (as determined by the hemoglobin level and degree of drop in hemoglobin). Sequestration crisis occurs in sickle cell disorders when large numbers of RBCs are suddenly pooled in the spleen and liver. These organs can enlarge rapidly causing pain, hypoxemia, and hypovolemic shock. Bone marrow transplant is successful to treat sickle cell disease for some individuals, but it is not used to treat sequestration crisis. Antibiotics are used to treat infections. Hydroxyurea relieves the disorder by increasing the proportion of Hb F.