White Blood Cell Count

All of the WBC's arise from the same?

"pluripotent" stem cell within bone marrow as RBC

Differential count

% of each type of leukocyte An increase % of one type of leukocyte = a decrease in another type of leukocyte

What is a "shift to the left" in WBC production? What is it indicative of?

-when neutrophil production is significantly stimulated, early immature neutrophils (called band or stab cells) often enter the circulation -an ongoing acute bacterial infection

What are the precautions for immunocompromised patients?

1. Observe protective isolation. 2. Avoid bacteremia from patient's own bacterial flora (rectal, floss, teeth, encourage oral ans skin hygiene) 3.Avoid bacterial confirmation from foods (newly opened packages, avoid fresh fruits and veggies and chees with active mold growth) 4.Avoid infection by administration of intramuscular injections. 5. Administer antibiotics within 1hr of being ordered 6. Observe closely for infections or fever.

For patients receiving chemotherapy, how would a decrease in WBC count affect further treatment?

Contraindicates further further chemo

What are the age related concerns for the elderly?

Fail to respond to infection by absence of leukocytosis. may not develop an increased WBC even in the presenec of a severe bacterial infection

Used to evaluate patients with what conditoins?

Infections Neoplasm Allergy Immunosuppresants

What happens to the number of eosinophils as the allergic reaction diminshes?

Levels decrease

What is the order of frequency for leukocytes?

Neutrophils<lymphocytes< monocytes<eosinophils<basophils

What is the functino of neutrophils?

Phagocytosis:killing and digestion of bacterial microorganisms

How does an RBC arise from the pluripotent stem cell?

Stem cell--> erthyroblast-->normoblast-->reticulocyte-->RBC

Leukemoid rx

WBC count may be extremely high Reach levels associated w/leukemia QUickly resolved once the infection is treated ex:sepsis

Absolute neutrophil count determination

WBC x (% neutrophils + % bands)

What stimulates neutrophil production?

acute bacterial infections and trauma

What advantage does monocytes have over neutrophils?

can be produced more rapildy spend a longer time in circulation

Decreased total WBC count occurs in?

cases of bone marrow failure leukopenia <4000

absoulte count

differential count x total wbc countt

IF: what can increase WBC count?

eating physical acticity stress final month of pregnancy and labor

What is the function of lymphocytes?

fight chronic bacterial infection and acute viral infection

What is the major function of WBC's?

fight infection and react against foreign bodies or tissues

A reduction in WBC (particularly neutrophils) indicates?

from elevated range-->normal range = resolution of an infection

What copmounds does the cytoplasm of basophils contain

heparin histamine serotonin -infiltrates the tissue involved in allergic rx and further the inflammatory rx

when is wbc count highest? lowest?

highest: late afternoon lowest: morning

An increased total WBC count may indicate

infection inflammation tissue necrosis leukemic neoplasia

Basophils (mast cells) and eosinophils respond to what condition?

involved in allergic rxs do not respond to bacterial or viral infections

What conditions can cause increased total WBC count?

leukocytosis >10000 trauma, stress

What are nongranulocytes?

lymphocytes and monocytes

A dramatic decrease in WBC count from normal range indicates?

marrow failure high risk of septicemia and death

B cells

mature in blood marrow humoral immunity (antibody production)

T cells

mature in thymus cellular type immune rxs killer, supressor, T4 helper ells

Granulocytes

neutrophils, basophils, eosinophils

Characteristics of nongranulocytes

no cytoplasmic granules mononuclear cell small, single rounded nuclei

What else can stimulate production of basophils and eosinophils?

parasitic infestation

What does ANC determine

patient's real risk for infection

IF:splenectomy

persistent mild --> moderate elevation of WBC count

Monocytes

phagocytic cells capable of fighting bacteria (similar to neutrophils)

function of monocytes

phagovytosis: remove necrotic debris and microorganisms from the blood produces interferon: body's endogenous immunostimulant

Fucntion of basophils and eosinophils

phagoxytosis of antigen-antibody complexes

ANC below 1000 means?

pt must be placed in protective isolation, ze are severely compromised, have a great risk for infection

How do monocytes arise from the pluripotent stem cell?

stem blast monoblast monocytes

How do lymphocytes arise from the pluripotent stem cell?

stem cell lymphoblast lymphocyte

How do platelets arise from pluripotent stem cell?

stem cell megakaryoblast megakaryocyte platelet

How do basophils and eosinophil arise from the pluripotent stem cell?

stem cell myeloblast baso/eosinophilic metamyelocyte basophil/eosinophil

How does a neutrophil arise from the pluripotent stem cell?

stem cell myeloblast neutophilic metamyelocyte band/stab cells neurtophil

What are the age related concerns for normal newborns and infants?

tend to have HIGHER WBC values than adults

Neutrophils are:

the most common granulocute produced in 7-14 days exist in ciruculation for 6 hrs

Total WBC count

total # of leukocytes

A persistent increase in WBC (particularly neutrophils) indicates?

worsening of infectious process (ex: appendicitis)