White Blood Cell Pathology

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1. 
A patient presents with both acute and chronic infections and a total WBC count at 1,000/µL, with an especially low neutrophil count. Patient currently taking chemotherapeutic medication. What is your diagnosis?
 
Agranulocytosis
treat with antibiotics and adjustment of chemo meds
 
2. 
A patient presents with fever, malaise, and oral ulcerations. A dental exam shows loss of bone around the teeth. At time of visit, lab tests show a WBC count at 3,000/µL, but a week later, it is back to normal. What is your diagnosis?
 
Cyclic Neutropenia
treatment is unknown since cause is unknown
 
3. 
A patient presents with a WBC count higher than 10,000/µL, with an especially high neutrophil count. She has both malaise and fever, and is suffering from an infection caused by pyogenic bacteria. What is your diagnosis?
 
Bacterial Leukocytosis
treat with antibiotics
 
4. 
A patient presents with a WBC count higher than 10,000/µL, with an especially high monocyte and lymphocyte count. He shows signs of an acute viral infection. What is your diagnosis?
 
Virus-associated Leukocytosis
 
5. 
A patient presents with fever, weakness, malaise, and a prominent lymphadenopathy in the cervical and inguinal groups. Laboratory findings show leukocytosis of 15,000 to 20,000/µL lymphocytes and monocytes. At first look, the lymphocytes appear malignant. A rapid lab test shows the presence of the Epstein Barr virus. The patient noted she "probably has whatever her boyfriend has." What is your diagnosis?
 
Infectious Mononucleosis
treat with pain meds, steroids, antiviral meds, and bed rest
 
6. 
A patient presents with fever, malaise, a slight anemia, and a WBC count at 100,000/µL. A lab smear shows circulating malignant lymphocytes. This condition recently developed, and is rapidly progressive. What is your diagnosis?
 
Acute Lymphocytic Leukemia
treat with chemotherapy and radiation - responds well.
 
7. 
A patient presents with fever, malaise, a slight anemia, and a WBC count at 100,000/µL. A lab smear shows malignant granulocytes (neutrophils or monocytes). This condition recently developed, and is rapidly progressive. What is your diagnosis?
 
Acute Mylogenous Leukemia
treat with chemotherapy and radiation - poor response, often fatal.
 
8. 
A patient presents with fever, malaise, a slight anemia, and a WBC count at 100,000/µL. This condition has been progressing over time. A lab smear shows malignant lymphocytes. What is your diagnosis?
 
Chronic Lymphocytic Leukemia
treat with chemotherapy and radiation - responds well.
 
9. 
A patient presents with fever, malaise, a slight anemia, and a WBC count at 100,000/µL. This condition has been progressing over time. A lab smear shows malignant granulocytes (neutrophils or monocytes) and genetic testing reveals the presence of the "Philadelphia Chromosome." What is your diagnosis?
 
Chronic Myelogenous Leukemia
treat with chemotherapy and radiation - poor response, often fatal.
 
10. 
A patient presents with massive lymphadenopathy, present in the cervical, axillary, and inguinal groups. Lymph nodes are firm to palpation. A lab smear shows the presence of multinucleated, "owl eye" cells (Reed Sternberg cells). No malignant cells are found in circulation. What is your diagnosis?
 
Hodgkin Lymphoma
treat with chemotherapy and radiation. measured in stages 1-4, 4 being most severe and worst prognosis.
 
11. 
A patient presents with enlarged axillary and inguinal lymph nodes, low grade fever, and night sweats. She has jad a rubbery, painless lymph node for about a month. A lab smear shows malignant lymphocytes which are not circulating. What is your diagnosis?
 
Non-Hodgkin Lymphoma
treat with chemotherapy and radiation - prognosis usually bad, but better response recently.
 
12. 
A patient presents with multiple rapidly growing oral tumors. Histologically, a sea of lymphocytes in a starry sky pattern are seen in the lymph nodes. Epstein Barr virus is found to be present. What is your diagnosis?
 
Burkitt Lymphoma
treat with chemotherapy and radiation. African BL has a good prognosis, while Non-African does not. (50% 5 yr)
 
13. 
Leukopenia
 
white blood cell count less than 6,000/µL
 
14. 
Leukocytosis
 
white blood cell count above 10,000/µL
 
15. 
A patient presents with oral and skin petechiae and facial redness. Her platelet count is low (less than 200,000/µL), and there is an increased bleeding time because of this. The patient was recently using aspirin and antibiotics. What is your diagnosis?
 
Thrombocytopenia
treat with platelet infusions, splenectomy (if spleen is causing the problem), and steroids
 
16. 
A patient presents with vascular thrombosis and a platelet count above 350,000/µL. What is your diagnosis?
 
Thrombocytosis
platelet count always high, but vascular thrombosis only if above 350,000/µL
 
17. 
A patient presents with a purple-red bruise on the skin. He comes in with complaints that his clotting time is greatly inclreased, but he has a normal bleeding time. What is your diagnosis?
 
Hemophilia
for most common type (Hemophilia A), always replace missing factors (in this case Factor VIII) before surgery.
 
18. 
Neutropenia
 
low neutrophil count
 
19. 
Neutrocytosis
 
high neutrophil count
 
20. 
Monocytopenia
 
low monocyte count
 
21. 
Monocytosis
 
high monocyte count
 
22. 
Lymphocytosis
 
increase in lymphocytes
 
23. 
Lymphocytopenia
 
decrease in lymphocytes
 
24. 
Leukemia
 
malignant proliferation of certain circulating white blood cells.
 
25. 
Malignant Lymphoma
 
malignancy of the lymph node - cells are not circulating.
 
26. 
Total Normal Leukocyte Count
 
6,000 - 10,000/µL
 
27. 
Percentage Breakdown for Neutrophils, Lymphocytes, and Monocytes
 
Neutrophils - 60-70%
Lymphocytes - 30-40%
Monocytes - 5-8%