1. 1 PROTG EDUCATION CENTER, LLC Giving the Gift of Education www.ProtegeEducation.com Career Development Program High school graduates & College students SAT PSAT NJ ASK Grades 3 to 12 Science Math (Biology, Chemistry & Physics) College Biology, Biochemistry, Microbiology, Immunology, Chemistry & Physics Biology Research Lab Assistant Certificate of Completion Medical Laboratory Scientist ASCP exam Preparation Presentation, Public Speaking & Leadership Skills Certificate of Completion Tutoring & Test Preparation 732-432-4900 Computer Science Certificate of Completion

2. Medical Laboratory Scientist Hematology Part 2 of 4 White Blood Cells Brief overview 2Protg Education Center, LLC All rights reserved www.ProtegeEducation.com Presented by Nithianandan Selliah, PhD Scientist Founder and CEO of Protg Education Center, LLC 3. Protg Education Center, LLC All rights reserved www.ProtegeEducation.com Blood Smear Stain 3 Smear from Wrights stain A & D : Neutrophilic B & E : Eosinophilic C : basophilic F : Plasma cell (not in blood) G & H : small lymphocytes I : medium lymphocytes J, K & L : monocytes Source: Basophils, Eosinophils, Lymphocytes (T cells and B cells), Monocytes, Neutrophils A B C D E F G H I J K L 4. Protg Education Center, LLC All rights reserved www.ProtegeEducation.com White Blood Cells (WBC) Count Five major types of white blood cells: Basophils, Eosinophils, Lymphocytes (T cells and B cells), Monocytes, Neutrophils Normal Results The normal number of WBCs in the blood is 4,500-10,000 white blood cells per microliter (mcL). Abnormal Results: Low count A low number of WBCs is called leukopenia. It may be due to: Bone marrow deficiency or failure (infection, tumor, or abnormal scarring) Cancer treating drugs, or other medicines Certain autoimmune disorders such as lupus Disease of the liver or spleen Radiation treatment for cancer Certain viral illnesses, such as Mono Cancers that damage the bone marrow Very severe bacterial infections HIV infection (low CD4 T-cell count) 4 5. Protg Education Center, LLC All rights reserved www.ProtegeEducation.com White Blood Cells (WBC) Count It may be due to: Anemia Certain drugs or medications (see list below Cigarette smoking Infections, most often those caused by bacteria Inflammatory disease (such as rheumatoid arthritis or allergy) Leukemia Severe mental or physical stress Tissue damage (for example, burns) There may also be other less common reasons for this result. . Drugs that may lower your WBC count include: Antibiotics Anticonvulsants Anti thyroid drugs Arsenicals Captopril 5 Chemotherapy drugs Chlorpromazine Clozapine Diuretics Histamine-2 blockers Sulfonamides Quinidine Terbinafine Ticlopidine Drugs that may increase WBC counts include: Beta adrenergic agonists (for example albuterol) Corticosteroids Epinephrine Granulocyte colony stimulating factor Heparin Lithium Abnormal Results: High count A high number of WBCs is called leukocytosis. 6. Protg Education Center, LLC All rights reserved www.ProtegeEducation.com WBC Cytochemical Stains Leukocyte alkaline phosphate (lap) : neutrophils, (alkaline phosphatase) Myeloperoxidase stain (mps) : primary granules of myeloid cells (peroxidase). Periodic acid schiff reaction (pas): stains high molecular weight carbohydrates normally present in most blood cell types except pronormoblasts. Sudan black (sbb): stains phospholipids and lipoproteins present in granules of monocytes and granulocytes. Acid phosphate : stains acid phosphatase present in the lysosomes of all hematopoietic. Acid phosphate with tartrates resistance: acid phosphatase present in all hematopoietic cells, located in lysosomes. Nonspecific esterase stain: stains esterases in monocytes and macrophages. Specific esterases (naththol AS-D chloroacetate) stain (cae): stains esterases present in mature and immature neutrophils in mast cells. 6 7. Protg Education Center, LLC All rights reserved www.ProtegeEducation.com Eosinophil, Basophil & Platelets 7 Source: 8. Protg Education Center, LLC All rights reserved www.ProtegeEducation.com Lymphocyte & Monocyte 8 Source: 9. Protg Education Center, LLC All rights reserved www.ProtegeEducation.com Lymphocyte Morphology 9 Atypical lymphocytes (in infectious mononucleosis). Some are very large, some have primitive nuclei with a diffuse chromatin pattern and nucleoli, some nuclei are lobulated, some cells have voluminous basophilic cytoplasm. B lymphocytes may differentiate into plasma cells with an increased amount of basophilic cytoplasm, a pale-staining area near the nucleus (the Golgi zone) and an eccentric nucleus with clumped chromatin. There may also be plasmacytoid lymphocytes with characteristics intermediate between those of lymphocytes and plasma cells. http://www.bloodmed.com/home/ebook.asp?book=0865427178&id=3 10. Protg Education Center, LLC All rights reserved www.ProtegeEducation.com Neutrophil Morphology 10 Neutrophils may also show increased lobulation This is known as right shift. Neutrophils with six or more lobes are said to be hypersegmented. Neutrophil hypersegmentation is an important clue to the presence of deficiency of vitamin B12 or folic acid. Increased granulation: Toxic granulation, vacuolation and left shift (the two white cells are band forms). Increased granulation is usually a reaction to infection or inflammation and is therefore referred to as toxic granulation. 11. Protg Education Center, LLC All rights reserved www.ProtegeEducation.com Neutrophil Morphology 11 Decreased granulation: A blood film of a patient showing a myeloblast and a neutrophil. The myeloblast has a high nucleocytopasmic ratio, a diffuse chromatin pattern and a single nucleolus. The neutrophil is hypogranular. A neutrophil containing a Dhle body, a small bluegrey cytoplasmic inclusion that can be seen just below the nucleus. Cytoplasmic inclusions may be present as an inherited or acquired abnormality. The commonest such abnormality is a small, pale, bluegrey inclusion that occurs both during pregnancy and in infection and inflammation and is known as a Dhle body http://www.bloodmed.com/home/ebook.asp?book=0865427178&id=3 12. 12 PROTG EDUCATION CENTER, LLC Giving the Gift of Education www.ProtegeEducation.com Career Development Program Medical Laboratory Scientist ASCP exam Preparation Affordable rates Online tutoring available for out-of-state students 732-432-4900info@ProtegeEducation.com 13. 13 PROTG EDUCATION CENTER, LLC Giving the Gift of Education www.ProtegeEducation.com Career Development Program High school graduates & College students SAT PSAT NJ ASK Grades 3 to 12 Science Math (Biology, Chemistry & Physics) College Biology, Biochemistry, Microbiology, Immunology, Chemistry & Physics Biology Research Lab Assistant Certificate of Completion Medical Laboratory Scientist ASCP exam Preparation Presentation, Public Speaking & Leadership Skills Certificate of Completion Tutoring & Test Preparation 732-432-4900 Computer Science Certificate of Completion 14. 14 PROTG EDUCATION CENTER, LLC Giving the Gift of Education www.ProtegeEducation.com Thank You Tel: 732-432-4900 Email: info@ProtegeEducation.com