CAP Pro Course - Hematology - White Blood Cell Inclusions

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Author: Margaret A. Reinhart, MS, MT(ASCP)
Reviewers: Rory Huschka, M.Ed., MT(ASCP); Laurie Bjerklie, M.A., MLS(ASCP).

Continuing Education Credits

Objectives

  • Recognize toxic morphologic changes associated with reactive neutrophilia.
  • Identify nuclear alterations observed in peripheral blood leukocytes.
  • Correlate various white blood cell inclusions with specific diseases and disorders.
  • Recognize and associate certain unusual or rarely seen inclusions with selected malignant conditions.

Course Outline

  • Recognize toxic morphologic changes associated with reactive neutrophilia.
      • Introduction to Toxic Changes in Granulocytes
      • Toxic Granulation
      • Toxic Vacuolization
      • Döhle Bodies
      • Artifactual Toxic Granulation and Toxic Vacuolization
      • Quick Reference Guide: Toxic Changes in Neutrophils
      • While performing a manual differential, an MLS found these inclusions in three of the neutrophils. They did not include a comment on the report. What ...
      • A medical resident comes to the hematology lab to look at one of her patient's blood smears. Upon examination, the resident says, "I suspect this pati...
      • A student was performing a differential on a patient and saw that all of the neutrophils had these very consistent, dark-staining granules, as seen in...
  • Identify nuclear alterations observed in peripheral blood leukocytes.
      • Artifacts: Pyknotic (Necrobiotic) Nuclei of Neutrophils
      • Hypersegmentation of Neutrophils
      • Barr Bodies
      • Hyposegmentation of Neutrophils (Pelger-Huët Anomaly)
      • Pelger-Huët Anomaly vs. Pseudo-Pelger-Huët
      • What is a likely cause of the appearance of these neutrophils?
      • About 12% of neutrophils seen in a patient's peripheral blood appeared similar to the one at the right. Among the choices listed, what is the most lik...
      • A new colleague is performing a manual differential. The total percentage of neutrophils is within range, but they are observing a very high percentag...
  • Correlate various white blood cell inclusions with specific diseases and disorders.
      • Alder-Reilly Anomaly
      • Chediak-Higashi Syndrome
      • May-Hegglin Anomaly
      • Intracellular Bacteria
      • Intracellular Fungal Organisms
      • Anaplasma and Ehrlichia
      • Quick Reference Guide: White Blood Cell Inclusions
      • You are examining a patient's blood smear about whom you do not know the clinical history. You come across several unusual inclusions in a few of the ...
      • The neutrophils in the blood smear of an HIV positive patient are showing these distinctive inclusions. Identify these inclusions.
      • A 52-year-old man presents to the Emergency Department complaining of severe headaches, lethargy, and muscle aches. The patient reveals that he has ju...
  • Recognize and associate certain unusual or rarely seen inclusions with selected malignant conditions.
      • Auer Rods
      • Faggot Cells
      • Burkitt's Cells
      • In which of the following cells are Auer rods most likely to be found?
      • An MLS student is examining a bone marrow smear (image shown on the right) and is asked what type of leukemia this patient probably has. Although she ...
  • References
      • References

Additional Information

Level of Instruction:  Intermediate
Intended Audience:  This program is designed as an educational and training tool for MLS, MT, and MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author Information:   Margaret Reinhart, MS, MLS(ASCP) is the MLS Program Director and Senior lecturer in Biological Sciences at the University of the Sciences in Philadelphia, PA where she teaches hematology, clinical immunology, parasitology, and other related courses. She is also an adjunct instructor in Hematology at Pennsylvania Hospital, Philadelphia, PA. She holds a Master's Degree in Biology and in Health Care Administration.
Reviewer Information:  Rory Huschka, M.Ed., MLS(ASCP), has over 20 years of experience as a medical technologist, technical supervisor, professor, and manager. He is a former Program Director of Medical Laboratory Science and Medical Laboratory Technician Programs. He currently works on the content development team at MediaLab, Inc. Rory holds a BS degree in Medical Technology from North Dakota State University and a Master's in Educational Leadership. 
Reviewer Information:  Laurie Bjerklie, M.A., MLS(ASCP)CM is currently a Content Developer for MediaLab and LabCE. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 14 years of experience in higher education and has held faculty positions in both MLT and MLS programs. She most recently served as the Program Manager of Medical Laboratory Science at Saint Louis University.

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