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Lymphocytes (Nursing)

by Rhonda Lawes

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    00:01 Now when you talk about lymphocytes, we have three types: T cells, B cells, and NK cells.

    00:09 So the T cells and the B cells are named from where they come.

    00:13 NK just means natural killer cells, so they're pretty cool.

    00:18 So T cells mature in the thymus.

    00:20 So make sure you circle the "T" and circle the "T" in thymus and underline it, so it's easy for you to remember.

    00:27 Now, these guys are helper cells. They're the servants.

    00:29 They're the ones who really get in there and get the job done.

    00:32 They're helper cells because they help other cells mature, activate, and function.

    00:38 So that's the first type of T cell. There's T helper cells.

    00:42 Next, there's T cytotoxic cells. Now, these guys destroy cells that are infected with viruses. That's pretty cool.

    00:50 So T cells come from the thymus.

    00:53 There's T helper cells that help other cells be all they can be.

    00:57 There's cytotoxic T cells that destroy cells if they've been infected with a virus.

    01:01 Remember, viruses come in and take over cells.

    01:04 And then there's memory cells because they remember antigens from past infections.

    01:09 This is what's really cool.

    01:11 That's what helps you fight off infection. If you've been infected with something before, these T cells remember and they'll help you deal with it.

    01:20 Now the B cells are formed in the bone, okay, so that's really an easy way to remember things.

    01:25 T cells come from the thymus, B cells come from the bone.

    01:29 Now, in your plasma, they produce large amounts of antibodies, which is awesome because that can deliver it all the way around through the body.

    01:36 They also are B memory cells, so they remember past infections, too.

    01:41 The last group are the natural killer cells.

    01:44 Now, they're kind of similar to the cytotoxic T cells, but they kill virus-infected cells and tumor cells.

    01:51 Okay, let that sink in.

    01:54 Did you know that your body, your immune system, can actually kill cancer cells? Yeah. They do it all the time. So when we're thinking about lymphocytes.

    02:05 Let's back it up. They do some amazing things.

    02:08 When it comes to killing cells, natural killers can kill virus-infected cells and tumor cells.

    02:16 Cytotoxic T cells destroy cells that are infected with viruses.

    02:20 So there's something we can chunk and put together.

    02:23 That which ones have memory? The B cells and the T cells have memory.

    02:28 Other than that, T cells are helpers, and the B cells produce large amounts of antibodies in the plasma.

    02:35 So that's kind of looking at the 3 different types of lymphocytes.

    02:39 So we've got T, B, and NK, natural killer cells.

    02:44 They're usually about 15%-41% of your total white blood cells.

    02:50 Now you get your lab work back, you notice your white cell counts are up, and now you look at specifically the lymphocytes are up, so that could be a sign of a viral infection.

    02:59 The neutrophils respond initially to bacterial more.

    03:03 So if the neutrophils are up, that's probably a bacterial infection.

    03:07 But if the lymphocytes are up, that's probably a viral infection. So that's one way you can tell the difference just from the CBC test.

    03:15 Okay, the leukemias can also cause an increase in lymphocytosis and adrenal insufficiency.

    03:22 So again, you're looking at all your patient's assessment, all their information, and if you notice -- you're seeing signs of adrenal insufficiency and they have lymphocytosis, that helps you make a better diagnosis.

    03:35 Okay, now lymphocytopenia is going to be what you see in a person who is HIV positive.

    03:40 That means you have Human Immunodeficiency Virus present in your bloodstream, and that destroys the T cells; the CD4 T cells, specifically.

    03:51 Now the difference between HIV and full-blown AIDS is once the CD4 T cell level gets <200, and they have an opportunistic infection, then that means they are in full-blown AIDS.

    04:04 So, HIV means the virus is present, but AIDS means it has destroyed so many of the T cells that the CD4 T cell count is <200.

    04:14 But for now, remember a low lymphocyte count or lymphocytopenia one reason could be because the patient has HIV.

    04:22 Also, if their bone marrow is failing, for whatever reason, or aplastic anemia, you'll see low lymphocytes.

    04:29 Again, comes back up, excessive glucocorticoids.

    04:33 This is lupus. SLE is systemic lupus erythematosus.

    04:37 RA stands for rheumatoid arthritis.

    04:41 Then comes up with chemotherapy or immunosuppression.

    04:45 Okay. So we talked about HIV.

    04:48 Does it make sense why bone marrow failure would give you low lymphocytes? Right. Bone marrow failure is going to give you low blood cells, period.

    04:58 Excessive glucocorticoids, we've discussed that in previous issues, and see how many times that comes up.

    05:04 My best recommendation would be for you to make 1 chart and flip this around backwards. It's a great strategy.

    05:11 Pick something like immunosuppression, and then list all of the different cell abnormalities that are caused by immunosuppression.

    05:20 Look at excessive glucocorticoids and list all those again.

    05:23 Making your own chart will really help you supercharge your studying habits and your retention.

    05:29 So go back through the slides when you have some time, after you're done watching the video, and make a new and different chart.

    05:35 That way, you're showing your brain how to look at this information from a different perspective.

    05:39 I promise you, the time you invest will pay off big.


    About the Lecture

    The lecture Lymphocytes (Nursing) by Rhonda Lawes is from the course Complete Blood Count (CBC) (Nursing).


    Included Quiz Questions

    1. T lymphocytes
    2. B lymphocytes
    3. Natural killer cells
    4. D lymphocytes
    5. C lymphocytes
    1. Neutrophils are elevated in bacterial infections, and lymphocytes are elevated in viral infections.
    2. Lymphocytes are elevated in bacterial infections, and neutrophils are elevated in viral infections.
    3. Neutrophils are decreased in bacterial infections, and lymphocytes are decreased in viral infections.
    4. Lymphocytes are decreased in bacterial infections, and neutrophils are decreased in viral infections.
    1. Lymphocytopenia
    2. Monocytopenia
    3. Eosinopenia
    4. Neutropenia

    Author of lecture Lymphocytes (Nursing)

     Rhonda Lawes

    Rhonda Lawes


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