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Differential

Neutrophils

Neutrophils are so named because they are not well stained by either eosin, a red acidic stain, nor by methylene blue, a basic or alkaline stain. Neutrophils, are also known as 'segs', 'PMNs' or 'polys' (polymorphonuclears). They are the body's primary defense against bacterial infection and physiologic stress. Normally, most of the neutrophils circulating in the bloodstream are in a mature form, with the nucleus of the cell being divided or segmented. Because of the segmented appearance of the nucleus, neutrophils are sometimes referred to as 'segs.' The nucleus of less mature neutrophils is not segmented, but has a band or rod-like shape. Less mature neutrophils - those that have recently been released from the bone marrow into the bloodstream - are known as 'bands' or 'stabs'. Stab is a German term for rod.

Increased neutrophil count

An increased need for neutrophils, as with an acute bacterial infection, will cause an increase in both the total number of mature neutrophils and the less mature bands or stabs to respond to the infection. The term 'shift to the left' is often used when determining if a patient has an inflammatory process such as acute appendicitis or cholecystitis. This term is a holdover from days in which lab reports were written by hand. Bands or stabs, the less mature neutrophil forms, were written first on the left-hand side of the laboratory report. Today, the term 'shift to the left' means that the bands or stabs have increased, indicating an infection in progress.

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For example, a patient with acute appendicitis might have a 'WBC count of 15,000 with 65% of the cells being mature neutrophils and an increase in stabs or band cells to 10%'. This report is typical of a 'shift to the left', and will be taken into consideration along with history and physical findings, to determine how the patient's appendicitis will be treated.

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Stabs or band cells are normally about 10% of the total leukocyte count.

In addition to bacterial infections, neutrophil counts are increased in many inflammatory processes, during physical stress, or with tissue necrosis that might occur after a severe burn or a myocardial infarction. Neutrophils are also increased in granulocytic leukemia.

Decreased neutrophil count

A decrease in neutrophils is known as neutropenia. Although most bacterial infections stimulate an increase in neutrophils, some bacterial infections such as typhoid fever and brucelosis and many viral diseases, including hepatitis, influenza, rubella, rubeola, and mumps, decrease the neutrophil count. An overwhelming infection can also deplete the bone marrow of neutrophils and produce neutropenia. Many antineoplastic drugs used to treat cancer produce bone marrow depression and can significantly lower the neutrophil count. Types of drugs that can produce neutropenia include some antibiotics, the psychotropic drug lithium, phenothiazines, and tricyclic antidepressants.

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A patient with an acute viral infection may have a decreased neutrophil count.

Eosinophils

Eosinophils are associated with antigen-antibody reactions. The most common reasons for an increase in the eosinophil count are allergic reactions such as hay fever, asthma, or drug hypersensitivity. Decreases in the eosinophil count may be seen when a patient is receiving corticosteroid drugs.

Basophils

The purpose of basophils is not completely understood. Basophils are phagocytes and contain heparin, histamines, and serotonin. Tissue basophils are also called'mast cells.' Similar to blood basophils, they produce and store heparin, histamine, and serotonin. Basophil counts are used to analyze allergic reactions. An alteration in bone marrow function such as leukemia or Hodgkin's disease may cause an increase in basophils. Corticosteroid drugs, allergic reactions, and acute infections may cause the body's small basophil numbers to decrease.

Lymphocytes

Lymphocytes are the primary components of the body's immune system. They are the source of serum immunoglobulins and of cellular immune response. As a result, they play an important role in immunologic reactions. All lymphocytes are produced in the bone marrow. The B-cell lymphocyte also matures in the bone marrow; the T-cell lymphocyte matures in the thymus gland. The B cells control the antigen-antibody response that is specific to an offending antigen. The T cells are the master immune cells of the body, consisting of T-4 helper cells, killer cells, cytotoxic cells, and suppressor T-8 cells. The majority of lymphocytes that circulate in the blood are T-lymphocytes, rather than B-lymphocytes. To help diagnose immune system deficiencies such as AIDS, the lab does specialized tests of T-lymphocytes. In the WBC, T and B-lymphocytes are reported together. In adults, lymphocytes are the second most common WBC type after neutrophils. In young children under age 8, lymphocytes are more common than neutrophils.

Lymphocytes increase in many viral infections and with tuberculosis. A common reason for significant lymphocytosis is lymphocytic leukemia. The majority of both acute and chronic forms of leukemia affect lymphocytes.

Shift

Due to research on HIV infection, a virus that affects T-lymphocytes, much more is now known about lymphocytes and their functions. HIV causes a reduction in the total number of lymphocytes as well as changes in the ratios of the types of T-lymphocytes. Corticosteroids and other immunosuppressive drugs also cause lymphopenia. A decreased lymphocyte count of less than 500 places a patient at very high risk of infection, particularly viral infections. It is important when the lymphocyte count is low to implement measures to protect the patient from infection.

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Monocytes

Monocytes are the largest cells in normal blood. They act as phagocytes in some inflammatory diseases and are the body's second line of defense against infection. Phagocytic monocytes produce the antiviral substance interferon. Diseases that cause a monocytosis include tuberculosis, malaria, Rocky Mountain spotted fever, monocytic leukemia, chronic ulcerative colitis and regional enteritis

The Body.com is an enormous resource about HIV infection. Visit this link for insight into how the CBC is interpreted in light of HIV infection.

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blame shifting

The act of exchanging accusations and blame, as between two or more parties, during a dispute or some undesirable event. After the team lost the match, there was a bit of blame shifting going on between the players and the coaches.The government parties prefer to partake in blame shifting during an economic crisis.

graveyard shift

A work shift that occurs late at night. I'm a morning person, so I could never work the graveyard shift like you do.

make shift

old-fashioned To cope or manage to do something without all the resources that one would ideally like to have. Often followed by 'with' or 'without,' depending on the context of the sentence. We don't have all the spices we need for this recipe, but we can make shift with what we have.Since I forgot to pick up milk on the way home, I guess we're just going to have to make shift without it.When I was growing up, we didn't have a lot of money, but we made shift.

seismic shift

A major change. (Seismology is the study of earthquakes.) That press conference was such a disaster that I'm worried it will cause a seismic shift in how voters view him as a candidate for president.In just the last century, there has been a seismic shift in the treatment of women in this country.

shift (one's) arse

rude slang To hurry up and move. Usually used as an imperative. Primarily heard in UK. Hey, you in the red sedan! Shift your arse, already!Would you go upstairs and tell the kids to shift their arses?

shift (one's) ground

To adopt a different viewpoint or opinion. I was shocked when Liz suddenly shifted her ground and started seeing things as I did.

shift (the) deckchairs on the Titanic

To partake in or undertake some task, activity, or course of action that will ultimately prove trivial or futile in its possible effect or outcome. Primarily heard in UK, Australia. For all his blustering about overhauling the education system, the prime minister might as well have been shifting the deckchairs on the Titanic for all the good these proposals will do.You're applying for arts council funding? Why don't you just shift deckchairs on the Titanic while you're at it?

shift for (oneself)

To do things for oneself; to not rely on the help or patronage of someone else. It's no wonder that kids these days can't hold down meaningful jobs, when they're pampered from birth and can't shift for themselves by the time they leave school.You're going to have to learn to shift for yourself before you head off to college.

shift gears

To quickly or abruptly change what one is doing or discussing. With that out of the way, let's shift gears and discuss our strategy for the third quarter.About halfway into the story, the book shifts gears and begins a narrative from the perspective of the antagonist.

shift off

1. To cause someone else to become responsible for some burden or unpleasant undertaking. A noun or pronoun can be used between 'shift' and 'off.' Often followed by 'on someone.' We're the youngest team in the office, so everyone shifts off the worst jobs on us.This is your problem to deal with. You can't just shift it off on someone else.
2. obsolete To delay, defer, or postpone some task or responsibility. A noun or pronoun can be used between 'shift' and 'off.' The court will not allow us to shift off these proceedings any further.

stick shift

1. A transmission system in a motor vehicle that requires the driver to manually change gears with a clutch and shifting lever. I never learned how to drive a stick shift, so Mary had to drive for the whole road trip.
2. A motor vehicle that has such a manual transmission. My last car was a stick shift, so it took a little while to get used to this new automatic.

swing shift

A work shift typically beginning in the late afternoon or early evening and ending around midnight. I worked the swing shift at a 24-hour restaurant for a while, and it really messed up my body clock.I hate it when they put me on the swing shifts at the hospital.

the shifting sands of (something)

The constantly changing circumstances or aspects of something that makes it particularly difficult to understand or contend with. Older adults often find themselves struggling to keep up with the ever-shifting sands of technology.Part of the problem is that we've convinced ourselves that personal happiness depends on the shifting sands of romantic love, which does real damage to our ability to live fulfilled and contented lives as independent people.
Farlex Dictionary of Idioms. © 2015 Farlex, Inc, all rights reserved.

fend for oneself Go to shift for

See also: fend, for, go, shift, to

shift for oneself

and fend for oneself
to get along by oneself; to support oneself. I'm sorry, I can't pay your rent anymore. You'll just have to shift for yourself. When I became twenty years old, I left home and began to fend for myself.

shift one's ground

Fig. to change one's opinions or arguments, often without being challenged or opposed. At first Jack and I were on opposite sides, but he suddenly shifted ground and started agreeing with me. Jim has very fixed views. You won't find him shifting his ground.

stick shift

1. having to do with a nonautomatic transmission or a car that has one. I prefer a stick shift car—I don't know why. The stick shift models are cheaper—that's why.
2. a nonautomatic transmission. I can't drive a stick shift! My husband took the other car and stuck me with the stick shift.
McGraw-Hill Dictionary of American Idioms and Phrasal Verbs. © 2002 by The McGraw-Hill Companies, Inc.

shift for oneself

Also, fend for oneself. Provide for one's own needs, as in Don't worry about Anne; she's very good at shifting for herself, or The children had to fend for themselves after school. The first term, using shift in the now obsolete sense of 'manage,' was first recorded about 1513; the variant, using fend for in the sense of 'look after,' was first recorded in 1629.

How To Shift To Hogwarts

The American Heritage® Dictionary of Idioms by Christine Ammer. Copyright © 2003, 1997 by The Christine Ammer 1992 Trust. Published by Houghton Mifflin Harcourt Publishing Company. All rights reserved.

shifting sands

You can talk about the shifting sands of a situation when it keeps changing, and this makes it difficult to deal with. It's a struggle to keep up with the shifting sands of fashion.The problem is that the whole economy has been built on the shifting sands of finance, not the rock of industry.
Collins COBUILD Idioms Dictionary, 3rd ed. © HarperCollins Publishers 2012

make shift

do what you want to do in spite of not having ideal conditions; get along somehow.

shift for yourself

manage as best you can without help.
See also: for, shift
To Shift

shift your ground

To Shift say or write something that contradicts something you have previously written or said.
Farlex Partner Idioms Dictionary © Farlex 2017

shift your ˈground

(usually disapproving) change your opinion or position, especially during an argument or a discussion: He’s shifted his ground on many major policy issues. OPPOSITE: stand fast/firm

(the) ˌshifting ˈsands (of something)

How to shift realities tonight used to describe a situation that changes so often that it is difficult to understand or deal with it: the shifting sands of the digital age
See also: sand, shift

shift for

v.
To provide for, take care of, or defend oneself without assistance. Used reflexively: The teenagers went camping, confident that they could shift for themselves.

To Shift Synonym

The American Heritage® Dictionary of Phrasal Verbs. Copyright © 2005 by Houghton Mifflin Harcourt Publishing Company. Published by Houghton Mifflin Harcourt Publishing Company. All rights reserved.

blame shifting

To Shift From One Form To Another

n. a process in business and government wherein the blame for something bad is shifted from person to person. (A coinage that has appeal because it fills the need to express the concept succinctly.) Can’t we have a decent argument without your constant blame shifting?

graveyard shift

n. the night shift of work in a factory, usually starting at about midnight. (see also swing shift.) The pay is pretty good on the graveyard shift.

stick shift

1. mod. having to do with a nonautomatic transmission or a car that has one. I prefer a stick shift car—I don’t know why. The stick shift models are cheaper—that’s why. This one’s stick shift.
2. n. a nonautomatic transmission. My husband took the other car and stuck me with the stick shift.

swing shift

n. an evening work shift in a factory, usually from midafternoon to midnight. (see also graveyard shift.) My brother works the swing shift, so I never get to see him.
To Shift
McGraw-Hill's Dictionary of American Slang and Colloquial Expressions Copyright © 2006 by The McGraw-Hill Companies, Inc. All rights reserved.
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To Shift A Graph Vertically Or Horizontally

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