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SBL Exam 1 > L1 - Pathology Of WBCs > Flashcards

L1 - Pathology Of WBCs Flashcards

1
Q

What is the leukocyte common antigen?

A

CD45

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2
Q

What marker is present when myeloblast -> promyelocyte?

A

CD34

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3
Q

Which markers are associated with early lymphocytes (prolymphocytes)?

A

TdT

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4
Q

Which markers are associated with B lymphocytes?

A

CD19, CD20, CD10 and Pax 5

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5
Q

What markers are associated with NK cells?

A

CD16 and C56

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6
Q

Which markers are associated with T cells?

A

CD4 and CD8

CD1-5, C7

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7
Q

What is neutropenia?

A

Reduced number of neutrophils in the blood

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8
Q

What is agranulocytosis?

A

Marked reduction in WBC production from the bone marrow

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9
Q

What is cytopenia?

A

Reduction in the number of mature cells

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10
Q

What is pancytopenia?

A

Deficiency of all cellular components of the blood (WBC, RBCs and platelets)

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11
Q

What is absolute neutrophil count?

A

Combined percentage of neutrophils and bands x WBC

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12
Q

ANC below what value is very serious?

A

<500

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13
Q

Worsening degrees of neutropenia place people at risk for what?

A

Deadly infections

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14
Q

What can cause severe neutropenia?

A 
Not enough made or too much destroyed 
Drug toxicity (sometimes purposeful) 
Aplastic anemia 
Megaloblastic anemia 
Immune destruction (Ab mediated) 
Hypersplenism
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15
Q

What happens as a result of severe neutropenia?

A

Overwhelming infection (bacterial or fungal)

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16
Q

What are the basic types of lymphoid neoplasia?

A

B cells, T cells, plasma cells, Hodgkin and NK cell

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17
Q

What are the types of myeloid neoplasia?

A

Acute myeloid leukemia
Myelodysplasia
Myeloproliferative neoplasia

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18
Q

What is a type of histiocytic neoplasia?

A

Langerhans cell histiocytosis

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19
Q

What things can contribute to white cell neoplasia?

A 
Genetic mutations (typically acquired) - proto-oncogenes 
Viral infections (HTLV-1 EBV, HHV-8) 
Chronic infection (H pylori)
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20
Q

What is a leukemia?

A

Affects the bone marrow/blood

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21
Q

What is lymphoma?

A

Affects lymph nodes

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22
Q

What circumstances will give a better prognosis for ALL?

A

Ages 2-10
Low peripheral WBC count
Hyperdiploidy
t(12;21)

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23
Q

What circumstances will give a worse prognosis for ALL?

A

Age <2
Adolescence/adulthood
High WBC count (>100k)

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24
Q

What kinds of cells are seen on a peripheral smear showing myeloma?

A

Plasma cells, plasma blasts, multinucleated forms, Mott cells, Russel bodies, Dutcher bodies

25
Q

What can monoclonal gammopathy of undetermined significance (MGUS) become?

A

Multiple myeloma

26
Q

What percentage of plasmacytosis confirms multiple myeloma?

A

Greater than or equal to 60%

27
Q

If you have a >10% plasmacytosis, what do you need?

A

More testing

28
Q

Describe multiple myeloma

A

Monoclonal gammopathy
Plasma cells in the bone marrow
Clinical evidence of organ damage (CRAB)
Hyper viscosity

29
Q

How is ALL diagnosed?

A

With morphology, staining, flow cytometry

30
Q

How is B cell NHL diagnosed?

A

Morphology, staining, flow cytometry

31
Q

How is myeloma diagnosed?

A

Morphology, staining, SPEP/ImmFix

32
Q

How is Hodgkin lymphoma diagnosed?

A

Morphology and staining

33
Q

How is AML classified?

A

I. AML with genetic aberrations (t8;21, t15;17)
II. AML with MDS like features (poor prognosis)
III. AML, therapy related (very poor prognosis)
IV. AML, not otherwise specific (based on differentiation of the blasts)

34
Q

What will you see in CML?

A

Marked leukocytosis (WBC >100k)
Increased Buffy coat
Splenomegaly
Extramedullary hematopoiesis

35
Q

What are the functions of the spleen?

A

Phagocytosis of blood cells and blood borne matter
Ab production
Hematopoiesis (fetal and in certain adult conditions)
Sequestration of blood cells

36
Q

What are some splenic conditions?

A

Enlargement (splenomegaly, hypersplenism)
Rupture
Neoplastic involvement
Infarcts

37
Q

What can cause splenomegaly?

A 
Reactive splenitis (most often due to viral infection) 
Congestive splenomegaly (most often due to hepatic dysfunction)
38
Q

What is hypersplenism?

A

Enlargement of the spleen associated with cytopenias

May be due to an issue with circulating cells themselves or due to a primary/secondary splenic disorder

39
Q

How can hereditary spherocytosis cause splenic enlargement?

A

Stiff red cells get stuck in sinuses

40
Q

How can sickle cell anemia cause splenic enlargement?

A

Sickled cells are trapped

41
Q

How can idiopathic thrombocytopenic purpura (ITP) cause splenic enlargement?

A

Platelets are opsonized, spleen clears them

42
Q

What splenic disorders can cause splenic enlargement?

A

Congestive splenomegaly

43
Q

What can cause splenic rupture?

A

Most often the result of blunt abdominal trauma

Splenomegaly may cause spontaneous rupture (more likely if associated with rapid enlargement)

44
Q

It is far more common to see splenic involvement by what than primary tumors?

A

Hematologic malignancies

45
Q

What can cause splenic infarct?

A

It can outgrow its vascular supply

Or it can get clogged (blood only has one way into the spleen - no collaterals)

46
Q

What are two forms of thymic pathology?

A

Hyperplasia

Thymoma

47
Q

Myasthenia gravis can be the result of what?

A

Auto Abs produced in either thymic hyperplasia or thymoma

48
Q

What are warning signs of lymphoma (B symptoms)?

A

Fever
Night sweats
Unexpected weight loss

49
Q

What are the causes of leukocytosis?

A

Increased marrow production
Increased release from marrow stores
Decreased margination
Decreased extravasation into tissues

50
Q

What can cause increased marrow production of leukocytes?

A

Chronic infection or inflammation (GF dependent)
Paraneoplastic (e.g. HL, GF dependent)
Myeloproliferative neoplasms

51
Q

What can cause increased released of leukocytes from marrow stores?

A 
Acute inflammation (e.g. with infection) 
Chronic inflammation (many causes)
52
Q

What can cause decreased margination of leukocytes?

A

Exercise and catecholamines

53
Q

What can cause decreased extravasation of leukocytes into tissues?

A

Glucocorticoids

54
Q

What can cause neutrophilic leukocytosis?

A

Acute bacterial infection

55
Q

What can cause eosinophilic leukocytosis (eosinophilia)?

A

Asthma, hay fever, parasitic infections, drug reactions

56
Q

What can cause basophilic leukocytosis (basophilia)?

A

Rare, often indicative of MPNs

57
Q

What can cause monocytosis?

A

Chronic infections such as TB

Auto immune disorders (SLE, IBS)

58
Q

What can cause lymphocytosis?

A

Viral infections (hepatitis, cytomegalovirus, EBV)

SBL Exam 1 (8 decks)

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