blood Flashcards

Question

Megaloblastic Anemia | Clinical Features

Answer 1

• Fatigue, shortness of breath, weakness • Destruction of posterior and lateral columns in the spinal cord—results in a loss of the senses of vibration and proprioception, as well as loss of the deep tendon reflexes • Treatment Vitamin B12 injections or folic acid supplementation.

Answer 2

• Increased red blood cell Destruction (hemolysis) • Intracorpuscular defects – Structural abnormalities Sickle cell anemia, thalassemia, or hereditary spherocytosis • Extracorpuscular defects – Antibodies, infectious agents, or mechanical factors – Autoimmune hemolytic anemia, hemolytic disease of the newborn, transfusion reactions, malaria, hemolytic anemia caused by cardiac valve prosthesis, disseminated intravascular coagulation

Answer 3

Pathogenesis Substitution of glutamic acid by valine in  chain • Synthesis of an abnormal beta chain of globin • HbA gets mutated to HbS • Low O2 tension causes deformities (sickling) • Hemolytic crisis (avoidance of strenuous exercise) • Aggregates cause tissue ischemia

Answer 4

``` Multiple infarcts in various organs Neurologic defects; sharp pain in the bones, spleen (autosplenectomy), and extremities; retinal infarcts Hyperbilirubinemia and jaundice (bile stones). No definitive therapy, high mortality. Avoid conditions that cause sickling and combat infections ```

Answer 5

``` • Retarded intellectual development and neurologic deficits (TIAs, small infarcts, stroke) • Cardiopulmonary insufficiency (HF, MI, Pulmonary edema and PE) • Recurrent infections • HbS< 40% asymptomatic • HbS 40-80% mild to moderate disease • HbS>80% typical symptoms of disease • High mortality ```

Answer 6

Prevalent of people of the Mediterranean • Genetic defect in the synthesis of HbA that reduces the rate of globin chain synthesis • No abnormal hemoglobin produced • Quantitative rather than qualitative (rate of synthesis of normal is slower than we need it to be- so no abonormalities just lack of) • beta-Thalassemia—reduced synthesis of the beta chain of globin • alpha-Thalassemia—reduced synthesis of the alpha chain of globin • Thalassemia minor or thalassemia trait – Heterozygotes – Only one of the 4 chains is missing – Mild, nonspecific symptoms – Microcytic Hypochromic anemia – Requires no treatment

Answer 7

lack of Hba and get Hbf (a lot)- spleen breakdown more RBC causes jaundice, large speen, inlarge liver, hemosideration, growth retardation , cardiorespiratory insufficiency

Answer 8

Thalassemia major – Homozygotes – Severe and serious disease • Splenomegaly, hemosiderosis, and hepatomegaly • Bone marrow—compensatory hyperplasia • Calvarium—“crew-cut” hair on radiographic study • Hyperbilirubinemia and jaundice • Chronic anemia that retards the growth of children • Impairment of normal intellectual development • Cardiorespiratory insufficiency • No treatment for thalassemia mEDETERANIAN

Answer 9

• The primary defect in the genes encoding either ankyrin or alpha or beta chain of spectrin • The most common hereditary disease of red blood cells in Caucasians • Autosomal dominant disease • Peripheral blood—spherocytes, anisocytosis • Hemolytic or aplastic crises—splenomegaly, jaundice • Splenectomy- treatment but no cure- SPLEEN SEES ITS TOO SMALL SO DESTROYS THEM - hyperspleenism

Answer 10

Erythrocytosis • Increased number of red blood cells • Primary polycythemia, or polycythemia vera – Clonal proliferation of hematopoietic stem cells – Uncontrolled production of red blood cells and an increased total red blood cell mass – Myeloproliferative disorder • Secondary polycythemia – Increased red blood cell volume owing to erythroid bone marrow hyperplasia caused by erythropoietin – Usually caused by prolonged hypoxia – Living at high altitudes, anoxia secondary to chronic lung disease, congenital heart disease, renal carcinoma-

Answer 11

Clonal proliferation of hematopoietic stem cells – Uncontrolled production of red blood cells and an increased total red blood cell mass – Myeloproliferative disorder

Answer 12

– Increased red blood cell volume owing to erythroid bone marrow hyperplasia caused by erythropoietin – Usually caused by prolonged hypoxia – Living at high altitudes, anoxia secondary to chronic lung disease, congenital heart disease, renal carcinoma

Answer 13

``` Hypertension • Dark red or flushed face • Headaches, visual problems, neurologic symptoms • Splenomegaly • Hypercellular bone marrow seenin smokers too ```

Answer 14

• Reduction in white blood cell count to belownormal levels • Neutropenia (agranulocytosis) – Bacterial infections • Lymphopenia – Bacterial, viral, fungal, and parasitic infections Short-term treatment is with antibiotics (fatigue, light headed)

Answer 15

• Increased number of white blood cells in the peripheral blood • Granulocytosis, or neutrophilia – Bacterial infection • Eosinophilic leukocytosis, or eosinophilia – Allergies and some skin diseases or parasitic infections • Lymphocytosis – Viral infections, chronic infections, some autoimmune disorders – Splenomegaly (septic spleen), lymphadenopathy (enlarged)

Answer 16

– Bacterial infection

Answer 17

– Allergies and some skin diseases or parasitic infections

Answer 18

– Viral infections, chronic infections, some autoimmune disorders – Splenomegaly (septic spleen), lymphadenopathy (enlarged)

Answer 19

leukimia and lymphoma and multiple myeloma

Answer 20

``` s—malignant disease involving white blood cell precursors in the bone marrow and peripheral blood (acute and chronic) – Myeloid – Lymphoid lymphocytic ```

Answer 21

—lymphoid cell malignant diseases predominantly involving the lymph nodes – Non-Hodgkin’s lymphoma – Hodgkin’s lymphoma

Answer 22

malignant disease of plasma | cells

Answer 23

The causes of most lymphomas and leukemia's, like the causes of most other malignant tumors, are unknown. • Viruses – HTLV-1 (Human T-Cell leukemia virus 1) – EBV (Epstein Barr Virus) • Endogenous oncogenes – t(8 (is translocated to chromosome 14) ,14)—Burkett's lymphoma – t(9,22)—chronic myelogenous leukemia (Philadelphia chromosome)

Answer 24

Bone marrow is infiltrated with malignant cells. • Peripheral blood contains an increased number of immature blood cells. • Complications include anemia, recurrent infections, and uncontrollable bleeding. • 85% of all leukemia's affect children and are acute • Chronic leukemia's found mostly in adults

Answer 25

• Most common form of leukemia in children< 5yrs most common leukemia in kids • Massive infiltration of the bone marrow and peripheral blood with immature lymphoid cells (blasts) • 20-30% of all leukemia's • Recurrent infections, generalized weakness, and bleeding into the skin and major internal organs • Enlarged lymph nodes and mild splenomegaly • Treatment—with modern chemotherapy, remission can be induced in 2/3 of all patients • Without chemotherapy it is lethal within 3-6 months

Answer 26

Acute Lymphoblastic Leukemia. Acute Myelogenous Leukemia Chronic Myelogenous Leukemia Chronic Lymphocytic Leukemia

Answer 27

This is the most common form of acute leukemia in adults.!!!!!! • Has an acute course; without treatment patients die within 6 months of onset of symptoms • Chemotherapy can induce remission in 60% of patients • 15-30% remain disease free for 5 years • High dose irradiation + chemotherapy followed by bome marrow transplantation during the 1st remission have a 70% 3-year survival.

Answer 28

Malignant disease of pluripotent hematopoietic stem cells capable of differentiating into neutrophils (alll cell lines are affected) • Bone marrow and peripheral blood overgrown with malignant stem cells and their descendants • 15% of all leukemia's: Slow onset • Disease of adulthood, anemia and hypermetabolism (tired and prone to infection) • Three phases of the disease: – Chronic phase: (2 to 3 years) <10% bone marrow blasts – Accelerated phase: >10% bone marrow (nonfunctional) blasts & >20% basophils in peripheral blood; increasing unresponsive to therapy – Blast crisis:> 20% blast in bone marrow • Tyrosine kinase inhibitors: induce remission in 90% of patients (!!!!!!) • Philadelphia (Ph1) chromosome, with BCR/ABL gene rearrangement

Answer 29

It affects any age group. • All forms are malignant • Malignant cells often infiltrate the lymph nodes, spleen, thymus, or bone marrow, but they may also involve any other organ in the body. • Extranodal lymphoma: originating outside of lymph nodes; in solid organs, GI, brain, eyes and skin • There are two large categories: – Non-Hodgkin’s lymphoma (NHL) – Hodgkin’s lymphoma

Answer 30

its not harmful- hasnt mastatised to the blood stream

Answer 31

attafhes to base membrane of the cell to the blood stream and spread and some go to specific organs, example prostate- goes to brain

Answer 32

• Two major categories B and T cell neoplasms and NK- cell neoplasms • Most have the B cell phenotype • Occur in all age groups but most common in adults • Malignant cells Can spill over into blood and present as leukemia • Involve lymph nodes, bone marrow, spleen and thymus but can also be Extranodal • Most common site of Extranodal is GI • Clinical features: lymph node enlargement; splenomegaly and lymphocytosis (increase) • fatigue, fever, weight loss, anemia, leukopenia infections

Answer 33

non and the hogkins lymphomas

Answer 34

( non hogkins lymphomas) This is the most common form of lymphoma in the United States (45% of all lymphomas). • It is mostly seen in older people. • The tumor is slow growing. • Most patients present with long-standing enlargement of the lymph nodes and only mild symptoms. • Most patients survive 7 to 9 years after diagnosis of the disease.

Answer 35

This is the most common aggressive form of NHL. • Complete infiltration of large lymphoid cells that have irregular outline and prominent nuclei • Tissue is infiltrated with large lymphoid cells that have irregular nuclear outlines and prominent nucleoli. • Spread to major organs is common • With chemotherapy, complete remission can be induced in 75% of patients.

Answer 36

• This is a highly malignant tumor composed of small B cells. • Extranodal masses are often more prominent than enlarged lymph nodes. • Endemic variant: – Sub-Saharan Africa – Children infected with Epstein-Barr Virus (EBV) – Mandible and facial soft tissue involvement • Sporadic variant: – Children and young adults most often affected – Abdominal mass (e.g., ovarian or intestinal mass) • Most children and young adults can be cured. • Adriamycin and rituximab — a potent chemotherapy regimen given in the hospital about every three weeks.

Answer 37

A form of malignant disease that is pathologically distinct from other lymphomas • Disease spreads from one set of lymph nodes to another • Usually central lymph nodes • Age distribution curve is bimodal, with one peak at 25 years and another at 55 years. • Classical Hodgkin’s Lymphoma; Reed-Sternberg Cells are present (Bilobed or multilobed nucleus and prominent nucleoli surrounded by a clear halo (derived from B lymphocytes) • Non Classical Hodgkin’s Lymphoma: Lymphocytic Cells with Popcorn Nuclei:

Answer 38

s are present (Bilobed or multilobed nucleus and prominent nucleoli surrounded by a clear halo (derived from B lymphocytes)- present in hodkin lymphomas!!!!!!!

Answer 39

NON classical hodkins lymphomas

Answer 40

reed-sternberg

Answer 41

Lymph nodes are enlarged (neck and mediastinum). • Extranodal involvement and leukemic spread are rare. • Prognosis of the disease depends primarily on the clinical stage. – Stage I and II tumors are associated with an excellent prognosis and a high rate of cure (>90%) with chemotherapy. – Advanced disease has a less favorable prognosis.

Answer 42

1: involvement of single lymphnode, 2È 2 or more site 3: deseases on both sides of daiphragm may include spleen or localized 4: widespread liver bone marrow, skin, lung

Answer 43

Most patients older than 45 years of age • Malignant plasma cells typically proliferate in the bone marrow and destroy the surrounding bone (bone fractures) • Hypercalcemia • Renal failure • Anemia and leukopenia Malignant Disease: transformation of a single plasma cell • Clonal expansion leads to an overgrowth in bone marrow • Because theses cells are descendants from a single cell they are termed “monoclonal” • Plasma cells secrete immunoglobulins which can be detected in the serum • After malignant transformation of a single plasma cell the descendants of this malignant cell all secrete the same form of immunoglobulin • Diagnosis is based on the following: – X-ray studies (lytic lesions) – Serum electrophoresis (monoclonal spike) – Bone marrow biopsy (neoplastic plasma cells in increased numbers) – Bence Jones Protein in urine (first biochemical tumor marker) • Most patients die within 3 to 4 years, primarily of kidney failure or infection Most patients> 45 years • Malignant cells destroy bone marrow • Punch holes through blood forming bones • Hypercalcemia with deposition in the kidney • Chemotherapy ineffective • secondary Raynauds syndrome

Answer 44

– Bence Jones Protein in urine (first biochemical tumor marker)

Answer 45

crue cut- thalasemia- dont confuse with bone leision of multiple myeloma

Answer 46

medeteranina

Answer 47

increase rate of loss or destruction

blood Flashcards

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