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Pathology 3000 > Blood Disorders - Final Exam > Flashcards

Blood Disorders - Final Exam Flashcards

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1
Q

Fluid of blood

A

Plasma

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2
Q

Cells of blood

A

WBC (leukocytes)
RBC (erythrocytes)
Platelets (thrombocytes)

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3
Q

Sites of hematopoiesis

A

Adults: calvarium, vertebrae, ribs, sternum, pelvis
Children: most bones
Fetus: most ones
Embryo: yolk sac, liver cords

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4
Q

Centrifuging of blood

A

Plasma at top
Buffy coat (WBC and platelets) in middle
RBC at bottom

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5
Q

Erythrocytes

A

For transportation of oxygen from lungs into peripheral tissues
Live in circulation for 120 days - broken down in spleen

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6
Q

Hemoglobin

A

Complex molecules consisting of four heme groups (Fe in middle) and four globins
97% Hemoglobin A

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7
Q

Fetal hemoglobin

A

Alpha chains and gamma chains

In children, traces in adults

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8
Q

Bilirubin

A

Heme is broken down and Fe is removed

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9
Q

Hemoglobin synthesis

A

Requires iron, Vit B12, Vit B6, folic acid

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10
Q

Erythropoietin

A

Kidney sensing O2 is low and secrete hormone to tell bone marrow to make more RBC

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11
Q

Thrombocytes

A

Platelets

Essential clotting factors

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12
Q

Malignant transformation of hematopoietic cells (2)

A

Solid tumors or leukemia

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13
Q

Anemia (3)

A

Reduction of Hb in blood - below normal levels
Less than reference range established in given population
Associated with appearance of abnormal Hb, reduction in RBC, structural abnormalities of RBC

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14
Q

Causes of anemia (3)

A
  1. Decreased hematopoiesis
  2. Abnormal hematopoiesis
  3. Increased loss or destruction of RBC
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15
Q

Decreased hematopoiesis (2)

A
  1. Bone marrow failure (aplastic anemia, myelophthisic anemia)
  2. Deficiencies of nutrients (vit B12, folic acid, protein)
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16
Q

Abnormal hematopoiesis

A

Usually consequence of genetic abnormalities

Sickle cell anemia

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17
Q

Increased loss and destruction of RBC (4)

A
  1. Bleeding
  2. Intrasplenic sequestration
  3. Immune hemolysis
  4. Infections
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18
Q

Aplastic anemia

symptoms: 5

A

Idiopathic, secondary
Bone marrow depletion of hematopoietic cells (consists only of fibroblasts, fat cells, scattered lymphocytes)
Anemia, leukopenia, thrombocytopenis
Uncontrollable infections, bleeding tendency, chronic fatigue, sleepiness, weakness

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19
Q

Iron deficiency anemia

(histology: 2
causes: 3)

A

Most common form
Hypochromic (pale), microcytic (small) RBC
Increased loss of iron, inadequate iron intake or absorption, increased iron requirements

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20
Q

Megablastic anemia

histology: 3

A

Caused by deficiency of vit B12 or folic acid
Large RBC (macrocytic anemia)
Bone marrow is hypercellular with numerous megaloblasts (abnormal RBC precursors)
Hypersegmentation of neutrophils

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21
Q

Vit B12 deficiency (3)

A
  1. Pernicious anemia
  2. Lack of gastric intrinsic factor
  3. Atrophic gastritis
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22
Q

Folic acid deficiency

A

Inadequate intake

Due to diet or malabsorption

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23
Q

Hemolytic anemia (4)

A
  1. Increased RBC destruction
  2. Intracorpuscular or extracorpuscular defects
  3. Compensatory erythroid hyperplasia of BM
  4. Hyperbilirubinemia (jaundice)
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24
Q

Intracorpuscular defects (3)

A
  1. Structural abnormalities
  2. Sickle cell anemia, thalassemia, hereditary spherocytosis
  3. Infection
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25
Extracorpuscular defects
1. Antibodies, infectious agents, mechanical factors 2. Autoimmune hemolytic anemia, hemolytic disease of newborn, transfusion reactions, hemolytic anemia due to cardiac valve prosthesis, disseminated intravascular coagulation
26
Sickle cell anemia
``` Substitution of glutamic acid by valine Synthesis of abnormal beta chain of globin Most prevalent among African populations Multiple infarctions in various organs Jaundice ```
27
Sickle cell anemia - low oxygen
Hemoglobin S polymerizes and forms chain that deforms cells Reversible if O2 is back up, quickly All symptoms occur due to clotting
28
Long term complications of sickle cell anemia (3)
1. Delayed intellectual development, neurologic deficits Largely avoided due to medical surveillance and appropriate management or crises 2. Cardiopulmonary insufficiency 3. Recurrent infections
29
Thalassemia (histology: 1 symptoms: 5 developmental: 2)
Genetic defect in synthesis of HbA, do not produce enough Reduced rate of globin chain synthesis Beta or alpha chain affected Minor (heterozygotes) or major (homozygotes, very serious) Hypochromic (pale RBC) anemia Splengomegali, hemosiderosis, hepatomegaly Bone marrow: compensatory hyperplasia Calvarium (crew cut) hair on radiographic study - a lot of hematopoiesis in skull and changes the way it looks Jaundice Chronic anemia that slows growth of children Impaired normal intellectual development Cardiorespiratory insufficiency
30
Immune hemolytic anemias
Mediated by antibodies that destroy RBC (autoantigens, alloantigens, neoantigens) Mismatched blood transfusion Hemolytic disease of new bown Autoimmune hemolytic anemias
31
Neoantigens
Caused by penicillin getting absorbed into RBC
32
Polycythemia vera
Too much Hb Primary + secondary Erythrocytosis Increased number of RBC
33
Primary Polycythemia
Cancer Myeloproliferative disorder Clonal proliferation of hematopoietic stem cells Uncontrolled production of RBC
34
Secondary Polycythemia
Increased RBC volume due to erythroid bone marrow hyperplasia caused by erythropoietin Usually caused by prolonged hypoxia
35
Risk factors of secondary polycythemia (4)
1. Living at high altitudes 2. Anoxia secondary to chronic lung disease 3. Congenital heart disease 4. Renal carcinoma
36
Polycythemia symptoms (7)
1. Hypertension 2. Dark red or flushed face 3. Headaches 4. Visual problems 5. Neurologic symptoms 6. Splegomegaly 7. Hypercellular bone marrow
37
Leukocytic disorders (4)
1. Leukopenia 2. Leukocytosis 3. Leukemia 4. Lymphoma
38
Leukopenia
Reduction in WBC | Neutropenia or lymphopenia
39
Neutropenia
Reduction in neutrophils | Caused by bacterial infections or drugs
40
Lymphopenia
Reduction in lymphocytes | Bacteria, viral, fungal, parasitic infections
41
Leukocytosis
Increased number of WBC in peripheral blood | Neutrophilia, eosinophilia, lymphocytosis, splengomegaly, lymphadenopathy
42
Neutrophilia
Increased WBC | due to bacterial infection
43
Eosinophilia
Increased WBC due to allergies, some skin diseases, parasitic infections
44
Lymphocytosis
Increased WBC due to viral infections, chronic infections, some autoimmune disorders
45
Malignant disease of WBC (3)
1. Leukemias 2. Lymphomas 3. Plasma cell myeloma
46
Leukemia | symptoms: 3
Malignant disease involving WBC or their precursors in BM, peripheral blood Anemia, recurrent infections, uncontrollable bleeding Myeloid or lymphoid
47
Myeloid
From neutrophil, basophil, etc
48
Lymphoid
B or T cells
49
Lymphomas | locations: 5
Lymphoid cell malignant diseases predominantly involving lymph nodes Most common in adults, aggressive forms in kids Malignant cells infiltrate lymph nodes, spleen, thymus or BM or extranodal spread
50
Non-Hodgkin's lymphoma
B cell, T cell, NK cell Most have B cell phenotype All age groups (more common in adults) Can spill over in blood and present as leukemia
51
Hodgkin lymphoma
``` B cell only Bimodal age distribution (25 +55) 5 types Reed-Sternberg cells present Enlarged lymph nodes Stage I and II have excellent prognosis Extranodal involvement and leukemic spread is rare ```
52
Plasma cell myeloma
Malignant disease of plasma cells High level of antibodies Most patients older than 45 Malignant cells proliferate in BM
53
HTLV-1
Causes lymphoma cancer
54
EBV
Causes Burkitt's lymphoma
55
t(8,14)***
Burkitt's lymphoma
56
t(9,22)***
Chronic myelogenous leukemia | Philadelphia chromosome
57
t(15,17)
Acute promyelocytic leukemia
58
Acute lymphoblastic leukemia | treatment: 1
Immature form of cells Very serious, can die immediately without treatment Most common in children, almost always B cell origin Massive infiltration of BM and peripheral blood with immature lymphoid cells (B cell blasts) Modern chemotherapy
59
Chronic myelogenous leukemia | treatment: 1
Mature type of cell BM, peripheral blood overrunn with neutrophils and precursors Three phases (chronic phase, accelerated phase, blast crisis) Treatment with tyrosine kinase inhibitors Philadelphia chromosome with BCR-ABL gene rearrangement (t9,22)
60
Age distribution of leukemias
Rate goes up with age | except acute lymphocytic
61
Acute myelogenous leukemia
Most common form of acute leukemia in adults Clonal proliferation of myeloid precursors in BM (abnormal cells or cytogenic abnormalities) Without treatment, most patients due within 6 months after symptom onset
62
Chronic lymphocytic leukeumia
Malignant disease involving lymphocytes, mainly B cells Most patients older than 50 Should be expected if lymphocytes are >5000/mL Medial survival: 7-9 years after diagnosis
63
Follicular lymphoma | symptoms: 2
Most common form of lymphoma in USA (45%) Mostly seen in older people Slow growing Presents with long-standing elargement of lymphnodes, mild constitutional symptoms Median survival: 7-9 years
64
Diffuse large-cell lymphomas
Most aggressive form of NHL Tissue infiltration by large lymphoid cells with irregular nuclear outlines, prominent nucleoli Complete remission in 75% of patients with chemotherapy
65
Burkitt's Lymphoma
Highly malignant tumour composed of small B cells Extranodal masses Endemic or sporadic variants Most children and young adults can be cured
66
Endemic variant of Burkitt's lymphoma
Sub-saharan Africa Children infected with EBV Mandible, facial soft tissue involvement
67
Sporadic variant of Burkitt's lymphoma
Children and young adults | Abdominal masses
68
5 types of Hodgkin's lymphoma
1. Nodular sclerosing 2. Lymphocyte predominant 3. Lymphocyte rich 4. Mixed cellularity 5. Lymphocyte depleted
69
Reed-Sternberg cells (2)
Bilobed or multilobed nucleus, prominent nucleoli surrounded by clear halo
70
Multiple myeloma
Plasma cell myeloma
71
Diagnosis of plasma cell myeloma (4)
1. X ray studies 2. Serum electrophoresis 3. Bone marrow biopsy 4. Clinical presentation Survival rate is less than 3-4 years from diagnosis Most die from kidney failure and infection
72
Diagnosis of Non-Hodgkin's lymphoma (2)
1. Light microscopy | 2. Ancillary techniques (flow cytometry, immunositochemistry, cytogenetic analysis)
73
Clinical features of Non-Hodgkin's lymphoma (3)
1. Lymph node enlargement 2. Systemic consitutional symptoms 3. Extranodal tumor spread
74
Symptoms of plasma cell myeloma (5)
1. Lytic lesions (punched out holes) in calvaria vertebrae 2. Hypercalcemia (osteoclast function) 3. Renal failure 4. Anemia 5. Leukopenia

Pathology 3000 (14 decks)

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