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Disease Mechanisms > Ch 13: WBC, Lymph Node, Spleen & Thymus > Flashcards

Ch 13: WBC, Lymph Node, Spleen & Thymus Flashcards

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1
Q

what three cell types come from the lymphoid lineage

A

NK cells
B cells
T cells

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2
Q

what three cell types come from myeloblasts

A

neutrophils
eosinophils
basophils

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3
Q

what cell type comes from a monoblast

A

monocyte

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4
Q

what are the two key features to maintain hematopoiesis

A

cells need to be pluripotent (able to differentiate into anything) and be self-renewing

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5
Q

what is a myeloblast

A

immature granulocyte (neutrophil, basophil, and eosinophil)

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6
Q

what are leukocytes (white blood cells)

A

cells are larger than erythrocytes with a prominent nucleus
move throughout the blood
adhere to wall of vessel and squeeze through to get to infection in surrounding tissue
include granulocytes and agranulocytes

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7
Q

what are granulocytes

A

type of leukocyte that contains granules that are released when activated
three types: neutrophil, eosinophil, basophil

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8
Q

what are agranulocytes

A

type of leukocyte that lacks visible granules
two types: monocytes and lymphocytes

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9
Q

what is leukopoiesis

A

process in bone marrow where hematopoietic stem cells form new leukocytes
divide into myeloid and lymphoid cell line

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10
Q

what is the myeloid cell line

A

comes from a hematopoietic stem cell
differentiate first into blast cells then into most formed elements such as erythrocytes, platelets, granulocytes, and agranulocytes

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11
Q

what is the lymphoid cell line

A

comes from a hematopoietic stem cell
differentiated into lymphoblasts that will become B cells, T cells, and NK cells

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12
Q

what is a band or stab cell

A

final precursor stage of cell
develop into mature granulocytes which enter bloodstream

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13
Q

what is the normal amount of band or stab cells in the peripheral blood

A

5-10%

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14
Q

what is the precursor (band/stab) cell of granulocytes

A

promyelocyte which differentiates into neutrophil, eosinophil, and basophil band cells then finally mature granulocytes

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15
Q

what is the precursor (band/stab) cell of agranulocytes, specifically monocytes

A

promonocyte which differentiates directly into monocyte

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16
Q

what is the precursor (band/stab) cell of agranulocytes, specifically B and T lymphocytes

A

prolymphocyte which differentiates into B and T lymphocytes

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17
Q

what is leukopenia

A

lower than normal WBC count usually due to reduced number of neutrophils

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18
Q

what is neutropenia

A

reduced number of neutrophils

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19
Q

what are symptoms of leukopenia

A

can cause prolonged infections, fever, tachycardia, sepsis and death

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20
Q

what are two examples of untreated leukopenia that lead to death

A

typhoid fever
rickettsiae

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21
Q

what is leukocytosis

A

higher than normal WBC count usually due to neutrophilia
usually caused by numerous amounts of granulocytes
commonly seen during an infection

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22
Q

what is neutrophilia

A

excess amount of neutrophils

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23
Q

what are the four mechanisms of leukocytosis

A

increased marrow production
increased release from marrow stores
decreased margination
decreased extravasation into tissues

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24
Q

what is a leukemoid reaction

A

extreme elevation of WBC
ex. leukemia

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25
what is lymphopenia
decreased number of lymphocytes in the body
26
what are some common causes of lymphopenia
congenital immunodeficiencies HIV therapy followed by cytotoxic drugs autoimmune disorders malnutrition acute viral infections
27
what is are lymphoid neoplasms
group of hematologic malignancies derived from lymphoid cells found in the bone marrow or in the peripheral blood
28
what are the 5 categories of lymphoid neoplasms
precursor B-cell peripheral B-cell precursor T-cell peripheral T-cell and NK cell Hodgkin lymphoma
29
what are precursor B-cell neoplasms
neoplasms of immature B-cells
30
what are peripheral B-cell neoplasms
neoplasms of mature B-cells
31
what are precursor T-cell neoplasms
neoplasm of immature T-cell
32
what are peripheral T-cell and NK cell neoplasms
neoplasms of mature T cells and NK cells
33
what are Hodgkin lymphomas
neoplasms of Reed-Sternberg cells and variants
34
what are myeloid neoplasms
a group of neoplasms originating from hematopoietic progenitor cells from the bone marrow
35
what are the three categories of myeloid neoplasms
acute myeloid leukemia (AML) myelodysplastic syndrome myeloproliferative neoplasm
36
what is acute myeloid leukemia (AML)
accumulation of immature myeloid forms (blasts) in bone marrow
37
what is myelodysplastic syndrome
defective maturation of myeloid progenitors which leads to ineffective hematopoiesis and therefore, cytopenia increases your risk for acute myeloid leukemia
38
what is a myeloproliferative neoplasm
increased production of 1 or more blood cells
39
what is lymphadenopathy
enlarged lymph nodes due to increase in size/numbers of germinal centers two types: localized vs generalized
40
what are the three main causes of lymphadenopathy
invasion of malignant cells endocrine disorders lipid storage diseases (gaucher disease)
41
what are leukemias
clonal disorder in a single progenitor cell where it undergoes malignant transformation in the bone marrow leads to uncontrolled proliferation of malignant leukocytes which overcrowds the bone marrow and leads to pancytopenia two types: lymphoid and myeloid
42
what are two types of myeloid leukemias
acute myeloid leukemia (AML) chronic myeloid leukemia (CML)
43
what are two types of lymphoid leukemias
acute lymphoblastic leukemia (ALL) chronic lymphocytic leukemia (CLL)
44
what are the four main types of leukemia
acute lymphoblastic leukemia (ALL) acute myeloid leukemia (AML) chronic myeloid leukemia (CML) chronic lymphocytic leukemia (CLL)
45
how are leukemias classified
predominant cell of origin (myeloid or lymphoid) acute vs chronic
46
what is the acute classification of leukemia
undifferentiated or immature (blast) cells rapid onset with short survival
47
what is chronic classification of leukemia
differentiated cells that do not function normally slow progression
48
what are some causes of leukemia
family history congenital disorders infection environmental factors drugs chromosome abnormalities
49
which chromosomal abnormalities are most commonly seen with leukemias
reciprocal translocations (philadelphia chromosome) inversions and deletions
50
philadelphia chromosome can cause which type of leukemia
chronic myeloid leukemia
51
who is most likely to get leukemia
adults although young children around 1-4 are susceptible to acute lymphoid leukemia
52
who is acute lymphoblastic leukemia (ALL) most common in
least common overall but most common childhood leukemia (80%)
53
how does acute lymphoblastic leukemia affect children
affects precursor B and T cells leading to immature lymphoblasts 85% are B-cell types
54
how does acute lymphoblastic leukemia affect adults
mixture of affected B and T precursor cells
55
what is the mechanism of acute lymphoblastic leukemia (ALL)
chromosomal deviations block differentiation which allows for accumulation of immature, nonfunctional blast cells leads to overcrowding and bone marrow failure, ultimately pancytopenia
56
how is acute lymphoblastic leukemia (ALL) treated
aggressive chemotherapy and supportive measures 95% of children achieve remission; 75-85% cured
57
what is remission
signs and symptoms of conditions are reduced, does not yet mean you're cured need 5 years of remission to be considered cured
58
what is acute myeloid leukemia (AML)
abnormal proliferation of immature myeloid blast cells in bone marrow more aggressive and most common in those over 60 years of age
59
what is the mechanism of acute myeloid leukemia (AML)
acquired mutations interfere with differentiation leading to an accumulation of immature, nonfunctional myeloid blast cells leads to overcrowding, bone marrow failure, and pancytopenia
60
how is acute myeloid leukemia (AML) diagnosed
need at least 20% myeloid blast cells in bone marrow often times see auer rods
61
what are auer rods
needle-like azurophilic granules sometimes found in acute myeloid leukemia (AML)
62
how is acute myeloid leukemia (AML) treated
chemotheraphy and supportive measures complete remission in 60% of patients 15-30% become free of disease for 5 years
63
what do those with acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL) present with
pancytopenia pain in joints and bones due to infiltrates CNS involvement (headaches, vomiting, nerve palsies) due to bleeding spleen and liver enlargement (mostly ALL) lymphadenopathy
64
what do those with pancytopenia present with
anemia (fatigue, weakness, pallor) thrombocytopenia (abnormal bleeding) leukopenia (low WBC and fever)
65
what is chronic lymphocytic leukemia (CLL) -who does it mainly effect
most common leukemia of adults in western world most common in males around 60 caused by clonal malignancy of mature B-cells median survival is 4-6 years
66
what is the mechanism of chronic lymphocytic leukemia (CLL)
genetic deletions and trisomy lead to over expression of BCL-2 (anti-apoptotic protein) accumulation of abnormal B-cells leads to hypogammaglobulinemia
67
what three things are most affected in patients with chronic lymphocytic leukemia (CLL)
lymph nodes (lymphadenopathy) spleen bone marrow
68
what is hypogammaglobulinemia
low serum immunoglobulin or antibody levels
69
what is chronic myeloid leukemia (CML) -what does it present with -how is it treated
disease of mostly adults but can occur in children, most common around 50-60 yrs old presents with: hypercellular bone marrow, lots of leukocytes, and enlarged spleen treated with BCR-ABL inhibitors
70
what is the mechanism of chronic myeloid leukemia (CML)
acquired mutation (usually Philadelphia chromosome) leads to activation of tyrosine kinases (BCR-ABL) leads to proliferation of granulocytic and megakaryocytic progenitors and abnormal release of immature granulocytic forms in bone marrow
71
what are the presentations of those with chronic lymphocytic leukemia (CLL)
usually asymptomatic but some may experience infections, fatigue, weight loss, and anorexia
72
what are the presentations of those with chronic myeloid leukemia (CML)
painful splenomegaly slower progressive phase (asymptomatic) accelerated phase (symptoms) terminal phase (blast crisis)
73
which chromosome is the ABL gene found on
chromosome 9
74
which chromosome is the BCR gene found on
chromosome 22
75
which type of leukemia comes mostly from Philadelphia chromosome translocations
chronic myeloid leukemia (CML)

Disease Mechanisms (19 decks)

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