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patho > Ch. 24 in class notes > Flashcards

Ch. 24 in class notes Flashcards

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1
Q

neutrophils, eosinophils, and basophils are what type of leukocyte division?

A

granulocytes

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2
Q

NK cells, T-cells, and B cells are what kind of leukocyte division

A

lymphocytes

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3
Q

3 divisions of leukocytes

A

granulocytes
monocytes/macrophages
lymphocytes

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4
Q

cells that have the potential to differentiate into different blood cells

A

pluripotent stem cells

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5
Q

lymphocyte that coordinate immune response

A

cd4 and t cells

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6
Q

lymphocytes that attack infected cells

A

cd8 and t cells

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7
Q

lymphocyte that produce antiboides to fight infection

A

b cells

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8
Q

type of lymphocyte that identify and lyse infected cancer cells

A

nk cells

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9
Q

regulate proliferation

A

growth factors

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10
Q

bone components

A

stromal cells
osteoblasts and endothelial cells
extracellular matrix proteins

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11
Q

lymphoid tissue superficial cortex divisions include

A

t cell domain
b cell domain (primary and secondary follicle)

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12
Q

immunologically incactive b cell domain

A

primary follicle

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13
Q

b cell domain that has germinal centers

A

secondary follicle

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14
Q

ensures increased affinity of antibodies produced by mature b cells

A

germinal centers

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15
Q

association with mucous membranes of the GU system, alimentary canal, and respiratory passages

A

lymphatic system function

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16
Q

lymphoid tissue surrounding mucous membranes of the GU system, alimentary canal, and respiratory passages

A

Diffuse Lymphoid Tissue or Mucosa-Associated Lymphoid Tissue (MALT)

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17
Q

a decrease in the absolute number of leukocytes in the blood

A

leukopenia

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18
Q

are the most commonly affected White Blood Cell

A

neutrophils

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19
Q

what type of deficiencies are these: Agranulocytosis, Congenital, Acquired, Autoimmune, Infection-Related, and Drug-Related

A

neutrophil, neutropenia

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20
Q

Abnormally low number of neutrophils and commonly defined as a circulating neutrophil count of less than 1500 uL
- Denotes an absence of neutrophils
- Since neutrophils play a crucial role in host-defense mechanisms against infection, a decrease leads to a higher risk of infection
- Can result from decreased neutrophil production, increased usage of neutrophils, or a shift from the blood to tissue compartments

A

agranulocytosis

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21
Q

-Rare disorder, split into two subtypes
Severe: diagnosed in infants, with counts of less than 200g/L. Associated with severe bacterial infections
- Is also known as Kostmann syndrome, which is characterized by an arrest in myeloid maturation, which can be inherited as autosomal dominant or recessive
- This is caused by mutations in the HAX-1 gene, which causes a loss of mitochondria. Those with this disorder are prone to severe bacterial infections, and 20% will develop Acute Myelogenous Leukemia
Cyclic: discovered in children younger than 2 yoa, associated with acute stomatologic disorders. Occurs with periodic oscillations between normal and abnormal neutrophils
- Bone marrow can function normal for awhile, but there is still a risk of severe life-threatening infections if the bone marrow function decreases for a period of time
- These cycles are less noticeable as someone ages

A

congenital neutropenia

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22
Q

2 subtypes of congenital neutropenia

A

severe and cyclic

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23
Q

diagnosed in infants, with counts of less than 200g/L. Associated with severe bacterial infections
- Is also known as Kostmann syndrome, which is characterized by an arrest in myeloid maturation, which can be inherited as autosomal dominant or recessive
- This is caused by mutations in the HAX-1 gene, which causes a loss of mitochondria. Those with this disorder are prone to severe bacterial infections, and 20% will develop Acute Myelogenous Leukemia

A

severe congenital neutropenia

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24
Q

discovered in children younger than 2 yoa, associated with acute stomatologic disorders. Occurs with periodic oscillations between normal and abnormal neutrophils
- Bone marrow can function normal for awhile, but there is still a risk of severe life-threatening infections if the bone marrow function decreases for a period of time
- These cycles are less noticeable as someone ages

A

cyclic congenital neutropenia

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25
This is caused by mutations in the HAX-1 gene, which causes a loss of mitochondria
severe congenital neutropenia
26
Encompasses a spectrum of processes. Includes primary and secondary autoimmune, infection-related, and drug-related neutropenias. A number of bone marrow disorders, hematopoietic malignancies, and radiation therapy may induce neutropenia These are essentially cases of neutropenia which are developed in adolescence or adulthood
acquired neutropenia
27
Antibodies directed against neutrophil cell membrane antigens or bone marrow progenitors - Primary (not associated with other pathologic processes) - Rare disorder of childhood. Moderate-severe neutropenia - Benign condition with mild-moderate infections for children - Disorder is not typically seen in adults - Secondary (associated with other pathologic processes) - Mainly occurs with Rheumatoid Arthritis, and Lupus
autoimmune neutropenia
28
Rare disorder of childhood. Moderate-severe neutropenia - Benign condition with mild-moderate infections for children - Disorder is not typically seen in adults
primary autoimmune neutropenia
29
- Mainly occurs with Rheumatoid Arthritis, and Lupus
secondary autoimmune neutropenia
30
Different infectious diseases can cause neutropenias Most common is viral Infections are caused physiologically by decreasing neutrophil production, losing neutrophils by toxins, or problems in the spleen - Neutropenia is a common manifestation of Acquired Immunodeficiency Syndrome (AIDS), where a suppression of bone marrow cell proliferation is often aggravated by infectious consumption of neutrophils and antiviral drugs
infection related neutropenia
31
Neutropenia is a common manifestation of
Acquired Immunodeficiency Syndrome (AIDS)
32
suppression of bone marrow cell proliferation is often aggravated by infectious consumption of neutrophils and antiviral drugs
aids
33
Usually related to drugs used in the treatment of cancer Treatments like chemotherapy or radiation kill cancer cells as well as immune cells, which causes a decrease in neutrophils Factors such as age, immune status, overall health, and prior history can make patients be at higher risk Older patients are more prone due to age-related cellular change in neutrophils
drug induced neutropenia
34
is a self-limiting lymphoproliferative disorder caused by the Epstein-Barr Virus Clinical Course Incubation period of 4-6 weeks Prodromal period consisting of malaise, anorexia, fever and chills Complications Enlarged spleen Hepatitis Encephalitis
infectious mononucleosis
35
incubation period of mono
4-6 weeks
36
Group of disorders characterized by abnormal growth of plasma cells Types: Monoclonal Gammopathy of Undetermined Significance (MGUS), Multiple Myeloma, Localized Plasmacytoma Multiple Myeloma: proliferation of malignant plasma cells in bone bone marrow Osteolytic bone lesions M protein overproduction (monoclonal immunoglobulins)
plasma cell dyscrasias
37
proliferation of malignant plasma cells in bone bone marrow Osteolytic bone lesions M protein overproduction (monoclonal immunoglobulins)
multiple myeloma
38
Symptoms: Bone pain Kidney problems (nephropathy & renal failure) Pathologic fractures Hypercalcemia Anemia Recurrent infections Thrombocytopenia (purpura)
multiple myelotion
39
diagnostic criteria of multiple myeloma
Classic Triad: Monoclonal protein of Bence Jones proteins in urine Bone Marrow Plasmacytosis Lytic bone lesions
40
Characterized by bone marrow being largely replaced by proliferating, abnormal, premature malignant neoplasms (derived from hematopoietic precursor cells)
leukemias
41
immature lymphocytes & their progenitors that originate in the bone marrow but they go into the spleen, lymph nodes, CNS, and other tissue
lymphocytic leukemias
42
pluripotent myeloid stem cells in bone marrow & interfere with maturation of ALL blood cells (granulocytes, erythrocytes, and thrombocytes)
myelogenous leukemias
43
Cancers of the hematopoietic progenitor cells, sudden onset, with signs and symptoms related to decreased bone marrow function
acute leukemias
44
Group of neoplasms composed of precursor B or T lymphocytes (lymphoblasts 90% of ALL cases have numeric and structural changes in the chromosomes of the leukemic cells children
Acute Lymphoblastic Leukemia (ALL)
45
Diverse group of neoplasms affecting myeloid precursor cells in bone marrow Associated with acquired genetic alterations that inhabit terminal myeloid differentiation Normal marrow elements are replaced by an accumulation of undifferentiated blast cells which is what leads to the anemia, thrombocytopenia, and neutropenia
acute myeloid leukemia AML
46
Malignancies involving the proliferation of more fully differentiated myeloid and lymphoid cells
chronic leukemias
47
Clonal malignancy of B lymphocytes most common form of leukemia in adults in Western world
chronic lymphocytic leukemia (CLL)
48
Disorder of pluripotent hematopoietic progenitor cell Characterized by excessive proliferation of marrow granulocytes, erythroid precursors, and megakaryocytes Believed to develop when a single, pluripotent hematopoietic stem cell acquires a Philadelphia chromosome 3 stages: chronic phase of variable length, short accelerated phase, and terminal blast crisis phase
chronic myelogenous leukemia (CML)
49
Chronic phase of variable length Slow & nonspecific symptoms Characteristic lab finding is leukocytosis with immature granulocyte cell types in peripheral blood - stage of CML
stage 1
50
short accelerated phase Characterized by enlargement of spleen and progressive symptoms Increase in basophil count and more immature cells in blood or bone marrow confirm transformation to accelerated phase- CML phase
stage 2
51
terminal blast crisis phase Evolution to acute leukemia and is characterized by an increasing number of myeloid precursors, especially blast cells in blood Splenomegaly may increase greatly Symptoms of leukostasis may occur- CML stage
stage 3
52
abrupt onset of fatigue (anemia), night sweats, low-grade fever, weight loss, bleeding, bone pain and tenderness, neutropenia, generalized lymphadenopathy, splenomegaly, hepatomegaly, CNS involvement, and leukostasis
acute leukemias sx
53
asymptomatic at diagnosis, lymphocytosis, increase in lymph nodes, with aggressive CLL there is rapid sequence of increasing lymphadenopathy, hepatosplenomegaly, fever, abdominal pain, weight loss, progressive anemia, and thrombocytopenia with a rapid rise in lymphocyte count; hypogammaglobulinemia
CLL
54
chronic phase (non specific symptoms); accelerated phase- splenomegaly and abdominal pain, and constitutional symptoms (nigth sweats, bone pain, weight loss, bleeding and easy bruising)
CML
55
genetic mutations in genes regulating growth, differentiation, & apoptosis
ALL
56
associated with acquired genetic alterations that inhibit terminal myeloid differentiation
acute myeloid leukemia
57
% immature wbc
60-80
58
determines subtype of leukemia
Immunophenotyping
59
one of the most helpful tools in finding chromosomal abnormalities indicating acute leukemia Also helps determine how pt will respond to Tx
cytogenic studies
60
hallmark of chronic leukemia
presence of the BCR-ABL gene product
61
where lymphoma arise from
in peripheral lymphoid tissues
62
Originates at extranodal sites and spreads to contiguous nodes- lymphoma
NHL
63
Arises in single node or chain of nodes -lymphoma
HL
64
but potentially mutated Ig genes in Reed- Sternberg cells is the cause
HL
65
NHL sybtype- T cell exhaustion Th cells promote tumor; better prognosis, risk for males >65
follicular
66
NHL subtype- unknown cause (potentially EBV or HIV); aggressive, common ages 60-70
diffuse large B cells
67
NHL subtype- EBV & malarial infection; very aggressive, endemic regions Africa
burkitt
68
NHL subtype- IgG gene rearrangement; 3 year prognosis, age 60
mantal cell
69
NHL subtype- late stage memory B cells, inflammation allows for more mutation
marginal zone
70
HL subtype- clonal proliferation “Reed Sternberg” and Hodgkin cells; women age 15-35
classic
71
HL sybtype- “popcorn/lymphohistiocytic” cells; 80% survival
Nodular lymphocyte-predominant
72
these are sx of what- Painless enlargement of single/group nodes Mediastinal masses Cough and dyspnea Weight loss Fever and chills Night sweats
HL
73
these are sx of what- Painless lymphadenopathy Affected lymph nodes present in retroperitoneum, mesentery, and pelvis
NHL
74
: Reed-sternberg cells are the hallmark Lymph node tissue bx Imaging Bipedal lymphangiogram CT scan Bone marrow bx Staging based off # lymph nodes to determine Tx
HL
75
Lymph node biopsy Immunophenotyping: lineage & clonality Staging to determine Tx
NHL
76

patho (8 decks)

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