Chapter 29 Flashcards by Desiree Namou

what are leukocytes?

basophils
eosinophuls
neutrophils
monocytes
lymphocytes

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reasons affecting leukocyte production?

many hematologic disorders are _______
many ___________ metastasize to the bone marrow, affecting leukocyte production

malignancies

nonhematologic malignancies

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granulocytosis (neutrophilia)

is evident in the first stages of infection or inflammation
if the need for neutrophils increases beyond the supply, then the immature neutrophils (banded neutrophils) are released into the blood
premature release of immature leukocytes is termed a ________
leukemoid reaction

shift to the left

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infectious mononucleosis
-acute, self limiting viral infection of __________
-commonly caused by the _____ - ___%
transmission by saliva

B lymphocytes

EBV - 85%

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infections mononucleosis in _____ is
-an acute viral infection of _________
caustive agents include _______

children
lymphocytes
Epstein-Barr

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infectious mono
classic triad of symptoms:
1.
2.
3. \_\_\_\_\_\_\_ of the \_\_\_\_\_\_\_

diagnostic test
-_______ qualitative test for ______ antibody detects ___

fever
pharyngitis
lymphadenopathy of the cervical lymph nodes
monospot
heterophilic 
IgM

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leukemias
are malignant disorders of the blood and blood forming organs
uncontrolled proliferation of malignant leukocytes
classification:
-predominant cell of origin: ______ or ______
-rate of progression: ____ or ____

myeloid, lymphoid

acute, chronic

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acute leukemia
presence of undifferentiated or immature cells usually blast cells
-rapid onset with short survival
-disease is ________ bone marrow

from the

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chronic leukemia
predominant cell is mature but does not function normally
slow progression
disease starts ______ bone marrow

outside

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for acute and chronic leukemia
the current classification of leukemia is based on
1. ___________ (either myloid or lymphoid)
2 __________(which usually reflects the degree at which cell differentiation was arrested when the cell became malignant (acute or chronic

predominant cell type

rate of progression

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acute lymphocytic leukemia (ALL)
disease is ______ bone marrow so:
-is defined as greater than 30% _______ in blood or bone marrow
-ALL is the most common leukemia in children
-ALL is a progressive _______ defined by the presence of greater that 30% lymphoblasts in the bone marrow or blood

acute lymphocytic leukemia (ALL)
from the bone marrow
lymphoblasts
neoplasm

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disease is myeloid so:
this is caused by an abnormal proliferation of _____ precursor cells
most common adult leukemia

acute myelogenous leukemia
(AML)
myeloid

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-__________ is often present and _____-___ causes initiation of this
-this chromosome is present in more than ___% of those with CML, and the presence of the _____
protein is responsible for the _____ of CML

chronic myelogenous leukemia
(CML)
philadelphia chromosome
BCR-ABL1 
95%
BCR-ABL1
initiation

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CML
clinical manifestations
\_\_\_\_\_\_\_, \_\_\_\_\_\_\_, and \_\_\_\_\_\_\_\_
-chronic phase
-lasts \_\_ to \_\_ years
symptoms: may \_\_\_\_\_\_\_\_

accelerated phase

lasts __ to __ months
primary symptoms develop:_______

terminal blast phase

______
survival: only __ to __ months

infections, fever, weight loss
2-5 yeyars
not be apparent
6, 18
splenomegaly
blast crisis
3, 6

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CML

no ____
combined _________
_______ response ______
______ stem cell _________

cure
chemotherapy
biologic response modifiers
allogeneic stem cell transplantation

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affects monoclonal B lymphocytes

____ fail to mature into ____ cells that synthesize _________
is derived from transformation of a partially _____ that has not yet encountered _______
has a familial tendency
is common in adults older than 50

chronic lymphocytic leukemia (CLL)
B cells
plasma
immunoglobulins
mature B cells
antigen

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enlarged lymph nodes that become palpable and tender

local ________
_____ of an inflammatory lesion located near the _______
general
occurs in the presence of ___ or ____ disease

lymphadenopathy
drainage, enlarged node
malignant, nonmalignant

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malignant lymphomas
two major categories
\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_
result from genetic mutations or a viral infection

hodgkin lymphoma

non-hodgkin lymphoma

hodgkin lymphoma
_______ cells in the lymph nodes
-are necessary for the ______ but not specific to hodgkin lymphoma
-are derived from malignant ________ that usually become _______

_____ cells represent malignant _______ and ______ ______
clinical manifestations
-_______, causing _____ and _______.
local symptoms caused by _____ and _____ of the lymph nodes are a result of ________

reed-sternberg
diagnosis
B cells
binucleate
reed sternberg
transformation
proliferation
B cells
lymphadenopathy
pressure
obstruction
pressure obstruction
lymphadenopathy

non-hodgkin lymphoma
-clonal expansion of B cells T cells and or NK cells occurs
treatment:
_______ or _______ or combination of both
monoclonal antibody: ________

chemotherapy, radiation

rtuximab

burkitt lymphoma
very fast growing tumor of the jaw and facial bones (africa)
rare ih US
______ in __% cases. found in ___________, is associated with this in ______ children
-in non-________ burkitt lymphoma, the most common presentation is ______, _______, ______, and _______

EBV, 90%
nasopharyngeal secretions
African
African 
abdominal swelling, night sweats, fever, weight loss

alterations of splenic function
__________: may be classified as pathologic
__________: overactive spleen
___________: occurs with hepatic cirrhosis
__________: engorgement by macrophages with indigestible materials from various “storage diseases”
manifestation: anemia from RBC destruction
treatment: ______ of the spleen

splenomegaly
hypersplenism
congestive splenomegaly
infliltrative splenomegaly
removal

_______ develop from B lymphocytes, a type of white blood cell that is made in the bone marrow

normally when bacteria or viruses enter the body some of the B cells will change into them
the plasma cells make _______ to fight bacteria and viruses, to stop infection and disease!!!

plasma cells

antibodies

multiple myeloma
in multiple myeloma, cells are abnormal _________ (a type of white blood cells) that build up in the bone marrow and form ___ in many forms of the body
normal plasma cells make ______
as the number of multiple myeloma cells increases, more _____ are made
this can cause the blood to _____ and keep the bone marrow from making enough healthy ______
multiple myeloma cells also damage and weaken the ________

plasma cells
tumors
antibodies
antibodies
thicken
blood cells
the bone

multiple myeloma malignant plasma cells produce abnormally large amounts of one class of immunoglobulin -unattached _________ of the immunoglobulins (_______) can pass through the _______ and damage the ________ clinical manifestations - _________

``` light chains bence jones proteins glomerulus renal tubular cells hypercalcemia ```

MM and hypercalcemia - _____ acts as an _______ activating factor and stimulate ______ to reabsorb bone - this process results in ______ and _____, resulting from release calcium from the ______ of bone

``` IL 6 osteoclastic osteoclasts bone lesions, hypercalcemia breakdown ```

certain conditions within the blood vessels predispose an individual to develop clots spontaneously

thromboembolic disease

a stationary clot attached to the vessel wall (made up of fibrin and blood cells)

thrombus

form under conditions of high blood flow and are composed mostly of platelets aggregates held together by fibrin strands

arterial thrombi

form in conditions of low flow and are composed mostly of red cells with larger amounts of fibrin and few platelets

venous thrombi

treatment of thromboembolic disease therapy consists of ______ or ______ of the clot

removal, lysis

thromboembolic disease the risk of developing spontaneous thrombi is related to several factors below referred as the: __________ 1. ________ injury to blood vessels 2. _______ blood flow 3. rapid ______ of the blood 4. stagnant ______ blood flow

``` Virchow's triad endothelial turbulent arterial coagulation venous ```

hypercoagulability - condition in which a individual is at risk for thrombosis primary (______): results are the _____ in _____ that are involved in _______ secondary (______): causes include a variety of clinical ________

``` hereditary defects proteins homeostasis acquired disorders ```

disorders of coagulation - defects or deficiencies of one or more clotting factors (______) - impaired _____: inability to promote coagulation and the development of a stable fibrin clot. ______ deficiency of ______ - consumptive thrombohemorragic disorders: _____________ coagulation

``` hemophilias hemostasis dietary vitamin K disseminated intravascular ```

why does the blood not clot properly? some clotting factors defects are inherited and usually involve a single factor such as ________ or ________ disease other coagulation defects are acquired and tend to result from deficient synthesis of clotting factors by the ____. causes include _______ and dietary ______ of _______

hemophilias, von Willebrand disease liver disease deficiency vitamin K

vitamin K deficiency impaired ______ vitamin K is required for normal_______ factor synthesis by the _________ -necessary for synthesis and regulation of ________, procoagluant factors (__, __, __) and proteins _ and _ (anticoagulants) -deficiency: leads to ______ -treatment: ______ administration of ______ most common cause of vitamin K deficiency is total ________ with _____ therapy

``` hemostasis clotting liver prothrombin VII, IX, X C, S bleeding parenteral, vitamin K parenteral nutrition antibiotic ```

consumptive thrombohemorrhagic disorders | -the description of ___ an unregulated release of _______ with subsequent ____ formation and accelerated __________

DIC (disseminated intravascular coagulation) thrombin fibrin fibrinolysis

disseminated intravascular coagulation diagnosis: most reliable and specific test for diagnosis _______ - a molecule produced by ____ clots. The test measures a specific ___ related product

D-dimer fibrin DIC

thrombocytopenia (low platelets) | two diseases:

immune thrombocytopenic purpura | thrombotic thrombocytopenic purpura

ITP (immune thrombocytic purpura) -__ antibody targets platelet ______ antibody coated platelets are sequestered and removed from ________ (________ in the spleen remove antibody coated platelets) ``` acute form develops after ________ -is one of the most common _______ bleeding disorders chronic form usually is found in adults bottom line point ITP is: -_________ with _______ antibodies ```

``` IgG glycoproteins circulation mononuclear phagocytes viral infections childhood autoimmune disease anti-platelet ```

a red purple discolorated caused by diffuse _____ in the skin

purpura

disorders of platelets | TTP is: ________ react with _______ cells to cause arterial _______

platelets endothelial cells occlusions

``` in TTP: pathognomonic pentad of symptoms 1. extreme ________ 2. intravascular __________ 3. _______ signs and symptoms most often involving the ___ (approx 65% exhibit ______ disturbances, behavorial _________, ______ or ________) 4. _____ failure 5. ______ ```

``` thrombocytopenia hemolytic anemia ischemic CNS memory irregularities headaches comas kidney fever ```