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Hematopoietic Function (Exam 3) Flashcards

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1
Q

Leukocytes (WBCs)

A

key players in inflammatory response and fighting infection

normal= 5000-10000 cells/mL in blood

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2
Q

Leukocytosis

A

increased leukocytes

indicate ongoing infectious process

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3
Q

Leukocytopenia/Leukopenia

A

decreased leukocytes

indicates immunosuppression or deficiency

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4
Q

Neutrophils

A

usually first leukocyte to arrive at infection site

2000-7500 cells/mL

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5
Q

Neutropenia

A

condition where concentration of neutrophils reaches <1500 cells/mL

M: DEPEND ON SEVERITY OR CAUSE, but include infections and ulcerations (especially mucous membranes) and other signs of infection like fever; ALL SIGNS OF IMMUNODEFICIENCY

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6
Q

Granulocytosis (Neutrophilia)

A

increase in granulocytes

NEUTROPHILIA IS EVIDENT IN FIRST STAGES OF AN INFECTION OR INFLAMMATION

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7
Q

Shift-to-the-left (A shift to immaturity)

A

IF THE NEED FOR NEUTROPHILS INCREASES BEYOND SUPPLY, IMMATURE NEUTROPHILS ARE RELEASED FROM BONE MARROW

SHIFT TO THE RIGHT WHEN POPULATION RETURNS TO NORMAL

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8
Q

Infectious Mononucleosis

A

the “kissing disease” spread by oral transmission, coughing, and sneezing; self-limiting and mostly prevalent in adolescents and young adults

EPSTEIN-BARR VIRUS (EBV), HERPES FAMILY

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9
Q

Infectious Mononucleosis Pathogenesis

A

incorporated B cells produce heterophile antibodies, some remain after recovery for life and may cause asymptomatic spread

insidious onset after 4-8 week incubation, causing anorexia, malaise and chills and manifestations will intensify to leukocytosis, fever, sore throat, lymphadenopathy, risk for splenic rupture

ACUTE PHASE 2-3 WEEKS, RECOVERY MAY TAKE UP TO 2-3 MONTHS

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10
Q

Lymphomas

A

cancers affecting the lymphatic system

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11
Q

Hodgkin Lymphoma

A

less common; solid tumors contain Reed-Sternberg cells often originating in lymph nodes of upper body (neck, chest, upper arms); primarily in adults 20-30 yrs, second peak 70 yrs

disease spreads from one lymph node to next via lymphatic vessels

several subtypes, most curable with chemotherapy, radiation or surgery

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12
Q

S/S of Hodgkin Lymphoma

A

enlarged painless lymph nodes which typically begin in upper body
mediastinal mass
splenomegaly
fever
weight loss
night sweats
pruritus (severe itching)

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13
Q

Non-Hodgkin Lymphoma

A

90% of all lymphomas, 5 yr survival rate is 68%; involves nodes throughout body and may originate in T/B cells

resembles Hodgkin lymphoma in manifestation, staging and treatment; spreads and is diagnosed differently (no Reed-Sternberg cells)

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14
Q

Leukemia

A

cancer of the leukocytes, the second most common blood cancer after lymphoma

most common cancer among children

leukemia cells abnormally proliferate and crowd normal blood cells and limits normal cell functioning

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15
Q

Risk Factors of Leukemia

A

mutagens (chemical, viral, radiation)
smoking
chemotherapy
diseases (Downs syndrome)
immunodeficiencies

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16
Q

Acute Lymphoblastic Leukemia

A

most common, primarily affects children, responds well to therapy, has good prognosis

less differentiated

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17
Q

Acute Myeloid Leukemia

A

affects primarily adults, responds fairly well to therapy, reasonably good prognosis

less differentiated

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18
Q

Chronic Lymphoid Leukemia

A

affects primarily adults, responds poorly to therapy but most patients live years after diagnosis since it’s slow moving

more differentiated

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19
Q

Chronic Myeloid Leukemia

A

affects primarily adults, prognosis is improved by allogeneic bone marrow transplant

more differentiated

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20
Q

Leukemia Manifestations

A

leukopenia (frequent infections)
anemia (fatigue, activity intolerance)
thrombocytopenia (increased bleeding risk)
lymphadenopathy
joint swelling
bone pain
weight loss
anorexia
hepatomegaly
splenomegaly
CNS dysfunction

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21
Q

Multiple Myeloma

A

cancer of the plasma cells, the third most common blood cancer and often affects older adults

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22
Q

Multiple Myeloma Pathogenesis

A
  1. excessive # of abnormal plasma in bone marrow crowd blood forming cells, destroys bone marrow by increasing osteoblast activities
  2. bone destruction: hypercalcemic pathologic fractures!
  3. causes Bence Jones protein excretion in urine
  4. often advanced progression when diagnosed
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23
Q

Multiple Myeloma Manifestations

A

insidious onset

anemia
thrombocytopenia
leukopenia
decreased bone density
bone pain
hypercalcemia
renal impairment

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24
Q

Anemia

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A

decreased # of erythrocytes, reduction of hemoglobin, or abnormal hemoglobin

decreases oxygen-carrying capacity and creates tissue hypoxia; acquired or inherited

25
Anemia Manifestations
weakness fatigue pallor syncope dyspnea tachycardia
26
Anemia Classifications
size (*identified by terms that end in -cytic; **macrocytic, microcytic, normocytic***) hemoglobin content (*identified by terms that end in -chromic; **normochromic and hypochromic***)
27
Iron-Deficiency Anemia
most common as iron is necessary for hemoglobin production; hypochromic, microcytic anemia; *most often seen in women of childbearing age, children younger than 2, elderly clients* **CAUSES:** *decreased iron intake in diet/absorption issues, increased bleeding, GI disorders affecting iron absorption like celiac, gastritis and bariatric surgery*
28
Iron-Deficiency Anemia Manifestations
cyanotic sclera brittle nails decreased appetite headache irritability stomatitis pica delayed healing
29
Pernicious Anemia
vitamin b12 deficiency (required for DNA synthesis), usually caused by autoimmune lack of intrinsic factor; macrocytic and normochromic **leads to decreased maturation, cell division and potentially neurologic complications caused by myelin breakdown**
30
Pernicious Anemia Manifestations
bleeding gums diarrhea impaired smell loss of deep tendon reflexes anorexia personality or memory changes positive Babinskis sign stomatitis parasthesia unsteady gait
31
Aplastic Anemia
bone marrow depression of all blood cells (*pancytopenia*); often ideopathic, autoimmune, medical, viral or genetic potentially insidious, sudden and severe onset **MANIFESTATIONS INCLUDE ANEMIA, LEUKOCYTOPENIA, THROMBOCYTOPENIA SYMPTOMS**
32
Hemolytic Anemia
excessive erythrocyte destruction (*hemolysis*) several different types including sickle cell anemia and thalassemia
33
Hemolytic Anemia Causes
idiopathic autoimmune genetics infections blood transfusion reactions blood incompatibility in neonate
34
Sickle Cell Anemia
hemoglobin S causes erythrocytes to carry less oxygen and clog vessels, leading to hypoxia and tissue ischemia; more common in african/mediterranean descent, south and central america, caribbean, middle east **HETEROZYGOUS sickle cell trait means less than half of erythrocytes are sickles** **HOMOZYGOUS means sickle cell disease (almost all erythrocytes are sickled)** *SICKLED CELLS OCCLUDE BLOOD VESSELS AND BLOCK BLOOD FLOW*
35
Sickle Cell Anemia Manifestations
**typically appear around 4 months of age** painful episodes of tissue ischemia and necrosis that can last for hours to days, triggered by dehydration, stress, altitude or fever
36
Thalassemia
most autosomal recessive, some autosomal dominant; most common in mediterranean or asian, indian and african descent ABNORMAL FORM OR INADEQUATE AMOUNT OF HEMOGLOBIN; ALPHA OR BETA
37
Alpha Thalassemia
4 genes (2 from each parent) are needed to make alpha protein, severity of symptoms depends on how many genes are missing **all 4 genes are missing=severe form called alpha thalassemia major**
38
Beta Thalassemia
2 genes (1 from each parent) are needed to make beta protein **if 1 gene affected you’re a carrier, if both are affected you have moderate to severe anemia**
39
Thalassemia Manifestations
abortion growth and development delays fatigue dyspnea heart failure hepatomegaly splenomegaly bone deformity jaundice infections **liver and spleen filter RBCs; RBCs that are damaged or dying are trapped by spleen and liver which destroy the cells**
40
Polycythemia Vera
a rare neoplastic disease of abnormally high RBCs that increase blood volume and viscosity, leading to tissue ischemia and necrosis; primary, secondary and relative **bone marrow produces too many RBCs, and sometimes too many leukocytes and platelets**
41
Primary Polycythemia Vera
mutation in JAK2 gene leads to uncontrolled hematopoietic stem cell growth
42
Secondary Polycythemia Vera
long term low O2 levels (severe heart disease or lung disease, smoking, high altitudes, exposure to high levels of CO)
43
Relative Polycythemia Vera
appearance of increased RBCs because of reduction in plasma (dehydration)
44
Hypercoagulable State
clogging and occlusion of blood vessels
45
Polycythemia Vera Complications
tissue ischemia and necrosis thrombosis hypertension heart failure hemorrhage splenomegaly hepatomegaly acute myeloblastic leukemia
46
Polycythemia Vera Manifestations
cyanotic/plethoric skin hypertension tachycardia dyspnea headaches vision impairment **INTENSE, PAINFUL ITCHING THAT APPEARS TO BE INTENSIFIED BY HEAT OR EXPOSURE TO WATER (*aquagenic pruritus*) SO PEOPLE AVOID WARM WATER WHEN SHOWERING**
47
Platelets
vital components of coagulation cascade normal concentration range from 150000-350000 cells/mL
48
Thrombocytosis
increased platelet levels INCREASES RISK OF THROMBUS FORMATION
49
Thrombocytopenia
decreased platelet levels <150000/mm3 INCREASES RISK OF BLEEDING AND INFECTION *<100000: becomes clinically significant* *<50000: hemorrhage from minor trauma* *<15000: spontaneous bleeding* *<10000: severe bleeding*
50
Thrombocytopenia Causes
DECREASED PLATELET PRODUCTION (**viral infections, drugs/radiation therapy, chronic renal failure, bone marrow hypoplasia or cancer**) INCREASED PLATELET CONSUMPTION (**Heparin-induced thrombocytopenia (HIT), Idiopathic (immune) thrombocytopenia purpura (ITP), Thrombotic thrombocytopenia purpura, Disseminated intravascular coagulation (DIC)**)
51
Hemophilias
inherited bleeding disorder that results in decreased coagulation (a mutation in a gene that provides instructions for making clotting factors); A or B *X-LINKED RECESSIVE* **may be inherited or caused by spontaneous mutation of factor gene (30%)**
52
Hemophilia A
factor VIII deficiency; more common (1 in 5000 male births)
53
Hemophilia B
factor IX deficiency (*Christmas disease*); 1 in 30000 male births
54
Hemophilia Manifestations
bleeding or signs of bleeding (*bruising, petechia, etc.*) **may see s/s during infant circumcision or when infant starts crawling/walking** hemarthrosis
55
Hemarthrosis
bleeding into the joints
56
Von Willebrand Disease (VWD)
most common hereditary bleeding disorder, characterized by decreased platelet adhesion and aggregation; multiple types with different inheritance patterns and may be acquired or spontaneous *mutation on chromosome 12 that causes deficit of Von Willebrand factors which normally causes platelets to aggregate and stick to vessel wall when injured* **MANIFESTATIONS: abnormal bleeding that is hard to stop, indications of bleeding (*bruising, petechia, etc.*)**
57
Immune Thrombocytopenic Purpura (ITP)
hypocoagulation due to autoimmune destruction of platelets; acute (*self-limiting and more common in children with sudden onset*) and chronic (*more common in women and adults age 20-50*) **MANIFESTATIONS: abnormal bleeding or indications of bleeding (*petechiae, mucosal bleeding, epistaxis, purpura*)**
58
ITP Causes
idiopathic autoimmune disease live vaccine immunization immunodeficiency disorders (*AIDS*) viral infections

Pathology (10 decks)

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