Leukocyte and Lymphoid Pathophysiology

Question 1

quantitative disorders

Answer 1

changes in number of WBCs

-Leukocytosis or leukopenia

Question 2

qualitative disorders

Answer 2

disrupted function of WBCs

Question 3

leukocytosis

Answer 3

elevation in # WBCs

• normal response with infection, stress, etc
• abnormal leukocytosis caused by malignancies or blood disorders

Question 4

leukopenia

Answer 4

decrease in # WBCs

-abnormal

Question 5

what causes leukopenia

Answer 5

decreased production in marrow or increased destruction
exposure to radiation
autoimmune disease
chemotherapy
anaphylactic shock

Question 6

Infectious Mononucleosis

Answer 6

acute viral infection of B lymphocytes usually caused by Epstein-Barr virus

Question 7

what do B-lymphocytes do

Answer 7

produce antibodies

Question 8

what % of Mono cases are caused by Epstein-Barr virus?

Answer 8

80%

Question 9

how is epstein barr virus spread

Answer 9

saliva (NOT airbourne)

Question 10

A lymphocytosis

Answer 10

associated with infectious mononucleosis

Question 11

typical symptoms of infectious mononucleosis

Answer 11

high fever
lymph node swelling
headache
sore throat
chills

Question 12

age range for infectious mononucleosis

Answer 12

80% of kids infected by age 4
symptomatic IM usually occurs age 15-35
rare after age 40

Question 13

how Mono is diagnosed

Answer 13

10% of lymphocytes are atypical
fever
pharyngitis
presence of heterophile antibodies (IgM)

Question 14

tx for mono

Answer 14

rest and avoid strenuous activity
analgesics (ibuprofen)
antipyretics (meds that decrease fever)
treat any opportunistic infections with antibiotics

Question 15

leukemias

Answer 15

malignant disorder of the blood and blood forming tissues

Question 16

what tissues form blood

Answer 16

marrow

Question 17

how does leukemia start

Answer 17

loss of regulation of cell division; bone marrow gets overcrowded which suppresses production of normal cells

Question 18

4 subtypes of leukemia

Answer 18

Acute lymphocytic leukemia
Acute myelogenous leukemia
chronic lymphocytic leukemia
chronic myelogenous leukemia

Question 19

acute lymphocytic leukemia (ALL)

Answer 19

less than 30% lymphoblasts in blood or bone marrow

there is a blockage of cell differentiation, so the cells don’t reach full function

Question 20

what type of research has led to tx for ALL?

Answer 20

HIV

Question 21

what is the most common leukemia in kids under age 10?

Answer 21

acutelymphocytic leukemia

Question 22

complications of acute lymphocytic leukemia

Answer 22

bleeding disorders
anemia
opportunistic infections
enlargement of spleen and lymph nodes

Question 23

why do spleen and lymph nodes enlarge?

Answer 23

cells accumulate in liver, spleen, and lymph nodes

Question 24

is there a genetic component in ALL?

Answer 24

yes, but not clearly understood

Question 25

what populations have increased incidence of ALL?

Answer 25

developed countries | higher socioeconomic groups

Question 26

acute myelogenous leukemia

Answer 26

accumulation of myeloid precursor cells in bone marrow

Question 27

what are myeloid precursor cells?

Answer 27

precursor to WBCs

Question 28

risk factors for AML

Answer 28

``` exposure to radiation, chemotherapy, benzene older age (highest in 50s) downs syndrome ```

Question 29

complications of AML

Answer 29

clotting disorders anemia infection

Question 30

tx for ALL and AML

Answer 30

``` chemotherapy bone marrow transplant (best in ALL) stem cell transplant blood transfusion (tx anemia) nutrition therapy antibiotics (treat opportunistic infection) ```

Question 31

what causes chronic leukemias

Answer 31

acquired injury to DNA of a bone marrow stem cell | renegade cells

Question 32

causes of injury to DNA

Answer 32

``` toxic compounds (carcinogens, benzene) tobacco ```

Question 33

what happens in chronic lymphocytic leukemia

Answer 33

B-cells fail to mature and produce antibodies | sometimes T cells are affected

Question 34

tx of chronic lymphocytic leukemia

Answer 34

chemotherapy steroid therapy stem cell therapy?

Question 35

how does chronic myelogenous leukemia start

Answer 35

renegade stem cell leads to excessive proliferation in marrow

Question 36

sx of CML

Answer 36

painful enlargement of spleen | painful swelling of lymph nodes

Question 37

tx of CML

Answer 37

chemotherapy stem cell transplant interferon therapy (investigational)

Question 38

interferon therapy

Answer 38

prevents viral DNA from getting into host cells | may suppress and/or destroy renegade cells

Question 39

most common types of malignant lymphomas

Answer 39

Hodgkin Lymphoma | Non-Hodgkins Lymphoma

Question 40

Hodgkin lympoma most common in what populations

Answer 40

caucasions | teens, 20s, 50s, 60s

Question 41

characteristics of Hodgkin Lymphoma

Answer 41

presence of Reed-Sternberg cells (malignant cells)

Question 42

sx of Hodgkin Lymphoma

Answer 42

``` fever weight loss night sweats swelling of lymph glandular tissue increased erythrocyte sedimentation rate ```

Question 43

tx of Hodgkin Lymphoma

Answer 43

radiation therapy chemotherapy marrow transplant stem cell transplant

Question 44

how many stages of Hodgkin Lymphoma

Answer 44

IV

Question 45

Characteristics of Non-Hodgkin Lymphoma

Answer 45

several subcategories based on type of renegade cell | can have low, medium, and high grade

Question 46

how is Non-Hodgkin lymphoma dx

Answer 46

biopsy of lymph tissue

Question 47

tx of Non-Hodgkin Lymphoma

Answer 47

``` varies depending on type of cell involved chemotherapy radiation therapy immunotherapy cell transplantation (sometimes) ```

Question 48

does Hodgkin or Non-Hodgkin lymphoma have a worse prognosis

Answer 48

Non-Hodgkin