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Flashcards in Midterm WBC Review Deck (78):
1

What cause flow cytometry to be used

AIDS

2

T-cell CD markers
B-Cell
NK cell
All cells

T: 1-8
B: 19,20
NK: 15, 56
All: 45

3

Use of flow cytometry?

COnfirm diagnoses

4

Most common form of leukopenia

Neutropenia

5

Neutropenia neutrophil count?
3 causes
Which most common

Less than a 1000/ul

1. Inadequate granulopoiesis
2. Accelerated removal
3. Drug toxicity (most common)

6

Drug responsible for neutropenia usually

Chemo

7

Major problem with leukopenia

Infections

8

Reactive leukocytosis
Reaction to what?
Mimics what?
Lab count definition

Infection or inflammatory stimuli
Mimics leukemia (leukemoid reaction)
WBC greater than 50,000

9

Define leukoerythroblastosis?

Presence of nucleated RBC's and left shift of neutrophils

10

Three toxic changes in neutrophilia (3)

1. Toxic degranualation
2. Dohle bodies
3. Cytoplasmic vacuoles

11

Infectious mono
Main blood manifestation (primary histo finding)
3 other symptoms

Reactive lymphocytosis
Sore throat, lymphadenitis, splenomegaly

12

Infectious mono cause
How to detect (2)

EBV

Monospot test or Specific EBV Ab's in blood

13

Acute nonspecific lymphadenitis
Two location types
Two specific types

Localized or generalized
Bubos: yersinia pestis
Scrofula: mycobacteria

14

Chronic nonspecific lymphadenitis
Three causes
Common finding in cancer lymph nodes
Two lymph node locations

Viral infection, Post-vaccination, Dilantin
Sinus histiocytosis in lymph nodes draining cancers
Inguinal and axillary lymph nodes

15

Cat scratch fever
Cause
2 results

Bartonella henselae

1. Regional lymphadenopathy
2. Stellate necrotizing granulomas

16

Leukemias are only found where? 2

Peripheral blood
Bone marrow

17

Main finding in Hodgkin lymphoma

Reed-sternberg cell

18

Main cell-origin of most lymph neoplasms

B-cell

19

Effaced lymph node means you can exclude what?

Lymphoma

20

Acute leukemias
How it presents
Lab findings (3)

Abrupt stormy onset
Anemia, Thrombocytopenia, >20% blasts

21

Precursor B and T cell leukemia/lymphoma
Age of patients
Pre-B present how? Involvement of what
Pre-T present how? Involvement of what
WIll both appear how at some point?
Pre-B age
Pre-T age?

Children/young adults
Leukemia with BM and PB involement
Mediastinal mass involving thymus
ALL
Child
Teenager

22

Special title of ALL?

Most common cancer of children

23

Pre-B CD markers? (2)

CD19 and CD20

24

Pre-T CD marker?

CD1, CD2, CD5, CD7, and later CD3, CD4, CD8

25

Enzyme found in both Pre-B and Pre-T?

TdT

26

Which is best prognosis, PreB or Pre-T?

Pre-B better

27

Small lymphocytic lymphoma/CLL
Special title
Age
Histo finding
Two special markers
Two complications

Most common leukemia in Western world
60
Smudge cells
CD23 and CD5 along with pan-B
Autoimmune hemolytic anemia and thrombocytopenia

28

Follicluar lymphoma
3 special markers
How to stage
Major mutation
Result of mutation

CD10, BCL6, BCL2
Bone marrow part of staging
14:18 translocation
Overexpress BCL2

29

Diffuse Large B-cell lymphoma
Title
Age
Growth pattern

Most common form of NHL
60
Aggressive and diffuse

30

Burkitt lymphoma
Histo pattern
Age
Main manifestation in US
Main manifestation in Africa
Main translocation
Gene involved
Gene on what chromosome
What is on other chromosome

Starry sky
Young
Visceral
Jaw involvement
8:14 translocation
c-MYC gene
Chromosome 8
Ch 14 has Ig Heavy chain

31

Mantle cell lymphoma
Age and sex
Two markers positive
One marker negative
Most translocation
Gene involved

Old males
CD5 and BCL1/Cyclin D1 positive
Negative for CD23
11:14 translocation
Cyclin D1/BCL1

32

Marginal zone lymphoma is commonly found where?

Marginal Zone Lymphoma (extranodal)

33

Marginal zone lymphoma MALT is associated with what? (3)

1. Sjogren
2. Hashimoto
3. H. pylori

34

Hairy Cell Leukemia
Age/Sex/Ethnic
Histo finding
3 special CD markers
Triad of symptoms
Major stain for this type

Middle-aged Caucasian males
Hair-like cytoplasmic projections
CD11c, CD25, CD103
Splenomegaly, Pancytopenia, Dry Tap
TRAP stain

35

Plasma Cell neoplasms/Dyscrasias
Cell type
Has what diagnostic feature
Common urine finding

IG-secreting B Cells
Monoclonal spike = M Component
Bence Jones proteins (light chains)

36

Plasma cell myeloma
Title
Primary clinical finding
Blood level finding
M component is mainly what
Urine finding
Complication of urine finding
Blood histo finding (2)

Most common plasma cell dyscrasia
Multifocal lytic lesions of axial skeleton
Hypercalcemia
IgG
Bence Jones proteins
Amyloidosis
Rouleaux formation and Mott Cells with Russell bodies

37

Solitary plasmocytoma
Presentation
Usually develop what after time

Solitary bony lesion in skeleton or soft tissues
Disseminated disease like myeloma after time

38

Monoclonal Gammopathy of Undetermined Significance
Seen in who?
Severity

M component spike in healthy elderly patients
Not severe, but should monitor

39

Lymphoplasmacytic Lymphoma
M component Ig?
Can progress to what syndrome?
What makes this syndrome special?

IgM
Waldenstrom Macroglobulinemia
Hyperviscosity syndrome

40

Peripheral T cell neoplasms have what markers?
How do they respond to therapy

2, 3, 5

Respond poorly to therapy

41

Anaplastic large Cell lymphoma
Rearrangement of what gene
Chromosome
Main cell
Age
Best prognosis

ALK gene
2p23
Anaplastic cells
Children and young adults
ALK+ tumors best prognosis

42

Adult-T cell leukemia
Cause:
4 clinical findings

HTLV-1
Skin lesions, hepatosplenomegaly, hypercalcemia, elevated WBC count

43

Mycosis FUngoides and Sezary
Cells appear how

Cerebriform

44

Mycosis fungioides 3 phases

Inflammatory pre-mycotic
plaque phase
tumor phase

45

Sezary syndrome
Main presentation

Generalized exfoliative erythroderma

46

Large Granular lymphocytic leukemia
Two histo findings
Which form is more aggressive

Abundant blue cytoplasm and scattered coarse azurophilic granules
NK cell

47

Extranodal NK/T-cell lymphoma
Presents how
Virus association

Nasopharyngeal mass
EBV

48

Hodgkin lymphoma
Primary cell
Two CD markers
Origin of most
Age
Curable?

Reed-Sternberg cell
CD15 and CD30
B cell
Young adults
Curable

49

The classic hodgkin lymphoma are positive for what two markers
Negative for what two?
Virus associated with many of these

CD15 and CD30
CD20 and CD45 negative
EBV

50

Nodular sclerosis lymphoma
Title
Two histo findings

Most common form of HL overall
Lacunar cells and collagen fibrosis bands

51

MIxed cellularity hodgkin lymphoma
Title
Sex
EBV%

Most common form of HL in elderly
Males
70%

52

Lymphocyte rich hodgkin lymphoma
Predominate cell
EBV association

Reactive lymphocytes
40% EBV

53

Lymphocyte Depletion Hodgkin Lymphoma
Title
Two patient types
EBV%

Least common form of HL
Elderly and HIV
90% EBV

54

Lymphocyte Predominance HOdgkin lymphoma
Male/Sex
Characteristic cells
RS cell presence?
Two positive markers
Two negative markers
EBV association?

Younger males
Lymphohistiocytic/Popcorn cells
R-S cells very rare
CD20 and BCL6 positive
CD15 and CD30 negative

55

Acute myeloid leukemia
Mutation mechanism
Age association
Peaks when
1st order diagnosis
Primary histo finding
CD markers
Key diagnostic finding

Acquired oncogenic blocks differentiation
Increases with age
Peaks after 60
Karyotypic findings
Auer Rods
CD13, CD14, CD15, CD33
> 20% myeloblasts

56

The M3 version of AML is named what?

Acute promyelocytic leukemia

57

APL
Translocation
Two genes and their chromosome
Two complications
Characteristic Cell

15:17
RARA gene on 17 and PML gene on 15
DIC and bleeding diatheses
Faggot cell

58

Myelodysplastic
Mechanism
Bone marrow change
Age of onset
Primary complication
Most patients die of what

Abnormal differentiation
Bone marrow hypercellular
Age of onset = 70
Refractory anemia occurs
Marrow failure (platelet loss/infection)

59

Myeloproliferative disorders
Mechanism
Main mutation
Two specific mutations
Change in marrow
Change in liver/spleen

Cells capable of normal differentiation divide like crazy
Mutated tyrosine kinases
BCR-ABL (9/22) and JAK2
Marrow proliferates
Hepatosplenomegaly

60

Chronic myeloid leukemia
Mutation
Age
Organ change
WBC changes (2)
Bone marrow change
One diagnostic test
Two progressions
Treatment

Adults
Philadelphia chromosome 9/22
Splenomegaly
WBC increase with basophil increase
Panhyperplasia of marrow
Decreased LAP score
Accelerated phase or Blast crisis
Gleevec

61

Relative polycythemia definition

Plasma volume decreases elevating HCT

62

Absolute polycythemia definition

Actual increase in total red cell mass

63

Difference between primary and secondary absolute polycythemias?

Primary = Low EPO levels
Secondary = Increased EPO levels

64

Polycythemia Vera
Definition
Mutation
Age
Primary finding

Increase in RBC mass independent of EPO
JAK2 mutation
Elderly
Intense pruritis

65

Essential thrombocytosis
Cell type proliferating
Platelet count
Main mutation

Megakarocytes
>600,000
JAK2

66

Myelofibrosis
Mutation
Two characteristic cells
One WBC increase

JAK2
Leukoerythroblastosis and teardrop cells
Increased basophils

67

Langerhans cell histiocytosis
Specific granules
2 antigens

Birbeck granules
S-100 and CD1a antigens

68

Multifocal multisystem LCH
Where are lesions
Age
If untreated

Lesions of trunk and scalp
Before age 2

69

Unifocal and multifocal unisystem LCH
Three common bone lesions
Age
Complication

Skull, ribs, femur
Kids
Diabetes insipidus

70

Pulmonary LCH
Common patient type

Adult smokers

71

Splenic insufficiency concern

Increased chance of sepsis from encapsulated bacteria

72

What is hypersplenism?

Spleen overworks in removing blood cells and results in penias

73

Causes of congestive splenomegaly? 3

Central venous congestion
CIrrhosis of liver
Portal vein thrombosis

74

Hypoplasia or aplasia of spleen more common

Hypoplasia

75

What is common splenic congenital abnormality

Acessory spleen

76

DiGeorge syndrome
Path
Mechanism
Symptoms

Thymic hypoplasia/aplasia
22q11
Catch-22
Cardiac abnormality
Abnormal facies
THymic aplasia
Cleft palate
Hypocalcemia
Hypoparathyroidism

77

Thymic hyperplasia seen in who?

Myasthenia gravis

78

Thymoma
Definition
Associated with what disease
Causes what RBC disorder

Thymic tumor
Myasthenia gravis
Pure red cell aplasia