WBC disorders

Question 1

What is Mononucleosis “Mono” and infection of?

Answer 1

B lymphocytes

Question 2

What is Mononucleosis “Mono” cased by

Answer 2

Epstein-Barr virus (EBV)

Question 3

Who is the Mononucleosis “Mono” most prevalent in

Answer 3

adolescence/young adults

Question 4

what is the mode of transmission for Mononucleosis “Mono”

Answer 4

EBV-contaminated saliva

Question 5

What is Mononucleosis “Mono”

Answer 5

self limiting lymphoproliferative disorder

Question 6

what is the patho of Mononucleosis “Mono”

Answer 6

atypical lymphocytes proliferate

Question 7

what is the onset of Mononucleosis “Mono”

Answer 7

insidious; incubation 4-8 weeks

Question 8

what are some clinical manifestations of Mononucleosis

Answer 8

lymphadenopathy,hepatitis, splenomegaly, extreme fatigue, lethargy

Question 9

What lab would you see increased in Mononucleosis

Answer 9

WBC increased(~ 12-18,000); 95% lymphocytes

Question 10

What is the acute phase of Mononucleosis

Answer 10

2-3 weeks

Question 11

degree of lethargy for mono

Answer 11

2-3 months

Question 12

treatment of mono

Answer 12

symptomatic and suppotive

Question 13

what is Myelodysplastic Syndrome

Answer 13

agroup of related hematologic disorderscharacterized by a change in the quantity and qualityof bone marrow elements

Question 14

characteristics of Myelodysplastic Syndrome

Answer 14

Affects elderly (> 65)

CM: cytopenias
anemia, infection and spontaneous bleeding or bruising

Etiology: unknown, maybe an environmental trigger

Question 15

what is the diagnostic for Myelodysplastic Syndrome

Answer 15

laboratory &bone marrow biopsy

Question 16

treatment for Myelodysplastic Syndrome

Answer 16

Treatment- depends on disease severity- supportive,Granulocyte colony-stimulating factor (G-CSF),erythropoietin, chemotherapy, bone marrow transplant

Question 17

What are leukemias

Answer 17

Malignant neoplasms of cells originally derived from a single hematopoietic cell line

Question 18

characteristics of leukemic cells

Answer 18

Are immature and unregulated
(undifferentiated)
Proliferate in bone marrow

Circulate in blood

Infiltrate spleen, lymph nodes

Disease of children and adults

Question 19

classes of leukemia

Answer 19

Acute lymphocytic (lymphoblastic) leukemia (ALL)*

Chronic lymphocytic leukemia (CLL)**

Acute myelocytic leukemia (AML)

Chronic myelocytic leukemia (CML)

Question 20

What is the Most common childhood leukemia

Answer 20

Acute lymphocytic (lymphoblastic) leukemia (ALL)*

Question 21

What is the ** Most common leukemia in older adults

Answer 21

Chronic lymphocytic leukemia (CLL)**

Question 22

cause of Leukemia

Answer 22

Unkown; adults may be increased with exposure to radiation

Question 23

4 parts - What is the patho of leukemic cells

Answer 23

Are an immature type of WBC​
Capable ofincreased rate of proliferation/have prolongedlife span​
Cannot perform function of mature leukocytes→are ineffective as phagocytes​
Interfere with maturation of normal bone marrowcells (including RBC & platelets)​

Question 24

Onset of Acute Leukemia

Answer 24

Sudden,stormy

Question 25

S/S of acute leukemia

Answer 25

related to decreased (mature) WBC, decreased RBC, decreased platelets

Question 26

actue leukemia is diagnosised based on what

Answer 26

Blood/bone marrow tissue ↔ presence of immature WBC’s (blasts) – may constitute 60-100% of cells

Question 27

onset of chronic leukemia

Answer 27

more insidious

Question 28

characteristics of CLL

Answer 28

older adults (88.2% 5-year survival rate) Relatively mature lymphocytes that are immunologically incompetent S&S: fatigue, wt loss, anorexia, infections

Question 29

characteristics of CML

Answer 29

adults & children (69.7% 5-year survival rate) Leukocytosis with immature cell types (presents with increased granulocyte count) S&S: fatigue, wt loss, diaphoresis, bleeding, abdominal discomfort

Question 30

Treatment of Leukemia

Answer 30

Goal – attain remission Cytotoxic chemotherapy Stem Cell Transplant Allogeneic – volunteer donor Syngeneic – identical twin Autologous – patient’s own

Question 31

Risks of leukemia treatment

Answer 31

Infection rejection relapse

Question 32

what are malignant lymphomas

Answer 32

Neoplasms of cells derived from lymphoid tissue

Question 33

2 types of malignant lymphomas

Answer 33

hodgkin disease non-hodgkin disease

Question 34

characteristics of hodgkin disease

Answer 34

Characterized by painless, progressive, rubbery enlargement of a single node or group of nodes – usually in neck area 

Question 35

what cell can be found in a biopsy of hodgkin disease

Answer 35

Reed-Stenberg cell – distinctive tumor cell found with lymph biopsy 

Question 36

diagnosis of hodgkin disease

Answer 36

peripheral blood analysis, lymph node biopsy, bone marrow exam, radiographic evaluation (CT, MRI, PET) 

Question 37

Factors that interact with hodgkin disease

Answer 37

Epstein Barr Virus, genetic predisposition, exposure to toxins 

Question 38

Clinical manifestations of hodgkin disease

Answer 38

insidious onset; painless enlarged lymph nodes & other nonspecific symptoms 

Question 39

treatments for hodgkin disease

Answer 39

Chemotherapy- Radiation  Stem Cell Transplant 

Question 40

non-hodgkin disease

Answer 40

Also neoplastic disorder of lymphoid tissue  However, spreads early → liver, spleen & bone marrow  Also characterized by painless, superficial lymphadenopathy; also extranodal symptoms   more common in older adults

Question 41

clinical manifestation of non-hodgkin disease

Answer 41

painless lymph node enlargement &  non-specific symptoms 

Question 42

diagnosis of non-hodgkin disease

Answer 42

similar to Hodgkins lymphoma; increased extranodal sites  

Question 43

treatment of non-hodgkin disease

Answer 43

chemotherapy  radiation  refractory cases- stem cell transplant  Rituximab (Rituxan), ibritumomab tiuxetan (Zevalin), tositumomab (Bexxar) & others 

Question 44

What is Multiple Myeloma

Answer 44

Plasma cell cancer (B cells)​ Atypical proliferation of one of immunoglobulins, “M protein” – a monoclonal antibody (→ increased osteoclasts; lead to bone destruction/resorption)​

Question 45

Multiple Myeloma is characterized by

Answer 45

bone pain/fractures; also symptoms r/t impaired production of RBC & WBC​

Question 46

T/F Multiple myeloma makes the body unable to maintain humoral immunity

Answer 46

True

Question 47

Who is more likely to have multiple myeloma

Answer 47

men>women avg age 65 Blacks > whites

Question 48

multiple myeloma clinical manifestations

Answer 48

etiology: unknown CM: slow and insidious, skeletal pain, hypercalcemia

Question 49

diagnostic test for multiple myeloma

Answer 49

laboratory, radiographic, bone marrow exam  Monoclonal antibody protein in serum and urine  Pancytopenia  Hypercalcemia  Bence Jones proteins in urine  Elevated serum creatinine  X-rays osteolytic lesions 

Question 50

Treatments for multiple myeloma

Answer 50

watching, corticosteroids, chemotherapy, biologic therapy, stem cell transplant, biphosphonates; adequate hydration