WBC disorders Flashcards
(152 cards)
1
Q
malignant proliferation of cell native to lymphoid tissue
A
Lympomas
2
Q
what are the precurosrs and derivatives of lympohomas
A
Lymphocytes
3
Q
what might lymphomas invovled
A
Solid tissue
Marrow
Blodd
4
Q
what are the types of Lymphomas
A
Hodgkin
non-hodgkin
5
Q
Malignant proliferation of cell native to bone marrow which often spill inot blood
A
Leukemias
6
Q
where can leukemias spread
A
Solid organs (liver and spleen)
7
Q
what is a Lymphoma of a distinctive cell type(reed-sternberg cell)
A
Hodgkin lymphomea
8
Q
where does Hodgkin lympohoma arise and spread
A
arise in SIngle lymph node to spread to invovle contiguous nodes
9
Q
how can you cure hodgkin lymphoma
A
Chemo
Radio
10
Q
when do people tend to get Hodgkin Lymphoma
A
Bimodel (2-3rd decade and then once at an age greater than 50)
11
Q
how many new cases in 2017 of Hodgkin lymphoma
A
8,300
12
Q
what is needed to diagnoses Hodgkin Lmyphoma
A
Lymph node biopsy to identigy Reed-sternberg cells in apropriate background
13
Q
what do Reed-sternberg cells look like
A
Large with mirror image nuclei and prominent nucleoili
14
Q
how much of the cells of the lymph node are malignant in the case of Hodgkin Lymphoma
A
less than 2%
15
Q
what is the germinal center for Reed-sternberg cells
A
B lymphocyte
16
Q
what virus is often found in a Reed-Sternberg cell
A
Epstein-Barr virus(70%)
17
Q
what are the spread of idsease in Hodgkin Lymphoma
A
Lymph nodes
Spleen
Liver
Bone marrow
18
Q
use of staging in Hodgkin Lymphoma
A
Determine treatment and prognosis
19
Q
what is done to Stage Hodgkin lymphoma
A
Combo of clinical findings and imaging
20
Q
what is low stage hodgkin lymphoma
A
Localized involvement
21
Q
what is High stage Hodgkin lymphoma
A
Wide spread disease with distant of bone marrow involvement
22
Q
statge 1 Hodgkin Lymphoma
A
Tumor in 1 anatomic region or 2 contiuous anatomic rgion on the same side of daiaphragm
23
Q
stage 2 hodgkin lymphoma
A
Tumor in more than 2 anatomic regions or two non-contiguous regions on the same side of the diaphragm
24
Q
Stage III Hodgkin Lymphoma
A
Tumor on both sides of the diaphragm
does no extend beyond lymph nodes, spleen or Waldeyer’s ring
25
stage IV Hodkin Lymphone
Tuor in bone marrow, lung, etc
| - any organ side outisde lymph nodes, spleen or Waldeyer's ring
26
symptoms of Hodgkin Lymphoma
Fever
Night sweats
Significant uneplained weight loss
27
what determines treatement of Hodgkin lymphoma
Stage
28
what is done to treat low stage hodgkin lymphoma
Chemo
| Radio
29
what is done to treat high stage hodgkin lymphoma
Chem
30
what is the risk for development of secondary treatment related acute leukemia after treating hodkin lymphoma
Low risk
31
what are "B" signs/symptoms of Hodgkin Lymphoma associated with
Worse prognosis
32
what stage of Hodgkin lymphome tends to have B symptoms
Stage III and Stage IV
33
5 year survival rate of Stage I and IIA hodgkin lymphoma
ablmost 100%
34
5 year survivial rate of Stage IV hodgkin lymphoma
50%
35
do RS cells alone mean that you've got Hodgkin lymphoma
No, need the appropriate histo background
36
what does term mean for hodgkin lymphoma
Amount of rumor burden
| distribution in the body
37
what is low stage disease mean for hodgkin lymphoma
Localized
no systemic signs (fever, weight loss)
better prognosis
38
what is high stage disease for hodgkin lymphoma
widespread
| worse prognosis
39
what does deviding staging up into A and B mean for for hodgkin lymphoma
A: Absensce of systemic symtoms
B: presence of systemic symtoms
40
how does the lymph node look in hodgkin Lymphomas
Enlarged, painless, superficial
41
what complications can arise from advanced Hodgkin lymphomas
Infections
Anemia
Thrombocytopenia
42
what are neoplastic lymphocytes originating in lymph nodes or extranodal lymphoid tissues (arise in lymph tissue)
Non-hodgkin lymphoma
43
how many types of Non-hodgkin lymphoma is there
2 dozen types
44
what is the origin of non-hodgkin lymphoma cells
85% B cell
| 15% T cell
45
what age does incidence of Non-hodgkin lymphoma rise
steadily after age of 40
46
cases of on-hodgkin lymphoma in 2017
72,000
47
Linical sings of non-hodgkin lymphoma
Painless lymph node englargement
Systemic symptoms in 30% of patients
Frequent immune abnormalities
Splenomegaly
48
what else may be invovled in non-hodgkin lymphomas
GI tract
Bones
CNS
49
What all is involved in the Classification of NHL
World Health Organization
50
what does Classification of NHL depend on
Morphologic
Clicial
Immunophenotypic
Molecular features
51
what growth patterns can NHL have
Nodule
| Diffuse
52
what cell sizes can NHL have
Small
| Large
53
what is better Nodular or diffuse NHL
Nodule is better
54
what is better, large or small cell NHL
Small better than large
55
what is low stage NHL
Localized
56
what is high stage NHL
numerous sites of involvement or bone marrow invovlement
57
what does PRognosis of NHL depend on
on the sub-type of lymphoma(not stage, this is an exception)
| - also grading
58
how does one treat NHL
Chemo
Possible Radiation
Bone Marrow transplant
59
is there more morphologic diversity in Hodgekin or non-hodgkin lymphoma
More in non-hodgkin
60
Does Hodgkin or non-hodgkin lymphoma have multi node invovlement
non-hodgkin has multinode invovlement
61
what has more frequent extranodal spread and peripheral blood invovlement, hodgkin or non-hodgkin
Non-hodgkin
62
what is needed to diagnoses non-hodgkin lymphoma
Histo examination
63
do all lymphoid neoplasms arise from a signle cell
Yes
64
when does a lymphoma develop cellularily
When a monoclonal expasion of lymphocytes are arrested at a particular stage in transformation
65
why do immune abnormalities occur in lymphomas
Because they are tumors of the immune system
66
How does NHL usually present itself
enlarged lymph noes
Evidence of extranodal spread
enlarged liver or spleen
67
Does bone marrow get invovled more in hodgkin or non-hodgkin
Non-hodgkin more
68
what represents the leukemic phase of non-hodgkin lymphone
Lymphoma cells circulating in the peripheral blood
69
what complications of Hodkin lymphoma can occur
Infection
Anemia
thrombocytopenia
70
what is Leukemia with a rapdi onset with balsts in the blood
Acute Leukemia
71
what cells are affected in acute leukemia
Myeloid
| Lymphoid cells
72
what is leukemia with indolent onset
chronic Leukemia
73
what cells are affected in chronic leukemia
Myeloid and lymphoid cells but more mature
74
survival of acute leukemia
Fatal, living only months
75
survivial of chronic leukemia
years or decades (indolent)
76
wbc cound of acute and chronic leukemia
Both often increased
77
how does bone marrow change in acute and chronic leukemia
Acute: great than 20% blasts
chronic:blasts typically not increased
78
what is the cloncal growth of primitive lymphoid cell
Acute lymphoblastic leukemia
79
what types of cell exist in Acute lymphoblastic leykemia
B and T cells
80
what tends to accompany acute lymphoblastic leukemia
Increase WBC
| thrombocytopenia
81
what age tends to get acute lymphoblastic leukemia
Children
| less than 15 years old
82
what may come along with acute lymphoblastic leukemia
Lymphadenopathy
| Splenomegaly
83
what does Acute Lymphoblasti Leukemia prognosis relate to
Cytogenetics
84
do chidlren or adults have better prognosis of acute lymphoblastic leukemia
Children have good prognosis
| Adults have beed
85
what is the treatment for acute lymphoblastic leukemia
Chemo is mainstay
| bone marrow transplant at relapse
86
Classification of Leukemia based on cell types
Myelogenous (myeloid and monocytic)
| lymphoid
87
Acute lymphoblastic Leukemia accounts for how much of acute leukemias
40%
88
what are the subtypes of Acute lymphoblastic Leukemia
Early B precursor
Pre B
Matuer B
T cell
89
doe Lymph node, Liver and Spleen enlargement often come with ALL or AML
more with Acute Lymphoblastic Leukemia
90
what has the best prognosis of Acute lymphoblastic Lekemias
children 2-10
| PRe b cell type
91
what is Cloncal proliferation of primitive myeloid cell
Acute Myelogenous Leukemia
92
what are the subtypes of Acute myelogenous Leukemia based on
Morphology
Cytochem
Immunophenotype
Cytogen
93
what tends to happen negatively to acute myelogenous Leukemia
Increased WBC
anenia
Thrombocytopenia
94
do children or adults get Acute myelogenous Leukemia
Adults
95
what is often present in the cytoplasm of people with Acute Myelogenous Leukemia
Myeloperozidase
96
what is the mainstay of treatment for Acute mYelogenous Leukemia
Chemo
97
how well does treatment do for Acute Myelogenous Leukemia
70% remission
| many relapse
98
what influences Prognosis of Acute myelogenous Leukemia
Cytogenetics
99
what is the proliferating cell in Acute myelogenous leukemia
Primitive myeloid cell
100
what type of Leukemia has Auer rods
Acute Myelogenous Leukemia
101
what is the most predictive Prognosis for Acute myelogenous Leukemia
Karyotype
102
what is it called when Lesional cells from AML proliferate into soft tissue including the gingival
Granulocytic sarcoma
103
what is Clonal proliferation of mature B lymphocytes, identical to small lymphocytic lymphoma
Chronic Lymphocytic leukemia
104
how common is Chronic Lymphocytic leukemia
Most common adult leukemia in US
105
what do cell affected by Chronic Lymphocytic elukemia express
surface IgM with kappa light chain restriction
| High BCL2
106
who tends to get Chronic Lymphocytic leukemia
over 60 years
| men (2:1)
107
what happens to White cell cound in Chronic Lymphocytic leukemia
Gradual increase in White cell count with lymphocytosis
108
what happens to organs in Chronic Lymphocytic leukemia
Spelnomegaly
| Lymphoadenopathy
109
what disorders tend to develop as disease progresses
Anemia
| Thrombocytopenia
110
what do Tumor cells in Chronic Lymphocytic leukemia supress and lead to whaty
Supress normal B cell
| leading to hypogammaglobulinemia
111
how does Chronic Lymphocytic Leukemia progress
Eventually terminate into higher grade prcess
- acute leukemia
- high grade lympho
112
what is the treatment base for Chronic Lymphocytic leukemia
Chemo
113
what does the proliferating cell in Chronic Lymphocytic Leukemia look like
Mature appearing
Immunologically incompetent
lymphocyte
114
does Chronic Lymphocytic Leukemia come from one cell
Monoclonal(yes)
115
what are most the cell source for CHronic Lymphocytic Leukemia
95% B cell type
116
How common I Chronic Lymphocytic Leukemia
2/3 of Chronic Leukemia
117
what forms as marrow is overrun by leukemic cells during chronic lymphocytic leukemia
Cytopenias (anemia and thrombocytopenia)
118
survival time for Chronic Lymphocytic Leukemia
4-6 years
119
what is the A Clonal Proliferation of Immature Granulocytes
Chronic Myelogenous Leukemia
120
what cells are affected in CHronic Myelogenous Leukemia
Stem cells
121
what happens to cells affected by chronic Myelogenous Leukemia
Increase in WBC, Eosinophilia, basophilia
| Left shifted Granulocytes
122
what secondary disorder accompanies Chronic Myelogneous Leukemia
Thrombocytosis Anemia
123
what organ is affected in CHronic Myelogenous Leukemia
Splenomegaly
124
what kind fo Abnormality causes Chronic Myelogenous Leukemia
```
Cytogenetic Abnormality (t(9;22)
Phiadelphia Chromosome
```
125
what cuases Chronic Myelogenous Leukemia
Molecular fusion of bcr and abl genes
126
what does targeted chemo do for Chronic Myelogenous Leukemia
Blacks the bcr-abl tyrosine Kinase to induce remission in most patients
127
what is done for relapsed or resistance CHronic mYelogenous Leukemia
Bone marrow Transplant
128
What does the Abnormal cells do to LEukemias
Suppress growth, maturation, and function of nromal cells
129
what does Leukemia do to Body organs
Infiltrate
130
what does leukemia do to the immune system
Dysfunction
131
what does the Fusion of BCR and ABL genes do
Mimic effect of growth factor activation
132
what marks the terminal phase of Chronic Myelogenous Leukemia
- Increase in immature cell in peripheral blood and bone marrow
- Decreased response to treatment (blast crisis)
133
what is a clonal proliferation of Monoclonal plasma cells
Multiple Myeloma
134
what is made during mutliple myeloma
Monoclonal heavy and or light chain production (IgG most common)
135
when do people get multiple myeloma
late middle age (to elderly)
136
how common is mutliple myeloma
30,000 cases in US for 2016
137
what happens to bones in Multiple Myeloma
Multiple lytic bone lesion
| Hypercalcemia
138
what happens to bone marrow in multiple myeloma
Bone marrow infiltration by plasma cells
139
what happens to serum in multiple myeloma
increased serum monoclonal protein
| normal immunoglobulins suprress
140
what complications come along with Mutliple Myeloma
Renal Failure
Infection
Bence-Jones proteinuria (light chains)
141
are plasma cells in blood common in mutliple Myeloma
No
142
what happens to RBC in multiple meloma
Rouleaux formation (stacking)
143
how does Marrow plamsa cells infiltrate in multiple myeloma
Single cells and sheets
144
prognosis of Multiple myeloma
variable, but usually porn
145
suruvial for multiple myeloma
media (4-6 years)
| indolent is even longer
146
how do we try and treat multiple myeloma
Chemo
radio
bone marrow transplant
147
success of chemo in multiple myeloma
Recent success with thalimomide analogs and anti-resorptives)
148
why use radio for multiple myeloma
Palliation (bone pain)
149
does Multiple Myeloma lead to an increase in all immunoglobins
No, just one type
150
what immunoglobins tend to be increased from Multiple myeloma
60% IgG
| 20-25% igG
151
what is Bence Jones Proteinuria
when only lifht chains are produced in multiple myeloma and it is pissed out
152
why does Bone resorption occur in multiple myeloma
secretion of osteoclast activator factors by myeloma cells
