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WBC disorders Flashcards

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1
Q

Causes of painless lymphadenopathy

A
  • Chronic inflammation
  • Metastatic carcinoma
  • Lymphoma
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2
Q

Treatment for follicular lymphoma

A

Rituximab (anti-CD20 antibody)

*Reserved for symptomatic patients

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3
Q

Which of the myeloproliferative disorders is not associated with increased risk for hyperuricemia or gout?

A

Essential thrombocythemia

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4
Q

Polycythemia vera is associated with a ________ mutation.

A

JAK2 kinase

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5
Q

What is the blood smear characteristic of mycosis fungoides?

A

Lymphocytes with cerebriform nuclei (Sezary cells)

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6
Q

Why is there an increased risk for infection in multiple myeloma?

A

monoclonal antibody lacks antigenic diversity; infection is the most common cause of death in multiple myeloma

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7
Q

Which neoplasm is associated with reactive polycythemia?

A

Renal cell carcinoma

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8
Q

most common age of patients with AML

A

50-60

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9
Q

Which markers are positive in Hodgkin lymphoma?

A

CD15 AND CD30

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10
Q

Which type of myeloproliferative disorder rarely progresses to marrow fibrosis or acute leukemia?

A

Essential thrombocythemia

*Platelets are just blebs of cytoplasm from megakaryocytes

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11
Q

What is the cause of marrow fibrosis in myelofibrosis?

A

Megakaryocytes produce excess platelet-derived growth factor (PDGF) cuasing marrow fibrosis

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12
Q

Causes of eosinophilia

A
  • Allergic reactions (type I hypersensitivity)
  • Parasitic infections
  • Hodgkins lymphoma
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13
Q

A negative monospot test suggests ______ as possible cause of mono.

A

CMV

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14
Q

T-ALL is characterized by which markers?

A

CD2 to CD8

*The blasts do NOT express CD10

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15
Q

Adult T- cell leukemia is associated with HTLV-1 and is most commonly seen in which countries?

A

Japan and the Caribbean

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16
Q
  • Lacunar cells
  • Enlarging cervical or mediastinal lymph node
A

Nodular sclerosis (Hodgkin lymphoma)

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17
Q

BCl2 expression in follicles. Follicular hyperplasia or follicular lymphoma.

A

Follicular lymphoma

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18
Q

The neoplastic cells of multiple myelome active the ________ receptor.

A

RANK receptor on osteoclasts

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19
Q

How is definitive diagnosis of mon made?

A

By serologic testing for the EBV viral capsid antigen

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20
Q

Characteristics of blasts

A

Large

Immature

punched out nucleoli

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21
Q

What sites are infected by EBV?

A

Oropharynx

Liver

B cells

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22
Q

Overexpression of cyclin D1 promotes _____ transition in the cell cycle, facilitating neoplastic proliferation.

A

G1/S

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23
Q

Gastric MALToma may regress with treatment of __________.

A

H.Pylori

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24
Q

Positive test for tartate-resistant acid phosphatase

A

Hairy cell leukemia

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25
Subtypes of hodgkin lymphoma
* Nodular sclerosis * Lymphocyte-rich * Mixed cellularity * Lymphocyte-depleted
26
Cytogenetic malfomation in Burkitt's lymphoma
t(8,14), resulting in the translocation of c-myc on chromosome 8 to IgH on chromosome 14
27
Rouleaux formation of RBCs on blood smear
Multiple Myeloma \*Increased serum protein decreases charge betCween RBCs
28
All of the myeloproliferative disorders are associated with a JAK2 kinase mutation, except \_\_\_\_\_\_\_\_\_.
CML
29
Acute presentation of leukemia
Anemia (fatigue) Thrombocytopenia (bleeding) Neutropenia (infection)
30
In my cosis fungoides, aggregates of neoplastic cells in the epidermis are called \_\_\_\_\_\_\_\_\_.
Pautrier microabscesses
31
Clinical features of multiple myeloma
* Increased risk of infection * Hypercalcemia * Lytic lesions * M Spike- Elevated serum protein * Rouleaux formation * Primary AL amyloidosis * Proteinuria
32
Types of Acute Leukemia
Acute lymphoblastic leukemia Acute myelogenous leukemia
33
Complications of most myeloproliferative disorders
* Increased risk for hyperuricemia and goat due to high turnover of cells * Progression to marrow fibrosis or transformation to acute leukemia
34
Acute leukemia is the neoplastic proliferation of \_\_\_\_\_\_\_\_\_.
Blasts \*Accumulation of \>20% blasts in the bone marrow
35
Types of Chronic Leukemia
* Chronic lymphocytic leukemia * Hairy cell leukemia * Adult cell leukemia/lymphoma * Mycosis Fungoides \*Chronic leukemia is the neoplastic proliferation of mature circulating lymphocytes; characterized by a high WBC count
36
Which type of hodgkin has the best prognosis of all types?
Lyphocyte rich
37
CD1a+ S-100
Langerhans cell histiocytosis
38
Causes of lymphopenia
* Immunodeficiency * High cortisol stae * Autoimmune destruction * Whole body radiation
39
* Bone pain with hypercalcemia * M spike * Anemia * Bone lytic lesions * Renal involvement
Multiple myelome
40
Where does T cell hyperplasia occur to cause splenomegaly in EBV infections?
T-cell hyperplasia in the periarterial lymphatic sheath (PALS), white pulp
41
What bacterial infection causes lymphocytic leukocytosis?
Bordetella pertussis \*Produce **lymphocytosis-promoting factor**, which blocks circulating lymphocytes from leaving the blood to enter the lymph node.
42
How do high cortisol states lead to neutrophilic leukocytosis?
Impairs leukocyte adhesion, leading to release of marginated pool of neutrophils
43
Clinical features of Adult T cell leukemia
* Rash * Generalized lymphadenopathy with hepatosplenomegaly * Lytic bone lesions with hypercalcemia
44
Treatment for Waldenstrom macroglobulinemia
Acute complications are treated with plasmapheresis, which removes IgM from the serum
45
Disruption of normal lymph node architecture. **Follicular hyperplasia or follicular lymphoma.**
Follicular lymphoma
46
Neoplastic proliferation of reed-sternberg cells
Hodgkin lymphoma
47
* blurry vission and headache * Budd-Chiari Syndrome * Flushed face * Itching
Polycythemia vera
48
What types of NHL lead to proliferation of intermediate-sized B cells?
Burkitt's lymphoma
49
How is polycythemia vera distinguised from reactive polycythemia?
* In PV, erythropoietin levels are decreased and SaO2 is normal * In reactive polycythemia , SaO2 is low and EPO is increased * In reactive polycythemia due to ectopic EPO production from renal cell carcinoma, EPO is high and SaO2 is normal.
50
Chronic myeloid leukemia is driven by t(9,22) which generates a BCR-ABL fusion protein with increased ________ activity.
Tyrosine kinase
51
Tingible body macrophages. **Follicular hyperplasia or follicular lymphoma.**
Follicular hyperplasia \*Cells undergo apoptosis in follicular hyperplasia. They do not in Follicular lymphoma
52
What cytogenic traits determine the prognosis of ALL?
* t (12,21)- good prognosis * t (9,22)- poor prognosis
53
Viral infection will lead to what type of lymph node hyperplasia?
Paracortex
54
ALL has positive staining for \_\_\_\_\_\_\_\_\_. AML has positive staining for \_\_\_\_\_\_\_\_\_.
TdT; myeloperoxidase (MPO) \*TdT is found when staining the nucleus. MPO is found when staining the cytoplasm
55
Types of Acute myeloid leukemia
* Acute promyelocytic leukemia * Acute monocytic leukemia * Acute megakaryoblastic leukemia
56
What is the most definitive characteristics of lymphoblasts ?
TdT \*TdT absent in myeloid blasts and mature lymphoctes
57
What are common symptoms of hodgkin lymphoma? What do these symptoms present?
* Fevers, chills, weight loss, and night sweats * may lead to fibrosis * Reed- Sternburg cells secrete cytokines
58
What is the CD8 T cell response to EBV?
* Generalized lymphadenopathy * Splenomegaly * High WBC count with atypical lumphocytes in the blood
59
Myelofibrosis blood smear
Leukoerythoblastic smear * Tear drop RBCs * Nucleated RBCs * Immature granulocytes
60
Cuases of lymphocytic leukocytosis
* Viral infections * Bordetella pertussis
61
What types of NHL lead to proliferation of small B cells?
Follicular lymphoma Mantle cell lymphoma Marginal zone Lymphoma Small lymphocytic lymphoma
62
Cytogenetic abnormalities seen in acute promelocytic leukemia
* t(15,17), which involves translocation of the **retinioic acid** **receptor (RAR**) on chromosome 17 to chromosome 15 * RAR disruption blocks maturatuon and promyelocytes accumulate
63
Which type of hodgkin is associated with abundant eosinophils?
mixed-cellularity
64
Causes of monocytosis
* Chronic inflammatory states * Autoimmune or infectious * Malignancy
65
Neoplastic proliferation of mature CD4 T cells that infiltrate the skin, producing localized skin rash, plaques, and nodules
Mycosis fungoides
66
Possible causes of reactive polycythemia
* Lung disease * High altitude * Ectopic EPO production from renal cell carcinoma
67
ALL presents in children with down syndrome ______ (before/after) age of five. AML presents in children with down syndrom ____ (before/after) age of five.
After; before
68
Treatment for neutropenia
GM-CSF or G-CSF \*Boost granulocyte production
69
Cytogenic marker for follicular lymphoma
t(14,18) \*BCL2 on chromosome 18 translocates to the Ig heavy chain locus on chromosome 14
70
High serum _______ may be present in multiple myeloma.
IL-6 \*Stimulates cell growth and immunoglobulin production
71
What is the primary cause of symptoms seen in polycythemia vera?
Hyperviscocity of blood
72
Monoclonality. Follicular hyperplasia or follicular lymphoma.
Follicular lymphoma
73
Presentation of myelodysplastic syndromes
* Cytopenias * Hypercellular bone marrow * Abnormal maturation of cells * Increased blast (\<20%) \*Cells don't get out into blood
74
Crystal aggregates of MPO may be seen as \_\_\_\_\_\_\_.
Auer rods
75
The african form of burkitt's lymphoma involves the \_\_\_\_\_\_\_\_\_\_. The sporadic form involves the \_\_\_\_\_\_\_\_\_.
Jaw; abdomen
76
Cytogenetic problem in mantle cell lymphoma
t(11,14) in which Cyclin D1 gene on chromosome 11 translocates with IgH on chromosome 14
77
Complication of follicular lymphoma
Progression to diffuse large B-cell lymphoma
78
Chronic lymphocytic leukemia is the neoplastic proliferation of _________ cells that express CD5 and CD20.
Naive B Cells
79
How is CML distinguised from a leukemoid reaction?
1. Negative leukocyte alkaline phosphaase stain 2. Increased basophils 3. t(9,22)
80
* Blasts infiltrate gums * Lack MPO
Acute monocytic leukemia
81
\_\_\_\_\_\_\_\_\_ is used for screening for mono.
**Monospot test** \*Detects IgM antibodies that cross-react with horse or shep red blood cells (**heterophile antibodies**)
82
list examples of chronic inflammatory states associated with marginal zone lymphoma
* Hashimoto thyroiditis * Sjogren syndrome * H. pylori gastritis
83
Rheumatoid arthritis and early stages of HIV infection will lead to what type of lymph node hyperplasia?
Follicular
84
Complications of chronic lymphocytic leukemia
* Hypogammaglobulinemia * Autoimmune hemolytic anemia * Transformation to diffuse large B-cell lymphoma (Richter transformation)
85
Immature neutrophilic cells are characterized by decreased \_\_\_\_\_\_.
CD16 (Fc receptors) \*Results in decreased opsonization
86
Most common primary malignancy of bone
Multiple myeloma
87
* Co expression of CD5 and CD20 * Increased lymphocytes * Smudge cells
Chromic lymphocytic leukemia
88
Causes of infectious mononucleosis
EBV CMV \*less common
89
* t(15, 17) * Increased risk for DIC
Acute promyelocytic leukemia
90
Causes of neutrophilic leukocytosis
* Bacterial infection or tissue necrosis * High cortisol state \*Induce release of marginated pool (both) and bone marrow neutrophils, including immature forms (infection/necrosis)
91
Neoplastic proliferation of mature myeloid cells, especially RBCs
Polycythemia vera
92
In chronic lymphocytic leukemia, involvement of lymph nodes leads to generalized lymphadenopathy and is called \_\_\_\_\_\_\_\_\_\_.
Small cell lymphoma
93
In hairy cell leukemia, where are hair cells trapped in the spleen?
Red pulp
94
Clinical features of Hairy Cell Leukemia
* Splenomegaly * "Dry tap" on bone marrow aspiration \*Lymphadenopathy is usually absent
95
Clinical feautures of Waldenstrom macroglobulinemia
* Generalized lymphadenopathy * Increased serum protein with M spike (IgM) * Visual and neurologic deficits * Bleeding
96
B-ALL is characteristized by lymphoblasts that express what markers?
CD10, CD19, CD20
97
\_\_\_\_\_\_\_\_\_\_\_ is the earliest change to emerge after whole body radiation.
Lymphopenia
98
Complications of mono
* Increased risk for splenic rupture * Rash if exposed to ampicillin * Recurrence (due to dormancy) and B cell lymphoma (in immunodeficiency)
99
First line of treatment for CML
Imatinib, which blocks tyrosine kinase activity
100
How does T-ALL present in teenagers?
As a mediastinal thymic mass called a lymphoblastic lymphoma
101
Which type of hodgkin is the most aggressive?
Lymphocyte-depleted \*Usually seen in the elderly and HIV-positive people
102
Draining of tissues with cancer will lead to what type of lymph node hyperplasia?
Sinus histiocytes (medulla)
103
ALL has an excellent response to chemotherapy but requires prophalaxis to _______ and \_\_\_\_.
Scrotum; CSF
104
Treatment of polycythemia vera
Phlebotomy Hydroxyurea (second line)
105
Clinical features of myelofibrosis
* Splenomegaly due to extramedullary hematopoiesis * Leukoerythroblastic smear * Increased risk of infection, thrombosis, and bleeding
106
Hematopoiesis occurs via a stepwise maturation of _______ hematopoietic stem cells.
CD 34+
107
Causes of painful lymphadenopathy
Lymph nodes draining a region of acute infection
108
Adult T-cell leukemia is the neoplastic proliferation of ___________ .
Mature CD4 T cells
109
Causes of neutropenia
* Drug toxicity * Damage to stem cells results in decreased production of WBCs, especially neutrophils * **Severe** infection
110
Essential thrombocythemia is assocated with ________ mutation.
JAK2 kinase
111
Why does a high cortisol state lead to lymphopenia?
Induces apoptosis of lymphocytes
112
In CML, _________ suggests progression to accelerated phase of disease.
Splenomegaly \*Transformation to acute leukemia usually follows shortly thereafter
113
Primary effusion lymphoma associated with which virus
HHV8
114
Which form of MALToma is resistant to antibiotics?
t(11,18)
115
Which lymphoma is associated with a BRAF mutation?
Hairy cell leukemia
116
Fried egg appearance in bone marrow
Hairy cell leukemia
117
High Ki67
Diffuse large b cell lymphoma
118
CD38
Plasma cells
119
Stains for amyloid
Congo red stain Apple green birefringence
120
CD20+, CD30-, CD15-
Nodular lympocyte predominant hodgkin
121
Conditions associated with a thymoma
Epithelial neoplasm of thymus Myastenia gravis Pure red cell aplasia

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