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WBC Path Flashcards

1
Q
  • an increase in total circulating white blood cells
A

Leukocytosis

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2
Q
  • an elevated white blood cell count that is a physiologic response to
    stress or infection
A

Leukemoid reaction

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3
Q

– a decrease in total circulating white blood cell count

A

Leukopenia

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4
Q

– all cell lines affected – anemia, thrombocytopenia,

neutropenia

A

Pancytopenia

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5
Q

Clinically relevant neutropenia –

Absolute Neutrophil Count (ANC) < _____/mm3

A

500

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6
Q

Causes of ______
 Decreased production of neutrophils
 Drugs
 Hematologic disease – cyclic neutropenia
 Nutritional deficiency – B12, Folate
 Myelophthisis
 Increased destruction - autoimmune reactions

A

Neutropenia

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7
Q 
 Regular, periodic reductions in neutrophils
 Symptoms greatest at nadir – fever, 
lymphadenopathy, malaise, pharyngitis, 
ulcerations, periodontitis
 Treatment - supportive care, cytokine 
therapy (G-CSF)
A

Cyclic Neutropenia

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8
Q
  • the neoplastic cells are in the bone

marrow and blood

A

Leukemias

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9
Q
  • the neoplastic cells are in the

lymph nodes – (also extranodal sites)

A

Lymphomas

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10
Q

Arises in bone marrow

Spreads to peripheral blood

A

Leukemia

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11
Q

Arises in peripheral lymphoid tissue, usually in lymph nodes
Forms a discrete tissue mass
May eventually spread to peripheral blood and bone marrow

A

Lymphoma

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12
Q 
\_\_\_\_\_ Leukemia
Abrupt, stormy onset
No maturation - precursor cells (blasts) 
proliferate
Kills rapidly without treatment
Cure is possible
A

Acute Leukemia

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13
Q 
\_\_\_\_\_ leukemia
Insidious course
Maturation - mature cells proliferate
Often not treated unless symptomatic
Cannot be cured
A

Chronic Leukemia

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14
Q

Clinical Symptoms of _____ ______
Cytopenias - depression of normal bone marrow function
Bleeding – petechiae, ecchymoses, epistaxis, gingival
hemorrhage due to thrombocytopenia
Fever - infections due to absence of mature granulocytes
Fatigue - anemia

A

Acute Leukemia

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15
Q

Lymphoblasts - immature precursor B or T lymphocytes
arrested at early stage of development
A disease of children
Good prognosis with aggressive chemotherapy

A

Acute Lymphoblastic Leukemia

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16
Q

Myeloblasts – immature myeloid precursors (granulocytic,
monocytic, erythroid, megakaryocytic) with no terminal
myeloid differentiation
Adults
Prognosis – chemotherapy, bone marrow transplantation.
More difficult to treat than ALL.
Gingival enlargement in monocytic types

A

Acute Myeloblastic Leukemia

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17
Q

Clinical Symptoms of _____ leukemia
Often clinically silent
Incidental leukocytosis on CBC

A

Chronic Leukemia

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18
Q 
Adults
Insidious onset, slow progression
Philadelphia chromosome – t(9:22) bcr-abl fusion gene
Splenomegaly, fever, fatigue
Blast crisis 
Bone marrow transplantation
A

Chronic Myelogenous Leukemia

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19
Q 
 Translocation t(9:22)
 Proto-oncogene abl on long arm chromosome 
9(q34)
 Transposed to bcr region (breakpoint cluster 
region) on chromosome 22(q11)
 Results in bcr-abl fusion gene
 Gene product is abnormal 
bcr-abl tyrosine kinase
 Induces cell proliferation
A

Philadelphia Chromosome

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20
Q

Most common type of leukemia
Adults, often asymptomatic
Hypogammaglobulinemia – infections
Anti red cell autoantibodies – autoimmune hemolytic anemia
Anti platelet autoantibodies – autoimmune thrombocytopenia
Richter syndrome – may transform to high grade lymphoma

A

Chronic Lymphocytic Leukemia

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21
Q
  • non-tender lymph node enlargement,

extra-nodal mass

22
Q
  • cytopenias due to suppression of

hematopoiesis

23
Q

Are there such things as benign lymphomas?

A

All lymphomas are malignant

24
Q 
Clinical Presentation of \_\_\_\_
 Painless lymphadenopathy with firm, 
enlarged, rubbery, freely movable, 
non-tender lymph nodes
 Generally involves multiple lymph 
nodes in a non-contiguous pattern
 Frequently involves extranodal sites
25
____ grade lymphoma - indolent, difficult to cure
Low grade
26
____ grade lymphoma - aggressive, often curable
High grade
27
_____ lymphoma “African Jaw Lymphoma” B-Cell NHL EBV association
Burkitt Lymphoma
28
``` ______ Lymphoma– Low Grade Arises from Mucosal- Associated Lymphoid Tissue “MALT-oma” - mature B cells Often indolent Salivary glands, Sjogren Syndrome May transform to high grade lymphoma ```
MALT Lymphoma
29
_____ Lymphoma A sub-type of non-Hodgkin lymphoma (NHL) A high grade B cell neoplasm, most rapidly-growing human neoplasm The endemic form has a predilection for jaws of children
Burkitt Lymphoma
30
What are the 4 EBV associations?
1. Infectious Mononucleosis 2. Lymphomas – NHL and HL e. g. Burkitt lymphoma (NHL) 3. Nasopharyngeal Carcinoma 4. Oral Hairy Leukoplakia
31
``` Cytogenetics of ______  Translocations, t(8:14) is the most common  c-myc proto-oncogene on chromosome 8 has a role in cell cycle progression  Immunoglobulin gene promoters cause overexpression of c-myc  Overexpression of c-myc oncogene promotes inappropriate cellular proliferation ```
Burkitt Lymphoma
32
``` Oral Findings in ______ Rapidly growing painless swelling, producing paresthesia, loose teeth Rapid demise if untreated ```
Burkitt Lymphoma
33
What is the neoplastic cell present in Hodgkin Lymphoma?
Reed-Sternberg cell/ Owl-eye cell
34
``` General Characteristics of ________ Bimodal age distribution - young adults, older adults Painless lymphadenopathy Constitutional symptoms variable Fever – Pel-Ebstein fever Night sweats Weight loss Generalized pruritus Association with Epstein Barr virus ```
Hodgkin Lymphoma
35
Spread of ______________ |  Uniform, predictable pattern of spread from one lymph node region to the next
Hodgkin Lymphoma
36
“B” Symptoms for Staging of ________ Recurrent, unexplained fevers Night sweats Unintended weight loss
Non-Hodgkin Lymphoma
37
If Hodgkin lymphoma is stage 1, radiation or chemo?
radiation
38
If Hodgkin lymphoma is stage 4, radiation or chemo?
Chemo
39
Older adults Disseminated neoplasm of terminally-differentiated B lymphocytes (plasma cells) Multifocal lytic bone lesions, hypercalcemia, bone pain Myelophthisic anemia, predisposition to infections
Multiple Myeloma
40
Oral Findings of _______: Lytic lesions, loose teeth, pain, paresthesia, pathologic fracture Macroglossia - amyloidosis
Multiple Myeloma
41
Laboratory Findings of _________ Elevated serum calcium, protein, immunoglobulins Elevated erythrocyte sedimentation rate (ESR) Rouleaux formation
Multiple Myeloma
42
 Clinical assessment for adequate number and function of platelets.  The bleeding time test represents the time taken for a standardized skin puncture to stop bleeding  The normal range depends on the actual method used and varies from 2 to 9 minutes  It is abnormal when there are congenital or acquired platelet defects  Drugs – ASA, NSAIDS  Von Willebrand Disease
Bleeding Time Test
43
- decrease in platelets
Thrombocytopenia
44
- increase in platelets
Thrombocytosis
45
 Aspirin - inhibits aggregation for lifetime of platelet (8-10d) (irreversible)  NSAIDs - inhibits aggregation until drug eliminated (reversible)  Von Willebrand Disease - compound defect involving platelet function and coagulation pathway  Normal platelet count with increased bleeding time
Thrombasthenia
46
Platelet count < 100,000 /mm3
Thrombocytopenia
47
``` Causes of _______ Decreased production - aplastic anemia Increased destruction – immunologic destruction Sequestration in spleen – splenomegaly Dilution - massive transfusion ```
Thrombocytopenia
48
Autoimmune disease– antiplatelet autoantibodies produce thrombocytopenia Treatment with steroids, splenectomy
Immune Thrombocytopenic | Purpura (ITP)
49
Primary: hematopoietic stem cell disorder Increased numbers of megakaryocytes producing dysfunctional platelets Reactive Asplenia Inflammatory disorders
Thrombocytosis
50
What type of leukemia is most likely to infiltrate the gingiva?
AML

Pathology (26 decks)

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