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Blood (Immunity)
Patho
| Question | Answer |
|---|---|
| what does the hematopoietic system include? (3) | blood, bone marrow, and lymphoid system |
| What is the hematopoietic system? | blood generating system in the kidneys |
| What are the 3 types of granulocytes? | neutrophils, eosinophils, and basophils |
| all the phagocytic cells are ________ | granulocytes |
| what granulocyte maintains all normal host defenses? | neutrophils |
| bands that shift from left to right | immature neutrophils |
| segs | mature neutrophils |
| Contain degrading enzymes used to destroy foreign sub, complex polysaccharides, proteins, lipids...Mediates the inflam response...Begin in the myeloblasts in the bone marrow...> levels of myeloblasts in the blood are of a blood cell prolif. disorder | neutrophils |
| Exercise, stress, epinephrine, and corticosteroids can raise levels r/t causing a shift back into the circulation | neutrophils |
| Endotoxins and microbes cause decrease levels r/t the neutrophils leaving the circulation for the tissue | neutrophils |
| Release enzymes/chemical mediators that detoxify agents in allergic reactions | eosinophils |
| Increase in parasite infections | eosinophils |
| Release heparin along with the mast cells for anti-coagulation and histamine for allergic reactions | basophils |
| originate in lymphoid stem cells in the bone marrow and defend against microbes in the immune response | lymphocytes |
| from antibodies that produce plasma; humoral mediated immunity | B cells |
| form CD4 and CD8; cell mediated immuninty | T cells |
| Engulf larger and greater quantities than neutrophils and Important in chronic inflammation and immune response | monocytes and macrophages |
| What are the 4 types of WBC? | Granulocytes, lymphocytes, monocytes, and macrophages |
| bone marrow is made of 3 cell types..what are they? | self-renewing stem cells, diff progenitor parent cells, and functional mature blood cells |
| erythrocytes are ____ | RBC |
| myelocytes are ____ | granulocytes and monocytes |
| lymphocytes are ___ | T cells and B cells |
| megakarocytes are ____ | PLT's |
| cytokines regulates the blood cells | colony stimulating factors |
| where the lymphocytes orignate, mature and interact with antigens | lymphiod tissue |
| what is the central lymphiod tissue consist of? | bone marrow and the thymus |
| where the T cells mature | thymus |
| where all lymphocytes originate | bone marrow |
| what does the peripheral lymphoid tissue do? | is the site where mature lymphocytes respond to foreign antigens |
| What does the peripheral lymphoid tissue include? (4) | lymph nodes, spleen, mucosa-assoicated lymph tissue, and cutaneous immune system |
| leukopenia | < WBC |
| leukocytosis | > WBC |
| what is the normal WBC count? | 5 to 10 thousand |
| neutrophil count of < 500 | neutropenia |
| agranulocytosis | < 200 neutrophils |
| What are some causes of Neutropenia? (6) | Increased removal from the blood d/t inflammation and infection, Drug-induced granulocytopenia, Periodic neutropenia, bone cancer, idiopathic neuropenia, Felty's syndrome |
| felty's syndrome | spleen destruction |
| all the myeloid cells are impaired leading to anemia, thromobocytopenia, and agranulocytosis | aplastic anemia |
| traps neutrophils in the spleen | splenomegaly |
| > destruction of neutrophils in the spleen | felty's syndrome |
| What are 3 causes of congenital neutropenia | cyclic neutropenia, koffman's syndrome. and transient (temporary) neutropenia |
| Autosomal dominant, Periods of neutropenia occurring every 21-30 days and lasting 3-6 days, Unknown cause | Cyclic neutropenia |
| May occur sporadically or be autosomal recessive, Normal RBC, PLT, and WBC levels w/ low neutrophils, Monocytes and eosinophils may be increased | Koffman's Syndrome |
| Occurs in infants of hypertensive mothers, Usually last 1-60 hours, but may persist 3-30 days,Decreased neutrophil production | transient (temporary) neutropenia |
| What are the S/S of Neutropenia? | fever, malaise, chills, weakness, and fatigue and LOW WBC |
| What are some complications of neutropenia? | resp. infections are common...ulcerations of mouth, skin, vagina, and GI tract are common |
| What is the TX for neutropenia? | ABT, hematopoietic growth factors |
| is known as the kissing disease | infectious mononucleosis (mono) |
| What are the 2 non-neoplasic disorders of WBC? | mononucleosis and neutropenia |
| self-limiting lyphoproliferative disorder caused by EBV, which is in the herpes family | infectious mono |
| EBV infects the B cells by killing the cell or being incorporated into its genome. Those B cells with incorporated EBV produce heterophil antibodies that are used for diagnosis | mono |
| ____ are vital for fighting mononucleosis | CD8 and NK cells |
| Once the disease is eliminate, a few B cells remain altered; therefore giving the individual an asymptomatic infection for life and occasional shedding of the EBV to others spreading the disease | mono |
| What are the S/S of mononucleosis? | fever, malaise, anorexia, chills, pharyngitis, and myphadenopathy |
| What are 6 rare side effets of mononucleosis? | 1. severe toxic pharyngotonsillitis may obstruct airways 2. cranial nerve palsies 3. encephalitis 4.meningitis 5.transverse myelitis and 6. Guillain-Barre syndrome |
| acute illness usually last 2-3 weeks; may not fully recover for 2-3 months | mononucleosis |
| what is the treatment for mono? | bedrest, analgesics/antipyretics |
| insidious (vague) onset | mono |
| what is mono's incubation period? | 4-8 weeks |
| what are 3 neoplastic disorders (malignant lymphomas)? (4) | Hodgkin's disease, non-hodgkin's lymphoma, leukemias,multiple myeloma |
| involves solid tumors with the presence of Reed-Strenberg cells | Hogdkin's Disease |
| 7th most common | Hogdkin's Disease |
| most curable cancer | Hogdkin's Disease |
| what are the S/S (by stage) of Hogdkin's Disease? | S/S-painless enlarge nodes (Stage A); wt loss, fever, or night sweats (Stage B); fatigue, pruritis, and anemia may indicate a spread of the disease; anergy, increased neutorphils, & mild anemia are common |
| What happens in the late stages of Hogdkin's Disease? | pt is susceptible to infections |
| Where does Hogdkin's Disease originate? | one lymph node then spreads to the other nodes and surrounding tissues |
| although Hogdkin's Disease has an unknown cause, what may be the cause? | viruses, carcinogens, or immune related |
| How does the staging work in Hogdkin's Disease? | based on the # of lymph nodes and whether it has moved to the bone marrow and liver |
| what is the TX for Hogdkin's Disease? | irradiation and chemo |
| ____% cure rate for Hogdkin's Disease with TX | 70 |
| How is Hogdkin's Disease DX? | presence of Reed-Sternberg cells in a lymph node biopsy, CT, lymphangiography, and gallium scans |
| Cells of the lymphoid tissue become abnormal and eventually crowd out normal cells in the surrounding area | Non-Hodgkin's Lymphomas |
| has no reed-sternberg cells | Non-Hodgkin's Lymphomas |
| Where does Non-Hodgkin's Lymphomas orginiate? | outside the lymph nodes and spreads rapidly |
| If Non-Hodgkin's Lymphomas is heterogenous there is a potenital for___ | malignancy |
| Non-Hodgkin's Lymphomas is ____X more common than Hodgkin's | 3 |
| Non-Hodgkin's Lymphomas is more common in which gender? | males |
| most common place for Non-Hodgkin's Lymphomas to orginiate | T and B cells |
| what is the cause of Non-Hodgkin's Lymphomas? | unknown, but may be a virus |
| most common s/s of Non-Hodgkin's Lymphomas | painless, swollen lymph nodes, but depends on the stage |
| What is the DX for Non-Hodgkin's Lymphomas? | DX-lymph node biopsy, bone marrow biopsy, serological studies, CT scans, and nuclear medicine studies |
| What is the TX for Non-Hodgkin's Lymphomas? | TX-radiation, chemo combination, bone marrow and stem cell transplantations |
| Cancer of the blood-forming tissues of the bone marrow, spleen, and lymph system; Characterized by an abnormal proliferation and accumulation of immature WBCs and their precursors | Leukemias |
| What are the 4 types of Leukemias | 1. Acute lymphocytic/lymphoblastic Leukemias (ALL) 2. Acute Myelogenous/myelocytic leukemia (AML) or acute granulocytic leukemia (AGL) 3. Chronic lymphocytic leukemia (CLL) 4. Chronic myelogenous leukemia (CML) |
| Leukemias most common in kids | Acute lymphocytic/lymphoblastic leukemia (ALL) |
| immature lymphocytes proliferate in the marrow and abnormal leukemic cells resemble immature lymhpocytes or lymphoblasts | Acute lymphocytic/lymphoblastic leukemia (ALL) |
| a 2nd rise in incidence occurs in middle age and older adults | Acute lymphocytic/lymphoblastic leukemia (ALL) |
| immature granulocytes proliferate and accumulate in the marrow | Acute Myelogenous/myelocytic leukemia (AML) or acute granulocytic leukemia (AGL) |
| rate of incidence > with age esp. over 50 years of age | Acute Myelogenous/myelocytic leukemia (AML) or acute granulocytic leukemia (AGL) |
| auer rods may be present in the cytoplasm of the myelolasts | Acute Myelogenous/myelocytic leukemia (AML) or acute granulocytic leukemia (AGL) |
| a standard dignosis for Acute Myelogenous/myelocytic leukemia (AML) or acute granulocytic leukemia (AGL) is that over ___% of hempatopoietic cells must be ____ | 30%...myeloblasts |
| a hematologic disorder of the bone marrow, is referred to as pre-leukemia and may progress to AML; this syndrome has abnormal hematologic cell production and low peripheral blood counts | myelodysplastic syndrome |
| leukemia that is more common in men | Chronic lymphocytic leukemia (CLL) |
| leukemia that occurs more frequnently b/t the ages of 50-70 and has a more grandual onset | Chronic lymphocytic leukemia (CLL) |
| Abnormal incompetent lymphocytes proliferate, accumulate, and spread to other lymphatic tissue | Chronic lymphocytic leukemia (CLL) |
| Abnormal stem cells lead to an uncontrolled proliferation of granulocyte cells resulting in a marked increased in circulating blast cells, which an then lead to leukostasis and intracerebral hemorrhage | Chronic myelogenous leukemia (CML) |
| In most cases, the characteristic chromosomal abnormality is present-Philadelphia chromosome (on chromosome # 22) | Chronic myelogenous leukemia (CML) |
| Occurs primarily b/t the ages of 30-50; slightly higher in men; more gradual onset | Chronic myelogenous leukemia (CML) |
| Abnormal or immature WBCs form and do not function properly leading to the massive proliferation of abnormal immature cells and fewer WBCs | Leukemias Pathophysiology |
| The abnormal cells can continue to multiply and infiltrate damaging the bone marrow, spleen, lymph nodes, liver, kidneys, lungs, gonads, skin, and CNS | Leukemias Pathophysiology |
| Normal bone marrow becomes diffusely replaced w/ abnormal or immature WBCs, interfering w/ the bone marrow’s ability to produce other types of cells such as erythrocytes and thrombocytes-bone marrow depression | Leukemias Pathophysiology |
| has more of a rapid onset, progresses rapidly, with a short clinical course; left untreated, death will result in days to months; symptoms relate to depressed bone marrow, infiltration of leukemic cells into other organs, and hypermetabolis | Acute Leukemias Pathophysiology |
| has a more insidious onset w/ a more prolonged clinical course; asymptomatic early in the disease; life expectancy may be more than 5 years; symptoms relate to hypermetabolism of leukemia cells infiltrating other organ systems; cell mature and function mo | Chronic Leukemias Pathophysiology |
| What are the S/S of Leukemia? | S/S-anemia, infection (decreased functioning WBCs), hemorrhage (thrombocytopenia), SOB, fatigue, malaise, weakness, wt loss, decreased activity tolerance, petechiae, ecchymosis, gingival bleeding, epistaxis, pallor, lymphoadenopathy, hyperuricemia |
| What is the DX of acute leukemia? | DX-presence of leukemic cells in the peripheral blood, bone marrow, or extramedullary tissue, presence of blasts in circulation and bone marrow, and anemia |
| What is the TX of acute leukemia? | TX-Chemo, radiation, bone marrow transplants |
| massive destruction of malignant cells during initial phase of tx; can be life threatening | Tumor Lysis syndrome (acute leukemia) |
| What is the DX of chronic leukemia? | same as acute: DX-presence of leukemic cells in the peripheral blood, bone marrow, or extramedullary tissue, presence of blasts in circulation and bone marrow, and anemia |
| What is the TX of chronic leukemia? | TX-may do nothing or may do chemo, interferon, allogenic bone marrow transplants, stem cell transplants |
| plasma cell neoplasm | multiple myeloma |
| occurs mostly in men 50-69; more prominent in AA..and the cause is unknown | multiple myeloma |
| has an inappropriate response to an antigen or a virus like particle | multiple myeloma |
| Malignant plasma cells arise from one clone of B cells, proliferate w/I the hematopoietic tissue, and then infiltrate the rest of the bone to produce osteolytic lesions | multiple myeloma |
| during multiple myeloma, bone destruction leads to ___ | hypercalcium and pathologic fractures |
| Occasionally, you see a marked increase of IgG and IgA making the blood more viscous and occluding small blood vessels | multiple myeloma |
| production of an abnormal immunoglobulin indicated by elevated blood levels and the presence of Bence Jones protein in the urine | Hallmark of multiple myeloma |
| What are the S/S of multiple myeloma? | gradual, insidious onset, recurrent infections, bone pain (bone destruction and lytic bone lesions), cord compression (vertebral collapse), diffuse osteoporosis, renal stones (high Ca levels), hypercalcemia, renal disease (renal stones and Bence Jones pro |
| What is the DX for multiple myeloma? | DX-clinical manifestations, presence of Bence Jones proteins, bone marrow studies, and lab studies |
| What is the TX for multiple myeloma? | TX-not very effective; chemo, radiation, and thalidomide (Thalomid) |
Created by:
TayBay15
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