Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
wbc path 1
path
| Question | Answer |
|---|---|
| WBC count | Normal: 5-10 K/µL Leukopenia: <5 K/µL Leukocytosis: >10 K/µL |
| Causes of neutropenia | Drug toxicity (e.g. chemotherapy)//Severe infection (e.g. gram |
| Causes of lymphopenia | Immunodeficiency (e.g. DiGeorge syndrome [no thymus] or HIV)// High cortisol state (e.g. exogenous corticosteroids or Cushing syndrome)// Autoimmune destruction (e.g. SLE)// Whole body radiation |
| Causes of neutrophilic leukocytosis | Bacterial infection or tissue necrosis (release of marginated pool and recruitment of bone marrow neutrophils/ High cortisol state (release of marginated pool) |
| Marginated pool | leukocytes "hang" in lung vasculature//cortisol disrupts adhesion, releases marginated pool// causes leukocytosis |
| Fc receptors | Fc receptors help neutrophils recognize immunoglobulin (opsonin for phagocytosis)//lack of CD16 indicates lack of Fc receptors |
| Causes of monocytosis | chronic inflammatory states (autoimmune or infectious)// malignancy |
| Causes of eosinophilia due to increased IL | 5 production//allergic reactions//parasitic infections//Hodgkin lymphoma |
| Causes of basophilia | classically seen in chronic myeloid leukemia |
| Causes of lymphocytic leukocytosis | viral infections//B. pertussis infection |
| Acute leukemia | accumulation of neoplastic blasts (>20% in the bone marrow)//blasts crowd out normal hematopoiesis// blasts enter blood, result in high WBC count with large appearance and "punched out" nucleoli |
| TdT | DNA polymerase in lymphoblasts, but not myeloblasts or mature lymphocytes// can stain for TdT to diagnose ALL |
| ALL | accumulation of >20% lymphoblasts in bone marrow// positive stain for TdT// most commonly arises in children// association with Down syndrome (usually >5yo)// subclassified into B |
| B- ALL | accumulation of TdT+ lymphoblasts expressing CD10, CD19, and CD20//excellent response to chemo// requires prophylaxis to scrotum and CSF// t(12,21) has good prognosis (usually in kids), t(9,22) has poor prognosis (usually in adults) |
| T-ALL | usually presents in teenagers as a thymic mass (called "lymphoma")// remember T's: T cells, teenagers, thymic mass |
| AML | accumulation of >20% myeloblasts in bone marrow// positive stain for myeloperoxidase// crystal aggregates of MPO: Auer rods// may arise from myelodysplastic syndromes |
| Acute promyelocytic leukemia | subtype of AML// has t(15;17): translation of retinoic acid receptor// RAR blocks maturation of promyelocytes// treatment = atra |
| Acute monocytic leukemia | subtype of AML//blasts usually lack MPO //characteristically infiltrate gums// |
| Acute megakaryoblastic | subtype of AML// blasts usually lack MPO //associated with Down syndrome (usually <5yo) |
| Chronic leukemia | accumulation of mature LYMPHOcytes, characterized by a high WBC count with blasts <20%// often insidious onset// usually seen in older adults |
| CLL | accumulation of naive B cells that co// most common type of leukemia// see increased lymphocytes and smudge cells// can involve lymph nodes |
| Complications of CLL | hypogammaglobulinemia (infection most common cause of death)// autoimmune hemolytic anemia//transformation to large B cell lymphoma (will see enlarging lymph nodes or spleen) |
| Hairy cell leukemia | accumulation of mature B cells with "hairy" cytoplasmic processes// TRAP+ // features: splenomegaly (hairy cells in red pulp), "dry" bone marrow tap (due to marrow fibrosis)// excellent response to cxtrpy |
| Adult T cell leukemia/lymphoma (ATLL) | accumulation of mature CD4+ T cells//associated with HTLV// presents with rash, generalized lymphadenopathy, hepatosplenomegaly, punched out bone lesions with hypercalcemia |
| Mycosis fungoides | accumulation of mature CD4+ T cells that infiltrate skin// presents with localized skin rash, plaques, nodules: called Pautrier microabscesses// cells can spread to the blood// characteristic lymphocytes with cerebriform nuclei (Sezary cells) |
| Myeloproliferative disorders | accumulation of mature myeloid cells// usually in late adulthood(50//high WBC count with hypercellular bone marrow// all myeloid cells are increased, but classified based on dominant myeloid cell producedall myeloid cells are increased, but classified bas |
| Complications of MPD | - increased risk for hyperuricemia and gout (high cell turnover) - progression to marrow fibrosis - transformation to acute leukem |
| CML | - type of MPD, granulocytes are predominant cell type - basophils characteristically increased - t(9;22): Philadelphia chromosome --> BCR-ABL fusion protein with increased tyrosine kinase activity |
| Treatment for CML | Imatinib// blocks tyrosine kinase activity of BCR |
| Outcomes of CML | can transform to AML (2/3) or ALL (1/3) because mutation is in the pluripotent stem cell |
| How to distinguish CML from leukemoid reaction CML will have: | negative LAP stain//increased basophils//t(9;22) |
| Polycythemia vera | - type of MPD, RBCs are predominant cell type - assoc with JAK2 kinase mutation - blood becomes hyperviscous, requires phlebotomy (without, death usually within a year) |
| S/sx of polycythemia vera | - splenomegaly (extramedullary hematopoiesis) - leukoerythroblastic smear (teardrop RBCs, nucleated RBCs, immature granulocytes) - increased risk of infection, thrombosis, bleeding |
| How to distinguish polycythemia vera from reactive polycythemia In polycythemia vera: | EPO levels are decreased// oxygen saturation is normal |
| Essential thrombocythemia | type of MPD, platelets are particularly increased// assoc with JAK2 kinase mutation //symptoms related to increased risk of bleeding AND/OR thrombosis (platelets either working really well or not at all)//rarely progresses to marrow fibrosis or acute leuk |
| Myelofibrosis | - type of MPD, megakaryocytes are particularly increased - assoc w/ JAK2 kinase mutation (50% of cases) - megakaryocytes produce excess PDGF --> marrow fibrosis |
| Causes of painful vs. painless lymphadenopathy | lymphadenopathy Painful: usually draining region of acute infection// Painless: seen w/ chronic inflammation, metastatic carcinoma, or lymphoma |
| Follicular lymphoma | - NHL of small CD20+ B cells that form follicle-like nodules - typically late adulthood - can progress to diffuse large B-cell lymphoma |
| Pathophys of follicular lymphoma | - Bcl2 normally inhibits apoptosis in peripheral cells - follicular cells generally lack Bcl2 so they can undergo testing - t(14;19) --> overexpression of Bcl2 --> cells that fail testing no longer die --> neoplasm |
| Treatment of follicular lymphoma | reserved for symptomatic pts//involves low |
| How to distinguish follicular lymphoma from reactive follicular hyperplasia Follicular lymphoma shows: | disruption of LN architecture// lack of tingible body macrophages (white spaces in follicle indicate macrophages are gobbling up apoptotic B cells)// Bcl2 expression //monoclonality |
| Mantle cell lymphoma | NHL of small CD20+ B cells that expand mantle zone around follicle //typically late adulthood |
| Pathophys of mantle cell lymphoma | t(11;14) --> overexpression of cyclin D1 --> promotes G1/S transition in cell cycle --> neoplasm |
| Marginal zone lymphoma | - NHL of small CD20+ B cells that expand the marginal zone around the mantle/follicle - assoc with chronic inflammatory states (e.g. Hashimoto thyroiditis, Sjogren syndrome, H. pylori gastritis)... marginal zone typically only present with chronic inflam |
| Burkitt lymphoma | - NHL of intermediate-sized CD20+ B cells - associated with EBV - translocations of c-myc (nuclear regulator) --> cell growth - high mitotic index and "starry sky" appearance under microscope |
| Classic presentation of Burkitt lymphoma extranodal mass in a child or young adult | extranodal mass in a child or young adult - African form: jaw - Sporadic form: abdomen |
| Diffuse large B | - most common form of NHL - large CD20+ B cells grow diffusely in sheets - clinically aggressive - arises sporadically or from transformation of lower-grade lymphoma - presents in late adulthood |
| Hodgkin lymphoma overview | - proliferation of Reed-Sternberg cells - cytokine release attracts other inflammatory cells, may lead to fibrosis and "B" symptoms (night sweats, fever, chills) - reactive cells are the bulk of the tumor - nodular sclerosis is most common subtype |
| Reed Sternberg cells | - large B cells with multilobed nuclei & prominent nucleoli ("owl eye" appearance) - neoplastic in Hodgkin lymphoma - classically CD15 and CD30+ with NO CD20 expression - secrete cytokines that attract lymphos, plasma cells, macrophages and eosinophils |
| Nodular sclerosis | - most common subtype of Hodgkin lymphoma - classically presents with enlarging cervical or mediastinal lymph node in young adult, usually female - lymph node divided by bands of sclerosis - Reed Sternberg cells present in lake-like spaces (aka lacunar |
| Best/worst prognosis for Hodgkin lymphoma | - lymphocyte-rich subtype has best prognosis - lymphocyte-deprived has worst prognosis (usually in elderly and HIV+) |
| Multiple myeloma | malignant proliferation of plasma cells in marrow// high serum IL //plasma cells overproduce osteoclast activating factor, Igs, light chain |
| S/sx of multiple myeloma | osteoclast activating factor// IgA & IgG// = bence jones protiens |
| Monoclonal gammopathy of undetermined significance (MGUS) | increased serum protein with M spike// other features of multiple myeloma are ABSENT// common in elderly, some will develop multiple myeloma |
| Waldenstrom macroglobulinemia | B cell lymphoma with monoclonal IgM production// similar to multiple myeloma but: no lytic bone lesions// visual and neurologic deficits (due to serum hyperviscosity)// bleeding (defective platelet aggregation)// treat with plasmapheresis |
| Langerhans cell histiocytosis | neoplastic proliferation of Langerhans cells// characteristic Birbeck (tennis racket) granules seen on EM// cells are CD1a+ and S100+// |
| data source | clarebp on quizlet(dot)com |
Created by:
ljacob2010
Popular Medical sets