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53 Cards in this Set
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Leukopenia |
decreased white blood cells |
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Neutropenia (granulocytopenia) |
a drop in the absolute count of neutrophils |
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Agranulocytosis |
severe granulocytopenia |
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Pancytopenia |
decreases in all components (RBCs,WBCs, platelets) |
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Thrombocytopenia |
decrease in platelets to less than 20,000 (150,000-400,000 normal) |
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Leukostasis |
# of circulating blasts is elevated |
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Remission |
absence of any detectable leukemic cells in the bone marrow |
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Leukemia |
malignant neoplasm of bone marrow and cells originally derived from hematopoietic stem cells |
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Leukemia Basic Pathology |
rapidly multiplying cells invade organs and tissues suppress normal cells |
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Leukemia Type of Cell |
Lymphocytic (lymphoblastic) - B, T, & NK Myelocytic (myeloblastic) - all others |
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Basic Categories of Leukemias |
Acute Lymphocytic Leukemia (ALL) Chronic Lymphocytic Leukemia (CLL) Acute Myelogenous Leukemia (AML) Chronic Myelogenous Leukemia (CML) |
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Leukemia General Manifestations |
Pale (anemic) SOB Fatigue susceptible to infection Bleeding due to lack of platelets |
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Acute Lymphocytic Leukemia (ALL) |
Aburpt onset, primarily children (80-85%), 1-7 yrs of age, white, well developed countries |
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ALL Etiology and Patho |
Unknown. ? virus or exposure to chemicals inutero
Pahto - B cells (85%) |
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Clinical Manifestations ALL |
increased blast cells, decreased WBCs, enlarged spleen and liver, CNS invasions (headaches and seizures) |
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ALL Prognosis |
Children 95% remission (5 yrs - 90%) Adults 80% remission (5 yrs - 75%) |
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AML Incidence and Onset |
Incidence - increases with age, primarily adults Onset - abrupt, 60 -65 yrs old median |
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AML Etiology and Pathi |
Etiology - unknown, ? high doses of radiation, smoking
Patho - neutrophils |
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AML Clinical Manifestations |
anemia, bleeding, infections, decreased platelets & RBCs, pain in bone & joints, increased WBCs |
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AML Prognosis |
w/o treatment 3 months 1/4 alive after 5 yrs |
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CLL Incidence and onset |
Incidence - older adults median age 60, 72 average, M:F - 2:1
Onset - slow |
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CLL Risk Factors and Patho |
Risk Factors - agent orange (vietnam)
Patho - 95% malignant B cell precursor, aquired change to DNA, T or NK involved, very aggressive |
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CLL Clinical Manifestations |
hypermetabolic state, found on routine blood work, rarely goes to CNS, prone to infections |
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CLL Prognosis |
variable 70% survive 5 yrs with treatment |
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CML Incidence and Onset |
Incidence - older adults
Onset - gradual
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CML Etiology and Patho |
Etiology - unknown, ? acquired injury to DNA
Patho - unique chromosomal abnormality (Philadelphia chromosome 9 & 22) |
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CML Clinical Manifestations |
pain on left side (spleen), hypermetabolic state, chronic, accelerated, |
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Prognosis CML |
poor, doesn't respond well to chemo |
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Chemotherapy Phases |
1. Induction - hit hard, a lot quickly 2. CNS prophylaxis 3. Consolidation (intensification) - reduce amt of cells. 4. Maintenance - oral chemo |
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Complications of Chemotherapy |
uric acid in blood stream 24 - 72 hours after initial chemo. Increased potassium. |
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Bone Marrow Transplant Autologous |
from self during remission |
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Bone Marrow Transplant Allografts |
from a close resembalence to patient |
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Bone Marrow Procedure |
1. Chemo 2. Infusion of bone marrow 3. Wait |
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Peripheral Stem Cell Treatment |
receive stem cells from donor |
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Bone Marrow Transplant Syngenic |
from identical twin |
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Lymphoma |
malignant tumor that arises from the malignant transformation of a lymphocyte in the lymphatic system |
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Hodgkin Lymphoma Incidence |
increased in young population & again in the elderly, slightly increased in males |
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Hodgkin Lymphoma Etiology |
unknown, Epstein Barr 50% of cases |
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Hodgkin Lymphoma Patho |
Reed-Sternberg cell, 3 nuclei, acquired damage to DNA in lymphocyte |
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Hodgkin Lymphoma Clinical Manifestations |
increased size of lymph nodes (cervical and diaphragm), increased WBCs, asymptomatic, dry cough, splenomegaly, increased temp, night sweats |
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Hodgkin Lymphoma Treatment and Prognosis |
Treatment - radiation
Prognosis - 86% cured |
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Non Hodgkin Lymphoma Incidence |
increases with age, male more than female, increase with AIDS |
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Non Hodgkin Lymphoma Etiology |
unknown, Epstein-Barr, side effect of leukemia |
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Non Hodgkin Patho |
acquired damage to DNA of lymphocyte (B cells) |
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Non Hodgkin Clinical Manifestations |
enlarged lymph nodes, weight loss, GI symptoms, fatigue |
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Non Hodgkin Prognosis |
Stage I or II - favorable
Stage III or IV - poor (5th most common for death) |
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Multiple Myeloma |
bone marrow / plasma cells, mass formation within bone |
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Multiple Myeloma Incidence and Onset |
Incidence - rare (1%), increased with age, males more than females, 22,000 new cases / yr, African Americans 2 x's as often.
Onset - very slow |
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Multiple Myeloma Risk Factors |
chronic exposure to chemicals and radiation, increased in HIV patients |
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Multiple Myeloma Etiology |
acquired injury to DNA of one cell in the sequence destined to be a plasma cell |
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Multiple Myeloma Patho |
B cell, usually IgG (after mature) IgA |
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Clinical Manifestations Multiple Myeloma |
C - increased calcium R - renal insufficiency A - anemia B - bone lesions
Bence Jones protein or M protein in urine, infections (urinary & bronchial), pathological fractures
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Multiple Myeloma Prognosis |
long term survival decreased, 30% alive within 5 yrs, die within a year without treatment |
