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45 Cards in this Set
- Front
- Back
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What pathological effects does Phenytoin have?
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Increases lymphocytes in the PB
Causes T-cell parafollicular hyperplasia Inhibits intestinal conjugase (which turns folate polyglutamates into absorbable monoglutamates) |
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What pathological effects does lead have?
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Denatures ferrochelatase (final step in heme synthesis, therefore an increase in protoporphyrin IX)
Denatures ALA dehydrase (which increases ALA causing nerve damage, cerebral edema and demyelination causing the child encephalopathy/adult nerve palsy) Denatures ribonuclease (no ribosomal degradation causing basophilic stippling in PB RBCs) Causes Fanconi's Syndrome (renal proximal tubule acidosis, phophaturia, aminoaciduria, glucosuria) |
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Eosinophilia occurs because...?
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Allergic (asthma, eczema, pemphigus, etc)
Parasitic (trich, tapeworm, roundworm, schistomaniasis) Other infections (scarlet fever, TB, leprosy) Drugs (sulfonamides, PCN, digitalis, nitrofurantin) Neoplastic (CML, Hodgkin's sometimes) |
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Causes oxidant stress in G6PD
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Primaquine, chloroquine, dapsone, sulfonamides (and fava beans)
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Causes decreased DNA synthesis
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Phenothiazine, chloramphenicol, purine/pyrimidine antagonists (methotrexate, hydroxyurea, azithioprine, cytosine arabinosine, 6-mercaptopurine)
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Symptoms of Polycythemia Vera
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Pruritus with bathing, ruddy face, peptic ulcer (histamine increases gastric acid), gout (from breaking down new abundance of nucleated cells (purines become uric acid)), decrease in EPO, increase in both RBCs and PV
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Plasma Dyscrasia: MGUS
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Common monoclonal gammapathy
Small spike in IgG Plasma cells are < 3% of marrow No BJ proteins |
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Plasma Dyscrasia: Solitary Skeletal Plasmacytoma
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Ribs/vertebra/pelvis
No plasmablasts in the marrow No BJ proteins 75% become MM Slight increase in M component |
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Plasma Dyscrasia: Extramedullary Plasmacytoma
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Upper respiratory
Slight increase in M component No malignant plasma cells in marrow No BJ protein |
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Plasma Dyscrasia: Lymphoplasmacytic lymphoma (Waldenstrom's)
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Neoplamic lymphaplasmatoid B cells
In old men M spike (IgM) BJ protein No lytic bone lesions General LAD (not found in MM) Anemia Involves marrow, spleen, liver Increased viscosity in blood Retinal hemmorhage, stroke, platelet aggregation defects 5 year survival |
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Plasma Dyscrasia: Heavy chain
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No light chains, no BJ protein
alpha - infiltrates upper respiratory tract, jejeunum causing malabsorption gamma - lymphoma mu - lymphocytic leukemia, lymphoma |
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Precursor B-Cell ALL
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TdT +
No Ig on surface t(12;21) CBF-alpha & ETV6 In children Pancytopenia Aggressive |
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Precursor T-Cell ALL
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Thymic precursor T cells
TdT + TAL1 rearrangements Adolescent males Thymic mass Aggressive |
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Burkitt's
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GC B-cell
CD10+ t(8;14) c-myc & Ig Also t(2;8), t(8;22) Endemic (African) version found with latent EBV Adolescents/young adults Jaw/Extranodal/Abdominal mass Aggressive |
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Diffuse Large B-Cell Lymphoma
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GC or post GC B-cell
RAR of BCL6 t(14;18) in some cREL amplified in some In adults mostly Rapid growing mass, some extranodal involvement Aggressive |
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Symptoms of Polycythemia Vera
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Pruritus with bathing, ruddy face, peptic ulcer (histamine increases gastric acid), gout (from breaking down new abundance of nucleated cells (purines become uric acid)), decrease in EPO, increase in both RBCs and PV
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Plasma Dyscrasia: MGUS
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Common monoclonal gammapathy
Small spike in IgG Plasma cells are < 3% of marrow No BJ proteins |
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Plasma Dyscrasia: Solitary Skeletal Plasmacytoma
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Ribs/vertebra/pelvis
No plasmablasts in the marrow No BJ proteins 75% become MM Slight increase in M component |
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Plasma Dyscrasia: Extramedullary Plasmacytoma
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Upper respiratory
Slight increase in M component No malignant plasma cells in marrow No BJ protein |
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Plasma Dyscrasia: Lymphoplasmacytic lymphoma (Waldenstrom's)
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Neoplamic lymphaplasmatoid B cells
In old men M spike (IgM) BJ protein No lytic bone lesions General LAD (not found in MM) Anemia Involves marrow, spleen, liver Increased viscosity in blood Retinal hemmorhage, stroke, platelet aggregation defects 5 year survival |
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Hairy Cell
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Post GC memory B-cell
Older men Pancytopenia Splenomegaly Indolent |
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Adult T-Cell leukemia/lymphoma
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Helper T-cell with CD25 (IL-2 receptor)
HTLV-1 in tumor cells Cutaneous lesions, marrow involvement Hypercalcemia Japanese/W African/Caribbean Aggressive |
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Anaplastic large T-Cell
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CTL's
RAR in ALK Children/young adults with lymph node/soft tissue disease Aggressive |
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Extranodal NK/T-cell Lymphoma
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NK or CTL (rarely)
EBV-associated destructive extranodal mass, often sinonasal with hemophagotic function Aggressive |
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Mycosis Fungoides/Sezary
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Helper T-cell
Adult with cutaneous patches/general erythema Indolent |
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T-cell Granular Lymphocytic Leukemia
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CD8 T-cells/NK types
Adult with splenomegaly, neutropenia, anemia Some with autoimmune disease |
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Extranodal marginal zone lymphoma
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Post GC memory B-cell
trisomy 18, t(11;18), t(1;14) Extranodal sites Adults with chronic inflammatory disease Usually stays local Indolent |
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Follicular lymphoma
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GC B-cells with CD10, BCL-2 and BCL-6
t(14;18) in BCL-2 Old people General LAD Marrow involved Indolent |
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Mantle Cell Lymphoma
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Naive B-cells with cyclinD1 and CD5
t(11;14) with BCL1 (cyclinD1) and IgH Old men with disseminated disese Moderately aggressive |
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Multiple Myeloma
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Plasma cells from post GC B-cells
RAR IgH Old people Lytic bone lesions Hypercalcemia Renal failure Primary amyloidosis |
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Small lymphocytic lymphoma/CLL
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Naive B-cell/post GC memory B-cell with CD5
Trisomy 12, deletions at 11q, 13q, 17p Old people Marrow, spleen, liver, lymph node disease PB involved (autoimmune hemolysis/thrombocytopenia) Indolent |
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T-cell associated Ag's
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CD1: cortical thymocytes/Langerhan's histiocytes
CD3: thymocytes/peripheral T-cells CD4: peripheral helper T-cells/thymocytes CD5: T-cells, some B-cells CD8: CTL/thymocytes/some NK cells |
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NK cell associated Ag's
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CD16: NK and granulocytes
CD56: NK and some T-cells |
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B-cell associated Ag's
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CD10=CALLA: marrow pre-B, GC B-cell
CD19: marrow pre-B, mature B-cells, not plasma cells CD20: marrow pre-B after CD19, mature B-cells, not plasma cells CD21: EBV receptor, on mature B-cells, follicular dendritic cells CD23: activated mature B-cells CD79a: marrow pre-B and mature B-cells |
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Monocyte/macrophage associated Ag's
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CD11c: monocytes, macrophages and granulocytes (Hairy cell leukemia)
CD13: monocytes and granulocytes CD14: monocytes CD15: granulocytes (RS cells and variants (Hodgkin's)) CD33: monocytes and myeloid progenitors CD64: mature myeloids |
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Random other Ag Markers
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CD34: Primary stem progenitor
CD30: Activated B, T and monocytes (RS cells and variants (Hodgkin's)) CD45: All leukocytes |
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Hodgkin's: Lymphocyte depletion
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GC and Post GC B-cell
Over 70% EBV associated Elderly Many HIV+ Moderately aggressive |
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Hodgkin's: Lymphocyte rich
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GC and post GC B-cell
40% EBV associated More in males Moderately aggressive |
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Hodgkin's: Nodular Schlerosing
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GC and post GC B-cell
Rarely EBV related Lacunar cells Mediastinal mass in females Moderately aggressive |
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Hodgkin's: Lymphocyte predominant
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GC B-cells
Not EBV associated L&H variant cells Young-middle age men Cervical/axillary LAD Indolent |
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Hodgkin's: Mixed-cellularity
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Post GC B-cells
70% EBV related More in men LAD Many RS cells Moderately aggressive |
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Basophilia in...
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Polycythemia Vera
Myeloproliferative reactions EMH Hypothyroidism |
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Dohle bodies
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Inclusions of RER from early maturational stages
Seen in myeloid left shifts Often seen with toxic granulations |
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May-Hegglin Anomaly
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Basophilic inclusions (altered RNA)
Giant platelets Thrombocytopenia Benign Often associated with bleeding |
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Alder-Reilly Anomaly
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Associated with muccopolysaccharidosis
Azurophilic granules (that look like toxic granulations) In all leukocytes |
