Path 3- Diseases Of Wbc's And Lymph Nodes

Front 1

Define Leukocytosis and what are the two types?

Back 1

Inc. WBC count
Benign and Neplastic (leukemia and Lymphoma)

Front 2

Define Neutropenia and name the two types

Back 2

decreased neutrophil count.
congenital & Acquired

Front 3

Causes of Congential Neutropenia

Back 3

staph and strep

Front 4

Causes of Acquired

Back 4

bacterial infection, chemotherapy, aplastic anemia, neoplasms, autoimmune, drug reaction(sulfa)

Front 5

Define Lymphadenitis

Back 5

inflammation of lymph nodes

Front 6

causes of lymphadenitis

Back 6

Infection: EBV(infectious mono), HIV(generalized lymphadenopathy), toxoplasmosis(Sm. organisms), Cat-scratch fever (lg. bacteria)
Autoimmune: Lupus erythematosis, rheumatoid arthritis
Skin Diseases: dermatopathic lymphadenopathy

Front 7

Tumors of the lymphocytes

Back 7

Lymphoma

Front 8

Nodal Lymphoma

Back 8

lymphoma in lymph nodes, spleen and bone marrow; these feel firm and rubbery and can't move them

Front 9

Extranodal Lymphoma

Back 9

lymphoma in nonlymphoid organs

Front 10

who is at highest risk for lymphoma?

Back 10

White males and agricultural workers

Front 11

what are the grades of lymphoma? And survival rates.

Back 11

low: 5-7+ yrs, incurable
Interim: 1-3 yrs
High: several months to 1 yr, some respond long term and are cured

Front 12

What are the stages of lymphoma?

Back 12

I: one node region or extranodal site
II: 2 node regions on same side of diaphragm
III: 2+ node regions on both sides of diaphragm
IV: into bone marrow or multiple extranodal orgs.

Front 13

what best predicts survival of lymphoma?

Back 13

Stages

Front 14

What are the subtypes of non-hodgkin's lymphoma

Back 14

Sm. lymphocytic, follicular lymphoma, Diffuse Lg. B-cell Lymphoma (most common)

Front 15

What type of antibody is used to tx the subtypes of lymphoma and why?

Back 15

Rituxan b/c it is an anti-CD20 monoclonal anitbody therapy drug and all of the subtypes are CD20 positive

Front 16

Which subtypes of lymphoma are commonly seen in bone marrow?

Back 16

Follicular Lymphoma and small lymphocytic

Front 17

Which lymphoma can present in any organ?

Back 17

Lg. B-cell lymphoma

Front 18

what are the two uncommon subtypes of Lymphoma?

Back 18

Burkitt's Lymphoma
Mycosis Fungoides

Front 19

Where is Burkitt's found in the body and in what population?

Back 19

jaw mass in young, ileum, retroperitonieum in elderly, HIV/AIDS population (Africa), associated w/ EBV

Front 20

What does Mycosis Fungoides present as and who gets it? Other name for it?

Back 20

Plaque to nodular lesions in skin.
Black males mostly
Cutaneous t-cell Lymphoma

Front 21

What is MALT Lymphoma and what is it associated with?

Back 21

Lymphoma of mucosa associated Lymphoid tissue; eshibits low grade behavior; can transform to lg. cell lymphoma
Helicobacter Pylori infection

Front 22

How is MALT treated? and when can it not be treated?

Back 22

multiple antibiotics and PeptoBismol.
tx fails when cytogenic lesions (irreversible transformations) have occured

Front 23

What are the extranodal sites of MALT Lymphoma?

Back 23

stomach (most), small intestine, colon/rectum, thyroid, lung, conjunctiva/eye(diffuse lg. cell)

Front 24

What is Hodgkin's Disease?

Back 24

a tumor with Reed-Sternberg cells (neoplastic; few), a background of fibrous bands, plasma cells, eosinophils, and lymphocytes

Front 25

What does Hodgkins usually get diagnosed as first and why?

Back 25

Reactive infection b/c all of the reed-sternberg cells covered by immune cells but when infection symptoms don't go away suspect Hodgkins

Front 26

List Hodgkin's subtypes in order of occurence:

Back 26

nodular sclerosis, mixed cellularity, lymphocyte predominant, lymphocyte depleted

Front 27

What is the most common subtype of Hodgkin's? what is the peak age and what group is at highest risk during this age?

Back 27

Nodular sclerosis (50%)
white women 20-24 yrs old

Front 28

Where does Hodgkin's present?

Back 28

mediastinal and neck lymph nodes (b/c associated w/ EBV and this is the latent site of it)

Front 29

What virus is Hodgkin's associated with?

Back 29

EBV

Front 30

How does Hodgkin's spread?

Back 30

thru lymph nodes only

Front 31

How does non-hodgkin's lymphoma spread?

Back 31

thru lymph and blood

Front 32

How are Hodgkin's lymphoma's staged?

Back 32

Same as non-hodgkin's: (Ann Arbor stages)
stage IV is least likely

Front 33

How is Hodgkin's treated?

Back 33

Radiotherapy (low stages), chemotherapy (high stages)

Front 34

What are the complications of therapy on Hodgkin's?

Back 34

Pulmonary fibrosis, secondary tumors (breast)- (both from radiation), Secondary MDS/leukemia (from chemo)

Front 35

What are the causes of benign leukocytosis?

Back 35

infections and bone marrow stimulating agents create this reaction in the body?

Front 36

What are the causes of neoplastic leukocytosis?

Back 36

Leukemia and lymphoma

Front 37

What is another name for Plasma Cell Myeloma?

Back 37

What is another name for Multiple Myeloma?

Front 38

What are three properties of Plasma cell myeloma?

Back 38

sheets of clonal plasma cells (kappa/lambda)
lytic bone lesions in vertebrae, skull, ribs most commonly
Monoclonal serum Ig > 3.5gm/dl

Front 39

What condition do sticky immunoglobulins cause in plasma cell myeloma?

Back 39

Rouleaux: hyperviscosity of the blood because the Ig is sticky

Front 40

What are 4 complications of Multiple myeloma?

Back 40

Lytic bone lesions (bone pain, pathologic fx's, vertebral body collapse)
infection
clotting problems
renal failure (Ig gets trapped in kidneys)

Front 41

What are some characteristics of Acute Leukemia?

Back 41

medical emergency
can die w/in 24 hrs.
occurs in all ages
sudden onset
mild lymphadenopathy
mild splenomegally
prominent anemia and
thromboctopenia
leukemia cells are immature
and blast cells
untreated die w/in 6 mo.

Front 42

what are some characteristics of chronic leukemia?

Back 42

slow process
insidious onset (complain of malaise and diffuse pain)
>40 yrs. old
moderate lymphadenopathy
moderate to severe splenomegally
mild anemia/thrombocytopenia
mature leukemic cells
untreated live 2-10 yrs

Front 43

What are the clinical features of anemia in association with acute leukemia?

Back 43

weakness and pallor

Front 44

What are the clinical features of thrombocytopenia in association with acute leukemia?

Back 44

bleeding or bruising spontaneously

Front 45

What are the clinical features of leukemia infiltrates in association with acute leukemia?

Back 45

bone or jt. pain, lymphadenopathy, hepatosplenomegally

Front 46

What are the clinical features of granulocytopenia in association with acute leukemia?

Back 46

fever
infection

Front 47

What are the clinical features of leukemia cells in CSF in association with acute leukemia?

Back 47

neurologic symptoms (headache, vomitting, visual disturbance)

Front 48

What are the characteristics of ALL (acute lymphoblastic leukemia)?

Back 48

any age
blood and marrow disease
blast cells fill marrow
bone pain
easy bruising
fatigue
resonds 85% of the time to tx

Front 49

what are the 2 subtypes of ALL?

Back 49

t-cell
b-cell

Front 50

What is the tumor form of ALL?

Back 50

Lymphoblastic lymphoma is the tumor form of what leukemia?

Front 51

Where does lymphoblastic leukemia occur most frequently?

Back 51

What type of lymphoma occurs frequently in the mediastinum?

Front 52

What is preleukemia?

Back 52

what is another name for Myelodysplasia?
Characterized by dysplastic myeloid cells present in bone marrow
blast cells must be <20% in
bone marrow
will become acute myeloid
leukemia if it progresses

Front 53

What are some features of dysplastic cells in preleukemia?

Back 53

multiple nuclei in RBCs
bilobed neutrophils
ringed sideroblasts (iron)

Front 54

What are the 4 classifications of myeloblastic syndromes?

Back 54

1. Refractory anemia (RA)
2. refractory anemia w/ ringed sideroblasts (RARS)
3. Refractory anemia w/ excess blasts (RAEB) (5% to <20%)
4. Chronic myeomonocytic leukemia (CMML)