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54 Cards in this Set

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Define Leukocytosis and what are the two types?
Inc. WBC count
Benign and Neplastic (leukemia and Lymphoma)
Define Neutropenia and name the two types
decreased neutrophil count.
congenital & Acquired
Causes of Congential Neutropenia
staph and strep
Causes of Acquired
bacterial infection, chemotherapy, aplastic anemia, neoplasms, autoimmune, drug reaction(sulfa)
Define Lymphadenitis
inflammation of lymph nodes
causes of lymphadenitis
Infection: EBV(infectious mono), HIV(generalized lymphadenopathy), toxoplasmosis(Sm. organisms), Cat-scratch fever (lg. bacteria)
Autoimmune: Lupus erythematosis, rheumatoid arthritis
Skin Diseases: dermatopathic lymphadenopathy
Tumors of the lymphocytes
Lymphoma
Nodal Lymphoma
lymphoma in lymph nodes, spleen and bone marrow; these feel firm and rubbery and can't move them
Extranodal Lymphoma
lymphoma in nonlymphoid organs
who is at highest risk for lymphoma?
White males and agricultural workers
what are the grades of lymphoma? And survival rates.
low: 5-7+ yrs, incurable
Interim: 1-3 yrs
High: several months to 1 yr, some respond long term and are cured
What are the stages of lymphoma?
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.
what best predicts survival of lymphoma?
Stages
What are the subtypes of non-hodgkin's lymphoma
Sm. lymphocytic, follicular lymphoma, Diffuse Lg. B-cell Lymphoma (most common)
What type of antibody is used to tx the subtypes of lymphoma and why?
Rituxan b/c it is an anti-CD20 monoclonal anitbody therapy drug and all of the subtypes are CD20 positive
Which subtypes of lymphoma are commonly seen in bone marrow?
Follicular Lymphoma and small lymphocytic
Which lymphoma can present in any organ?
Lg. B-cell lymphoma
what are the two uncommon subtypes of Lymphoma?
Burkitt's Lymphoma
Mycosis Fungoides
Where is Burkitt's found in the body and in what population?
jaw mass in young, ileum, retroperitonieum in elderly, HIV/AIDS population (Africa), associated w/ EBV
What does Mycosis Fungoides present as and who gets it? Other name for it?
Plaque to nodular lesions in skin.
Black males mostly
Cutaneous t-cell Lymphoma
What is MALT Lymphoma and what is it associated with?
Lymphoma of mucosa associated Lymphoid tissue; eshibits low grade behavior; can transform to lg. cell lymphoma
Helicobacter Pylori infection
How is MALT treated? and when can it not be treated?
multiple antibiotics and PeptoBismol.
tx fails when cytogenic lesions (irreversible transformations) have occured
What are the extranodal sites of MALT Lymphoma?
stomach (most), small intestine, colon/rectum, thyroid, lung, conjunctiva/eye(diffuse lg. cell)
What is Hodgkin's Disease?
a tumor with Reed-Sternberg cells (neoplastic; few), a background of fibrous bands, plasma cells, eosinophils, and lymphocytes
What does Hodgkins usually get diagnosed as first and why?
Reactive infection b/c all of the reed-sternberg cells covered by immune cells but when infection symptoms don't go away suspect Hodgkins
List Hodgkin's subtypes in order of occurence:
nodular sclerosis, mixed cellularity, lymphocyte predominant, lymphocyte depleted
What is the most common subtype of Hodgkin's? what is the peak age and what group is at highest risk during this age?
Nodular sclerosis (50%)
white women 20-24 yrs old
Where does Hodgkin's present?
mediastinal and neck lymph nodes (b/c associated w/ EBV and this is the latent site of it)
What virus is Hodgkin's associated with?
EBV
How does Hodgkin's spread?
thru lymph nodes only
How does non-hodgkin's lymphoma spread?
thru lymph and blood
How are Hodgkin's lymphoma's staged?
Same as non-hodgkin's: (Ann Arbor stages)
stage IV is least likely
How is Hodgkin's treated?
Radiotherapy (low stages), chemotherapy (high stages)
What are the complications of therapy on Hodgkin's?
Pulmonary fibrosis, secondary tumors (breast)- (both from radiation), Secondary MDS/leukemia (from chemo)
What are the causes of benign leukocytosis?
infections and bone marrow stimulating agents create this reaction in the body?
What are the causes of neoplastic leukocytosis?
Leukemia and lymphoma
What is another name for Plasma Cell Myeloma?
What is another name for Multiple Myeloma?
What are three properties of Plasma cell myeloma?
sheets of clonal plasma cells (kappa/lambda)
lytic bone lesions in vertebrae, skull, ribs most commonly
Monoclonal serum Ig > 3.5gm/dl
What condition do sticky immunoglobulins cause in plasma cell myeloma?
Rouleaux: hyperviscosity of the blood because the Ig is sticky
What are 4 complications of Multiple myeloma?
Lytic bone lesions (bone pain, pathologic fx's, vertebral body collapse)
infection
clotting problems
renal failure (Ig gets trapped in kidneys)
What are some characteristics of Acute Leukemia?
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.
what are some characteristics of chronic leukemia?
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
What are the clinical features of anemia in association with acute leukemia?
weakness and pallor
What are the clinical features of thrombocytopenia in association with acute leukemia?
bleeding or bruising spontaneously
What are the clinical features of leukemia infiltrates in association with acute leukemia?
bone or jt. pain, lymphadenopathy, hepatosplenomegally
What are the clinical features of granulocytopenia in association with acute leukemia?
fever
infection
What are the clinical features of leukemia cells in CSF in association with acute leukemia?
neurologic symptoms (headache, vomitting, visual disturbance)
What are the characteristics of ALL (acute lymphoblastic leukemia)?
any age
blood and marrow disease
blast cells fill marrow
bone pain
easy bruising
fatigue
resonds 85% of the time to tx
what are the 2 subtypes of ALL?
t-cell
b-cell
What is the tumor form of ALL?
Lymphoblastic lymphoma is the tumor form of what leukemia?
Where does lymphoblastic leukemia occur most frequently?
What type of lymphoma occurs frequently in the mediastinum?
What is preleukemia?
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
What are some features of dysplastic cells in preleukemia?
multiple nuclei in RBCs
bilobed neutrophils
ringed sideroblasts (iron)
What are the 4 classifications of myeloblastic syndromes?
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)