Alterations in Hematological Functions Pt. 2

Question 1

Myeloproliferative RBC Disorder

Answer 1

a group of slow-growing blood cancers in which the bone marrow makes too many abnormal red blood cells, which accumulate in the blood.

Question 2

Polycythemia

Answer 2

This is a myeloproliferative RBC disorder in which there is an overproduction of RBC happening in the bone marrow

Question 3

Leukocytosis

Answer 3

Leukocytosis-WBC count higher than normal

**Leukocytosis is a normal protective physiologic response to physiologic stressors

Question 4

Leukopenia

Answer 4

Leukopenia-WBC count lower than normal

• *Leukopenia is not normal and not beneficial
• *A low white count predisposes a patient to infections

Question 5

Infectious Mononucleosis

Answer 5

-Acute, self-limiting infection of B lymphocytes transmitted by saliva through personal contact
-Commonly caused by the Epstein-Barr virus (EBV)—85%
Treatment: nothing specific just let it run its course

Question 6

Signs/Symptoms of Infectious Mononucleosis

Answer 6

Symptoms: sore throat, fatigue, weakness, tonsillitis, fever, pharyngitis, swollen lymph nodes(lymphadenopathy) in the neck region, enlarged spleen(splenomegaly)

Question 7

Leukemia (Definition and Cause): 2 types–> Acute and Chronic

Answer 7

Leukemia is the uncontrolled proliferation(growth) of malignant/abnormal leukocytes causing overcrowding in the bone marrow (Leukocytosis)

• *It is a malignant disorder of the blood and blood-forming organs
• *Cause is unknown(could be genetic or environmental), but several genetic translocations have been observed

Question 8

Red marrow
vs
Yellow Marrow

Answer 8

Red marrow (aka Myeloid tissue) is responsible for the formation of red blood cells, platelets, and white blood cells

Yellow Marrow is primarily responsible for fat cell and some WBCs

Question 9

Pancytopenia

Answer 9

Occurs if cells crowd bone marrow; resulting in the decreased production of all normal blood cells

Question 10

Acute Leukemia (2 types)

Answer 10

Presence of undifferentiated or immature cells, usually blast cells
**too many immature white blood cells

Question 11

Acute Lymphocytic Leukemia (ALL)

Answer 11

• *most common leukemia in childhood (80%)

* *Most are of B cells origin(too many lymphoblasts)

Question 12

Acute Myelogenous Leukemia (AML)

Answer 12

• Primarily an adult disease
• Too many myeloblasts
• Linked to toxins(chemo) and congenital(disorder present from birth) disorder(such as down syndrome)
• May arise from myeloblasts or from monocyte-granulocyte precursor

Question 13

Chronic Lymphocytic Leukemia (CLL)

Answer 13

• More common in older patient >60 years
• Too many immature lymphocytes (Usually B lymphocytes) and immunologically incompetent
• Follows a SLOW chronic course

Question 14

Chronic Myelogenous Leukemia (CML)

Answer 14

• 3 Stages: Chronic, Accelerated, and Acute
• Affects Philadelphia chromosome
• Too many blood cells made in the bone marrow

Question 15

Acute vs Chronic Leukemia

Answer 15

Acute: rapid progression, more common in children
Chronic: progression is insidious and slow; more common in adult

**found more in men than women

Question 16

Signs and Symptoms of Leukemia

Answer 16

-Anemia
-Bleeding
*Petechiae: Small bleeds that are less than 3mm (small
red dots)
*Ecchymosis(aka bruise): Large, soft tissue bleeding;
Ecchymosis is extravasation of blood under the skin
that can be caused spontaneously by medical
conditions, such as thrombocytopenia.
-Thrombosis(blood clot inside b.v.)
-Hemorrhage
-DIC
-fever
-Infection
-Weight loss
-Neurologic manifestations
-Bone pain
-Elevated uric acid
-Liver, spleen, and lymph node enlargement

Question 17

Lymphadenopathy (2 types)

Answer 17

enlarged lymph nodes that become palpable and tender

Question 18

Local lymphadenopathy

Answer 18

• Drainage of an inflammatory lesion located near the enlarged node
• Localized to just the head and neck region

Question 19

General Lymphadenopathy

Answer 19

Occurs in the presence of malignant or nonmalignant disease

-Swollen lymph nodes across the body

Question 20

Malignant Lymphoma (2 major categories)

Answer 20

Malignant neoplasms of cells derived from lymphoid tissue (lymphocytes, histiocytes, and macrophages in lymphoid tissues)

Question 21

Hodgkin Lymphoma

Answer 21

• *Presence of Reed Sternberg Cells in lymph nodes
• Reed Sternberg cells are necessary for the diagnosis but are not specific to Hodgkins lymphoma
• Derived from B Cells
• Painless, progressive enlargement of lymph nodes on the neck is a manifestation of this

Question 22

It is widely accepted that the Reed-Sternberg cells represent the malignant transformation of lymph cells
True/False

Answer 22

True

Question 23

Physical Findings of Hodgkin Lymphoma

Answer 23

• Fever, weight loss, night sweats, adenopathy, pruritis, mediastinal mass, splenomegaly, and abdominal mass
• Find a painless, “rubbery” enlarged node on neck
  - usually found by men when shaving
• **Local Lymphadenopathy

Question 24

Treatment for Hodgkin Lymphoma

Answer 24

Adult Hodgkin lymphoma can usually be cured if detected and diagnosed early unlike non-Hodgkins lymphoma
Chemotherapy, Radiation, and Surgery are all treatment options

Question 25

Non-Hodgkin Lymphoma

Answer 25

• Unlike Hodgkin’s, which is localized, typically are multicentric in origin and involve various tissues (liver, spleen, bone marrow)
• more common than Hodgkin’s lymphoma with a worse prognosis
• No Reed-Sternberg Cells present in the biopsy
• Viral origin has been implicated; meaning the disease could be a result of a major viral infection

Question 26

Signs and Symptoms of Non-Hodgkins Lymphoma

Answer 26

Similar to Hodgkins Lymphoma, painless superficial lymphadenopathy but is general instead of local

Question 27

Treatment for Non-Hodgkins Lymphoma

Answer 27

A complete bone marrow transplant is the only treatment option for Non-Hodgkins Lymphoma

Question 28

Burkitt Lymphoma (Type of Non-Hodgkin Lymphoma)

Answer 28

• *Most common type of Non-Hodgkin Lymphoma in children
• Burkitt Lymphoma is a very fast growing tumor of the jaw and facial bones
• EPV found in nasopharyngeal secretions of patients