Blood Disorders Flashcards
Describe neuropenia
Low neutrophil count
What can cause neutropenia?
• Infections caused by bacteria, viruses, and protozoa
What patients are susceptible for neutropenia?
o Chronic disease
o Nutritional deficiency
o Myelotoxic medications (chemo)
What is neutrophilia?
High neutrophil levels
What conditions can cause neutrophilia?
• Extremely varied
• Acute infection
• Tissue damage
• Acute hemorrhage
• Eclampsia
• Exercise
• Seizure
• Steroids
What is lymphocytosis?
Increased lymphocytes
Who is at risk for lymphocytosis?
• Most children and adults are non-neoplastic
What is lymphocytopenia?
Decreased lymphocytes
What causes lymphocytopenia?
Immune disorders
-Medications
Are the number of monocytes low or high in a monocyte disorder
High
When do you see eosinophil disorders?
• Maybe seen in healthy individuals without disease
• Allergic Reactions
• Parasitic infections
• Neoplasm such as CML
• Acute Inflammation/Stress
• Corticosteroid Use
Describe basophil disorders
• All have increased levels
• CML
• Ulcerative colitis
• Chronic sinusitis
• Iron deficiency
• Small Pox
• Hodgins disease
What are the 3 components needed for homeostasis?
o Vessel Wall
o Platelets
o Coagulation System
What are the 4 functions of platelets?
o Adhesion to collagen at the site of vascular injury
o Aggregation of additional platelets to “plug” the leak in the blood vessel
o Release of platelet contents to promote hemostasis
o Provision of A phospholipid Surface to assemble proteins of the Coagulation Cascade
Characteristics of platelets
• Usually between 150-400
• Hemorrhage is not normally apparent until levels fall far below normal
• Levels below 50 will be dangerous when challenged with surgery or trauma
• Levels below 20 may result in spontaneous bleeding
• Young platelets function better than older platelets
Describe leukemias
• Unregulated proliferation of hematopoietic cells in the bone marrow
• Acute or chronic
• Often infiltrate other organs
• Acute
o Characterized by proliferation of immature precursor cells, rapid clinical course
• Chronic
o Proliferation of mature cells, longer clinical course
Goals of leukemia workshops
• Establish diagnosis
• Subtype the leukemia for treatment and prognosis
• Confirm cytogenic studies for prognosis
• Perform molecular genic studies
• Examine extramedullary tissue and fluids for involvement
• Evaluate the effectiveness of therapy
What are tests to perform to see if a patient has leukemia
• Peripheral Blood Smear
• Bone Marrow Biopsy
• Bone marrow aspirate
Describe acute leukemia
o Persistent with nonspecific complaints such as fatigue and persistent infection
o Most have normocytic normochromic anemia
o WBC count can range from high to low
o Large number of blast cells (immature white cells)
In order to make a diagnosis- blast cells must be 30% or more of all marrow cells
Describe acute lymphoblastic leukemia
o Commonly seen in children
o Prognosis is favorable in females from 2- 10 years old
o Favorable with WBC less than 10
o Cells are usually small and have suspicious nuclei
- Acute Myelogenous Leukemia
o Found in middle age adults and older adults
o Most common leukemia in newborns and infants
o Subtyping depends on tendency toward differentiation
o Cells have multiple large nuclei
o Presence of Auer rod is indicative
- Chronic Leukemia’s
o Usually disease of adults
o Presentation is variable
o Usually found incidentally
o Blood findings can range from pancytopenia to marked leukocytes
Chronic Myelogenous Leukemia
o Primarily affects adults
o Median age is 50
o Males slightly greater than females
o Nonspecific symptoms- weight loss, splenomegaly
o Most patients are asymptomatic
o Highly suggested by peripheral blood smear
o High neutrophils, eosinophils, and basophils
o WBC counts are usually greater than 25
o Myelocytes and neutrophils are predominant
o Usually normochromic, normocytic anemia
o Philadelphia chromosome is present in 90% of cases
o Initial phase lasts 3 to 4 years
o After that the patient may develop a blast crisis or accelerated phase
o After a blast crisis a median survival is 2-6 months and resistant to chemo
Chronic Lymphocytic Anemia
o Most common adult leukemia
o Average age of diagnosis is 55
o Males outnumber females 2.5: 1
o Result in the accumulation of small round lymphocytes in the blood, bone marrow, and organs
o Most discovered accidentally
o Total WBC might reach 600 or greater
o WBC are small, condensed, blochy chromatin with inconspicuous nuclei and scant cytoplasm
o 50% present with anemia and thrombocytopenia
o Neutropenia is not seen initially but develops as bone marrow infiltrates become more extensive
o Splenomegaly and lymphadenopathy
o CLL is staged by the Rai System and the Binet System
Lymphoma
- Lymphoma
o 2 kinds of Lymphoma
Hodgkin’s
- + RS
- Better Prognosis
Non-Hodgkin’s
- -RS
- Worse Prognosis
o Similar Clinical Presentations
o Presence of Reed-Sternburg cell on biopsy confirms Hodgkin’s
