Blood Disorders

Question 1

Describe neuropenia

Answer 1

Low neutrophil count

Question 2

What can cause neutropenia?

Answer 2

• Infections caused by bacteria, viruses, and protozoa

Question 3

What patients are susceptible for neutropenia?

Answer 3

o Chronic disease
o Nutritional deficiency
o Myelotoxic medications (chemo)

Question 4

What is neutrophilia?

Answer 4

High neutrophil levels

Question 5

What conditions can cause neutrophilia?

Answer 5

• Extremely varied
• Acute infection
• Tissue damage
• Acute hemorrhage
• Eclampsia
• Exercise
• Seizure
• Steroids

Question 6

What is lymphocytosis?

Answer 6

Increased lymphocytes

Question 7

Who is at risk for lymphocytosis?

Answer 7

• Most children and adults are non-neoplastic

Question 8

What is lymphocytopenia?

Answer 8

Decreased lymphocytes

Question 9

What causes lymphocytopenia?

Answer 9

Immune disorders
-Medications

Question 10

Are the number of monocytes low or high in a monocyte disorder

Answer 10

High

Question 11

When do you see eosinophil disorders?

Answer 11

• Maybe seen in healthy individuals without disease
• Allergic Reactions
• Parasitic infections
• Neoplasm such as CML
• Acute Inflammation/Stress
• Corticosteroid Use

Question 12

Describe basophil disorders

Answer 12

• All have increased levels
• CML
• Ulcerative colitis
• Chronic sinusitis
• Iron deficiency
• Small Pox
• Hodgins disease

Question 13

What are the 3 components needed for homeostasis?

Answer 13

o Vessel Wall
o Platelets
o Coagulation System

Question 14

What are the 4 functions of platelets?

Answer 14

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

Question 15

Characteristics of platelets

Answer 15

• 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

Question 16

Describe leukemias

Answer 16

• 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

Question 17

Goals of leukemia workshops

Answer 17

• 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

Question 18

What are tests to perform to see if a patient has leukemia

Answer 18

• Peripheral Blood Smear
• Bone Marrow Biopsy
• Bone marrow aspirate

Question 19

Describe acute leukemia

Answer 19

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

Question 20

Describe acute lymphoblastic leukemia

Answer 20

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

Question 21

3. Acute Myelogenous Leukemia

Answer 21

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

Question 22

4. Chronic Leukemia’s

Answer 22

o Usually disease of adults
o Presentation is variable
o Usually found incidentally
o Blood findings can range from pancytopenia to marked leukocytes

Question 23

Chronic Myelogenous Leukemia

Answer 23

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

Question 24

Chronic Lymphocytic Anemia

Answer 24

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

Question 25

Lymphoma

Answer 25

9. 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