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Pathophysiology - Whitney Wood > Ch 11 > Flashcards

Ch 11 Flashcards

1
Q

What causes blood cells to be formed?

A

blood cells are formed in different numbers based on need & regulatory factors

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2
Q

What are Colony Stimulating Factors (CSF)?

A

short acting regulators that STIMULATE proliferation, differentiation, & functional activation of stem cells in the bone marrow; they do NOT differentiate the lymphocytes, they just stimulate them

Interleukins: support the development of lymphocytes & act synergistically to aid the CSFs

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3
Q

From what stem cell do all blood cells originate?

A

Pluripotent Stem Cell

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4
Q

Lymphoid stem cells go on to become what types of specialized blood cells?

A

NK Cells, T Cells, and B Cells

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5
Q

Myeloid stem cells go on to become what types of specialized blood cells?

A

Monocytes, Granulocytes (Eosinophils, Neutrophils, Basophils), platelets, and Erythrocytes

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6
Q

Where are leukocytes formed?

A

(from stem cells) in the bone marrow so anything that affects stem cell availability or the bone marrow will affect the supply of leukocytes

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7
Q

REVIEW: What are basophils?

A

Basophils release heparin, histamine, and other inflammatory mediators. They are called Mast Cells when they are in the tissue/are mature.

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8
Q

Are all granulocytes phagocytic?

A

yes

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9
Q

What are the 3 different types of lymphocytes?

A

B cells, T cells, and NK cells

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10
Q

B Lymphocytes (B Cells)

A

mature in the bone marrow, differentiate into plasma cells, then hang out in lymph tissue where they continue to proliferate and produce antibodies

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11
Q

T Lymphocytes (T Cells)

A

leave the bone marrow as precursor (not totally differentiated) cells and differentiate in the thymus into CD4 helper or CD8 cytotoxic, then move onto the lymph tissue to proliferate

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12
Q

What are NK cells responsible for?

A

innate immunity

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13
Q

What are monocytes?

A

Monocytes are antigen-presenting cells. They create inflammatory mediators. They can last months to years in the tissue and they can mature into phagocytic macrophages.

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14
Q

Which type of leukocyte works the hardest when you receive a vaccine?

a. Eosinophils
b. Basophils
c. B-lymphocytes
d. Neutrophils

A

c. B-lymphocytes

A vaccination introduces antigens, causing your B lymphocytes to create antibodies.

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15
Q

Which type of leukocyte is created in the bone marrow (myeloid)?

a. Eosinophil
b. Basophil
c. Neutrophil
d. all of the above

A

d. all of the above

All granular leukocytes are created in the bone marrow.

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16
Q

Name the 2 primary lymph organs and the 3 secondary lymph organs.

A 
Primary = thymus and bone marrow
Secondary = spleen, lymph nodes, and tonsils
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17
Q

Explain lymph flow.

A

Fluid from the blood moves into the tissues from the capillaries via a pressure gradient. Any excess fluid that enters the tissues, goes into the lymph vessels and is transported back into the vena cava. Along that lymph flow to the vena cava, the fluid passes through peripheral lymphoid organs, where WBCs respond to any pathogens that might be in the fluid.

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18
Q

How big is a normal lymph node?

A

1mm-2cm

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19
Q

Lymph Nodes

A
  • 1mm-2cm
  • have a fibrous capsule around them and trabecular that provide support and structure
  • B & T cells are found in the outer cortex of the lymph node
  • the primary follicles are immunologically inactive (don’t have B/T cell activity)
  • the secondary follicle has active B/T cells
  • the lymph node has its own blood supply
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20
Q

Why would a lymph node enlarge during an infection? During Lymphoma?

A

because the secondary follicles are actively working and making new cells

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21
Q

What are the normal WBC count?

A

4500-10500

22
Q

What is Leukopenia?

A

an absolute decrease in # of WBC’s; usually neutrophils

23
Q

What is Neutropenia?

A

a decrease in # of neutrophils (

24
Q

What is Agranulocytosis?

A

a neutrophil count

25
Q

What causes Neutropenia/Agranulocytosis?

A
  • Can be caused by reduced or ineffective production (this includes overgrowth of cancer cells or bone marrow depression)
  • Can also be caused by excessive removal or destruction (this happens with inflammation and infection, immunologic destruction, CYTOTOXIC DRUGS, or Felty’s syndrome)
26
Q

What is the most common cause of neutropenia/agranulocytosis?

A

a drug related cause; neutropenia is especially common after chemo because chemo can cause bone marrow depression

27
Q

What signs and symptoms are seen with neutropenia/agranulocytosis?

A

Signs and symptoms are usually those of a secondary infection because the lack of neutrophils makes fighting infection less effective. The secondary infections are usually respiratory. Since the neutrophils are the first line of defense. They’re in the skin, GI, and upper respiratory tract, so it is important to monitor/prevent infection.

28
Q

What virus causes infectious mononucleosis?

A

Epstein-Barr Virus (EBV)

29
Q

How is infectious mononucleosis spread?

A

orally - via infected saliva; even after the person

30
Q

Explain the mononucleosis infection process.

A

EBV invades oropharyngeal lymphoid tissue, infecting B cells; EBV may kill the infected B lymphocyte & release virons, OR EBV may incorporate itself into the B cell’s genome

31
Q

What are heterophil antibodies associated with?

A

mononucleosis; EBV incorporates itself into an infected B cell’s genome. These B cells proliferate and produce heterophil antibodies used in diagnosis (detected on a monospot test)

32
Q

Explain the clinical course of mononucleosis.

A
  • mono has an incubation period of 4-8 weeks
  • prodromal period=malaise, anorexia, and chills
  • acute phase persists for 2-3 weeks
  • heterophil antibodies don’t develop for 2-3 weeks
  • you will see a WBC count of 12-18k which returns to normal by the 4th week
33
Q

What are the symptoms associated with mononucleosis?

A

fever, severe pharyngitis, and lymphadenopathy

34
Q

What are the general characteristics of leukemias?

A

malignant neoplasms of hematopoietic stem cells; in the bone marrow; abnormal white blood cells are created either from the amyloid stem cell line or from the lymphoid stem cell line; classified as either lymphocytic or myelogenous; less mature cells are created

35
Q

What is the most common cancer in children and adults?

A

leukemia

36
Q

The philadelphia chromosome is associated with which type of leukemia?

A

Chronic Myelocytic Leukemia (CML)

37
Q

What kinds of leukemias have seen a link to down’s syndrome?

A

acute leukemias (seen in both acute lymphocytic and acute myelocytic leukemias)

38
Q

What type of cancer do we typically see occuring in atomic bomb/radiation survivors?

A

all types of leukemia

39
Q

Define insidious

A

proceeding in a gradual, subtle way, but with harmful effects

40
Q

Differentiate between acute and chronic leukemias.

A

ACUTE:

  • rapid onset & progression
  • characterized by presence of very immature cells (blasts)
  • life expectancy 5yrs
41
Q

What is the most curable type of human tumor?

A

lymphomas

42
Q

What are the main differences/similarities with Hodgkin & Non-Hodgkin Lymphomas?

A

-both are solid tumors
-both derive from neoplastic lymph tissue & their precursors
Hodgkin: malignant B cells invade lymphoid organs
NON-Hodgkin:B & T cell issues

43
Q

What is Non-Hodgkin’s Lymphoma?

A
  • a heterogenous group of solid tumors composed of neoplastic lymphoid cells
  • malignant transformation can occur at ANY stage of the B or T cell differentiation
  • malignant transformation almost always occurs in the lymph tissue with B cell differentiation
44
Q

Is Hodgkins or Non-Hodgkins lymphoma more common?

A

non-hodgkins (3x more frequent)

45
Q

What are the different types of non-hodgkin lymphoma?

A
  • Follicular
  • Diffuse Large B cell (account for 50% of all NHLs-very aggressive)
  • Burkitt (associated with malaria & EBV-90% cure rate)
  • Mantle Cell
  • Marginal
46
Q

What is the most common clinical manifestation of non-hodgkin’s & hodgkins lymphomas?

A

painless, superficial lymphadenopathy in the neck, underarm, or groin

47
Q

Hodgkins Lymphoma

A
  • malignant B cells invade lymphoid tissue causing painless lymphadenopathy
  • curable in most cases
  • Reed-Sternberg cells
48
Q

What are Reed-Sternberg cells?

A

large distinctive tumor cells required for definitive diagnosis of Hodgkin’s lymphoma; formed from B cells; they may invade any area of the body, but are mostly detected in the spleen

49
Q

Multiple Myeloma

A
  • a plasma cell malignancy
  • manifests as bone pain (which is often ignored &put off as arthritis)
  • causes altered Ig production that leads to an increased risk for infection
  • causes increased blood viscosity which leads to heart failure and neuropathy
  • suppresses hematopoiesis which leads to anemia
  • causes proliferation of osteoclasts increasing the risk for fractures
  • causes hyperclacemia leading to kidney stones and renal disease, also GI issues and electrolyte imbalances
50
Q

True or false? Hodgkin lymphoma has a better prognosis than non-Hodgkin lymphoma.

A

True; Non-Hodgkin lymphoma originates from malignancies in both T- and B-lymphocytes, where Hodgkin malignancies originate in B-cells (a specific type called the Reed-Sternberg cell). Therefore, more immune function is lost in non-Hodgkin lymphoma, and the prognosis is not as good.

Pathophysiology - Whitney Wood (3 decks)

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