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Pathophysiology > Ch. 11 > Flashcards

Ch. 11 Flashcards

1
Q

Why are more blood cells made?

A

A need for them

What regulates them

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2
Q

What are colony stimulating factors?

A

Stimulate cell production

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3
Q

What are the two types of cells a pluripotent stem cell can differentiate into?

A

lymphoid stem cell

myeloid stem cell

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4
Q

What do our lymphoid stem cells differentiate into ultimately?

A

NK cells

T cells

B cells (can become plasma cells)

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5
Q

What do our myeloid stem cells differentiate into ultimately?

A

erythrocyte

megakaryocyte (platelets)

monocyte

Grunulocytes:

neutrophil

basophil

eosinophil

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6
Q

Where are these stem cells found that create the RBCs and WBCs?

A

Bone marrow

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7
Q

What do neutrophils do?

A

our primary pathogen fighting cells (first responders)

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8
Q

What do eosinophils do?

A

help control allergic responses

fight parasites

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9
Q

What do basophils do?

A

release heparin, histamine, other inflammatory mediators

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10
Q

What are MAST cells?

A

basophils that are in the tissues

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11
Q

Where do all of our granulocytes originate from?

A

bone marrow

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12
Q

Where do WBCs like to circulate and hang out?

A

the lymph tissue

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13
Q

What are our agranulcytes?

A

monocytes/macrophages

LYMPHOCYTES:
B cells
T cells
NK cells

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14
Q

What do our B cells do?

A

create antibodies

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15
Q

What do our T cells do?

A

control the immune response

cell-mediated immunity

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16
Q

What do our NK cells do?

A

kill antigenic cells

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17
Q

What do our monocytes do?

A

antigen presenting cells

create inflammatory mediators

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18
Q

How long do monocytes last in our tissues?

A

months to years

often have specific action

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19
Q

What does it mean that our lymphocytes (B,T,NK) are morphologically indistinguishable?

A

You cant tell these cells apart under a microscope.

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20
Q

Where do B cells mature?

A

bone marrow

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21
Q

Where do T cells mature?

A

the precursor cells leave the bone marrow and travel to the thymus to differentiate.

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22
Q

What are our lymph tissues?

A

Lymphatic vessels

lymphoid tissue

lymph nodes

thymus

spleen

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23
Q

What are our secondary lymph organs?

A

spleen
lymph nodes
tonsils

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24
Q

Where is excess fluid that the blood vessel doesnt take back get picked up by?

A

it enters the lymph vessels and gets transported back to the vena cava

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25
Q

What is the normal size of a lymph node?

A

1mm - 2cm

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26
Q

What are our lymph nodes shaped like?

A

oval or bean

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27
Q

Where in the lymph nodes do B and T cells hang out?

A

the outer cortex

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28
Q

Is the primary follicle of a lymph node immunologically active?

A

NO NO NO

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29
Q

Is the secondary follicle of a lymph node immunologically active?

A

YES YES YES

They have the germinal centers

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30
Q

Why is it important to know about mucosa associated lymph tissue?

A

If you see someone with a viral sore throat and you see red swollen tissue in the back of their throat, this extranodal lymph tissue that is inflammed

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31
Q

What happens to our lymph nodes during infection?

A

they get enlarged

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32
Q

What is the difference in a swollen lymph node during infections and a swollen lymph node associated with lymphoma?

A

Infection - the lymph node is tender and enlarged

lymphoma - lymph nodes are NOT tender, but are enlarged

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33
Q

What part of the lymph node causes enlargement?

A

the secondary follicle, its the part that is actively working making more cells

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34
Q

Do lymph nodes have a blood supply?

A

YES YES YES

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35
Q

What is a normal WBC count?

A

4500 - 10500

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36
Q

What is leukopenia?

A

an absolute decrease in # of WBCs (usually because of neutophils)

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37
Q

What is neutropenia?

A

a decrease in the # of neutrphils, often the cause of leukopenia

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38
Q

What number is considered neutopenia?

A
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39
Q

What is agranulocytosis and its lab value?

A

a neutrophil count of less than 200

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40
Q

What are our non-neoplastic WBC disorders?

A

leukopenia

neutropenia and agranulocytosis

aplastic anemia (effects all myeloid cells)

infectious mononucleosis (monocyte)

HIV (lymphoid cells)

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41
Q

What are our neoplastic disorders?

A

lymphoma

leukemia

plasma cell dyscrasia (multiple myeloma)

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42
Q

What are the mechanisms of neutropenia?

A

reduced or ineffective production of neutrophils:

    • overgrowth of neoplastic cells (leukemia, lymphoma) not allowing for proper production
    • bone marrow depression (chemotherapy, radiation)

Excessive removal or destruction:

    • inflammation and infection
    • immunologic destruction (autoimmune)
    • cytotoxic drugs (most common cause)
    • feltys syndrome
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43
Q

What is feltys syndrome?

A

the overdestruction of neutrophils in the spleen.

44
Q

What is the most common mechanism of neutropenia?

A

drugs

45
Q

What drugs are known to cause neutropenia?

A

chemotheraputic

antibiotics

46
Q

What are the signs and symptoms of neutropenia?

A

those of secondary bacterial or fungal infections
– increased risk; most often respiratory

fever, chills, malaise, fever, weakness, and fatigue

47
Q

Why is infectious mononucleosis called the kissing disease?

A

because it is transmitted though the saliva; orally

48
Q

What virus causes mononucleosis?

A

epstein-barr virus

49
Q

What group is mononucleosis most common in?

A

adolescents and young adults

50
Q

Is mono as contagious as everyone thinks?

A

NO NO NO

51
Q

By age 40, what percentage of people are said to have had EBV (epstein barr virus)?

A

90%

52
Q

What family is EBP part of?

A

herpies

53
Q

What is the issue with mono?

A

it is never really gone (still have low grade viral shedding), even when your symptoms go away, so you can asymptomatically spread it without even knowing it

54
Q

What is the #1 cause of organ transplant rejection?

A

EBV

55
Q

What tissue does EBV invade?

A

oropharyngeal lymphoid tissue

56
Q

What cells does mono invade?

A

B cells

57
Q

What happens to the B cell with EBV?

A

the B cell may die, which causes a release of more virions

58
Q

What happens when EBV incorporates itself into the B cells genome?

A

The cell makes heterophil antibodies (used in the diagnosis of mono with monospot), this process can take up to 2-3 weeks

59
Q

how long is the incubation period of mono?

A

4-8 weeks

60
Q

How does our immune system respond to mono?

A

it controls viral shedding by limiting the number of infected B cells with our CD8 cytotoxic cells and NK cells

61
Q

What is the onset of mono?

A

insidious

62
Q

What is the prodromal period of mono characterized by?

A

anorexia (poor appetite), malaise (can last months), chills

63
Q

What are the symptoms of mono?

A

fever, severe pharyngitis, LYMPHADENOPATHY (swollen lymph nodes, common, posterior cervical)

64
Q

Do some cases of mono go undiagnosed? and

A

Yes, not all have serious symptoms

65
Q

How long does the acute phase of mono last?

A

2-3 weeks

66
Q

How do we differentiate leukemia (and plasma cell dyscrasia) from lymphoma?

A

leukemia (multiple myeloma) - neoplasms that arise in the bone marrow

lymphoma - neoplasms arise in the lymphoid organs

67
Q

What is leukemia?

A

malignant neoplasms of hematopoietic stem cells (bone marrow)

68
Q

What does leukemia cause?

A

the creation of abnormal WBCs (can be lymphocytic or myelogenous USUALLY ONLY ONE BLOOD CELL LINE OR THE OTHER)

69
Q

What is some weird facts about leukemia in children and adults?

A

leukemia is a leading cause of death in children from ages 1-14 BUT 10 times more adults are diagnosed that children

70
Q

What do the leukemic cells from leukemia do to our body?

A

they interfere with the production and maturation of our normal WBCs

they can get into circulation and cross BBB (blood-brain-barrier) CAUSE ORF NEUROLOGIC SYMPTOMS (especially with acute lymphocytic leukemia)

these cells can infiltrate body organs

THESE ARE NOT TRANSFORMED CELLS, THEY ARE CANCER CELLS THAT ARE PRODUCED

71
Q

Do we know the cause of leukemia?

A

NO NO NO

72
Q

Where do we see high incidences of leukemia?

A

high levels or radiation

exposure to benzene and chemotherapy

genetic predisposition

73
Q

Event that effect the genes that regulate blood cell development can lead to what?

A

leukemia

74
Q

What are the four different types of leukemia and what did she say about each of them?

A

Acute lymphocytic leukemia (ALL): immature B and T precursors (high risk with down syndrome, radiation)

chronic lymphocytic leukemia (CLL): malignant production of B cells

acute myelocytic leukemia (AML): strongly linked with toxins and congenital disorders (high risk with down syndrome)

chronic myelocytic leukemia (CML): philadelphia chromosome

BOTH MYELOCYTIC HAVE AN OVERPRODUCTION OF ABNORMAL MONOCYTES AND GRANULOCYTES (B,T,NK CELLS GET UNDERPRODUCED BECUASE THEY OF CROWDING)

THE SAME THING HAPPENS JUST OPPOSITE WITH LYMPHOCYTIC LEUKEMIAS

ALSO OUR RBCS AND PLATELETS ARE BEING UNDERPRODUCED WITH ALL TYPES

75
Q

People with down syndrome are at high risk for what types of leukemia?

A

Both acute leukemias

76
Q

People with the philadelphia chromosome are at a high risk for what type of leukemia?

A

Chronic myelocytic leukemia

77
Q

People who have been exposed to radiation are at a high risk for what type of leukemia?

A

acute lymphocytic leukemia

78
Q

What are some clinical characteristic of the acute leukemias and the life expectancy?

A

rapid onset (sudden stormy)

rapid progression

life expectancy =

79
Q

What are some clinical characteristics of the chronic leukemias and the life expectancy?

A

Insidious onset

prolonged clinical course

cells are a little more mature (differentiated) so can perform some function

tend to delay seeking of care

life expectancy > 5 years

80
Q

What are the most curable human tumors?

A

lymphomas

81
Q

What do the hodgkin and non-hodgkin lymphomas have in common?

A

both are solid tumors

both derive from neoplastic lymph tissue and their precursors

82
Q

How would you describe the tumors of non-hodgkins lymphoma?

A

heterogenous (many different) groups of solid tumors composed of neoplastic lymphoid cells

83
Q

How many times more does non-hodgkins occur that hodgkins?

A

3X

84
Q

What causes non-hodgkins lymphoma?

A

we dont really know

could be VIRUSES:

  • -EBV *****
    • Human T-lyphotropic virus type I (HTLV-1)

could be BACTERIAL:
— H. pylori

85
Q

What cells can non-hodgkins originate in?

A

B cells or T cells (80-85% ARE OF B CELL ORIGIN)

86
Q

What are the different types of B cell lymphomas?

A
  • -follicular
  • -diffuse large B cell (account for 50% of all non-hodgkins lymphomas) good remission rate
  • -burkitts (90% cure rate)
  • -mantle cell
  • -marginal zone
87
Q

What are the clinical manifestations of non-H lymphoma?

A

painless, superficial lymphadenopathy in teh neck, groin, or underarm MOST FREQUENT

unexplained fever
night sweats
constant fatigue
unexplained weight loss
itchy skin
reddened patches on the skin
88
Q

What is special about how diffuse large B cell lymphoma spreads through the lymph vessels?

A

It doesn’t spread from one lymph node to the next in sequential order of the drainage flow, IT CAN SKIP NODES AND SHOW UP AT OTHERS, this is called non-contiguous spread.

also has a more frequent involvement of the GI tract, liver, testes and bone marrow

89
Q

How do we diagnose non-hodgkins lymphoma?

A

lymph node biopsy

90
Q

What happens during hodgkins lymphoma?

A

malignant B cells are invading lymphoid tissue, causing painless lymphadenopathy

91
Q

What is asymptom that is weirdly specific to hodgkins lymphoma?

A

Pain involved with the lymph nodes that ONLY occurs when consuming ALCOHOL

92
Q

What is the most common age group for hodgkins lymphoma?

A

young adults (18-24)

average age at onset 32

median age of onset is the 20s

93
Q

What are the common sites of lymphadenopathy for hodgkins lymphoma?

A

cervical

axial

inguinal chains

94
Q

Is hodgkins lymphoma curable in most cases?

A

YES YES YES

95
Q

What are reed-sternberg cells?

A

these are large distinctive tumor cells that have to be present in order to have a definitive diagnosis for hodgkins lymphoma.

96
Q

What causes hodgkins lymphoma?

A

We dont know

97
Q

Where do 1/3 of hodking lymphomas travel to?

A

spleen

98
Q

Does hodgkins lymphoma have contiguous spread?

A

YES YES YES

99
Q

What is multiple myeloma?

A

PLASMA CELL MALIGNANCY

abnormal B cells (plasma cells) produce abnormal antibodies, and also cause the proliferation of osteoclasts (break down the bone)

100
Q

Can multiple myeloma cause tumors?

A

YES YES YES

101
Q

What happens with the production of abnormal antibodies?

A

immune depression

proteins increase blood viscosity

infiltrate organs almost every one

102
Q

What does the proliferation of osteoclasts cause?

A

breakdown of bone

easy bone fractures

hypercalcemia

bone pain

kidney stones

renal disease

many people put this off as arthritis pain

103
Q

What is the normal prognosis of multiple myeloma?

A

very very poor

it invades almost every organ in the body

very hard to treat

104
Q

What else does multiple myeloma suppress?

A

hematopoiesis (RBC production)

causes anemia

105
Q

Does multiple myeloma cause electrolyte imbalances eventually?

A

YES YES YES

106
Q

Which type of lymphoma has a better prognosis?

A

HODGKINS LYMPHOMA

Pathophysiology (13 decks)

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