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Disease Mechanisms > Ch 13: WBC, Lymph Node, Spleen & Thymus > Flashcards

Ch 13: WBC, Lymph Node, Spleen & Thymus Flashcards

1
Q

what three cell types come from the lymphoid lineage

A

NK cells
B cells
T cells

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2
Q

what three cell types come from myeloblasts

A

neutrophils
eosinophils
basophils

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3
Q

what cell type comes from a monoblast

A

monocyte

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4
Q

what are the two key features to maintain hematopoiesis

A

cells need to be pluripotent (able to differentiate into anything) and be self-renewing

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5
Q

what is a myeloblast

A

immature granulocyte (neutrophil, basophil, and eosinophil)

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6
Q

what are leukocytes (white blood cells)

A

cells are larger than erythrocytes with a prominent nucleus
move throughout the blood
adhere to wall of vessel and squeeze through to get to infection in surrounding tissue
include granulocytes and agranulocytes

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7
Q

what are granulocytes

A

type of leukocyte that contains granules that are released when activated
three types: neutrophil, eosinophil, basophil

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8
Q

what are agranulocytes

A

type of leukocyte that lacks visible granules
two types: monocytes and lymphocytes

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9
Q

what is leukopoiesis

A

process in bone marrow where hematopoietic stem cells form new leukocytes
divide into myeloid and lymphoid cell line

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10
Q

what is the myeloid cell line

A

comes from a hematopoietic stem cell
differentiate first into blast cells then into most formed elements such as erythrocytes, platelets, granulocytes, and agranulocytes

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11
Q

what is the lymphoid cell line

A

comes from a hematopoietic stem cell
differentiated into lymphoblasts that will become B cells, T cells, and NK cells

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12
Q

what is a band or stab cell

A

final precursor stage of cell
develop into mature granulocytes which enter bloodstream

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13
Q

what is the normal amount of band or stab cells in the peripheral blood

A

5-10%

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14
Q

what is the precursor (band/stab) cell of granulocytes

A

promyelocyte which differentiates into neutrophil, eosinophil, and basophil band cells then finally mature granulocytes

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15
Q

what is the precursor (band/stab) cell of agranulocytes, specifically monocytes

A

promonocyte which differentiates directly into monocyte

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16
Q

what is the precursor (band/stab) cell of agranulocytes, specifically B and T lymphocytes

A

prolymphocyte which differentiates into B and T lymphocytes

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17
Q

what is leukopenia

A

lower than normal WBC count usually due to reduced number of neutrophils

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18
Q

what is neutropenia

A

reduced number of neutrophils

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19
Q

what are symptoms of leukopenia

A

can cause prolonged infections, fever, tachycardia, sepsis and death

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20
Q

what are two examples of untreated leukopenia that lead to death

A

typhoid fever
rickettsiae

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21
Q

what is leukocytosis

A

higher than normal WBC count usually due to neutrophilia
usually caused by numerous amounts of granulocytes
commonly seen during an infection

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22
Q

what is neutrophilia

A

excess amount of neutrophils

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23
Q

what are the four mechanisms of leukocytosis

A

increased marrow production
increased release from marrow stores
decreased margination
decreased extravasation into tissues

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24
Q

what is a leukemoid reaction

A

extreme elevation of WBC
ex. leukemia

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25
Q

what is lymphopenia

A

decreased number of lymphocytes in the body

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26
Q

what are some common causes of lymphopenia

A

congenital immunodeficiencies
HIV
therapy followed by cytotoxic drugs
autoimmune disorders
malnutrition
acute viral infections

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27
Q

what is are lymphoid neoplasms

A

group of hematologic malignancies derived from lymphoid cells found in the bone marrow or in the peripheral blood

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28
Q

what are the 5 categories of lymphoid neoplasms

A

precursor B-cell
peripheral B-cell
precursor T-cell
peripheral T-cell and NK cell
Hodgkin lymphoma

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29
Q

what are precursor B-cell neoplasms

A

neoplasms of immature B-cells

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30
Q

what are peripheral B-cell neoplasms

A

neoplasms of mature B-cells

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31
Q

what are precursor T-cell neoplasms

A

neoplasm of immature T-cell

32
Q

what are peripheral T-cell and NK cell neoplasms

A

neoplasms of mature T cells and NK cells

33
Q

what are Hodgkin lymphomas

A

neoplasms of Reed-Sternberg cells and variants

34
Q

what are myeloid neoplasms

A

a group of neoplasms originating from hematopoietic progenitor cells from the bone marrow

35
Q

what are the three categories of myeloid neoplasms

A

acute myeloid leukemia (AML)
myelodysplastic syndrome
myeloproliferative neoplasm

36
Q

what is acute myeloid leukemia (AML)

A

accumulation of immature myeloid forms (blasts) in bone marrow

37
Q

what is myelodysplastic syndrome

A

defective maturation of myeloid progenitors which leads to ineffective hematopoiesis and therefore, cytopenia
increases your risk for acute myeloid leukemia

38
Q

what is a myeloproliferative neoplasm

A

increased production of 1 or more blood cells

39
Q

what is lymphadenopathy

A

enlarged lymph nodes due to increase in size/numbers of germinal centers
two types: localized vs generalized

40
Q

what are the three main causes of lymphadenopathy

A

invasion of malignant cells
endocrine disorders
lipid storage diseases (gaucher disease)

41
Q

what are leukemias

A

clonal disorder in a single progenitor cell where it undergoes malignant transformation in the bone marrow
leads to uncontrolled proliferation of malignant leukocytes which overcrowds the bone marrow and leads to pancytopenia
two types: lymphoid and myeloid

42
Q

what are two types of myeloid leukemias

A

acute myeloid leukemia (AML)
chronic myeloid leukemia (CML)

43
Q

what are two types of lymphoid leukemias

A

acute lymphoblastic leukemia (ALL)
chronic lymphocytic leukemia (CLL)

44
Q

what are the four main types of leukemia

A

acute lymphoblastic leukemia (ALL)
acute myeloid leukemia (AML)
chronic myeloid leukemia (CML)
chronic lymphocytic leukemia (CLL)

45
Q

how are leukemias classified

A

predominant cell of origin (myeloid or lymphoid)
acute vs chronic

46
Q

what is the acute classification of leukemia

A

undifferentiated or immature (blast) cells
rapid onset with short survival

47
Q

what is chronic classification of leukemia

A

differentiated cells that do not function normally
slow progression

48
Q

what are some causes of leukemia

A

family history
congenital disorders
infection
environmental factors
drugs
chromosome abnormalities

49
Q

which chromosomal abnormalities are most commonly seen with leukemias

A

reciprocal translocations (philadelphia chromosome)
inversions and deletions

50
Q

philadelphia chromosome can cause which type of leukemia

A

chronic myeloid leukemia

51
Q

who is most likely to get leukemia

A

adults
although young children around 1-4 are susceptible to acute lymphoid leukemia

52
Q

who is acute lymphoblastic leukemia (ALL) most common in

A

least common overall but most common childhood leukemia (80%)

53
Q

how does acute lymphoblastic leukemia affect children

A

affects precursor B and T cells leading to immature lymphoblasts
85% are B-cell types

54
Q

how does acute lymphoblastic leukemia affect adults

A

mixture of affected B and T precursor cells

55
Q

what is the mechanism of acute lymphoblastic leukemia (ALL)

A

chromosomal deviations block differentiation which allows for accumulation of immature, nonfunctional blast cells
leads to overcrowding and bone marrow failure, ultimately pancytopenia

56
Q

how is acute lymphoblastic leukemia (ALL) treated

A

aggressive chemotherapy and supportive measures
95% of children achieve remission; 75-85% cured

57
Q

what is remission

A

signs and symptoms of conditions are reduced, does not yet mean you’re cured
need 5 years of remission to be considered cured

58
Q

what is acute myeloid leukemia (AML)

A

abnormal proliferation of immature myeloid blast cells in bone marrow
more aggressive and most common in those over 60 years of age

59
Q

what is the mechanism of acute myeloid leukemia (AML)

A

acquired mutations interfere with differentiation leading to an accumulation of immature, nonfunctional myeloid blast cells
leads to overcrowding, bone marrow failure, and pancytopenia

60
Q

how is acute myeloid leukemia (AML) diagnosed

A

need at least 20% myeloid blast cells in bone marrow
often times see auer rods

61
Q

what are auer rods

A

needle-like azurophilic granules sometimes found in acute myeloid leukemia (AML)

62
Q

how is acute myeloid leukemia (AML) treated

A

chemotheraphy and supportive measures
complete remission in 60% of patients
15-30% become free of disease for 5 years

63
Q

what do those with acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL) present with

A

pancytopenia
pain in joints and bones due to infiltrates
CNS involvement (headaches, vomiting, nerve palsies) due to bleeding
spleen and liver enlargement (mostly ALL)
lymphadenopathy

64
Q

what do those with pancytopenia present with

A

anemia (fatigue, weakness, pallor)
thrombocytopenia (abnormal bleeding)
leukopenia (low WBC and fever)

65
Q

what is chronic lymphocytic leukemia (CLL)
-who does it mainly effect

A

most common leukemia of adults in western world
most common in males around 60
caused by clonal malignancy of mature B-cells
median survival is 4-6 years

66
Q

what is the mechanism of chronic lymphocytic leukemia (CLL)

A

genetic deletions and trisomy lead to over expression of BCL-2 (anti-apoptotic protein)
accumulation of abnormal B-cells leads to hypogammaglobulinemia

67
Q

what three things are most affected in patients with chronic lymphocytic leukemia (CLL)

A

lymph nodes (lymphadenopathy)
spleen
bone marrow

68
Q

what is hypogammaglobulinemia

A

low serum immunoglobulin or antibody levels

69
Q

what is chronic myeloid leukemia (CML)
-what does it present with
-how is it treated

A

disease of mostly adults but can occur in children, most common around 50-60 yrs old
presents with: hypercellular bone marrow, lots of leukocytes, and enlarged spleen
treated with BCR-ABL inhibitors

70
Q

what is the mechanism of chronic myeloid leukemia (CML)

A

acquired mutation (usually Philadelphia chromosome) leads to activation of tyrosine kinases (BCR-ABL)
leads to proliferation of granulocytic and megakaryocytic progenitors and abnormal release of immature granulocytic forms in bone marrow

71
Q

what are the presentations of those with chronic lymphocytic leukemia (CLL)

A

usually asymptomatic but some may experience infections, fatigue, weight loss, and anorexia

72
Q

what are the presentations of those with chronic myeloid leukemia (CML)

A

painful splenomegaly
slower progressive phase (asymptomatic)
accelerated phase (symptoms)
terminal phase (blast crisis)

73
Q

which chromosome is the ABL gene found on

A

chromosome 9

74
Q

which chromosome is the BCR gene found on

A

chromosome 22

75
Q

which type of leukemia comes mostly from Philadelphia chromosome translocations

A

chronic myeloid leukemia (CML)

Disease Mechanisms (19 decks)

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