Chapter 11: Disorders of WBC and Lymphoid Tissues

Question 1

What is leukopenia?

Answer 1

abnormally low number of WBC in the blood

Question 2

What is granulocytopenia?

Answer 2

abnormally low concentration of granulocytes in the blood

Question 3

What is aplastic anemia?

Answer 3

deficiency in bone marrow maturation of all cell types from stem cells

Question 4

What is neutropenia?

Answer 4

Low number of neutrophils

Question 5

What is agranulocytosis?

Answer 5

it is a state of virtually no neutrophils

techinically a type of neutropenia

Question 6

List 4 causes of neutropenia.

Answer 6

1) acquired (drug, infection related)
2) congenital
3) neoplasms
4) autoimmune

Question 7

Describe what infectious mononucleosis is.

Answer 7

a self-limiting lymphoproliferative disorder that lasts 2-3 weeks

Question 8

What virus causes infectious mononucleosis?

Answer 8

the Epstein-barr virus

Question 9

What age groups is infectious mononucleosis more common in?

Answer 9

adolescents and young adults

Question 10

Describe the pathogenesis of infectious mononucleosis.

Answer 10

the virus penetrates the nasopharyngeal, oropharyngeal, and salivary lymphocytes into the lymphoid tissue.

It then binds to B cells and either kill it or incorporate itself into its genome.

If incorporated, circulates and secretes a hetorophil (antibody that reacts with antigens from other species) which can be traced to diagnose.

Once infection is over, some b-cells remain in the mouth and occasionally shed into saliva to transmit. Inc shedding when immune system is suppressed

Question 11

What type of cells are most important in regulating mono?

Answer 11

T cells and natural killer cells

Question 12

Describe the common manifestations of mono.

Answer 12

1) begins insidiously (4-8 wk incubation)
2) initial malaise, anorexia, and chills
3) pharyngitis, fever, lymphedema
4) hepatitis (liver inflammation) and spenomegaly are common
5) rarely (more in adult) cranial nerve palsies (disruption of nerve function)

Question 13

What are some complications that can occur as a result of mono?

Answer 13

ENCEPHALITIS: inflammation of the brain

MENINGITIS: infection of the brain

GUILLAIN-BARRE SYNDROME: immune system attacks peripheral nervous system

Question 14

Describe leukemia.

Answer 14

malignant neoplasms of cells originally derived from hematopoietic precursor cells.

replaces bone marrow and results in highly immature and large numbers of WBC

Question 15

List some causes of leukemia.

Answer 15

Largely unknown, but….

1) radiation exposure
2) benzene
3) antitumour drugs
4) post chemotherapy
5) genetic predisposition

Question 16

What are 2 conditions that give you a genetic predisposition for leukemia?

Answer 16

Down syndrome

Neurofibromatosis

Question 17

How is mono treated?

Answer 17

mainly symptomatic treatment.

bed rest
Tylenol for soar throat, headaches and fever

Question 18

How is leukemia classified?

Answer 18

either acute or chronic

and either myelocytic (myeloid stem line) or lymphocytic (lymphoid stem line)

Question 19

Describe the manifestations and characteristics of acute leukemia.

Answer 19

1) sudden onset
2) low grade fever, night sweats, weight loss
3) bone pain/tenderness
4) lymphadenopathy (swollen or enlarged lymph nodes)
5) symptoms of depressed bone marrow: WBC=infections, RBC=fatigue, thrombocytopenia=bleeding/bruisingng
6) leukostasis (inc number of circulating leukemic blast cells)
7) hyperuricemia (uric acid accumulation d/t cell breakdown

Question 20

what type of leukemia accounts for 1/3 of all leukemias?

Answer 20

chronic lymphocytic leukemia

Question 21

What is the biggest difference between chronic and acute leukemia?

Answer 21

Chronic is a proliferation of more fully differentiated cells than acute is.

Chronic is much more common in older adults

Question 22

What happens to the other stem cell line when there is a leukemia of the other?

Answer 22

its production is suppressed by the overproduction of the other

Question 23

What chromosome is affected in chronic myelogenous leukemia?

Answer 23

the Philadelphia Chromosome

Question 24

What are the three phases of chronic myelogenous leukemia?

Answer 24

CHRONIC

SHORT ACCELERATED

TERMINAL

Question 25

Describe the symptoms of the chronic phase of chronic myelogenous leukemia

Answer 25

non specific symptoms:

weakness, weight loss, anemia, thrombocytopenia

Question 26

Describe the symptoms of the short accelerated phase of chronic myelogenous leukemia.

Answer 26

Splenomegally
Low-grade fever
Night sweats
Bone pain

Question 27

Describe the terminal phase of chronic myelogenous leukemia.

Answer 27

Evolves to acute leukemia

the Ca spreads and infiltrates the skin, lymph nodes, bones, and CNS

Question 28

What type of cell does chronic lymphocytic leukemia most impact?

Answer 28

B-cells

it is called a B lymphocyte malignancy

Question 29

Describe the progression and manifestations of chronic lymphocytic leukemia.

Answer 29

Can have minimal symptoms or be rapid and fatal

manifestations:

• elevated lymphocytes
• lymphoedema
• hepatosplenomegaly
• hypogammaglobulinemia (dec antibodies)

Question 30

Describe treatment for chronic lymphocytic leukemia

Answer 30

chemotherapy
radiation
stem cell transplant

Question 31

Describe the cause of non-Hodgkin lymphoma

Answer 31

relatively unknown

but related to impaired immune system and infectious agents

Question 32

Describe the spread of non-Hodgkin lymphoma (NHL)

Answer 32

can originate in an of the lymphoid tissues, commonly originate in the nodes.

spreads unpredictably to the liver, lymphatic tissues, spleen, and bone marrow

Question 33

Describe the manifestations of non-Hodgkin lymphoma (NHL)

Answer 33

depend mainly on the type

slow growing painless lymphadenopathy, many eventually transform into more aggressive forms of lymphoma or leukemia

fever, sweating, weight loss, susceptibility to infections

Question 34

Describe treatment of Non-Hodgkin lymphoma.

Answer 34

localized radiation or combined with chemotherapy

Question 35

What may be a cause of Hodgkin lymphoma (HL)

Answer 35

previous exposure to infectious mononucleosis

Question 36

What type of cell must be present to indicate Hodgkin lymphoma (HL)

Answer 36

Reed-Sternberg cell

Question 37

Compare how Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) originate.

Answer 37

NHL: frequently arises in extranodal cites and spreads to anatomically contiguous nodes

HL: originates in a single node or chain of nodes

Question 38

Describe the manifestations hodgkins lymphoma (HL)

Answer 38

lymph node enlargement above the diaphragm

night sweats, pruritis, fever, chills, wt loss, fatigue, anemia

Question 39

Describe the treatment of Hodgkin lymphoma.

Answer 39

begins with staging then:

radiation and chemotherapy

Question 40

What is multiple myeloma? describe the process.

Answer 40

it is a plasma cell dyscrasia

proliferation of a single type of malignant plasma cells.

Main sites are bone and marrows. Results in abnormal proliferation of marrow plasma cells and activation of osteoclasts.

Question 41

What are some manifestations of multiple myeloma?

Answer 41

Pathologic fractures with hypercalcemia

bone pain

hyper-viscosity of body fluids d/t release of protein from bone

heart failure/nephropathy (d/t debris and viscosity)

myeloma nephrosis (from filtering)

Bacterial infections

Plasma cell tumors

symptoms of bone marrow suppression

Question 42

Describe the treatment options for multiple myeloma

Answer 42

Medications

high dose chemo and stem cell transplant