Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology > Chapter 11 - Hematopoetic and Lymphoid System > Flashcards

Chapter 11 - Hematopoetic and Lymphoid System Flashcards

1
Q

Microcytic

A

small red blood cells

decreased mean corpuscular volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Macrocytic

A

large blood cells

increased mean corpuscular volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypochromic

A

pale red cells

decreased mean corpuscular hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Poikilocytosis

A

oddly shaped red cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anisocytosis

A

mixture of red cell sizes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Target cells

A

bulls-eye red cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the different screening tests for Anemia?

A

hemoglobin, RBC indices (MCV, MCH), Reticulocyte Count (Marker of bone marrow response to low hemoglobin), Serum Ferritin (Adequacy of bone marrow iron stores), Peripheral Blood Smear Morphology (Clues to anemia causation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hemolytic anemias

A

A. Mechanical injury and microangiopathy
Mechanical injury - artificial heart valves
Microangiopathy - vessels narrowed by fibrin, DIC, or uremia

B. Immune mediated processes
Idiopathic, SLE, Rh arthritis, Lymphomas and chronic lymphocytic leukemias

C. Infection
Malaria

D. Hemoglobinopathies
Sickle cell anemia (AR), Thalassemia (AD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anemias of Impaired red cell production and decreased proliferation and differentiation

A

A. Anemia of suppression of bone marrow cells - aplastic anemia

B. Anemia of diminished erythropoiesis (nutritional deficiency) - iron deficiency anemia, vitamin B12 deficiency anemia, folic acid deficiency anemia

C. Anemia of ineffective erythropoiesis - anemias of chronic disease

D. Pernicious anemia - autoimmune anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hemolytic Anemia

A

Increased rate of red cell destruction

May be caused by mechanical trauma to red cells, autoimmune destruction of red cells, genetic abnormality resulting in abnormal hemoglobin structure, and genetic abnormality in red cell biochemistry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mechanical & Microangiopathic Hemolytic anemia

A

Mechanical - artificial heart valves of mechanical type

Microangiopathic hemolytic anemia - RBCs squeezed through abnormally narrowed vessels filled with fibrin, seen in disseminated intravascular coagulation and hemolytic uremic syndrome induced by E.coli infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Immune Mediated Hemolytic Anemias

A

Red cells are opsonized w/ antibody usually IgG which makes them targets for removal by the spleen which recognizes them as abnormal, 60% idiopathic and remainder are associated with another disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Infection Related Hemolytic Anemias

A

Malaria - Blackwater Fever: a complication of malaria in which RBCs burst in the blood stream (hemolysis) releasing hemoglobin directly into the vessels and into urine, frequently leading to kidney failure, cerebral malaria is most severe form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hemoglobinopathies

A

A group of hereditary disorders characterized by the presence of a structurally abnormal hemoglobin

Most common inherited genetic disorder worldwide

Result in decreased red cell survival and often acute hemolysis under certain biochemical and physiologic stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sickle Cell Anemia

A

Cause by the mutation in the beta-globulin chain

Single point mutation (missense mutation) in beta-hemoglobin gene that converts a GAG codon into a GUG, which encodes amino acid valine rather than glutamic acid, polymerization when deoxygenated

AR inheritance

Heterozygotes have about 40% HbS and 60% HbA

Removed from circulation by spleen reducing life span from 120 to 20 days

may cause widespread microvascular obstructions resulting in hypoxic tissue injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Oral manifestations of Sickle Cell Anemia

A

Orofacial and dental pain with absence of dental pathology, Pallor of the oral mucosa, Delayed eruption of teeth may be seen, Radiographic findings: step ladder trabecular pattern in the mandible is noted in 70% of patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Thalassemia

A

Heterogeneous group of genetic disorders of Hb synthesis characterized by a lack of or decreased synthesis of globin chains

Reduced beta chains in hemoglobin or reduced alpha chains

Microcytic and hypochromic, Red cell hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Thalassemia Major (Cooley’s Anemia)

A

Beta thalassemia result from either complete absence of beta chain globin synthesis or markedly reduced synthesis, thus abnormality is quantitative rather than qualitative as in sickle cell
AD inheritance
Unpaired alpha chains form insoluble precipitates which damage red cell membranes
Causes severe hemolytic anemia
Bone growth abnormalities due to expansion of the hematopoietic marrow leads to dental malocclusion

“Hair on end appearance, Chipmunk face”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Thalassemia Minor

A

Heterozygous state, mild microcytic hypochromic anemia
Normal life expectancy
No bone growth abnormalities
Resembles iron deficiency anemia; serum iron studies normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Oral manifestations of Thalassemia Major

A

spiky shaped and short roots, taurodontism, attenuated lamina dura, enlarged bone marrow spaces, small maxillary sinuses, Class II malocclusion, higher caries, no inc in gingivitis or periodontitis, salivary concentrations of phosphorous and IgA reduced may result in inc caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Aplastic Anemia

A

suppression of multipotential bone marrow stem cells resulting in pancytopenia

Suppression of hematopoiesis mediated by cytotoxic T lymphocytes, these cells produce inhibitory cytokines such as gamma interferon and tumor necrosis factor

Oral manifestations: hemorrhage, candidiasis, viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Iron Deficiency Anemia

A

initially, normochromic, normocytic until depletion, then microcytic, hypochromic
Iron deficiency anemia is the most common nutritional anemia
Values, Low hemoglobin, hematocrit, MCV, MCH, serum ferritin, and serum iron level

23
Q

Iron Deficiency Anemia causes:

A

Chronic Blood Loss: women (menstruation and post menopause), men (colonic carcinoma), both: gastric ulcers (NSAIDS)

Dietary: infants (breast fed only beyond 6 mo), develops at 1 yr

24
Q

Vitamin B12 Deficiency (Megaloblastic Anemia)

A

B12 & folate are necessary for DNA synthesis

Abnormally large immature red cell precursor in bone marrow called megaloblasts

Uncorrected deficiency leads to demyelination of nerves

Symmetrical numbness of hands and feet, as well as cognitive impairment in older individuals

Treatment: frequent parenteral injections of Vitamin B12

25
Q

Folate (Folic acid) Deficiency

A

Diminished dietary intake, increased demand (pregnancy), metabolic problems (alcoholism), drug-induced (methotrexate), Deficiency does not cause demyelination as does B12 deficiency

26
Q

Anemia of Chronic Disease

A

Mimics iron deficiency anemia except that bone marrow iron is normal or inc and serum ferritin levels are normal or increased

Associated with Chronic microbial infections, chronic immune disorders, defect in the utilization of recycled iron

27
Q

Pernicious Anemia

A

Malabsorption of Vitamin B12, Autoimmune gastritis

prevents binding of B12 to intrinsic factor

28
Q

Leukopenia (Decrease in white cells)

A

Neutropenia (dec in # of neutrophils)
Agranulocytosis (severe dec in granulocytes

Pathogenesis: decreased granulocyte production, increased granulocyte destruction, immune mediated injury, in overwhelming bacterial, fungal or rickettsial infections, inc peripheral utilization

Oral Health - dec in neutrophil counts, associated w/ painful mouth ulcerations

Lymphopenia (dec in # of lymphocytes)

29
Q

Leukocytosis

A

Inc. in number of white blood cells

Neutrophilic: acute bacterial infections
Eosinophilic: allergic disorders like asthma, hay fever, allergic skin diseases
Monocytosis: chronic infections (TB)
Lymphocytosis: chronic immunologic stimulation, viral infections

30
Q

Lymphocytosis

A

infectious mononucleosis

acute, self-limiting disease, chiefly of adolescents and young adults, Caused by ***Epstein Barr Virus (EBV)

Symptoms: fever, sore throat, cervical lymphadenopathy

Spleen is enlarged and susceptible to rupture, liver affected often causing a subclinical hepatitis

31
Q

Non-Hodgkin’s Lymphoma

A

neoplastic proliferation of lymphoid cells, usually arising in lymph nodes (65%) - remainder in parenchymal organs or soft tissue sites

Oral manifestations: intra oral mass, periapical pathology and mimics toothache, non healing ulceration w/ ill-defined irregular margins

32
Q

B cell Neoplasm: Burkitt Lymphoma

A

endemic (Africa) and sporadic

African form presents w/ massive involvement of maxilla and mandible

Caused by Epstein Barr Virus infection

33
Q

Extranodal Marginal Zone Lymphoma

A

Formerly MALT lymphoma, arises in association w/ mucosal sites

Favorable prognosis
May occur in oral cavity, conjuctiva, breast, gut, and salivary gland

arising in Hashimoto’s throiditis, Sjogren syndrome, H. pylori gastritis

34
Q

Mycosis Fungoides

A

Cutaneous (skin) lymphoma of neoplastic CD4+ T-cells, may eventually involve lymph nodes
May become generalized erythrodermic process “Sezary syndrome”

35
Q

Hodgkin Lymphoma

A

B-cell lineage neoplastic disorder, begins in a single node or node group
“Reed-Sternberg”

Classification: Nodular sclerosis (most common), lymphocyte rich, mixed cellularity, lymphocyte depletion, lymphocyte predominance, nodular type

Oral manifestations: treated w/ radiation causing dry mouth if submandibular and sublingual glands

36
Q

Acute Myeloid Leukemia (AML)

A

predominance of immature cells (myeloblasts), median age is about 50 years, most common acute leukemia in adults

37
Q

Acute Lymphocytic Leukemia (ALL)

A

Primarily disease of children, Peak incidence 4 years of age

pre-B cell origin

2-10 yrs w/ pre-B ALL have best prognosis (curable)
mature B-cell phenotype or T-cell type have less favorable prognosis
Adults are much less favorable

38
Q

Chronic Myeloid Leukemia

A

**Thrombocytosis (inc platelets) is common

about 90% of CML patients have the Philadelphia chromosome (Ph1), a 9:22 translocation

Gives rise to bcr-abl fusion gene which encodes ro an abnormal enzyme, bcl-abl tyrosine kinase

Slow progression, bone marrow transplant effecting

39
Q

Chronic Lymphocytic Leukemia

A

Most indolent of all leukemias, affects over 50 yrs
B-cell neoplasm
hypogammaglobulinemia (low immunoglobulin levels) is common
Autoimmune hemolytic anemia
accumulation of long-lived, nonfunctional B lymphocytes that infiltrate the bone marrow, blood, lymph nodes, spleen and liver

40
Q

Chronic Leukemia Oral manifestations

A

in contrast to acute leukemia, oral changes in chronic leukemia is uncommon

41
Q

Polycythemia (Rubra) Vera

A

An acquired hematopoietic stem cell disorder

overproduction of red blood cells, white blood cells, and platelets

JAK2 V617F mutations
JAK2 mutation renders cells hypersensititive to erythropoietin

Symptoms: Pruritus, Hemorrhagic and thrombotic complications

Oral Manifestations: Red-purple (erythematous) oral mucosa

42
Q

Multiple Myeloma

A

Malignant clonal proliferation of plasma cells in bone marrow
associated w/ multifocal “punched out” lytic bone lesions

Cells produce abnormal immunoglobulins -> “Bence-Jones” protein
Bone pain, fractures, renal failure, immunosuppression
Dental: poor healing, jawbone involvement, bleeding tendency, infections, pain and paresthesia

43
Q

Plasmacytoma

A

Single lesions of “multiple myeloma”
May occur in jaw bones or oral soft tissues rarely
may remain indolent for years, most become more like usual case of multiple myeloma eventually (5-10 yrs)

44
Q

Langerhans cell histiocytosis (Histiocytosis X)

A 
Clonal, neoplastic proliferation of dendritic antigen-presenting cells
Langerhans cells (dendritic mononuclear cells found in epidermis, mucosa, lymph nodes, and bone marrow)
BRAF mutations have been identified in 40-60% of cases

Single organ involvement (bone or skin)
Multi-organ involvement (no organ dysfunction or organ dysfunction (low-risk/high-risk)

Hand-Schuller-Christain disease
Letterer-Siwe disease

> 50% of cases seen in young patients
Skull, ribs, vertebrae, and mandible are common sites
Jaws are affected in 10-20% of cases
Radiographically, sharply punched-out radiolucencies w/out a corticated rim

45
Q

Disseminated Intravascular Coagulation (Consumptive Coagulopathy)

A

Overactivation of the coagulation cascade leads to formation of thrombi throughout the microcirculation
Intro of tissue thromboplastins during trauma or obstetrical complications and widespread injury to endothelial cells from bacterial endotoxins during gram-negative species are triggered by

Paradoxical - results from overactivity of the coagulation cascade rather than a primary failure to clot

46
Q

Thrombocytopenia

A

Platelet counts in range of 20,000/uL or less
Small vessel bleeding is characteristic producing petechiae, purpura and ecchymoses

Lack of production (bone marrow suppression)
Decreased survival (autoimmune: ITP, viral: infectious mono [EBV], Consumptive: Disseminated intravascular coagulation)
47
Q

Idiopathic Thrombocytopenic Purpura (ITP)

A

Autoimmune: may be isolated or may precede such diseases such as SLE)
Most common in females from 20-40 yrs

48
Q

Hemophilia - Factor VIII (Hemophilia A)

A

Classic, accounts for 80% of hemophilias, X-linked recessive trait, 30% are new mutations and do not have fam history
“Royal Disease”

49
Q

Factor IX Deficiency (Hemophilia B)

A

Christmas Disease, X-linked recessive, clinically resembles Factor VIII def, much less common and less severe

50
Q

Von Willebrand Disease

A

Usually mild symptoms, underdiagnosed
Most common inherited bleeding disorder
Either AD or AR, complete lack produces no levels of Factor VIII and is similar to severe factor VIII deficiency

51
Q

Massive Splenomegaly due to “Infiltrative Disease”

A

Chronic myeloproliferative disorders, chronic myeloid leukemia, chronic lymphocytic leukemia, hairy cell leukemia, lymphoma

52
Q

Massive Splenomegaly due to Circulatory disorders

A

Portal hypertension from liver cirrhosis, congestive heart failure

53
Q

Hypersplenism

A

excessive removal of 1+ of formed elements of the blood (Thrombocytopenia, neutropenia, anemia)
Primary hypersplenism: no existing splenic disease
Secondary hypersplenism: secondary to a disease w/ splenic involvement such as chronic leukemia

Pathology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions