Chapter 11- Polycythemia & Reactive Leukocytosis

Question 1

Relative polycythemia
(2° to dehydration)

Pathologic Cells

Answer 1

RBCs, increased

concentration

Question 2

Relative polycythemia
(2° to dehydration)

Patients

Answer 2

Anyone with an
illness (vomiting or
diarrhea) or uses
diuretics are at risk

Question 3

Relative polycythemia
(2° to dehydration)

Unique Features

Answer 3

Result of reduced fluid (serum) of the blood, which causes a relative increase in % of RBCs per volume

Question 4

Relative polycythemia
(2° to dehydration)

Prognosis

Answer 4

No impact of lifespan as long as they don’t die of hypovolemic shock (severe dehydration)

Question 5

Absolute polycythemia

a) Polycythemia vera (PCV)
b) Elevated EPO

Pathologic Cells

Answer 5

RBCs, increased

production

Question 6

Absolute polycythemia

a) Polycythemia vera (PCV)
b) Elevated EPO

Patients

Answer 6

Patients with JAK2
mutations develop
PCV

Elevated EPO
may be form of a medication or from
hypoxia (↑ altitude)

Question 7

Absolute polycythemia

a) Polycythemia vera (PCV)
b) Elevated EPO

Unique Features

Answer 7

Itching skin or risk for 30% have thrombotic

complications: stroke, M.I., organ infarction (spleen, kidneys)

Question 8

Absolute polycythemia

a) Polycythemia vera (PCV)
b) Elevated EPO

Prognosis

Answer 8

PCV: low levels of EPO, patients live 1.5-3 years without medical management, but are expected to live 10-20 years after diagnosis with management.

Question 9

Infectious mononucleosis

Pathologic Cells

Answer 9

B cells are infected with Epstein-Barr

virus (EBV)

Question 10

Infectious mononucleosis

Patients

Answer 10

Developed:
adolescence/young
adulthood

Developing: early childhood

Question 11

Infectious mononucleosis

Unique Features

Answer 11

“Atypical lymphocytes” are CD8+ T cells that are formed to attack the EBV-infected B cells and are found in peripheral circulation, fever, pharyngitis, generalized lymphadenitis, lymphocytosis
(12,000 – 18,000 cells/ µL), splenomegaly,

Dx. via monospot test, Transmitted via saliva (kiss)

Question 12

Infectious mononucleosis

Prognosis

Answer 12

Self-limiting within 4-6 weeks without Tx

Question 13

Cat-scratch disease

Pathologic Cells

Answer 13

Bartonella henselae is

introduced to the skin (eventually to lymphatics)

Question 14

Cat-scratch disease

Patients

Answer 14

90% are pediatrics,

frequently with a history of a cat scratch or thorn/splinter

Question 15

Cat-scratch disease

Unique Features

Answer 15

Lymphadenitis (axillary &
cervical nodes),
~2 weeks post infection, granuloma formation
(“irregular stellate necrotizing granulomas”)

Question 16

Cat-scratch disease

Prognosis

Answer 16

Self-limiting within 8-16 weeks without Tx., antibiotics may be
used in immunosuppressed
patients