Chapter 13: Leukopenia, Reactive Proliferation of White Cells and Lymphoid Neoplasms Flashcards

1
Q

How to hypoplastic states vs. hyperplastic/neoplastic states affect the ratio of fat cells:hematopoietic cells in the bone marrow when biopsied?

A
  • Hypoplastic = proportion of fat cells is >>> increased
  • Hyperplastic = the fat cells often dissapear
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2
Q

Where do the definitive hematopoietic stem cells (HSCs) arise from during development?

A

Mesoderm of the intraembryonic aorta / gonads/ mesonephros region

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3
Q

Where do HSCs migrate to during the 3rd month of embryogenesis, which becomes the chief site of blood cell formation until shortly before birth?

A

Liver

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4
Q

Where is the hematopoietically-active tissue found in adults?

A

Bone marrow of axial skeleton

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5
Q

In adults, where are BM biopsies typically collected from?

A

PSIS

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6
Q

Which cells lie next to bone marrow sinusoids and extend cytoplasmic processes that bud off into the bloodstream to produce platelets?

A

Megakaryocytes

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7
Q

What is the most common cause of clinically significant neutropenia (agranulocytosis)?

A

Drug toxicity

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8
Q

What are characteristics findings of the damage due to infections seen in agranulocytosis?

A

Ulcerating necrotizing lesions of the gingiva, floor of mouth, buccal mucosa, and pharynx

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9
Q

Neutropenic patients are at high risk for deep fungal infection caused by which 2 organisms?

A

Candida and Aspergillus

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10
Q

What is the most distinctive symptom of Franklin Disease (aka γ-heavy chain disease)?

A

Palatal edema

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11
Q

Characteristic findings of the LN’s associated w/ acute nonspecific lymphadenitis?

A

- Enlarged and painful

- Large, reactive, germinal centers containing numerous mitotic figures

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12
Q

What are 3 morphological features which favor a reactive (non-neoplastic) follicular hyperplasia?

A
  • Preservation of LN architecture
  • Marked variation in the shape and size of follicles
  • Presence of frequent mitotic figures, phagocytic macrophages (tingible body), and recognizable dark and light zones
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13
Q

Infection caused by what bacteria is associated with lymphocytosis?

A

Bordetella pertussis

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14
Q

What is the pathogenesis of hemophagocytic lymphohistiocytosis (aka macrophage activating syndrome)?

A

Systemic activation of macrophages and CD8+ cytotoxic T cells

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15
Q

What is the most common trigger for hemophagocytic lymphohistiocytosis (HLH)?

A

Infection, particularly EBV

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16
Q

What is the typical presenation of patient with hemophagocytic lymphohistiocytosis; what are lab values will be seen?

A
  • Pt presents w/ acute febrile illness assoc. w/ splenomegaly and hepatomegaly
  • Labs show anemia + thrombocytopenia + VERY high levels of plasma ferritin and soluble IL-2 receptor + ↑ LFT’s
17
Q

What are 2 major causes of neutrophilic leukocytosis?

A
  • Acute bacterial infections, especially pyogenic
  • Tissue necrosis (MI, burns)
18
Q

Basophilic leukocytosis is usually indicative of what?

A

Myeloproliferative disease