Chapter 24 Disorders of White Blood Cells and Lymphoid Tissues Flashcards
What is the Epstein Barr Virus? What does it do?
Typically asymptomatic disease that is transmitted via oral to oral route, via saliva.
AKA kissing disease
EBV targets the B cells found in the tonsils. Begins replicating itself and becomes reactivated in the infected persons saliva.
How does the Epstein Barr Virus progress to infectious mononucleosis?
What are the symptoms of infectious mononucleosis?
Fever, swollen lymph nodes, and inflamed tonsils. Spleen can also be enlarged.
Who is at highest risk for being affected by EBV?
Teens and young adults
What is the clinical course for infectious mononucleosis?
How does it spread throughout the body?
The disease is self-limiting. It has an incubation period of around 4 weeks. The patient is symptomatic with fever, enlarged neck lymph nodes, and inflamed tonsils for around 4 weeks. The infected remains contagious for up to 12 weeks post infection.
EBV enters the body via oral route. It then uses the B-cells found in the tonsils to spread throughout the lymphatic system.
What is the most common complications of infectious mononucleosis? Serious complications?
The most common complications are severe pharyngitis, lymph node enlargement throughout the lymphatic system, and possible petechial rash.
More serious complications include liver involvement with transient liver enzyme elevation. Hepatitis can occur with associated symptoms such as jaundice, nausea, anorexia, and hepatomegaly. Upper airway obstruction. Splenic rupture. Meningitis. Encephalitis. HODGKIN’s LYMPHOMA!!
How is infectious mononucleosis and EBV diagnosed?
- Monospot test - loos for heterophile antibodies. Heterophile antibodies are non-specific antibodies and are thought to contribute to the wide spread lymph node involvement.
2.
What are heterophile antibodies? What happens with antibiotic administration?
Heterophile antibodies are non-specific antibodies that are produced in the presence of EBV and infectious mononucleosis.
Since mono can present with similar symptoms to bacterial pharyngitis antibiotics targeting Strep are frequently given. These antibiotics result in a rash due to these heterophile antibodies.
Leukopenia
Decrease in the absolute number of leukocytes. Most often affects the neutrophils.
Neutropenia
Low number of neutrophils
What is Hodgkin Lymphoma?
What is a lymphoma?
Solid tumor found in the lymphatic system
Who is affected by Hodgkin’s lymphoma?
1. Age
2. Sex
3. Associations
Males are more likely to be affected. It is a disease of the young, ages 15-40 years old with a second peak affecting people 50 and older.
40% of lymphomas, less likely than non-Hodgkin’s
- History of EBV and infectious mononucleosis
How does Hodgkin’s present initially?
How does the disease progress? What is this called?
Initially presents with cervical lymphadenopathy or swollen lymph nodes in the neck region. These are painless.
The disease progresses via contagious spread, this is seen as a localized, chain spread of the lymphoma is a chain of connected lymph nodes.
What cell is a diagnostic hallmark of the disease? What does this cell do?
Reed-Sternberg cells are the hallmark cells of Hodgkin’s lymphoma. These are large, atypical, mononuclear tumor cells.
What signs and symptoms are seen with Hodgkin’s lymphoma?
Initial involvement includes painless enlargement of a single lymph node or group of them in the neck, supraclavicular area, axilla, or mediastinum.
Chills, NIGHT SWEATS, weight loss, PRURITIS.
Splenomegaly
How is Hodgkin’s lymphoma diagnosed?
The diagnosis is based off the presence or absence of Reed-Sternberg cells via a biopsy of the lymph node tissue.
How is Hodgkin’s lymphoma treated?
Irradiation and chemotherapy treatment. Radiation is chosen if the disease is localized. Chemo if diffuse.
What is leukemia?
Cancer affecting the blood and bone marrow. Causes uncontrolled growth of abnormal WBC which affect the functioning of regular cells.
Most common form of cancer in children and adolescents.
Hodgkin Vs Non-Hodgkin disease
Hodgkin is localized. Non-hodgkin is diffuse. HL has Reed-Sternberg cells.
