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Pass Program > Chapter 28: Lymphocytes, Leukocytes, and Granulocytes > Flashcards

Chapter 28: Lymphocytes, Leukocytes, and Granulocytes Flashcards

1
Q

What causes leukocytes to demarginize?

A

epinephrine and cortisol

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2
Q

Which proteins in the endothelium help pull neutrophils out of circulation?

A

selectin

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3
Q

Which proteins help anchor cells to endothelium?

A

integrins

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4
Q

I-CAM 1 ?

A

integrin

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5
Q

Which patients will have higher than normal demargination without infection?

A

steriod and epinephrine users

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6
Q

most common cause of leukopenia

A

viral infection (Parvo B19, Hep E, Hep C

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7
Q

drugs that blast bone marrow?

A

Vinblastine, AZT, Chloramphenicol, Benzene

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8
Q

Which organ can take over erythropoeisis?

A

spleen

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9
Q

What proteins help neutrophils get through endothelium?

A

P-CAM

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10
Q

What is leukemoid reaction? When do we see it?

A

extreme demargination during extreme stress (like burns)

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11
Q

Immature neutrophils with maximal germ-killing ability

A

bands

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12
Q

What sets leukemia apart from other leukocytosis?

A

Bands more than 5%

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13
Q

What virus can cause lymphomas?

A

EBV

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14
Q

most common age for ALL

A

0-15

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15
Q

What stain for ALL

A

PAS

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16
Q

What protein do lymphoblasts lose when they mature and which is a marker for ALL?

A

TdT (terminal deoxythymidine) +

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17
Q

What protein shows a good response to chemotherapy in ALL?

A

CALLA+ (Common ALL antigen)

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18
Q

Which monoclonal antibody is especially for B cells but shouldn’t be used in children?

A

Rituximab

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19
Q

What marker is for immature B cells?

A

CD9 and CD10

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20
Q

What marker is for mature B cells?

A

CD19, CD20, CD21

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21
Q

What leukemia has Auer rods?

A

AML

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22
Q

Which leukemia has the worst prognosis and why?

A

AML because it affects neutrophils, macrophages and monocytes and affects the humoral and cell mediated. The whole immune system is affected.

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23
Q

What does AML stain with?

A

Sudan black

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24
Q

What is the gene defect in AML?

A

trans (15,17)

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25
Q

What is normal pt. profile for CML?

A

30-50 more common in women

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26
Q

What is the normal pt. profile in CLL?

A

older men

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27
Q

Which gene is responsible for CML?

A

trans(9,22); Philadelphia chromosome

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28
Q

When do you treat CLL?

A

When WBC count is more than 100,000, because the cells can clot the blood vessels.

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29
Q

Which meds are used for CML /CLL?

A

Chlorambucil or “tinibs”

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30
Q

APL Promyeloblast Leukemia most common form

A

M3

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31
Q

What may happen in Promyeloblast Leukemia

A

DIC

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32
Q

clues for DIC

A

high D-dimer and fibrin split products

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33
Q

What is treatment for APL

A

vitamin A, matures cells and becomes AML, but prolongs life

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34
Q

What is the marker for Hairy Cell Leukemia?

A

TRAP + (Tartrate Resistant Acid Phosphatase

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35
Q

Which kind of cells do leukemias and lymphomas affect?

A

B cells

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36
Q

Which lymphoma has Reed-Sternberg cells?

A

Hodgkins Lymphoma

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37
Q

What is the marker for Hodgkin’s?

A

CD30, CD15

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38
Q

What is a sign of Hodgkin’s?

A

painless adenopathy

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39
Q

If pt has multiple painful adenopathy of cerrvical, supraclavicular, epitrochlear and inguinal nodes, what is the next best step in management?

A

biopsy

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40
Q

How does Non-Hodgkin’s present in the USA?

A

abdominal mass

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41
Q

How does Non-Hodgkin’s present in developing countries?

A

jaw mass

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42
Q

Most common Non-Hodgkin’s and its gene defect?

A

follicular t(14,18) heavy chain (14) and BCL-2 (18)

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43
Q

“starry sky” appearance Non-Hodgkin’s and its gene defect?

A

Burkitt lymphoma t(8,14) translocation of c-myc (8) and heavy-chain (14)

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44
Q

ABVD lymphoma treatment

A

Adriamycin, Bleomycin, Vioncristine, Dacarbazine

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45
Q

Which ABVD treatment causes lung fibrosis?

A

Adriamycin, Bleomycin

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46
Q

Which ABVD treatment causes neuropathy?

A

Vincristine

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47
Q

Most common cancer that causes myelofibrosis?

A

ALL, metastasis to bone

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48
Q

presentation of aplastic anemia

A

fatty infiltration of bone marrow, low ret count

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49
Q

When do you see dacrocytes (tear drop cells)?

A

myelofibrosis

50
Q

What kind of stones do people with Polycythemia Rubra Vera get?

A

Uric acid stones

51
Q

What lab will be raised in PRV?

A

LAP

52
Q

What acid is associated with Gram + bugs?

A

techoic acid

53
Q

Which kind of bacteria is more likely to have endotoxin?

A

gram -

54
Q

What causes toxic reaction in gram neg. bug?

A

Lipid A

55
Q

What is the membrane made of in gram neg. bacteria?

A

lipopolysaccharides

56
Q

Which bacteria will get worse after giving antibiotics and before getting better? why?

A

gram neg. because they release endotoxins

57
Q

most abundant granulocytes

A

neutrophils

58
Q

What kills catalase positive bacteria?

A

NADPH

59
Q

Which disease is NADPH defective because of superoxide dismutase deficiency?

A

CGD (X-linked)

60
Q

What causes an abscess?

A

free radicals

61
Q

Abscesses day 1 to 3

A

Staph aureus

62
Q

Abscesses day 3 to 7

A

Strep pyogenes

63
Q

Abscesses after day 7

A

anaerobes

64
Q

Management of abscess

A

cut and drain

65
Q

What kind of infection is malodorous and produces gas?

A

anaerobes

66
Q

What is the marker for monocytes in circulation?

A

CD4

67
Q

What is marker for macrophages in tissue?

A

CD14 mediated by interferon gamma

68
Q

Which infections cause monocytosis?

A

Salmonella, TB, EBV/CMV, Listeria, Syphilis (STELS)

69
Q

macrophage in brain

A

microglia

70
Q

macrophage in lung

A

type 1 pneumocytes

71
Q

mactrophage in liver

A

Kupffer cells

72
Q

macrophage in spleen

A

RES (reticuloendothelial system)

73
Q

macrophage in lymph nodes

A

dendritic cells

74
Q

macrophage in bone

A

osteoclasts

75
Q

macrophage in kidneys

A

mesangial cells

76
Q

macrophage in skin

A

Langerhan’s

77
Q

macrophage in Peyer’s patches

A

M cells

78
Q

macrophage in blood

A

monocytes

79
Q

macrophage in connective tissue

A

epithelioid cells, giant cells, histiocytes

80
Q

What infections have high mast cell and eosinophil counts?

A
  1. Allergies 2. parasites
81
Q

How do T cells initiate class switching?

A

bind to B cells by CD40 Ligand

82
Q

Which interleukin causes class switching and is produced by T cells?

A

IL-4

83
Q

What do mast cells release and what is the effect?

A

Histamine, venodilation, vasodilation, BP drop, bronchoconstriction, and sometimes anaphylactic shock

84
Q

What is SRS-A released by mast cells?

A

Slow reacting substance of anaphylaxis, a leukotreine that is the most severe bronchoconstrictor and vasoconstrictor (4-8 hours later)

85
Q

What do eosinophils release to regulate mast cells?

A

histaminase (breaks down histamine); arylsulfatase (breaks down SRS-A), Heparin (breaks clots when venodilating and vasodilating)

86
Q

What medicine is a mast cell stabilizer?

A

steroids

87
Q

What are antihistamines?

A

H1 blockers, block muscarinic receptors, dries out secretions

88
Q

MC 1st generation antihistamine

A

Diphenhydramine “Benadryl”

89
Q

What are H2 blockers used for

A

ulcers

90
Q

third gen antihistamine?

A

Loratadine (Claritin) Cetirizine (Zyrtec) Fexofenadine (Allegra)

91
Q

Eosinophilia NAACP

A

Neoplasia, Allergies/Asthma, Addison’s, Collagen Vascular dis., Parasites

92
Q

best drug for allergies

A

steroids

93
Q

oral steroid

A

prednisone

94
Q

IV steroid

A

methylprednisone

95
Q

topical steroid

A

hydrocortisone

96
Q

drug of choice for eczema

A

topical hydrocortisone

97
Q

steroid to replace cortisol

A

hydrocortisone

98
Q

steroid to replace aldosterone

A

fludricortisone

99
Q

If an adult suddenly develops hives but never had allergies, what should you suspect?

A

lymphoma

100
Q

The only reversible obstructive lung disease

A

asthma

101
Q

markers for T cells

A

CD3, CD4,, CD8

102
Q

Where T cells mature?

A

thymus

103
Q

After maturation where do T cells hang out?

A

paracortical areas of LN

104
Q

T cell lymphomas?

A

Mycosis fungoides/ Sezary syndrome

105
Q

What Interleukin is produced by macrophage? What does it do?

A

IL-1 produces fever, recruits T helper cells

106
Q

Which cells make other interleukins?

A

T-cells

107
Q

What do T cells use to make interleukins?

A

calcineurin

108
Q

Which meds block calcineurin?

A

cyclosporine, tacrilimus (used in transplants)

109
Q

What does IL 2 do?

A

recruits everybody

110
Q

What monoclonal antibody is used against IL2

A

daclizumab (in transplants to prevent rejection)

111
Q

What does IL-3 do?

A

B cell proliferation

112
Q

what is the second messenger for IL-3 and why?

A

tyrosine kinase because it is a growth factor

113
Q

What does IL-4 do?

A

controls class switching IgM to IgE and differation of B cells

114
Q

Which med blocks IL-4?

A

Dupilumab

115
Q

What does IL-5 do?

A

class switching to IgA only

116
Q

Which drug blocks IL-5 and which disease is it used for?

A

Mepolizumab used in atopic dermatitis

117
Q

What does IL-6 do?

A

controls acute phase reactants CRP and ESR

118
Q

What are potent chemotactant factors for neutrophils?

A

IL-8 and LTB-4

119
Q

Which three factors suppress cell mediated inflammation?

A

IL-10, TGFBeta, CTLA4

120
Q

What does IL-12 do?

A

Enhances cell mediated; suppress humoral response

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