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PA-S: PATHOPHYSIOLOGY > Chapter 29 > Flashcards

Chapter 29 Flashcards

1
Q

what are leukocytes?

A 
basophils
eosinophuls
neutrophils
monocytes
lymphocytes
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2
Q

reasons affecting leukocyte production?

  • many hematologic disorders are _______
  • many ___________ metastasize to the bone marrow, affecting leukocyte production
A

malignancies

nonhematologic malignancies

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3
Q

granulocytosis (neutrophilia)

  • is evident in the first stages of infection or inflammation
  • if the need for neutrophils increases beyond the supply, then the immature neutrophils (banded neutrophils) are released into the blood
  • premature release of immature leukocytes is termed a ________
  • leukemoid reaction
A

shift to the left

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4
Q

infectious mononucleosis
-acute, self limiting viral infection of __________
-commonly caused by the _____ - ___%
transmission by saliva

A

B lymphocytes

EBV - 85%

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5
Q

infections mononucleosis in _____ is
-an acute viral infection of _________
caustive agents include _______

A

children
lymphocytes
Epstein-Barr

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6
Q 
infectious mono
classic triad of symptoms:
1.
2.
3. \_\_\_\_\_\_\_ of the \_\_\_\_\_\_\_

diagnostic test
-_______ qualitative test for ______ antibody detects ___

A 
fever
pharyngitis
lymphadenopathy of the cervical lymph nodes
monospot
heterophilic 
IgM
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7
Q

leukemias
are malignant disorders of the blood and blood forming organs
uncontrolled proliferation of malignant leukocytes
classification:
-predominant cell of origin: ______ or ______
-rate of progression: ____ or ____

A

myeloid, lymphoid

acute, chronic

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8
Q

acute leukemia
presence of undifferentiated or immature cells usually blast cells
-rapid onset with short survival
-disease is ________ bone marrow

A

from the

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9
Q

chronic leukemia
predominant cell is mature but does not function normally
slow progression
disease starts ______ bone marrow

A

outside

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10
Q

for acute and chronic leukemia
the current classification of leukemia is based on
1. ___________ (either myloid or lymphoid)
2 __________(which usually reflects the degree at which cell differentiation was arrested when the cell became malignant (acute or chronic

A

predominant cell type

rate of progression

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11
Q

acute lymphocytic leukemia (ALL)
disease is ______ bone marrow so:
-is defined as greater than 30% _______ in blood or bone marrow
-ALL is the most common leukemia in children
-ALL is a progressive _______ defined by the presence of greater that 30% lymphoblasts in the bone marrow or blood

A

acute lymphocytic leukemia (ALL)
from the bone marrow
lymphoblasts
neoplasm

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12
Q

disease is myeloid so:
this is caused by an abnormal proliferation of _____ precursor cells
most common adult leukemia

A

acute myelogenous leukemia
(AML)
myeloid

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13
Q

-__________ is often present and _____-___ causes initiation of this
-this chromosome is present in more than ___% of those with CML, and the presence of the _____
protein is responsible for the _____ of CML

A 
chronic myelogenous leukemia
(CML)
philadelphia chromosome
BCR-ABL1 
95%
BCR-ABL1
initiation
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14
Q 
CML
clinical manifestations
\_\_\_\_\_\_\_, \_\_\_\_\_\_\_, and \_\_\_\_\_\_\_\_
-chronic phase
-lasts \_\_ to \_\_ years
symptoms: may \_\_\_\_\_\_\_\_

accelerated phase

  • lasts __ to __ months
  • primary symptoms develop:_______

terminal blast phase

  • ______
  • survival: only __ to __ months
A 
infections, fever, weight loss
2-5 yeyars
not be apparent
6, 18
splenomegaly
blast crisis
3, 6
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15
Q

CML

  • no ____
  • combined _________
  • _______ response ______
  • ______ stem cell _________
A

cure
chemotherapy
biologic response modifiers
allogeneic stem cell transplantation

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16
Q

affects monoclonal B lymphocytes

  • ____ fail to mature into ____ cells that synthesize _________
  • is derived from transformation of a partially _____ that has not yet encountered _______
  • has a familial tendency
  • is common in adults older than 50
A 
chronic lymphocytic leukemia (CLL)
B cells
plasma
immunoglobulins
mature B cells
antigen
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17
Q

enlarged lymph nodes that become palpable and tender

  • local ________
  • _____ of an inflammatory lesion located near the _______
  • general
  • occurs in the presence of ___ or ____ disease
A

lymphadenopathy
drainage, enlarged node
malignant, nonmalignant

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18
Q 
malignant lymphomas
two major categories
\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_
result from genetic mutations or a viral infection
A

hodgkin lymphoma

non-hodgkin lymphoma

19
Q

hodgkin lymphoma
_______ cells in the lymph nodes
-are necessary for the ______ but not specific to hodgkin lymphoma
-are derived from malignant ________ that usually become _______

_____ cells represent malignant _______ and ______ ______
clinical manifestations
-_______, causing _____ and _______.
local symptoms caused by _____ and _____ of the lymph nodes are a result of ________

A 
reed-sternberg
diagnosis
B cells
binucleate
reed sternberg
transformation
proliferation
B cells
lymphadenopathy
pressure
obstruction
pressure obstruction
lymphadenopathy
20
Q

non-hodgkin lymphoma
-clonal expansion of B cells T cells and or NK cells occurs
treatment:
_______ or _______ or combination of both
monoclonal antibody: ________

A

chemotherapy, radiation

rtuximab

21
Q

burkitt lymphoma
very fast growing tumor of the jaw and facial bones (africa)
rare ih US
______ in __% cases. found in ___________, is associated with this in ______ children
-in non-________ burkitt lymphoma, the most common presentation is ______, _______, ______, and _______

A 
EBV, 90%
nasopharyngeal secretions
African
African 
abdominal swelling, night sweats, fever, weight loss
22
Q

alterations of splenic function
__________: may be classified as pathologic
__________: overactive spleen
___________: occurs with hepatic cirrhosis
__________: engorgement by macrophages with indigestible materials from various “storage diseases”
manifestation: anemia from RBC destruction
treatment: ______ of the spleen

A 
splenomegaly
hypersplenism
congestive splenomegaly
infliltrative splenomegaly
removal
23
Q

_______ develop from B lymphocytes, a type of white blood cell that is made in the bone marrow

  • normally when bacteria or viruses enter the body some of the B cells will change into them
  • the plasma cells make _______ to fight bacteria and viruses, to stop infection and disease!!!
A

plasma cells

antibodies

24
Q

multiple myeloma
in multiple myeloma, cells are abnormal _________ (a type of white blood cells) that build up in the bone marrow and form ___ in many forms of the body
normal plasma cells make ______
as the number of multiple myeloma cells increases, more _____ are made
this can cause the blood to _____ and keep the bone marrow from making enough healthy ______
multiple myeloma cells also damage and weaken the ________

A 
plasma cells
tumors
antibodies
antibodies
thicken
blood cells
the bone
25
Q

multiple myeloma
malignant plasma cells produce abnormally large amounts of one class of immunoglobulin
-unattached _________ of the immunoglobulins
(_______) can pass through the _______ and damage the ________
clinical manifestations
- _________

A 
light chains
bence jones proteins
glomerulus
renal tubular cells
hypercalcemia
26
Q

MM and hypercalcemia

  • _____ acts as an _______ activating factor and stimulate ______ to reabsorb bone
  • this process results in ______ and _____, resulting from release calcium from the ______ of bone
A 
IL 6
osteoclastic
osteoclasts
bone lesions, hypercalcemia
breakdown
27
Q

certain conditions within the blood vessels predispose an individual to develop clots spontaneously

A

thromboembolic disease

28
Q

a stationary clot attached to the vessel wall (made up of fibrin and blood cells)

A

thrombus

29
Q

form under conditions of high blood flow and are composed mostly of platelets aggregates held together by fibrin strands

A

arterial thrombi

30
Q

form in conditions of low flow and are composed mostly of red cells with larger amounts of fibrin and few platelets

A

venous thrombi

31
Q

treatment of thromboembolic disease

therapy consists of ______ or ______ of the clot

A

removal, lysis

32
Q

thromboembolic disease

the risk of developing spontaneous thrombi is related to several factors below referred as the:

__________

  1. ________ injury to blood vessels
  2. _______ blood flow
  3. rapid ______ of the blood
  4. stagnant ______ blood flow
A 
Virchow's triad
endothelial
turbulent arterial
coagulation
venous
33
Q

hypercoagulability - condition in which a individual is at risk for thrombosis

primary (______): results are the _____ in _____ that are involved in _______
secondary (______): causes include a variety of clinical ________

A 
hereditary
defects
proteins
homeostasis
acquired
disorders
34
Q

disorders of coagulation

  • defects or deficiencies of one or more clotting factors (______)
  • impaired _____: inability to promote coagulation and the development of a stable fibrin clot. ______ deficiency of ______
  • consumptive thrombohemorragic disorders: _____________ coagulation
A 
hemophilias
hemostasis
dietary
vitamin K
disseminated intravascular
35
Q

why does the blood not clot properly?

some clotting factors defects are inherited and usually involve a single factor such as ________ or ________ disease

other coagulation defects are acquired and tend to result from deficient synthesis of clotting factors by the ____. causes include _______ and dietary ______ of _______

A

hemophilias, von Willebrand disease
liver disease
deficiency
vitamin K

36
Q

vitamin K deficiency
impaired ______
vitamin K is required for normal_______ factor synthesis by the _________
-necessary for synthesis and regulation of ________, procoagluant factors (__, __, __) and proteins _ and _ (anticoagulants)
-deficiency: leads to ______
-treatment: ______ administration of ______
most common cause of vitamin K deficiency is total ________ with _____ therapy

A 
hemostasis
 clotting
liver
prothrombin
VII, IX, X
C, S
bleeding
parenteral, vitamin K
parenteral nutrition
antibiotic
37
Q

consumptive thrombohemorrhagic disorders

-the description of ___ an unregulated release of _______ with subsequent ____ formation and accelerated __________

A

DIC (disseminated intravascular coagulation)
thrombin
fibrin
fibrinolysis

38
Q

disseminated intravascular coagulation
diagnosis:
most reliable and specific test for diagnosis
_______ - a molecule produced by ____ clots. The test measures a specific ___ related product

A

D-dimer
fibrin
DIC

39
Q

thrombocytopenia (low platelets)

two diseases:

A

immune thrombocytopenic purpura

thrombotic thrombocytopenic purpura

40
Q

ITP (immune thrombocytic purpura)
-__ antibody targets platelet ______
antibody coated platelets are sequestered and removed from ________ (________ in the spleen remove antibody coated platelets)

acute form develops after \_\_\_\_\_\_\_\_
-is one of the most common \_\_\_\_\_\_\_ bleeding disorders
chronic form usually is found in adults
bottom line point ITP is:
-\_\_\_\_\_\_\_\_\_ with \_\_\_\_\_\_\_ antibodies
A 
IgG 
glycoproteins
circulation
mononuclear phagocytes
viral infections
childhood
autoimmune disease
anti-platelet
41
Q

a red purple discolorated caused by diffuse _____ in the skin

A

purpura

42
Q

disorders of platelets

TTP is: ________ react with _______ cells to cause arterial _______

A

platelets
endothelial cells
occlusions

43
Q 
in TTP: 
pathognomonic pentad of symptoms
1. extreme \_\_\_\_\_\_\_\_
2. intravascular \_\_\_\_\_\_\_\_\_\_ 
3. \_\_\_\_\_\_\_ signs and symptoms most often involving the \_\_\_ (approx 65% exhibit \_\_\_\_\_\_ disturbances, behavorial \_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_ or \_\_\_\_\_\_\_\_)
4. \_\_\_\_\_ failure
5. \_\_\_\_\_\_
A 
thrombocytopenia
hemolytic anemia
ischemic 
CNS
memory
irregularities
headaches
comas
kidney
fever

PA-S: PATHOPHYSIOLOGY (18 decks)

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