Chapter 29 Flashcards
what are leukocytes?
basophils eosinophuls neutrophils monocytes lymphocytes
reasons affecting leukocyte production?
- many hematologic disorders are _______
- many ___________ metastasize to the bone marrow, affecting leukocyte production
malignancies
nonhematologic malignancies
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
shift to the left
infectious mononucleosis
-acute, self limiting viral infection of __________
-commonly caused by the _____ - ___%
transmission by saliva
B lymphocytes
EBV - 85%
infections mononucleosis in _____ is
-an acute viral infection of _________
caustive agents include _______
children
lymphocytes
Epstein-Barr
infectious mono classic triad of symptoms: 1. 2. 3. \_\_\_\_\_\_\_ of the \_\_\_\_\_\_\_
diagnostic test
-_______ qualitative test for ______ antibody detects ___
fever pharyngitis lymphadenopathy of the cervical lymph nodes monospot heterophilic IgM
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 ____
myeloid, lymphoid
acute, chronic
acute leukemia
presence of undifferentiated or immature cells usually blast cells
-rapid onset with short survival
-disease is ________ bone marrow
from the
chronic leukemia
predominant cell is mature but does not function normally
slow progression
disease starts ______ bone marrow
outside
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
predominant cell type
rate of progression
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
acute lymphocytic leukemia (ALL)
from the bone marrow
lymphoblasts
neoplasm
disease is myeloid so:
this is caused by an abnormal proliferation of _____ precursor cells
most common adult leukemia
acute myelogenous leukemia
(AML)
myeloid
-__________ 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
chronic myelogenous leukemia (CML) philadelphia chromosome BCR-ABL1 95% BCR-ABL1 initiation
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
infections, fever, weight loss 2-5 yeyars not be apparent 6, 18 splenomegaly blast crisis 3, 6
CML
- no ____
- combined _________
- _______ response ______
- ______ stem cell _________
cure
chemotherapy
biologic response modifiers
allogeneic stem cell transplantation
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
chronic lymphocytic leukemia (CLL) B cells plasma immunoglobulins mature B cells antigen
enlarged lymph nodes that become palpable and tender
- local ________
- _____ of an inflammatory lesion located near the _______
- general
- occurs in the presence of ___ or ____ disease
lymphadenopathy
drainage, enlarged node
malignant, nonmalignant
malignant lymphomas two major categories \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_ result from genetic mutations or a viral infection
hodgkin lymphoma
non-hodgkin lymphoma
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 ________
reed-sternberg diagnosis B cells binucleate reed sternberg transformation proliferation B cells lymphadenopathy pressure obstruction pressure obstruction lymphadenopathy
non-hodgkin lymphoma
-clonal expansion of B cells T cells and or NK cells occurs
treatment:
_______ or _______ or combination of both
monoclonal antibody: ________
chemotherapy, radiation
rtuximab
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 _______
EBV, 90% nasopharyngeal secretions African African abdominal swelling, night sweats, fever, weight loss
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
splenomegaly hypersplenism congestive splenomegaly infliltrative splenomegaly removal
_______ 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!!!
plasma cells
antibodies
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 ________
plasma cells tumors antibodies antibodies thicken blood cells the bone
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
- _________
light chains bence jones proteins glomerulus renal tubular cells hypercalcemia
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
IL 6 osteoclastic osteoclasts bone lesions, hypercalcemia breakdown
certain conditions within the blood vessels predispose an individual to develop clots spontaneously
thromboembolic disease
a stationary clot attached to the vessel wall (made up of fibrin and blood cells)
thrombus
form under conditions of high blood flow and are composed mostly of platelets aggregates held together by fibrin strands
arterial thrombi
form in conditions of low flow and are composed mostly of red cells with larger amounts of fibrin and few platelets
venous thrombi
treatment of thromboembolic disease
therapy consists of ______ or ______ of the clot
removal, lysis
thromboembolic disease
the risk of developing spontaneous thrombi is related to several factors below referred as the:
__________
- ________ injury to blood vessels
- _______ blood flow
- rapid ______ of the blood
- stagnant ______ blood flow
Virchow's triad endothelial turbulent arterial coagulation venous
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 ________
hereditary defects proteins homeostasis acquired disorders
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
hemophilias hemostasis dietary vitamin K disseminated intravascular
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 _______
hemophilias, von Willebrand disease
liver disease
deficiency
vitamin K
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
hemostasis clotting liver prothrombin VII, IX, X C, S bleeding parenteral, vitamin K parenteral nutrition antibiotic
consumptive thrombohemorrhagic disorders
-the description of ___ an unregulated release of _______ with subsequent ____ formation and accelerated __________
DIC (disseminated intravascular coagulation)
thrombin
fibrin
fibrinolysis
disseminated intravascular coagulation
diagnosis:
most reliable and specific test for diagnosis
_______ - a molecule produced by ____ clots. The test measures a specific ___ related product
D-dimer
fibrin
DIC
thrombocytopenia (low platelets)
two diseases:
immune thrombocytopenic purpura
thrombotic thrombocytopenic purpura
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
IgG glycoproteins circulation mononuclear phagocytes viral infections childhood autoimmune disease anti-platelet
a red purple discolorated caused by diffuse _____ in the skin
purpura
disorders of platelets
TTP is: ________ react with _______ cells to cause arterial _______
platelets
endothelial cells
occlusions
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. \_\_\_\_\_\_
thrombocytopenia hemolytic anemia ischemic CNS memory irregularities headaches comas kidney fever
