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Pathoma > Chapter 6 > Flashcards

Chapter 6 Flashcards

1
Q

How to treat neutropenia due to drug toxicity?

A

Give G-CSF or GM-CSF….

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2
Q

What is the most sensitive/earliest change to emerge after whole body radiation?

A

Lymphopenia (decreased number of lymphocytes)

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3
Q

In response to bacterial infection, see neutrophilic leukocytosis. What characterizes the immature cells (band cells)

A

Decreased Fc receptors (CD16). Don’t function quite as well…

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4
Q

During Hodgkin lymphomas, often see eosinophilia. What drives this?

A

Eosinophilic Chemotactic factor (Il-5).

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5
Q

When do you see basophilia?

A

CML

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6
Q

With what bacterial infection do you classically see LYMPHOCYTIC leukocytosis and why?

A

Bordetella pertussis. Produces lymphocytosis-promoting factor, which blocks circulating lymphocytes from leaving blood…

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7
Q

During infectious mononucleosis, what part of the lymph node expands to cause lymphadenopathy and with what cell type?

A

The paracortex expands, filled with CD8+ T cells…

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8
Q

During infectious mononucleosis, what part of the spleen expands leading to splenomegaly?

A

The Peri-Articular Lymphatic Sheath (PALS), also filled with CD8+ T cells…

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9
Q

What do you see in the WBC during infectious mononucleosis?

A

Incerased WBC with atypical lymphocytes (reactive CD8+ T cells)

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10
Q

If a patient has all of the symptoms of mono but a negative monospot test, what do they have?

A

CMV

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11
Q

Major complication of infectious mononucleosis?

A

SPLENIC RUPTURE!

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12
Q

What staining do you see with B-ALL?

A

TdT + (lymphoblastic) AND CD10, CD19, or CD20

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13
Q

What is TdT staining?

A

Stains for a DNA polymerase found in the nucleus of lymphoblasts…

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14
Q

Cytogenic abnormality seen in B-ALL commonly found in children?

A

t(12;21). Good prognosis

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15
Q

Cytogenic abnormality seen in B-ALL commonly found in adults?

A

t(9;22). Philadelphia. Worse prognosis…

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16
Q

What staining do you see with T-ALL?

A

TdT+ and CD2-CD8

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17
Q

Down syndrome is linked with leukemias. Which two do you frequently see and at what age?

A

Acute Megakaryoblastic Leukemia 5 yo.

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18
Q

What staining do you see with AML?

A

Myeloperoxidase + and Auer Rods (crystal aggregates of MPO)

19
Q

Acute promyelocytic leukemia is due to what cytogenic abnormality, causes what complications, and can be treated how?

A

t(15;17), translocation of RAR on 17 to 15. This allows them to dimerize, inhibits signally, blocks maturation…

Causes DIC!!!

Treat with all-trans-retinoic acid!

20
Q

Symptoms of Acute monocytic leukemia?

A

Infiltrate gums, cause inflammation and bleeding.

21
Q

What markers are expressed on CLL?

A

CD5 and CD20. Neoplastic proliferation of naive B cells, but CD5 (normally on T cells) erroneously expressed…

22
Q

What markers are expressed on Hairy Cell Leukemia and it is a cancer of what type of cell?

A

Neoplastic proliferation of mature B cells with hairy cytoplasmic processes. Positive for TRAP

23
Q

Clinical features of hairy cell leukemia?

A
  • Splenomegaly (due to accumulation of hairy cells in RED PULP)
  • Marrow fibrosis
  • Lymphadenopathy normally absent.
24
Q

How to treat Hairy Cell Leukemia?

A

Cladribine (2-CDA), an adenosine deaminase inhibitor. Get excellent results.

25
Q

What is mycosis fungoides?

A

Neoplastic proliferation of mature CD4+ T cells that infiltrate the skin!

26
Q

What are Pautrier microabscesses and when do you see them?

A

Aggregates of neoplastic T cells in the epidermis. Seen in Mycosis Fungoides.

27
Q

When Mycosis Fungoides cells spread to the blood, what is it called?

A

Sezary Syndrome

28
Q

What mutation causes polycythemia vera?

A

JAK2 Kinase mutation

29
Q

What are the clinical symptoms associated with polycythemia vera?

A
  1. Blurry vision/headaches
  2. Increased risk of venous thrombosis (think BUDD-CHIARI SYNDROME!)
  3. Flushed face due to congestion
  4. Itching, esp. after bathing. Due to histamine release from increased numbers of mast cells.
30
Q

What EPO and SaO2 levels are seen in Polycythemia vera?

A

SaO2 normal and EPO decreased

31
Q

What EPO and SaO2 levels are seen in Reactive Polycythemia? (hint- 2 types)

A
  1. Due to high alt/lung disease, see inc. EPO and low SaO2

2. Due to ectopic EPO production (renal cell carcinoma) see normal SaO2 and increased EPO.

32
Q

Cause of Essential Thrombocythemia?

A

JAK2 Kinase mutation.

33
Q

Symptoms of Essential Thrombocythemia?

A

Bleeding/Thrombosis. Rarely progresses to marrow fibrosis/acute leukemia, and no sign. risk of hyperuricemia/gout.

34
Q

Cause of Myelofibrosis?

A

JAK2 Kinase mutation…

35
Q

What cell markers are expressed in follicular lymphoma and what translocation causes it?

A

Express CD20 (B cells!). Caused by t(14;18) moving the Bcl2 gene on 18 next to IgG heavy chain.

36
Q

What translocation causes mantle cell lymphoma?

A

t(11;14), moving Cyclin D1 next to IgG heavy chain. Cyclin D1 promotes G1/S transition.

37
Q

When do you frequently see Marginal Zone Lymphomas?

A

When marginal zones are present, ie. during chronic inflammation.

Specifically, Hashimoto thyroiditis, Sjogren syndrome, and H pylori gastritis (MALToma)

38
Q

Where does Burkitt Lymphoma arise in African vs. sporadic cases?

A

African –> jaw

Sporadic –> abdomen

39
Q

What causes Burkitt’s Lymphoma?

A

t(8;14), which moves c-Myc (oncogene) next to IgG heavy chain.

40
Q

What cell markers are found on Hodgkin Lymphoma Reed-Sternberg cells?

A

CD15 and CD30 (NOT CD20, even though B cell origin)

41
Q

In the mixed cellularity subtype of Hodgkin’s Lymphoma, how are eosinophils drawn in?

A

Due to Il-5 production…

42
Q

What cytokine is often present in Multiple Myeloma to drive the plasma cell growth?

A

Il-6

43
Q

When are Birbeck granules (tennis rackets) and CD1a+ and S100+ cells seen?

A

Langerhans Cell Histiocytosis

Pathoma (15 decks)

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