Disorders of blood part 2 Flashcards

1
Q

Lymphoma

A

Malignant neoplasm involving proliferation of lymphocytes in lymphoid tissue.
All lymphomas are malignant with 35 subtypes.
Lymphoid tissue: thymus, bone marrow, lymph nodes, spleen, tonsils, intestinal lymphoid tissue

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2
Q

Non-hodgkin Lymphoma

A

Involves T and B cells, originate in extranodal tissue and migrates to contiguous lymph nodes.
Lymph node enlargement and cancerous transformation occur

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3
Q

Non-hodgkin lymphoma etiology

A

Unknown, but believed to be related to immune system impairment and certain infections
Site specific B and T cells at different levels of differentation migrate to specific parts of the lymph node for which they are normally associated

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4
Q

Non-hodgkin lymphoma classification

A

B cell or T cell either can be precursor or mature

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5
Q

Non-hodgkin B cell

A

Mature B cell lymphomas are most common, usually metastasize and involve marrow, impaired humoral immunity is seen with increased susceptibility to bacterial infections

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6
Q

Non-hodgkin clinical manifestations

A

Lymph node enlargement
Painless gradual lymph swelling
Extranodal sites are nasopharynx, GI tract, bone, thyroid, testes, and soft tissue

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7
Q

Non-hodgkin S&S

A

Fatigue, malaise, fever, weight loss, pruritis, sweating.
Hypermetabolism, anemia, infections
Approx 15 years survival

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8
Q

Hodgkin Lymphoma

A

HL features abnormal cells called Reed-Sternberg cells
Distinctive chromosomal abnormalities
Usually B cells are affected, lymphocyte count is decreased, arise in single and and spreads, four distinite types, believed to be related to immune and infections

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9
Q

Hodgkins Lymphoma S&S

A

Large painless bumps in neck axilla retroperitoneum and inguinal nodes
Fever, weakness, malaise, weight loss, anemia, back and neck pain, pericardial involvement
Can cause pressure or obstruction to extremities and can be painful, nerve irritated or pulseless

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10
Q

Stage of Hodgkins disease

A

I. One lymph node
II. Two or more lymph nodes same region on same side of diaphragm
III. Lymph nodes on both sides of diaphragm and spleen
IV. Multiple, diffuse

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11
Q

Leukemia

A

Neoplasms of hematopoietic precursor cells. Caused by gene disruption, unknown etiology but commonly related to treatment of cancer (HL) and EMFs

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12
Q

Common Features of Leukemias

A

Bone Marrow is infiltrated with malignant cells which replace precursors of erythrocytes, WBC and platelets.
Peripheral blood contains increased number of immature blood cells

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13
Q

Complications of leukemias

A

Anemia, recurrent infections, uncontrollable bleeding, overwhelming infection commonly causes death

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14
Q

Classification of leukemias

A
Acute or chronic
Myeloid -granulocytic-monocytic
Lymphoid - lymphocytic
AML
ALL
CML
CLL
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15
Q

ALL or AML

Acute lymphoid or myeloid leukemia

A

Young people
Proliferation of lymphoblasts (usually B lymphoblasts)
Involves proliferation of precursors for RBC, granulocytes and platelets
Disrupt normal bone function

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16
Q

ALL clinical manifestations

A

Increased number of immature and nonfunctional lymphocytes in bone marrow cause bone pain and tenderness, infections, decreased RBCs, anemia, poor healing, decreased platelets
Fever, diaphoresis, weight loss, lymphadenopathy, splenomegaly, hepatomegaly, increased viscosity

17
Q

CLL (most common) or CML

A

Neoplasms of hematopoietic precursors are more differentiated than in acute, longer survival when untreated
Older people, similar but less severe S&S (night sweats)

18
Q

Multiple Myeloma

A

Neoplasm of B cells that mature plasma cells
Multiple malignant tumors of plasma cells scattered throughout excess of IgG and also characterized by multiple bone lesions
Etiology is unknown but linked to immune disorders and infections

19
Q

Clinical manifestations of multiple myeloma

A

Bone resoprtion, pain, hypercalcemia, (low phosphate) 66% vertebrae for bone destruction
Low immunoglobins, recurrent infections, related to marrow obstruction (anemia neutropenia and thrombocytopenia)

20
Q

Hypercoagulability states

A

Increased platelet function (arterial distrubance or thrombocytosis) or increased activation of coagulation system

21
Q

Increased platelet function

A

Endothelial damage or increased platelet sensitivity to factors causing adhesion/aggregations

22
Q

Increased platelet function

A

Endothelial damage or increased platelet sensitivity to factors causing adhesion/aggregations
Thrombocytosis is >1000X10^9/L
Primary and secondary (genetic and acquired)

23
Q

Primary Thrombocytosis

A

Genetic disorder of thrombopoietic stem cells

Leads to proliferation of potentially non-functional platelets

24
Q

Increased activity of coagulation system

A

Primary and secondary causes

Increase in procoagulation factors OR decrease in anticoagulation factors

25
Primary coagulation
Mutations in genes creates altered clotting factor V which cannot be inactived by protein C (loss of anticoagulation mechanism) Leads to DVT and can be related to thromboembolism formation in pregnancy
26
Secondary coagulation issues
Immobility (blood stasis) Increased viscosity and deformed RBC can also cause lead to stasis via resistance to flow Paraneoplastic syndrome (certain cancers, troussea syndrome) Increased Estrogen Increase in synthesis of coagulation factors by liver and or decrease in synthesis of antithrombin III Autophospholipid Syndrome-IgG attacks protein-binding phospholipids to intereference with clotting cascad
27
Bleeding disorders
Thrombocytopenia Lack of coagulation factors DIC Reduced vessel integrity
28
Thrombcytopenia
< 1000X10^9/L Decreased production from aplastic anemia, multiple myeloma, radiation, cheo Increased sequestration from splenomegaly Increased destruction/use - autoimmune (transfusions, pregnancy) drug induced, DIC Decreased function from NSAIDS, Von Willebrand Disease
29
Lack of coagulation factors diseases
Hemophilia Von Willebrand Disease Secondary Etiologies
30
Hemophilia
Sex-linked congenital with forms A and B A is classic and a deficiency in factor VIII B (Christmas disease) is a deficiency in IX, transmitted as A
31
Hemophilia clinical manifestations
Severe is associated with spontaneous bleeding At 1-5% of normal, bleeding usually after trauma May experience spontaenous hematuria and epistaxis PTT and PT used to asses phases May require transfusions
32
PT prothrombin time and International normalized ratio (INR)
Measures integrity of extrinsic clotting system as well as factors common to both systems Also used to monitor effectiveness of coumadin
33
PTT partial thromboplastin time
Measures integerity of clotting intrinsic system and common components Often used to monitor standard (unfractionated) heparin anticoagulant therapy
34
Von Willebrand Disease
vWF platelet adhesion molecule found in platelet granules and endothelium, vWF also carries clotting factor VIII
35
Secondary Etiologies
Liver disease and Vit K deficiencies | Vit K needed for clotting factors 2,7,9 and 10
36
DIC
Widespread coagulation and bleeding within the vasculature | Endothelial damage factor XII activation