Disorders Of The White Blood Cells And Lympoid Tissue Flashcards
Penia
Deficiency
Neutropenia
An abnormally low amout of neutrophils within the blood
Leukopenia
A decrease in the absolute number of leukocytes within the blood
Pancytopenia
all of the blood cells are low
lymphoma
Diverse group of solid tumors composed of neoplastic lymphoid cells that vary with resect to molecular features, genetics, clinical presentation, and treatment.
What are the two types of lymphoma
Hodgkin and non-Hodgkin (NHL’s)
Pluripotent
not fixed as to developmental potentialities, not capable of differentiating into one of many cell types
“Blast”
new baby budding cell
How do all cells start out
as a stem cell
What are bands?
Immature Neutrophils
What are segs?
Segmented neutrophils
What is a normal differential for WBC
4000-11000
What are Eosinophils
leukocytes that constitute 1%-3% of the WBC. Help to control allergic responses and fight parasites
When do Eosinophils increase?
During allergic reactions and Parasitic infections
What are Basophils
Basophils are WBC that are present during inflammation. They contain Heparin and histamine. Present in IGE reactions.
What is heparin
an anticoagulant
What is histamine?
a vasodilator
What are leukocytes and where do they originate?
White blood cells that originate in the bone marrow and circulate through the lymphoid tissues in the body
Name the granulocytes
Neutrophils, Eosinophils, and Basophils come from the myeloid stem cell
Name the agranulocytes
lymphocytes and monocytes
What originates from the lymphoid stem cells in the bone marrow and travel between the blood and the lymphatic system
Lymphocytes
What cells originate from the lymphoid stem cell
NK, T cells and B cells
What cells originate from the myeloid stem cell
Monocytes, Granulocytes, Erythrocytes, Platelets
What is the number one reason for a low neutrophil count
Medications
Neutrophils
Primary pathogen-fighting cells
When would you see an elevated neutrophil count on a differential?
With an acute bacterial infection or inflammation
What shits to the left?
Bands
What does it mean to shift to the left?
Shift to the left is where their may be an infection that the body shoots out immature WBC because it can’t wait for the mature ones
A big increase in what kind of cell is not normal?
Basophils
What do basophils do?
Release heparin, seratonin, bradykinin, histamine and other inflammatory mediators.
Monocytes/ Macrophages (from myeloid stem cells) do what?
Antigen presenting cells,
Create inflammatory mediatiors,
are phagocyctic,
What does an increase in Monocytes suggest
May indicate infection. Inflammation, or Bone marrow injury (Leukemia)
RBC range
4.2 to 5.4
Hgb range
12-16
WBC Range
5,000 to 10.000
Neutrophils Range
55-70 ( if high, Bacterial infection)
Bands range
0-3
Eosinophils Range
1-2
Basophils
Less than 1
Name the leukocytes (from lymphoid cells)
B-cells, T-cells, Natural Killer cells
Leukocytes can be low from what?
Autoimmune diseases. Causes big lymphnodes- producing more B and T, inflammation, can be caused by mainly viruses or cancer
What do B cells create
Antibodies or Plasma
What do T cells do?
Control the immune response, cell mediated immunity
Which type of leukocyte works hardest when you receive a vaccination
B- Lymphocytes
What causes alterations in Leukocyte function
Quantitative disorders, and qualitative disorders
Quantitative disorders:
- increase or a decrease in the number of cells
- Bone marrow disorders or premature destruction of cells (not functioning properly either low or high)
- Response to infectious microorganism invasion
Qualitative Disorders:
- Disruption of cellular functions
- DNA or within the cell
Leukopenia and neutropenia is bad because of what (these are quantitive disorders)
A low white count predisposes a patient to infections, and having low levels these WBC is not normal and usually means cancer
Leukocytosis: (quantitive disorder)
is a normal protective physiologic response to physiologic stressors- means the body is trying to fight it so the WBC rises.
Quantitive; Low what are the danger numbers?
Under 1000 is really low. 500-1000 is the danger zone
Inadequate production= increased destruction
Increased destruction Leukopenia:
- Is immune mediated by itself or by drugs
Has increased destruction where it starts killing off own cells.
Why would you see a low WBC with a prolonged severe infection?
because cells are being destroyed very quickly and cannot be replaced fast enough
What does the spleen do?
Gets rid of old or non functioning cells
What is splenic sequestration (often seen with sickle cell)
spleen pulls cells that are not damaged or old and sequesters them prematurely. Sickle cell clogs up the spleen and doesn’t let WBC through. Is an over overactive spleen.
Hypersplenism aka splenomegaly=
inappropriate spleen function (overactive spleen)
Leukemia-
- cancer of the blood cells
- Creates abnormal White Blood Cells
- also interferes with erythrocyte and platelet maturation and causes platelet damage
Where does leukemia take place
within the bone marrow
Are leukemias Lymphocytic or Myelogenous?
Both Lymphocytic (lymphoid stem cells) and myelogenous (myeloid stem cells)
What is the difference between acute leukemia and chronic leukemia
Acute= rapid onset, has blast cells (immature) Chronic= slow onset, has mature cells but they do not function properly
What do you worry about with acute leukemia
Pancytopenia, worry about bleeding and immune responses.
Pancytopenia
all blood cells are low
What are the signs and symptoms of acute leukemia
- Infection
- Bleeding, bruising
- Anemia
- Malaise/Fatigue
- weight loss
- night sweats
- bone pain
- anorexia
Kinds of leukemias
Acute lymphocytic (ALL) Acute Myelogenous (AML)
Chronic Mylogenous Leukemia (CML) Philadelphia Chromosome= translocation of chromosome 9 and 22
Chronic Lymphatic Leukemia (CLL)
Lymphocytic Leukemias have lots of
B, T, NK but they are not functioning….so they do not make WBC, Monocytes, platelets or RBC because it is to busy making non functioing B, T, & NK cells
Lymphadenopathy:
Enlarged lymph nodes that become palpable and tender
General lymphadenopathy:
Occurs in the presence of malignant or non malignant disease
Local Lymphadenopathy
Drainage of an inflammatory lesion located near the enlarged node
Infectious Mononeucleosis symptoms
Big lymphnodes in the neck and groin area
What things cause lymphadenopathy
Neoplastic disease
Immunologic or inflammatory conditions
lipid storage diseases
Malignant Lymphomas
Malignant transformation of a lymphocyte and proliferation of lymphocytes, histocytes, their precursors, and derivatives in lymphoid tissues
Hodgkin Lymphoma
- Linked to EBV
- b cell problem that invades lymphoid organs such as the spleen, adenoids, and thalmus
- B cells go through apoptosis instead of becoming antibodies
What do you have to have present in order to diagnose hodgkin lymphoma
Reed Sternberg cells within the lymphnodes
Non-Hodgkin Lymphoma affects…
Both B Cells and T cells
What are the signs and symptoms of Hodgkin Lymphoma
- Adenopathy and Spleenomegaly (Enlarged adenoids and spleen
- Fever
- Weight loss
- Night sweats
- pruritus (itching)
Laboratory Findings for Hodgkin Lymphoma
- Elevated ESR (Indicates inflammation)
- Greatly elevated WBC
- Low Lymphocyte count
Non-Hodgkin Lymphoma
- Generic term for diverse group of lymphomas
- Non-Hodgkin Lymphomas are linked to chromosome translocations, viral and bacterial infections, environmental agents, immunodeficiencies, and autoimmune disorders
Which one is worse:
Non-Hodgkin Lymphoma or Hodgkin Lymphoma
Non-Hodgkin Lymphoma because it effects both B & T cells and there is so many different Non-Hodgkin Lymphomas
What does a Non-Hodgkin Lymphoma do
- clonal expansion of B cells (85%)
- changes in pro-oncogenes and tumor suppressor genes contribute to the cell immortality and thus increases malignant cells.
Burkitt Lymphoma:
- Most common type of Non-Hodgkin Lymphoma in children
- very fast growing tumor in the jaw or facial bones.
- involves adenoids
- linked to EBV
Infectious Mononeucleosis (IM)
- Acute self limiting infection of the B lymphocytes transmitted by saliva through personal contact
- Caused by the EBV 85% of the time
- B cells have a EBC receptor site
- Linked to Burketts Lymphoma, Nasopharyngeal carcinoma, hodgkin lymphoma
