E3 WBC disorders Flashcards
Infectious Mononucleosis “Mono”
-Self-limiting lymphoproliferative disorders
-Infection of B lymphocytes
-Atypical lymphocytes proliferate
Infectious Mononucleosis is caused by
Epstein-Barr virus (EBV)
Main mode of transmission for Infectious Mononucleosis
EBV contaminated saliva
“Kissing disease”
Also body fluids-Semen or blood/ Sex or organ transplant
What age group does Infectious Mononucleosis mainly effect?
adolescence/ young adults
Acute phase and Onset of Infectious Mononucleosis
Insidious, incubation 4-8 weeks
Acute phase 2-3 weeks
Some degree of debility/lethargy 2-3 months
Clinical manifestations of Infectious Mononucleosis
-Lymphadenopathy (swollen lymph nodes)
-Hepatits (swollen liver)
-Splenomegaly (swollen spleen)
-Extreme fatigue
-Fever
-Sore throat
-Body aches
-WBC increased and Lymphocytes increased
Treatment of Infectious Mononucleosis
Symptomatic & supportive
-Take tylenol & rest
-No vaccine
-Prevent by not kissing, sharing drinks, personal items
What is Myelodysplastic syndrome?
A group of related hematologic disorders characterized by a change in the quantity and quality of bone marrow elements
Who does Myelodysplastic syndrome usually effect?
elderly (65+)
Clinical manifestations of Myelodysplastic syndrome
-Cytopenias (low blood cell count)
-Anemia
-Infection
-Spontaneous bleeding or bruising
Etiology of Myelodysplastic syndrome
Unknown, maybe an environmental trigger
Diagnosis and treatment of Myelodysplastic syndrome
Diagnosis: Laboratory (CBC) & bone marrow biopsy
Treatment: Depends on severity-
-Supportive (Low grade/chronic)
-Granulocyte colony-stimulating factor (G-CSF)
-Erythropoietin (RBC prob)
-Chemo & Bone marrow transplant (severe)
What is Leukemias?
Malignant neoplasms of cells originally derived from a single hematopoietic cell line
aka immature WBCs that are unregulated or undifferentiated
Leukemic cells: (4)
- Are immature & unregulated
- Proliferate in bone marrow
- Circulate in blood
- Infiltrate spleen & lymph nodes
Who is most affected by Leukemia?
Children & adults
How is Leukemia classified?
According to their predominant cell type & whether the condition is acute or chronic
1. Acute Lymphocytic Leukemia (ALL): Most common childhood Leukemia
2. Chronic Lymphocytic Leukemia (CLL): Most common Leukemia in Older adults
3. Acute Myelocytic Leukemia (AML)
4. Chronic Myelocytic Leukemia (CML)
Myelocytic pathway
- Hematopoiesis
Pluripotential stem cell - Myeloid stem cells
- Granulocyte: macrophage stem cells
4a. Granulocyte stem cells
4b. Monocytic stem cells
5a. Neutrophils, Eosinophils, & Basophils
5b. Monocytes & Macrophages
*Immature granulocytes
Lymphocytic pathway
- Hematopoiesis
Pluripotential stem cell - Lymphoid stem cells
- Lymphocytes (T-cells, B-cells, plasma cells)
*immature lymphocytes
Cause of Leukemia
Unknown
Increased exposure to radiation
Pathogenesis of Leukemic cells (4)
- Immature type of WBC
- Capable of increased rate of proliferation// have prolonged life span
- Can’t perform function of mature leukocytes (ineffective phagocytes)
- Interfere with maturation of normal bone marrow cells (including RBC & platelets)
Acute Leukemia
-Sudden, stormy onset
-ALL: Mainly kids with high survival rate
-AML: adults with low survival rate
-S/S related to decreased (mature) WBC, RBC, & plateltes
-Bone pain, bruising, fever, fatigue, infection, kid may refuse to walk
Chronic Leukemia
-More insidious onset
-No sudden pain onset
-May be discovered during routine check up of blood count
-CLL: Mainly older adults with high survival rate
-CML: adults & kids with slightly lower survival rate
Chronic Lymphocytic Leukemia (CLL)
-Relatively mature lymphocytes that are immunologically incompetent
-S/S: fatigue, wt loss, anorexia, infections
Chronic Myelocytic Leukemia (CML)
-Leukocytosis with immature cell types (presents with increased granulocytes count & splenomegaly)
-S/S: fatigue, wt loss, diaphoresis, bleeding, abdominal discomfort
-Age 40-50
Treatment of Leukemia
-Goal: attain remission
-Cytotoxic chemotherapy
-Stem cell transplant
-Risks: Infection, rejection, relapse
What is Malignant Lymphoma? and the 2 types
-Neoplasms of cells derived from lymphoid tissue
-Hodgkins & Nonhodgkins
Hodgkins disease is characterized by
painless, progressive, rubbery enlargement of a single node or group of nodes- usually in neck area
What is the distinctive tumor cell found with Hodgkins disease
Reed-Stenberg cell
(Originate from B-cells in lymph nodes- they grow & spread in predictable manner)
Clinical manifestations of Hodgkins disease
Insidious onset, painless enlarged lymph nodes & other nonspecific symptoms
-fever, night sweats, wt loss, malaise
Treatment of Hodgkins disease
Good treatment due to predication of growth
-Chemotherapy
-Radiation
-Stem cell transplant
Non-Hodgkins disease is characterized by
Painless, superficial lymphadenopathy, extranodal symtoms (get lymph tissue outside of lymph nodes)
Non-Hodgkins disease is most common in ______ & the spread is
older adults
alot less predicable & prognosis is less certain
What makes Non-Hodgkins disease difficult to treat?
majority of pts have widely spread disease at time
Clinical manifestations of Non-Hodgkins disease
Painless lymph node enlargement & non-specific symptoms (fever, night sweats, wt loss)
Treatment of Non-Hodgkins disease
-Chemotherapy
-Radiation
-Refractory cases: stem cell transplants
-Rituximab, ibritumomab tiuextan, tositumomab
What is the typical location of Hodgkins disease
Cervical
What is Multiple Myeloma?
-Cancer of B cells
-Atypical proliferation of one of immunoglobulins “ M protein”: a monoclonal antibody (increased osteoclasts, lead to bone destruction)
-Unable to maintain humoral immunity (antibody secretion)
Multiple Myeloma is characterized by
-bone pain/fractures, also symptoms r/t impaired production of RBC & WBC
Who is most at risk for Multiple Myeloma?
African American Men Age 65
Clinical manifestations of Multiple Myeloma
Slow and insidious, skeletal pain, hypercalcemia
Diagnostics of Multiple Myeloma
-Monoclonal antibody protein in serum & urine
-Pancytopenia (Every WBC & RBC decreased)
-Hypercalcemia
-Bence Jones protein in urine
-Elevated serum creatinine (decreased kidney function)
-X-rays osteolytic lesions
