Exam 3 - Leukemia and other Disorders

Question 1

What is a neoplastic disorder involving WBC and no solid tumor?

Answer 1

Leukemia

Question 2

Is idiopathic in children

Answer 2

Leukemia

Question 3

Leukemia does what to the production of other normal cell leading to anemia

Answer 3

Suppresses production

Question 4

In leukemia, the nonfunctional cells that multiply uncontrollably in the bone marrow do what?

Answer 4

Cause pain and suppress the production of other normal cells leading to anemia

Question 5

Etiology: previous chemo, exposure to radiation, some viruses, chromosomal anomaly, and chemicals

Answer 5

Leukemia in ADULTS

Question 6

Large quantities of WBC are released into the general circulation and then&raquo_space;>?

Answer 6

infiltrate lymph nodes, spleen, liver, brain, and other organs

Question 7

Acute leukemia:

*high proportion of very immature nonfunctional cells (blast cells) in the bone marrow and peripheral circulation

*onset usually is abrupt

*marked signs and complications

Answer 7

Chronic leukemia:

*higher proportion of mature cells (although they may have reduced function)

*insidious onset and MILD sign

*better prognosis than with acute

Question 8

Leukemia S/S

Answer 8

*multiple infections (often unresponsive to
treatment
*severe hemorrhage (brain or digestive
tract)
*anemia
*bone pain (severe and steady even at rest)
*weight loss, fatigue (hypermetabolism;
keep an eye on H&H)
*lymph nodes, spleen, liver are often
enlarged and may cause discomfort
*fever (hypermetabolism or infection)

Question 9

Leukemia Diagnosis:

Answer 9

Peripheral blood smears - show immature leukocytes and altered numbers of WBCs

Anemia, thrombocytopenia

Bone marrow biopsy - confirms the diagnosis

Question 10

Leukemia management:

Answer 10

Chemotherapy
Biologic therapy (chronic forms)
Blood product replacement
Adequate hydration and nutrition
Bone marrow transplant

Question 11

More abrupt in children

Answer 11

Acute leukemia

Question 12

gradual onset

Answer 12

chronic leukemia

Question 13

Functions of the lymphatic system

Answer 13

*return excess interstitial fluid and protein to the blood
*filter and destroy unwanted material from the body fluids
*initiate an immune response
*interacts with all other body systems

Question 14

similar in structure to veins, but thinner walls, more valves, contain nodes at certain intervals

More permeable allowing passage of larger substances and protein

Answer 14

Lymphatic vessels

Question 15

Tonsils-protect against bacterial infection in the area of the opening between the nasal and oral cavities

Answer 15

Lymphoid Tissue

Question 16

Containing many lymphocytes and macrophages
Dispersed when there is infection
Situated along all lymphatic and blood vessels
Help to recognize pathogens

Answer 16

Lymph Nodes

Question 17

On the left side of the body
Defense, hematopoiesis, and RBC and platelet destruction, as well as serving as a reservoir for blood

Answer 17

SPLEEN

Question 18

Ruptured spleen

Answer 18

massive bleed

Question 19

overloaded spleen

Answer 19

high infection

Question 20

Thymus gland

Answer 20

Most active at until birth
Final site of lymphocyte development before birth
Secretes hormones after birth that enable lymphocytes to develop into mature T cells (attack foreign cells)

Question 21

clear, watery, isotonic fluid that is circulated in the lymphatic vessels

Answer 21

Lymph

Question 22

fluid that is not absorbed by the cells or the capillaries tend to accumulate in the interstitial space (swelling

Answer 22

Interstitial fluid

Question 23

As interstitial fluid builds it will drain into the lymphatic vessels and become _________?

Answer 23

Lymph

Question 24

enlarged lymph nodes due to inflammation or infection

Answer 24

Lymphadenopathy

Question 25

Diagnosis for Lymphadenopathy

Answer 25

Exam Ultrasound Fine-needle biopsy PET-CT (light up other lymph nodes to see what's up)

Question 26

Treatment for Lymphadenopathy

Answer 26

treat the cause

Question 27

*inflammation or infection of lymph nodes *common signs of another disease (bacterial, viral, malignancies) *manifests as swollen lymph nodes >an increase in size and extent over time usually indicates cancer *generalized lymphadenopathy >systemic symptoms instead of localized painful swelling

Answer 27

Lymphadenopathy

Question 28

Malignant neoplasms involving lymphocyte proliferation in the lymph nodes. Specific causes of ___________ have not been identified, but there is a higher incidence in adults who received radiation treatments during childhood

Answer 28

Lymphomas

Question 29

Usually affects adults age 20-40 Most often starts in the lymph nodes in the upper part of the body

Answer 29

Hodgkin Lymphoma

Question 30

Patho-initially a single group of lymph node lower extranodal involvement that non-Hodgkin Orderly contiguous spread (works its way down)

Answer 30

Hodgkin Lymphoma

Question 31

T-lymphocytes defective and the lymphocyte count is decreased-increased R/F recurrent infections T lymphocytes active in immune response increased risk of infection

Answer 31

Hodgkin Leukemia

Question 32

DX marker-Reed Sternberg cells (no cells if no _____________) 1st sign enlarged lymph nodes, often cervical, that is painless and nontender

Answer 32

Hodgkin Lymphoma

Question 33

S/S: Splenomegaly other enlarged lymph nodes general cancer signs (fatigue, anorexia, weight loss) Pruritis (itchy) frequent infections

Answer 33

Hodgkin Lymphoma

Question 33

Ann Arbor Staging System (how we identify what is going on) Treatment: radiation chemotherapy surgery

Answer 33

Hodgkin Lymphoma

Question 34

Usually seen in adults over 60 seeing more frequently in patients with HIV Tends to be more widespread that Hodgkin Lymphoma more lymph nodes involved extranodal involvement common No Reed-Sternberg Cells! Most cases involve B lymphocytes Risk factor: history of chemo; cancer unorganized widespread metastasis

Answer 34

Non-Hodgkin Lymphoma

Question 35

S/S: 1st symptom-enlarged painless lymph node Can be more difficult to treat due to widespread metastases and extranodal involvement Follow Ann Arbor Staging

Answer 35

Non-Hodgkin Lymphoma

Question 36

Multiple Myeloma

Answer 36

Malignancy involving the PLASMA cells (mature B lymphocytes involved in production of antibodies) Increased number of malignant plasma cells replace the bone marrow and erode the bone Blood cell and antibody production is impaired

Question 37

Multiple tumors in bone destruction develop in the vertebrae, ribs, pelvis, and skull Pathologic or spontaneous fractured Hypercalemia occur as bone is destroyed Tumor cells can spread throughout the body-lymph nodes and organs

Answer 37

Multiple Myeloma

Question 38

Insidious onset, usually well advanced by the time it is discovered Manifestations: frequent infections (antibody involvement) pain related to bone involvement, present at rest and with activity pathologic fractures anemia and bleeding tendencies (blood cell production impaired) proteinuria and kidney failure

Answer 38

Multiple Myeloma

Question 39

Management: Chemotherapy Supportive care analgesic for bone pain renal support blood transfusions

Answer 39

Multiple Myeloma

Question 40

Tissues in the extremities SWELL due to obstruction of the lymphatic vessels and accumulation of lymph

Answer 40

Lymphedema

Question 41

Etiology: Primary - congenital Secondary to cancer, tumor, radiation therapy, damage during surgery, removal of lymph nodes

Answer 41

Lymphedema

Question 42

Manifestations: *swelling, initially soft, but progresses to firm, painful and unresponsive to treatment *increased risk of frequent infections

Answer 42

Lymphedema

Question 43

Management: Bed rest, massage, ELEVATION Diuretics Surgical options when severe

Answer 43

Lymphedema

Question 44

Form of lymphedema resulting from infestation and blockage of lymph vessels by a parasitic worm (filaria) Extreme swelling can be so significant that the extremity looks like an elephant's leg

Answer 44

Elephantiasis

Question 45

S/S: thickening of subcutaneous tissue, frequent infections, skin ulcerations, fever Management: skin care and elevation antiparasitic drugs surgery to place shunt for fluid

Answer 45

Elephantiasis

Question 46

Lymphoproliferative disorder (not cancer)-overgrowth of lymphoid tissue Associated with higher risk of Lymphoma

Answer 46

Castleman Disease

Question 47

______________-affects one lymph node s/s: depend on location-large lump, difficulty breathing or eating, weight loss/poor appetite, cough Tx-remove the node if possible; if not, steroids or radiation to shrink/destroy node

Answer 47

Unicentric - Castleman Disease

Question 48

____________-affects multiple lymph nodes>>decreased immune response Tx- more difficult, too many nodes to remove; meds-steroids, anticancer, immunomodulating

Answer 48

Multicentric - Castleman Disease

Question 49

LEUKEMIA DIAGNOSIS AND MANAGEMENT

Answer 49

Question 50

LEUKEMIA SIGNS & SYMPTOMS

Answer 50