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Pathophysiology - Christi > Exam 3 - Leukemia and other Disorders > Flashcards

Exam 3 - Leukemia and other Disorders Flashcards

1
Q

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

A

Leukemia

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2
Q

Is idiopathic in children

A

Leukemia

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3
Q

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

A

Suppresses production

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4
Q

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

A

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

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5
Q

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

A

Leukemia in ADULTS

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6
Q

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

A

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

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7
Q

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

A

Chronic leukemia:

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

*insidious onset and MILD sign

*better prognosis than with acute

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8
Q

Leukemia S/S

A

*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)

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9
Q

Leukemia Diagnosis:

A

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

Anemia, thrombocytopenia

Bone marrow biopsy - confirms the diagnosis

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10
Q

Leukemia management:

A

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

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11
Q

More abrupt in children

A

Acute leukemia

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12
Q

gradual onset

A

chronic leukemia

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13
Q

Functions of the lymphatic system

A

*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

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14
Q

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

More permeable allowing passage of larger substances and protein

A

Lymphatic vessels

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15
Q

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

A

Lymphoid Tissue

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16
Q

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

A

Lymph Nodes

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17
Q

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

A

SPLEEN

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18
Q

Ruptured spleen

A

massive bleed

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19
Q

overloaded spleen

A

high infection

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20
Q

Thymus gland

A

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)

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21
Q

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

A

Lymph

22
Q

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

A

Interstitial fluid

23
Q

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

A

Lymph

24
Q

enlarged lymph nodes due to inflammation or infection

A

Lymphadenopathy

25
Q

Diagnosis for Lymphadenopathy

A

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

26
Q

Treatment for Lymphadenopathy

A

treat the cause

27
Q

*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

A

Lymphadenopathy

28
Q

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

A

Lymphomas

29
Q

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

A

Hodgkin Lymphoma

30
Q

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

A

Hodgkin Lymphoma

31
Q

T-lymphocytes defective and the lymphocyte count is decreased-increased R/F recurrent infections

T lymphocytes active in immune response
increased risk of infection

A

Hodgkin Leukemia

32
Q

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

A

Hodgkin Lymphoma

33
Q

S/S:

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

A

Hodgkin Lymphoma

33
Q

Ann Arbor Staging System (how we identify what is going on)

Treatment:
radiation
chemotherapy
surgery

A

Hodgkin Lymphoma

34
Q

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

A

Non-Hodgkin Lymphoma

35
Q

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

A

Non-Hodgkin Lymphoma

36
Q

Multiple Myeloma

A

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

37
Q

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

A

Multiple Myeloma

38
Q

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

A

Multiple Myeloma

39
Q

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

A

Multiple Myeloma

40
Q

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

A

Lymphedema

41
Q

Etiology:

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

A

Lymphedema

42
Q

Manifestations:

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

A

Lymphedema

43
Q

Management:

Bed rest, massage, ELEVATION
Diuretics
Surgical options when severe

A

Lymphedema

44
Q

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

A

Elephantiasis

45
Q

S/S:

thickening of subcutaneous tissue, frequent infections, skin ulcerations, fever

Management:
skin care and elevation
antiparasitic drugs
surgery to place shunt for fluid

A

Elephantiasis

46
Q

Lymphoproliferative disorder (not cancer)-overgrowth of lymphoid tissue

Associated with higher risk of Lymphoma

A

Castleman Disease

47
Q

______________-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

A

Unicentric - Castleman Disease

48
Q

____________-affects multiple lymph nodes»decreased immune response

Tx- more difficult, too many nodes to remove; meds-steroids, anticancer, immunomodulating

A

Multicentric - Castleman Disease

49
Q

LEUKEMIA DIAGNOSIS AND MANAGEMENT

A
50
Q

LEUKEMIA SIGNS & SYMPTOMS

A

Pathophysiology - Christi (4 decks)

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