Hematology 2 Flashcards
increased WBCs
leukocytosis
what is leukocytosis reactive to? how does it react?
toxic changes
shifts to the left (immaturity)
what would we expect to see in WBCs in a malignant state?
more immature and abnormal cells
decreased WBCs
leukopenia
what are 4 causes of leukopenia? (MOAD)
myelodysplastic syndrome (MDS)
overwhelming infection
aplastic anemia
drugs
what lab determines the concentration of each WBC type?
leukocyte differential
what should we suspect if we see increased lymphocytes and reactive forms?
viral infection
what should we suspect if we see increased PMNs (neutrophils)? (3)
bacterial infection
inflammation
stress
what are 2 key features of a benign process?
increased WBC
shift to the left (immature)
what are 3 reactive qualitative changes seen in a benign process?
toxic granules
vacuoles
dohle bodies
an increase in WBCs once our problem is fixed; reversible
leukemoid reaction
what process can mimic leukemia?
leukemoid reaction
deeply staining blue-black, large granules in the cytoplasm of neutrophils
toxic granulation
what are toxic granulations associated with? (3)
acute bacterial infection
burns
drug poisoning
small round or oval, clear/light blue staining areas in the neutrophil cytoplasm, that are RNA remnants of earlier stage
dohle body
what are dohle bodies associated with? (4) BITP
burns
infections
toxic exposure
pregnancy
reactive lymphocytes that are smaller in size, have an indented to lobulated nucleus, and are cytoplasmic granules
type I
the most common type of reactive lymphocytes that are darker at the periphery and molds around RBCs
type II
reactive lymphocytes that are called “immunoblasts”, look like fine-coarse chromatin, have a nucleoli, and a deeply basophilic cytoplasm
type III
large cells with abundant blue cytoplasm and lighter staining chromatin
reactive, atypical, or variant lymphocytes
what test causes enlarged lymph nodes and tonsils to have a purple/black and furry discoloration with white exudate?
monospot
what are 4 key features of a malignant process?
WBC increased (usually)
shift to the left
+ blasts
normal, inc., or dec. PLTs
what is due to a mutation in proto-oncogenes that become oncogenes?
neoplasms
oncogenes code for proteins that control the cell’s: (4)
growth
proliferation
differentiation
apoptosis
in a neoplasm, why do all WBCs have a similar morphology?
the cell is being replicated over and over again
what blast count is necessary for an acute leukemia diagnosis?
> 20%
what are the 3 criteria for the WHO classification of hematopoietic neoplasms?
percent of blasts
degree of cell maturation
presence and degree of dysplasia
which classification of neoplasms has more immature myeloblasts?
myeloid
which classification of neoplasms has more immature lymphoblasts?
lymphoid
what 3 things determine cell lineage and stage of maturation?
morphology
cytochemistry
immunophenotype (flow cytometry)
the microanatomical location of chemical products in the cell
cytochemistry
measures the antibodies that are present on the cell surface
flow cytometry
what 2 things determine cell subgroup?
cytogenetics
molecular genetics
the study of tissue, blood, or bone marrow - looking at cells closely via manual imaging through a microscope
cytogenetics
gives us the structure and function of a cell
molecular genetics
neoplasm of the bone marrow in which the stem cell is abnormal
myeloproliferative neoplasm (MPN)
what is the blast percentage in myeloproliferative neoplasms?
less than 20%
what is the most well known myeloproliferative neoplasm?
CML - chronic myelogenous leukemia
genetic mutation that results in abnormal proliferation of immature cells and a lack of cell maturation, leading to an increase in blasts (over 20%)
acute leukemia
one or more peripheral blood cytopenia with prominent maturation abnormalities
myelodysplastic syndrome (MDS)
what can myelodysplastic syndrome lead to?
acute leukemia
what percentage of blasts are present in MDS?
less than 20%
lymphoma that occurs in young adults and presents with reed-sternberg tumor cells; treatable and often cured
hodgkins lymphoma
where does hodgkins lymphoma usually arise?
cervical lymph nodes
aggressive lymphoma that responsive to treatment if spreading quickly, or less responsive if slow growing and indolent
non-hodgkins lymphoma
where does non-hodgkins lymphoma arise?
lymph nodes anywhere in the body
leukemia primarily involves what?
bone marrow
lymphoma primarily involves what?
lymph nodes
what does a B cell develop into when it encounters an antigen?
plasma cell
what is a plasma cell that becomes cancerous and grows out of control called?
multiple myeloma
what abnormal protein/antibody do abnormal plasma cells make?
monoclonal immunoglobin (protein); M-protein
what do malignant plasma cells stimulate, resulting in weak bones?
osteoclasts
