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Pathology > Hematology Lymphoid > Flashcards

Hematology Lymphoid Flashcards

1
Q

Normal WBC count

A

5-10k

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2
Q

Neutropenia can be due to (2)

A

Drug toxicity

Severe infection

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3
Q

Neutropenia tx

A

GMCSF

GCSF

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4
Q

Lymphopenia causes (4)

A 
Immunodef (DiGeorge Syndrome failure of thymus form)
High cortisol (apoptosis in lympho)
Autoimmune destruction (SLE) 
Whole body radiation (lymphocyte)
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5
Q

Most sensitive cell to radiation

A

Lymphocyte

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6
Q

Neutrophilic leukocytosis causes (3)

A

Bacterial i
Tissue necrosis
High cortisol

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7
Q

Inc in immature precursor neutrophils with dec FC receptors that recognize IgG

A

Left shift

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8
Q

Marker for dec FC receptor

A

CD16

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9
Q

Disrupts adhesion of neutrophils in marginated pool

A

cortisol

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10
Q

Monocytosis causes (2)

A

Chronic inflammation

Maligancy

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11
Q

Eosinophilia causes (3)

A

Allergic reactions
Parasitic infection
Hodgkin lymphoma

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12
Q

Eosinophilia occurs in hodgkins due to

A

inc IL5

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13
Q

Basophilia occurs in

A

CML

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14
Q

Lymphocytic leukocytosis (2)

A

Viral

Bordetella pertussis

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15
Q

B pertussis produces prevents entry of lymphocytes to LN

A

Lymphocytosis promoting factor

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16
Q

EBV infection resulting in lymphocytic leukocytosis comprised of reactive CD8 cells

A

Infectious mononucleosis

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17
Q

EBV transmitted through

A

saliva

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18
Q

EBV primarily affects

A

Oropharynx
Liver
B cells

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19
Q

Generalized LAD
Splenomegaly periarterual lymph sheath
High white count of atypical lymphocytes by CD8 cell response

A

Infectious mononucleosis

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20
Q

EBV infection results in hyperplasia of

A

paracortex LAD

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21
Q

Which area of white pulp in spleen is affected by EBV

A

periarterial lymphatic sheath blue in histology

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22
Q

Atypical lymphocytes (2)

A

Have larger nucleus
Abundant blue cytoplasm
Looks like monocyte

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23
Q

Screening for IM

A

Monospot test

Detects IgM heterophile (affinity to bind RBC fr other animal) antibodies
Turns positive in 1 week after infection
Negative suggets CMV or early

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24
Q

Definitive diagnostic for IM

A

EBV viral capsid antigen

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25
Q

IM complications (3)

A

Inc risk for splenic rupture
Rash if PCN
Dormancy of virus in B cell

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26
Q

EBV inc risk for

A

Lymphoma in AIDS

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27
Q

Neoplastic proliferation of mature lymphocytes

A

Chronic leukemia

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28
Q

High WBC count

Insidious onset in older adults

A

Chronic leukemia

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29
Q

Neoplastic proliferation of B Cells

A

Chronic lymphocytic leukemia

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30
Q

B cells express (2) in CLL

A

CD5 and CD20

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31
Q

Inc lymphocytes and SMUDGE cells on blood smear

A

CLL

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32
Q

Splattered cell in CLL

A

Smudge cell

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33
Q

Generalized LAD

with small lymphocytic lymphoma (mass)

A

CLL

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34
Q

CLL Complications (3)

A

Hypogammaglobulinemia (loss of antibody production)
Autoimmune hemolytic
Transformation to diffuse large B cell lymphoma

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35
Q

MCC of death in CLL

A

Infection

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36
Q

Neoplastic proliferation of mature B cells
Hairy cytoplasmic processes
+ TRAP

A

Hairy Cell Leukemia

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37
Q

HCL staining

A

Tartrate resistant acid phosphatase

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38
Q

Splenomegaly red pulp TRAPED in
Dry tap with bm aspiration
LAD ABSENT

A

Hairy Cell Leukemia

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39
Q

HCL responds excellently to

A

2 CDA

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40
Q 
Adenosine deaminase (purine degradation pathway) inhibitor 
Adenosine accumulates to toxic levels in neoplastic B cells
A

2 CDA

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41
Q

Neoplastic proliferation of mature CD4 T cell

A

Acute T Cell Leukemia Lymphoma

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42
Q

ATLL associated with

A

HTLV1 in Japan and carribean (Human T cell leukemia virus 1)

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43
Q

Rash
Generalized LAD with HSM
Lytic bone lesions with hypercalcemia

A

ATLL

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44
Q

Neoplastic proliferation of mature CD4 T Cell

A

Mycosis fungoides

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45
Q

Aggregation of T crll in epidermis is called

A

Pautrier microabscess

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46
Q

CD4+ T cells like to go to

forming

A

skin

rash, plaque, nodule

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47
Q

Neoplastic CD4 T cells that spread to blood

Characteristic lymphocyte with cerebriform nuclei

A

Sezary syndrome

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48
Q

Pathognomonic of Sezary syndrome

A

Lymphocyte with cerebriform nuclei

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49
Q

Accumulation of precursors of myeloid lineage

A

Acute myelogenous leukemia

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50
Q

Accumulation of immature lymphoid lineage

A

ALL

51
Q

Accumulation of mature lymphoid cells

A

CL

52
Q

Accumulation of mature myeloid cells

A

Myeloproliferative disorders

53
Q

Overproduction of rbcs

A

Polycythemia vera

54
Q

Disease of late adulthood
High WBC count
Hypercellular marrow
Cells of all lineages inc

A

Myeloproliferative disorder

55
Q

Myeloproliferative disorder complications (3)

A

1 hyperuricemia gout
2 marrow fibrosis
3 acute leukemia

56
Q

Neoplastic proliferation of mature myeloid cells esp basophils

A

Chronic Myeloid Leukemia

57
Q

CML translocation

A

t 9;22 BCRL ABL fusion with inc tyrosine kinase activity leading to overgrowth

58
Q

Tx for CML

A

Imatinib

blocks tk activity

59
Q

Phases of CML (3)

A

Chronic phase enlarged spleen suggesting acceleration worsening
Acceleration phase
Transformation phase - Acute Leukemia either AML or ALL bec mutation is in HSC

60
Q

PCV tx (2)

A

Phlebotomy

Hydroxyurea

61
Q

Tumor that produces EPO ectopically

A

Renal cell carcinoma

62
Q

Proliferation of mature myeloid esp platelets

Associated with JAK2 kinase mutation

A

Essential thrombocythemia

63
Q

IDA can also have inc

A

Platelet

Differentiate from essential thrombocythemia

64
Q

Inc risk of bleeding/thrombosis
Rarely progresses to marrow fibrosis or acute leukemia
No significant risk for hyperuricemia or gout

A

Essential thrombocythemia

65
Q

Neoplastic proliferation of mature myeloid cells megakaryocytes
Jak2 mutation

A

Myelofibrosis

66
Q

Marrow fibrosis occurs in myelofibrosis because of

A

PDGF

67
Q

Splenomegaly
Leukoerythroblastic smear (reticulin gates prohibit immature cells from exiting to blood, does not occur in spleen)
Inc infection, thrombosis bleeding

A

Myelofibrosis

68
Q

Pathognomonic of myelofibrosis

A

tear drop cell

69
Q

Painful LAD

A

acute

70
Q

painless LAD

A

chronic, metastatic, lymphoma

71
Q

Rheumatoid arthritis and HIV

A

follicle enlargement

72
Q

Viral infection

A

Paracortex englargement

73
Q

LN draining tissue with cancer

A

Sinus histoocytes

74
Q

Neoplastic prolif of lymphoid cells that form a mass

Arise in LN and extra nodal tissue

A

Lymhpoma

75
Q

60% of lymphomas

A

NHL

76
Q

40% of Lymphoma

A

HL

77
Q

Small neoplastic B cells (4)

A

Follicular
Mantle
Marginal
Small lymphocytic lymphoma

78
Q

Neoplastic proliferation of small B cells CD20 making follicle like nodules
Presents in late adulthood painless LAD

A

Follicular lymphoma

79
Q

Follicular lymphoma is driven by

A

t 14;18

BCL2 on ch18 translocates to Ig heavy chain locus on ch14

Overexpression of bcl2 inhibiting apoptosis

80
Q

Tx for Follicular lymphoma

A

Rituximab antiCD20

Chemotherapy

81
Q

Follicular lymphoma complication (2)

A

Progress to diffuse large B cell lymphoma

Enlarging lymph node

82
Q

Follicular lymphoma is differentiated from hyperplasia by (4)

A

1 disruption of LN architecture
2 lack of tingible body macrophage in germinal center
3 monoclonality (ratio of kappa to lambda light chain disruptive 20:1

83
Q

Neoplastic proliferation of small b cells that expand mantle zone
Late adulthood
painless LAD
expands region adjacent to follicle

A

Mantle Cell Lymphoma

84
Q

Mantle Cell Lymphoma is driven by

A

t 11;14

Cyclin D1 (helps cell go from G1 to S) phosphorylation on ch 11 translocates to Ig heavy chain ch 14

85
Q

Neoplastic small B cells that expand marginal zone

A

Marginal zone lymphoma

86
Q

Mantle B cell lymphoma is associated with (3)

A

Chronic inflamm states
Hashimoto, Sjogren’s, H pylori
Post germinal B cells form Marginal zone

87
Q

Marginal zone lymphoma in mucosal site

A

MALToma

88
Q

Neoplastic intermediate-sized B cells CD20

Associated with EBV

A

Burkitt lymphoma

89
Q

Burkitt lymphoma (2)

A

African form jaw

Sporadic form abdomen!

90
Q

Burkitt lymphoma is driven by

A

t 8;14 translocation of c-myc (nuclear regulator activating multiple genes resulting to a lot of growth) to Ig heavy chain locus on ch14

91
Q

Burkitt has high mitotic rate pathognomonic of

A

Starry sky on histology

92
Q

Neoplastic large B cells that grow diffusely in sheet

A

Diffuse large b cell lymphoma

93
Q

Most common form of non hodgkin lymphoma

Aggressive

A

DLBCL

94
Q

DLBCL arise (2)

A

sporadically

transformation of follicular lymphoma

95
Q

Pathognomonic of Hodgkin

A

Reed sternberg cell

96
Q

Neoplastic proliferation of reed sternberg cell which are large b cell with multilobed nuclei and prominent nucleoli

CD15 CD30

A

Hodgkin lymphoma

97
Q

Reed sternberg cell

A

Owl eye nucleus

98
Q

RS cells secrete

A

Cytokine

Hence with B symptoms
Attract lympho mac plasma eo (mass formation)
Fibrosis

99
Q

Basis of subtype of Hodgkin

A

type of reactive cellularity

100
Q

70% of cases of hodgkin

A

Nodular sclerosis

101
Q

Hodgkin variants (4)

A

Nodular sclerosis
Lymphocyte rich
Mixed
Lymphocyte depleted

102
Q

Enlarging cervical neck or mediastinal LN in young adult female

A

Nodular sclerosis

103
Q

Nodular sclerosis Hodgkin biopsy

A

Broad pink bands of fibrosis dividing lymph nides with RS cells in lake-like spaces lacunar cell

104
Q

Hodgkin with best prognosis

A

Lymphocyte rich

105
Q

Hodgkin with worst prognosis in elderly and HIV+

A

Lymphocyte-depleted

106
Q

Abundant in the mixed cellularity type

A

eosinophil by il-5

107
Q

Malignant proliferation of plasma cell in bm

A

Multiple myeloma

108
Q

Most common primary malignancy of bone driven by

A

Multiple myeloma

IL 6

109
Q

Pathognomonic of MM

A

Punched out lesions on xray

Bec of activation of RANK on osteoclast

Bone pain with hypercalcemia

110
Q

Elevated serum protein Immuneglobin
Sharp spike M spike in gamma region of serum electrophoresis
Indicating monoclonal immunoglobulin (IgG or IgA)

A

Multiple myeloma

111
Q

Multiple myeloma inc risk of infection bec

A

(1) lack antigenic diversity
Most common cause of death
2 dec charge in RBC - roleaux formation

112
Q

Circulation and overproduction of free light chain in serum depositing in tissue

A

Primary AL amyloidosis

113
Q

Free light chain excreted in urine

A

Bence Jones protein

Deposition in kidney leads to risk of myeloma kidney

114
Q 
Inc serum protein M spike on SPEP
No lytic lesion
No hypercalcemia
No amyloid
No bence jones protein
A

Monoclonal Gammopathy of Undetermined Significance

115
Q

MGUS is common in

1% develops

A

elderly

Multiple myeloma

116
Q

B cell lymphoma with monoclonal IgM production

A

Waldenstrom Macroglobulinemia

117
Q 
LAD
no lytic bones
Inc serum protein M spike IgM
Visual and neuro deficits (inc viscosity)
Bleeding
A

Waldenstrom Macroglobulinemia

118
Q

WM complications tx

A

Plasmapharesis

119
Q

Specialized dendritic cells in skin
From bone marrow monocytes
Present antigen to naive T cell

A

Langerhan cells

120
Q

Neoplastic proliferation of LH crlls

A

Langerhan cell histiocytosis

121
Q

LH pathognomonic for (2)

A

Birbeck tennis racket granules on em

CD1a+ S100+ IHC

122
Q

Malignant proliferation of LH cell
Skin rash and cystic skeletal defect in an infant
Multiple organ
Rapidly fatal

A

Letterer Siwe disease

123
Q

Benign proliferation of LH cell in bone
Pathologic fracture no skin involvement
Langerhan cells with mixed inflamm and eosinophilia

A

Eosinophilia granuloma

124
Q

Malignant proliferation of LH cell
Scalp, rash, lytic skull, diabetes insipidus, exopthalmos
child

A

Hand-Schuller-Christian

Pathology (24 decks)

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