Module 2.9 Disorders of WBC's

Question 1

REVIEW STEM CELL LINES

Answer 1

ITS ON ONE OF THE FIRST SLIDES

Question 2

Leukopenia

Answer 2

Decreased # of TOTAL lympohocytes in blood

Question 3

Neutropenia

Answer 3

specifically deficient in neutrophils

Question 4

Aplastic Anemia

Answer 4

depletion of all myeloid and lymphoid cells

Question 5

neonatal neutropenia

Answer 5

consider this when umbilical cord has not fallen off in two weeks

Question 6

Kostmann Syndrome

Answer 6

Group of diseases resulting in congenital severe NEUTROPENIA

Manifests in infancy with life threatening bacterial infections

Question 7

Acquired neutropenia causes

Answer 7

Autoimmune (primary or secondary)
Drug-related
Radiation to bone marrow
Hematologic malignancies

Question 8

Drugs that can cause neutropenia

Answer 8

Penicillin
propylthiouracil
aminopyrine
clozapine
chemo

Question 9

Neutropenia after viral infections

Answer 9

usually transient and resolves within 2 weeks.

Question 10

S/S of neutropenia

Answer 10

Initially same as bacterial or fungal infections.
Malaise, chills, fever, weakness

But with LOW WBC.

Question 11

Infectious Mononucleosis is caused by what virus

Answer 11

Epstein-Barr

Question 12

S/S of Mono

Answer 12

Fever
generalized Lymphadenopathy
Atypical lymphocytes in blood
Hepatitis
Hepatosplenomegaly

Question 13

Lymphomas come from what cell line

Answer 13

lymphoid

Question 14

Leukemia come from what cell line

Answer 14

either

Question 15

Plasma cell Dyscrasias come from what cell line

Answer 15

Lymphoid

Question 16

Non-hodgkin Lymphoma categories

Answer 16

Low grade lymphoma - B-Cell tumors

Intermediate Grade Tumors - B Cell and some T Cell lymphomas

High-grade Lymphomas - Immunoblastic (Bcell), Lymphoblastic (T-Cell) Burkitt and Non-Burkitt lymphomas

Question 17

Hodgkin Disease

Answer 17

Presence of Reed-Sternberg (looks like OWL eyes) Cell is the landmark feature

Question 18

Stage A hodgkin disease

Answer 18

Lack constitutional symptoms of cancer

Question 19

Stage B Hodgkin disease

Answer 19

40% of pt’s diagnosed at this stage.

Significant weight loss, fever, pruritus, night sweats.

Question 20

Advanced stage hodgkin disease

Answer 20

Fatigue, anemia

multiple organ system involvement.

Question 21

Where do hodgkin lymphomas originate?

Answer 21

Single node or chain of nodes

Question 22

Where do non-hodgkin lymphomas originate?

Answer 22

Extranodal sites, then spread to contiguous nodes.

May be viral in origin (epstein-barr or HTLV-1 or human T Lymphocyte virus)

Question 23

Characteristics of Hodgkin lymphoma presentation

Answer 23

Usually above diaphragm

Single Node enlargement. Painless

Question 24

Characteristics of Non-Hodgkin lymphoma presentation

Answer 24

Involves nodes below diaphragm (retroperitoneum, pelvis, mesentery)

Higher freq. of infections of all types

Question 25

WATCH RETUXIMAM VIDEO

Answer 25

WATCH RETUXIMAB VIDEO

Question 26

Treatments specific to Non-hodgkin Lymphoma

Answer 26

Adjuvant radiation therapy

Retuximab (monoclonal antibodies)

Question 27

Leukemias originate from

Answer 27

either cell line

Question 28

Classifications of Leukemias

Answer 28

Acute or Chronic Lymphocytic Leukemia (ALL or CLL)

Acute or Chronic Myologenous leukemia (ALM or CLM)

Question 29

Lymphocytic anemias involve:

Answer 29

immature lymphocytes and theri progenitors in BM, Spleen, LN’s, CNS, etc.

Question 30

Myelogenous Leukemias involve

Answer 30

pluripotent myeloid stem cells in BM

Interfere with maturation of all blood cells

Question 31

Warning signs of acute leukemias

Answer 31

Datigue
Pallor
Weight Loss
Repeated Infections

Question 32

Complications of acute leukemias

Answer 32

Leukostasis - plugging vessels!
Tumor Lysis syndrome
Hyperuricemia
Blast crisis

Question 33

Philedelphia chromosome

Answer 33

1st identification of an abnormal chromosome in cancer patients.

Question 34

Chronic Leukemia characteristics

Answer 34

cells are more well differentiated and not as aggressive.

Question 35

Criteria for remission in ALL or AML

Answer 35

Less than 5% blasts in bone marrow
Normal blood counts
Absence of cytogenetic abnormalities
Return to pre-illness performance status.

Question 36

Stages of treatment for acute leukemias

Answer 36

Induction - elicits remission
Intensification - Further reduces leukemic cells
Maintenance - maintains remission.

Question 37

Tumor Lysis Syndrome

Answer 37

major electrolyte disturbances caused by death of many cancer cells. (hyperkalemia)

Question 38

Multiple Myeloma

Answer 38

Plasma Cell Dyscrasia

Huge spike in one line of Gamma globulins.

Question 39

S/S of Multiple Myeloma

Answer 39

Affects bone and BM
Proliferation of osteoclasts - bone reabsorption/destruction.
Pathologic fractures
Hypercalcemia
Proteinuria - BENCE JONES PROTEINS IN URINE