October 6, 2015 - Reactive Lymphocytosis Flashcards

1
Q

Reactive Lymphocytosis

A

A polyclonal proliferation of T-cells, almost always due to infection. The absolute lymphocyte count is in excess of 4x109 / L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lymphocyte Populations in the Blood

A

T-cells (CD3+) is around 75%

B-cells (CD20+) is around 15%

NK-cells (CD56+) is around 5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Relative Proportion of T-Cell Subtypes

A

Helper T-cells (CD4+) is around 70%

Cytotoxic T-cells (CD8+) is around 30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Reactive Lymphocytosis Presentation

A

Classic presentation is symptoms similar to that of mono.

  • Fever, chills, night sweats
  • Cough (non-productive)
  • Headache and muscle aches
  • General malaise and loss of appetite
  • Photophobia
  • Ras
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Reactive Lymphocytosis on PE

A

The patient may have…

  • Pharyngitis
  • Meningismus
  • Rash
  • Jaundice
  • Lymphadenopathy (tender)
  • Hepatomegaly / splenomegaly
  • SOB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

DDx of Reactive Lymphocytosis

A

EBV

CMV

Rubella

Mumps

Pertussis (whooping cough)

Infectious hepatitis

HIV seroconversion

Also could be drug-related, stress, or post-splenectomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mononucleosis Presentation

A

Fever

Tender lymph nodes

Fatigue (often long duration)

May have palpable splenomegaly

May have hepatitis

Typical age is the teens/early 20’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Reactive Lymphocytosis and Neoplasism

A

You must rule out a neoplastic cause.

This can often be done by gathering a thorough history, performing an in-depth physical exam, and potentially ordering labwork.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pertussis Presentation

A

Lengthy respiratory infection around 6 weeks

Gram negative bacillus

Rhinorrhea, congestion, sneezing, and a hacking cough

Leukocytosis (15-100)

Normal, small-appearing lymphocytes on PBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Rubella Presentation

A

Congenital rubella is the most feared complication where virtually all organs are involved, along with permanent motor damage and mental retardation.

Lymphadenopathy, maculopapular rash, and fever.

Can culture the virus and detect antibodies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly