Review week 2 Flashcards
What commonly activate lymphocytes?
EBV
HIV
Any other-viral URTI e.g. RSV, influenza etc.
Explain EBV?
Infects epithelial and B-lymohocytes
Generalised T-cell reaction
EBV serology needed
What does glandular fever cause?
Tonsillar exudate and lymphadenopathy
What happens when EBV is mistaken for tonsilitis and amoxycillin is given?
Amoxycillin-induced rash
What are causes of regional lymohadenopathy?
Bacterial abscess
Met cancer - first spreads to regional nodes
What are causes of generalised lymphadenopathy?
Viral infection
Connective tissue disorders / RA / sarcoidosis
Lymphoid malignancy e.g. lymphoma
Met cancer
What are the differentials for Neutrophilia?
Bacterial infection Inflam e.g. RA Trauma/Post op Corticosteroids Myeloproliferative disease
What are differentials for Lymphocytosis?
Viral infection
Childhood response to infection
Chronic lymohocytic Leukaemia (smear cells)
With a Leucoerythroblastic blood picture, what are features of marrow infiltration?
Lymphoma
Non haemopoietic malignancies
Fibrosis
With a Leucoerythroblastic blood picture, what are features of marrow stress?
Sepsis
Severe bleeding
Shock
What are the 5 year survival rates for Hodgkins?
Stage 1 = 90%
Stage 2 = 80%
Stage 3 = 70%
Stage 4 = 50%
What are 2 ways of staging?
CT
PET
What does pancytopenia?
Anaemia
Neutropenia
Thrombocytopenia
What are immediate general side effects of cytotoxic drugs?
Bone marrow suppression
Gut mucosal damage
Hair loss (alopecia)
What are consequences of bone marrow failure?
Anaemia
Neutropenia - infection
Bleeding
What are causes of pancytopenia from an increased destruction point of view?
Sepsis
Hypersplenism
Immune
What are causes of pancytopenia from a decreased production point of view?
Infiltration B12/folate deficiency Drugs Myelodysplasia Aplastic anaemia
What can cause bone marrow to be hypocellular?
Drug induced aplasia e.g. cytotoxics
Aplastic anaemia
What can cause bone marrow to be hypercellular?
Infiltration
Normal cells: Peripheral destruction
Sepsis
Hypersplenism
What does the spleen do?
Immune response
Removal of effete red cells
What system is the spleen part of?
Reticuloendothelial
What can be treated by a splenectomy?
ITP
AIHA
What is the spleen necessary for?
Immunity to encapsulated organisms and malaria
What needs to be done following a splenectomy?
Vaccinate for meningococcus, pneumococcus and haemophilus influenzae
Prophylactic antibiotics
Prompt antibiotics in event of a fever
