Sweep 1.2

Question 1

• Extrinsic defect hemolytic anemias-

Answer 1

antibody, mechanical trauma, acquired

Question 2

o Autoimmune hemolysis-

Answer 2

extravascular hemolysis, patient makes antibodies to their own RBCs. phagocytosis of antibody coated RBC cand lead to partial loss of RBC membrane→ spherocytes

Question 3

• Pernicious anemia- caused by antibodies to

Answer 3

parietal cells and intrinsic factor

Question 4

o Absorption of B12 requires

Answer 4

intrinsic factor

Question 5

• Vitamin B12 and Folate deficiency-

Answer 5

Megaloblastic Anemia;

Question 6

need vitamin B12 and folate to make

Answer 6

thymidine, deficiency leads to delay in mitotic division, nuclear size increases, end result is huge red cell precursor (megaloblast).

Question 7

Vitamin B12 and Folate deficiency: Accumulation of

Answer 7

megaloblasts in bone marrow, less RBCs released, decreased production of mature RBCs→ impairment of DNA synthesis is systemic and affects other rapidly dividing cells

Question 8

• Aplastic anemia- production of all

Answer 8

cellular elements of blood is markedly decreased (pancytopenia)

Question 9

Aplastic anemia: >50% of cases are

Answer 9

idiopathic but hepatitis, drugs and toxins have been implicated

Question 10

Aplastic anemia: Theories:

•

Answer 10

Acquired defect in stem cell production, suppression of stem cells by T lymphocytes

Question 11

Aplastic anemia: o Clinically-

Answer 11

weakness, fatigue, leukopenia, decreased platelets

Question 12

Aplastic anemia: o Therapy-

Answer 12

bone marrow transplant, successful in pts <40yrs old

Question 13

• Myeloplastic anemia-

Answer 13

normal hematopoietic cells in marrow crowded out by tumor or fibrosis (usually multiple myeloma or metastatic cancer)

Question 14

• Polycythemia-

Answer 14

increase in red cell mass

Question 15

o Absolute polycythemia-

Answer 15

can be a primary or secondary phenomenon

Question 16

• Primary absolute polycythemia-

Answer 16

non-regulated proliferation of red cells and myeloid cells (polycythemia vera);

Question 17

Primary absolute polycythemia is a

Answer 17

stem cell disorder associated with normal or low levels of erythropoietin

Question 18

• Primary absolute polycythemia; Polycythemia vera can cause

Answer 18

neurologic and visual abnormalities due to sludging of red cells in capillaries→ treat with phlebotomy

Question 19

• Secondary absolute polycythemia→

Answer 19

living at high altitude, cyanotic heart disease, pulmonary disease, due to stimuli that increase erythropoietin

Question 20

• Lymphomas are

Answer 20

malignant proliferations of cells native to lymphoid tissue and are categorized into two main types– Hodgkin and non-Hodgkin lymphomas

Question 21

• Leukemias are

Answer 21

malignant proliferations of cells native to the bone marrow, which often spillover into the blood. Leukemias can spread to involve solid organs (usually liver and spleen).

Question 22

• Hodgkin Lymphoma- Reed-Sternberg cells with

Answer 22

inflammatory infiltrate. Accompanied by fever, arises in single or chain of nodes.

Question 23

HL: More common in

Answer 23

young adults ~30yrs. Contiguous spread within lymph node groups

Question 24

HL: o Cell of Origin-

Answer 24

Reed-Sternberg cell is neoplastic, mirror image nuclei and prominent nucleoli. Presence alone is not enough, need inflammatory infiltrate.

Question 25

Non-Hodgkin Lymphoma- arise in ——– and have capacity to spread; 85% —— origin; incidence rises steadily after age —–.

Answer 25

lymphoid tissue, B cell, 40

Question 26

NHL: Tend to have multiple

Answer 26

node involvement, more frequent extranodal spread and peripheral blood involvement, affects all ages

Question 27

NHL: o Cell of origin-

Answer 27

lymphoma develops when there is monoclonal expansion of arrested lymphocytes. Unregulated proliferation occurs

Question 28

NHL: o Clinical features and course-

Answer 28

painless enlarges lymph nodes, enlarged liver or spleen; bone marrow involvement more common than Hodgkin.

Question 29

NHL: • Complications-

Answer 29

infections, anemia and thrombocytopenia occur;

Question 30

NHL: • Treatment-

Answer 30

chemo, some radiotherapy, bone marrow transplant

Question 31

• Leukemias are

Answer 31

malignant neoplasms of hematopoietic tissue that arise in the bone marrow. The malignant cells proliferate in the bone marrow, commonly producing a pattern of diffuse infiltration. There is often “spill over” of the proliferating cells into the blood and other organs

Question 32

• Acute Lymphoblastic Leukemia (ALL)- proliferating cell in

Answer 32

primitive lymphoid cell;

Question 33

• Acute Lymphoblastic Leukemia (ALL)- ~40% of acute leukemia, most frequent type in

Answer 33

children <15yrs old, principal cause of cancer deaths in childhood (4yrs old is critical).

Question 34

• Acute Lymphoblastic Leukemia (ALL)- Enlarged

Answer 34

lymph nodes, liver, spleen is more common in ALL, also often involves CNS

Question 35

• Acute Lymphoblastic Leukemia (ALL)- o Affects all ages, Adults typically have

Answer 35

bad prognosis

Question 36

• Acute Lymphoblastic Leukemia (ALL)- o Treatment-

Answer 36

chemotherapy, bone marrow if relapse

Question 37

• Acute Lymphoblastic Leukemia (ALL)- o Best prognosis

Answer 37

child 2-10 with pre-B cell type

Question 38

• Acute myelogenous leukemia (AML)-

Answer 38

primitive myeloid cell implicated; increased WBC count with anemia and thrombocytopenia. More common in adults

Question 39

Acute myelogenous leukemia (AML)-

Cytoplasmic inclusions-

Answer 39

Auer rods

Question 40

Acute myelogenous leukemia (AML)- Proliferation into soft tissue→

Answer 40

granulytic sarcoma

Question 41

Chronic lymphocytic leukemia-

Answer 41

mature-appearing but immunologically incompetent lymphocyte implicated.

Question 42

Chronic lymphocytic leukemia- >—– B cell type, most commonly express ———-

Answer 42

95%, IgM-κ surface immunoglobulin

Question 43

Chronic lymphocytic leukemia- o Accounts for——–of chronic leukemias

Answer 43

2/3

Question 44

Chronic lymphocytic leukemia- o Most common in adults

Answer 44

> 60yrs; male : female 2:1

Question 45

Chronic lymphocytic leukemia- ======== common

Answer 45

Peripheral leukocytosis

Question 46

Chronic lymphocytic leukemia- ——- may develop as marrow is overrun by leukemic cells

Answer 46

Cytopenias

Question 47

Chronic lymphocytic leukemia- o Treatment-

Answer 47

chemo

Question 48

Chronic lymphocytic leukemia- o Survival

Answer 48

4-6yrs

Question 49

Plasma Cell Disorders- result from

Answer 49

clonal expansion of plasma cells