WBC disorders

Question 1

infectious mononucleosis “mono”

Answer 1

self-limiting lymphoproliferative disorder–lymphocytes growing too much; infection of B lymphocytes caused by Epstein-Barr virus

Question 2

Mono transmission

Answer 2

EBV-contaminated saliva most prevalent in teens/young adults bc spread through saliva and fluid

Question 3

mono onset

Answer 3

insidious, 4-8 week incubation period

Question 4

mono sx

Answer 4

nonspecific–lymphoadenopathy (swollen nodes in neck and armpit), hepatitis (swollen liver), splenomegaly (swollen spleen), tired, throat sore, body ache

Question 5

mono labs

Answer 5

inc WBCs; 95% lymphocytes–very high

Question 6

mono progression

Answer 6

2-3 weeks of acute phase; 2-3 months lethargy, debility

Question 7

mono tx

Answer 7

treat sx, supportive, sleep, hygiene, hydration

Question 8

myelodysplastic sx

Answer 8

group of related hematologic dx char by chx in quantity or quality of bone marrow elements; blood cells could not mature, accum, or short life

Question 9

myelodysplastic sx

Answer 9

cytopenias (low blood count)–anemia, infection and spon bleeding or bruising

Question 10

who does myelodysplastic sx affect?

Answer 10

most over 65

Question 11

myelodysplastic sx cause

Answer 11

unknown, maybe enviro trigger

Question 12

myelodysplastic sx diagnosis

Answer 12

labs and bone marrow biopsy

Question 13

myelodysplastic sx tx

Answer 13

depends on severity, supportive, chemo, GCSF, erythrypoietin, bone marrow transplant

Question 14

leukemias

Answer 14

Malignant neoplasms of cells originally derived from a single
hematopoietic cell line

Question 15

Leukemic cells char and locations

Answer 15

Are immature and unregulated (undifferentiated), Proliferate in bone marrow, Circulate in blood, Infiltrate spleen, lymph nodes

Question 16

how are leukemias classified?

Answer 16

according to their predominant cell type and acute vs chronic condition

Question 17

acute lymphotic (lymphoblastic) leukemia

Answer 17

most common childhood leuk; higher survival rate

Question 18

chronic lymphocytic leukemia

Answer 18

most common in older adults; Relatively mature lymphocytes that are immunologically incompetent; S&S: fatigue, wt loss, anorexia, infections

Question 19

acute myelocytic leukemia

Answer 19

mostly an adult disease; low 5-year survival rate

Question 20

lymphocytic leukemia

Answer 20

affects lymphoid stem cells especially lymphocytes

Question 21

myelocytic

Answer 21

affects myeloid stem cells esp granulocytes

Question 22

chronic myelocytic leukemia

Answer 22

Leukocytosis with immature cell types (presents with increased granulocyte count); S&S: fatigue, wt loss, diaphoresis, bleeding, abdominal discomfort from splenomegaly

Question 23

cause of leukemia

Answer 23

unknown; inc exposure to radiation

Question 24

Leukemic cells

Answer 24

Are an immature type of WBC; Capable of increased rate of proliferation/have prolonged life
span; Cannot perform function of mature leukocytes → are ineffective
as phagocytes; Interfere with maturation of normal bone marrow cells (including
RBC & platelets)

Question 25

acute leukemias

Answer 25

sudden, stormy onset; dec mature WBC, dec RBC, dec platelets, kids refuse to walk and bone pain

Question 26

acute leukemia diagnosis

Answer 26

based on blood/bone marrow tissue; find immature WBCs (blasts), may constitue 60-100% of cells

Question 27

Chronic leukemia

Answer 27

more insidious onset, often diagnosed during routine blood check

Question 28

leukemia tx

Answer 28

goal is remission; start with cytotoxic chemo, move to stem cell transplant (bone)

Question 29

Risks of leukemia tx

Answer 29

infection, rejection, relapse

Question 30

Malignant lymphomas

Answer 30

Neoplasms of cells derived from lymphoid tissue * Hodgkin Disease * Non-Hodgkin Disease

Question 31

Hodgkin disease

Answer 31

Characterized by painless, progressive, rubbery enlargement of a single node or group of nodes – usually in neck area and nonspecific sx; Reed-Stenberg cell

Question 32

Reed-Stenberg cell

Answer 32

distinctive tumor cell found with lymph biopsy; distinctive--for Hodgkins diagnosis

Question 33

Hodgkins cause

Answer 33

unknown, maybe EBV, genetic predis, exposure to toxins

Question 34

Hodgkin diagnosis

Answer 34

Diagnosis: peripheral blood analysis, lymph node biopsy, bone marrow exam, radiographic evaluation (CT, MRI, PET)

Question 35

Hodgkins tx

Answer 35

Chemotherapy- standard- doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine; 2-8 cycles * Radiation * Stem Cell Transplant

Question 36

Non-Hodgkin disease

Answer 36

Neoplastic dx of lymphoid tissue; spreads early to liver, spleen, bone marrow; char by painless, superficial lymphadenopathy, also extranodal sx; caught later, harder to diagnosis bc no distinguishing cell type

Question 37

Etiology of non-Hodgkin

Answer 37

unknown

Question 38

Non-Hodgkins diagnosis

Answer 38

similar to Hodgkins, inc extranodal sites--lymph tissue at non-lymph sites

Question 39

Non-Hodgkins tx

Answer 39

chemotherapy, radiation, refractory cases- stem cell transplant; Rituximab (Rituxan), ibritumomab tiuxetan (Zevalin), tositumomab (Bexxar) & others

Question 40

Multiple myeloma (Plasma cell myeloma)

Answer 40

atypical proliferation of "M" protein immunoglobulin which is a monoclonal antibody; inc osteoclast activity (bone b/d), can't maintain humoral immunity--get sicker

Question 41

Myeloma sx

Answer 41

bone pain/frac, also sx r/t impaired RBC and WBC count

Question 42

Who is more likely to get myeloma

Answer 42

men, around age 65, African Americans

Question 43

Myeloma CM

Answer 43

slow and insidious; anemia, bleeding, hypercalcemia from seeping out of bones, skeletal pain (often 1st sx)

Question 44

Multiple myeloma diagnosis

Answer 44

lab, radiography, bone marrow exam; look for bone b/d and monoclonal antibody protein serum and urine; pancytopenia (all cells dec), hypercalcemia, elevated serum creatinine, Bence Jones proteins in urine; Xray osteolytic lesions

Question 45

Multiple myeloma tx

Answer 45

watch, corticosteroids, promote bone health, chemo, stem cell transplants, adequate hydrations, biophosphates