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Year 5 Pathology > WBC Disorders > Flashcards

WBC Disorders Flashcards

1
Q

Main causes neutropenia

A 
Drug reactions (chemo)
Severe infections
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2
Q

Treatment for neutropenia

A

Treat infection

If chemo induced: GM-CSF or G-CSF

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3
Q

Causes lymphopenia

A

Immunodeficiency, e.g. DiGeorge
High cortisol states (causes apoptosis lymphos)
AI destruction, e.g. SLE
Whole body radiation

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4
Q

Which cell in body is most sensitive to radiation?

A

Lymphocytes

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5
Q

Causes neutrophilia

A

Bacterial infection
Tissue necrosis
High cortisol states: disrupts marginating pool

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6
Q

Left shift

A

Inflammation causes increased immature neutrophils, marked by fewer Fc receptors (CD16)

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7
Q

Causes monocytosis

A

Chronic inflamm states

Malignancy

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8
Q

Causes eosinophilia

A 
Neoplasia (HODGKINS--via IL-5 production)
Allergy, Asthma
Addison's
Collagen vascular diseases
Parasitic infections
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9
Q

Cause basophilia

A

CML

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10
Q

Causes lymphocytic leukocytosis

A

Viral infections

Bordetella pertussis

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11
Q

Infectious mononucleosis

A

EBV>CMV
Reactive CD8+ cells
Generalized LAD, splenomegaly (PALS), high lympho count with atypical lymphos
Monospot test detecte heterophile IgM Abs; definitive test with EBV viral capsid antigen
Risk splenic rupture–no contact sports 1 yr

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12
Q

Acute leukemia

A

Blasts >20%

Crowd out normal hematopoiesis so present with signs/sxs cytopenias: anemia, thrombocytopenia, neutropenia

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13
Q

Marker for ALL

A

Tdt+

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14
Q

Marker for AML

A

MPO

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15
Q

Which leukemia associated with Down’s after age 5

A

ALL

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16
Q

Which leukemia associated with Down’s before age 5

A

Acute megakaryoblastic anemia

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17
Q

Markers B-ALL

A

CD1-, CD19, CD20

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18
Q

Types B-ALL

A

t(12;21)-good prog. Kids

t(9;22)-poor prog. Adults

19
Q

Markers T-ALL

A

CD2-CD8; do not express CD10

20
Q

T-ALL presentation

A

Thymic mass in Teenager

Since causes mass in lymphoid organ, called Acute Lymphoblastic LYMPHOMA

21
Q

AML types

A

APML- t(15;17)
Acute monocytic-gums
Acute megakaryoblastic-Downs

22
Q

Myelodysplastic syndromes

A

Cytopenias, hypocellular bone marrow

23
Q

Chronic leukemia

A

Prolif MATURE lymphocytes
High white count
Insidious
Older adults

24
Q

CLL

A

Naive B cell prolif
CD5, CD20
SMudge cells
If goes to LNs=small lymphocytic LYMPHOMA
Can cause hypogammaglobulinemia (thus infection), AIHA, or can transform to diffuse large B cell lymphoma

25
Q

Hairy cell leukemia

A 
Mature B cell prolif
Stains TRAP
Hairy cytoplasmic processes
Splenomegaly (red pulp), dry tap, NO LAD (trapped in BM)
Excellent response to 2-CDA
26
Q

2-CDA

A

Adenosine deaminase inhibitor. Adenosine accumulates, which is toxic to B cells

27
Q

ATLL

A

Prolif CD4+
Assoc with HTLV
Rash, LAD, HSM, lytic bone lesions with hypercalcemia

28
Q

Mycosis Fungoides

A

Prolif CD4+
Rash, plaques, nodules-usu multiple
Neoplastic T cells in epidermis=Pautrier’s microabscesses
If spreads to blood=Sezary’s syndrome

29
Q

Sezary’s syndrome: classical cell appearance

A

Cerebriform nuclei

30
Q

Myeloproliferative Disorders

A

Accumulation MATURE myeloid cells
Neoplastic proliferation of ALL myeloid cells but named based on predominant cell
Late adulthood

31
Q

Complications myeloproliferative disorders

A

Hyperuricemia/gout
Progression to marrow fibrosis
Transformation to acute leukemia

32
Q

CML

A

Prolif myeloid cells, esp granulocytes (BASOPHILS)
t(9;22)-BCR-ABL with increased tyrosine kinase activity
Tx: imantinib
CAn transform to AML (2/3) or ALL (1/3)

33
Q

How do you distinguish CML from leukemoid reaction

A

CML:

  • LAP negative
  • t(9;22)
  • increased basophils
34
Q

Polycythemia Vera

A

Prolif myeloid cells, esp RBCs
JAK2 kinase mutation
Sxs hyperviscosity: blurry vision, HA, Budd-Chiari, flushed face, itching after bathing (mast cells)
Tx with phlebotomy, hydroxyurea

35
Q

PV versus reactive polycythemia

A

PV: normal SaO2, decreased EPO
Reactive-lung disease: decreased SaO2, increased EPO
Reactive-ectopic: normal SaO2, increased EPO

36
Q

Tumors producing ectopic EPO

A

RCC
HCC
Cerebellar hemangioma

37
Q

Essential thrombocytopenia

A

Prolif myeloid cells, esp platelets
JAK2 kinase mutation
Sxs: increased risk bleeding or thrombosis
Does not typically progress to marrow fibrosis or acute leuk

38
Q

Myelofibrosis

A

Prolif myeloid cells, esp MKs
JAK2 kinase mutation
MKs produce excess PDGF which causes marrow fibrosis
Splenomegaly once BM fibrosed, leukoerythroblastic smear, increased risk infxn, thrombosis, bleeding
Teardrop cells

39
Q

T(9;22)

A

CML on exams

Note that can also be subtype of B-ALL. Adults, poor prognosis

40
Q

T(15;17)

A

APML

retinoic acid receptor

41
Q

T(8;14)

A

Burkitts

C-myc

42
Q

T(11;14)

A

Mantle cell

Cyclin D1

43
Q

T(14;18)

A

Follicular lymphoma
Bcl-2
Centroblasts, centrocytes

Year 5 Pathology (6 decks)

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