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WBC disorders Flashcards

1
Q

malignant proliferation of cell native to lymphoid tissue

A

Lympomas

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2
Q

what are the precurosrs and derivatives of lympohomas

A

Lymphocytes

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3
Q

what might lymphomas invovled

A

Solid tissue
Marrow
Blodd

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4
Q

what are the types of Lymphomas

A

Hodgkin

non-hodgkin

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5
Q

Malignant proliferation of cell native to bone marrow which often spill inot blood

A

Leukemias

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6
Q

where can leukemias spread

A

Solid organs (liver and spleen)

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7
Q

what is a Lymphoma of a distinctive cell type(reed-sternberg cell)

A

Hodgkin lymphomea

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8
Q

where does Hodgkin lympohoma arise and spread

A

arise in SIngle lymph node to spread to invovle contiguous nodes

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9
Q

how can you cure hodgkin lymphoma

A

Chemo

Radio

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10
Q

when do people tend to get Hodgkin Lymphoma

A

Bimodel (2-3rd decade and then once at an age greater than 50)

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11
Q

how many new cases in 2017 of Hodgkin lymphoma

A

8,300

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12
Q

what is needed to diagnoses Hodgkin Lmyphoma

A

Lymph node biopsy to identigy Reed-sternberg cells in apropriate background

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13
Q

what do Reed-sternberg cells look like

A

Large with mirror image nuclei and prominent nucleoili

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14
Q

how much of the cells of the lymph node are malignant in the case of Hodgkin Lymphoma

A

less than 2%

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15
Q

what is the germinal center for Reed-sternberg cells

A

B lymphocyte

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16
Q

what virus is often found in a Reed-Sternberg cell

A

Epstein-Barr virus(70%)

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17
Q

what are the spread of idsease in Hodgkin Lymphoma

A

Lymph nodes
Spleen
Liver
Bone marrow

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18
Q

use of staging in Hodgkin Lymphoma

A

Determine treatment and prognosis

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19
Q

what is done to Stage Hodgkin lymphoma

A

Combo of clinical findings and imaging

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20
Q

what is low stage hodgkin lymphoma

A

Localized involvement

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21
Q

what is High stage Hodgkin lymphoma

A

Wide spread disease with distant of bone marrow involvement

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22
Q

statge 1 Hodgkin Lymphoma

A

Tumor in 1 anatomic region or 2 contiuous anatomic rgion on the same side of daiaphragm

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23
Q

stage 2 hodgkin lymphoma

A

Tumor in more than 2 anatomic regions or two non-contiguous regions on the same side of the diaphragm

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24
Q

Stage III Hodgkin Lymphoma

A

Tumor on both sides of the diaphragm

does no extend beyond lymph nodes, spleen or Waldeyer’s ring

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25
Q

stage IV Hodkin Lymphone

A

Tuor in bone marrow, lung, etc

- any organ side outisde lymph nodes, spleen or Waldeyer’s ring

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26
Q

symptoms of Hodgkin Lymphoma

A

Fever
Night sweats
Significant uneplained weight loss

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27
Q

what determines treatement of Hodgkin lymphoma

A

Stage

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28
Q

what is done to treat low stage hodgkin lymphoma

A

Chemo

Radio

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29
Q

what is done to treat high stage hodgkin lymphoma

A

Chem

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30
Q

what is the risk for development of secondary treatment related acute leukemia after treating hodkin lymphoma

A

Low risk

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31
Q

what are “B” signs/symptoms of Hodgkin Lymphoma associated with

A

Worse prognosis

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32
Q

what stage of Hodgkin lymphome tends to have B symptoms

A

Stage III and Stage IV

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33
Q

5 year survival rate of Stage I and IIA hodgkin lymphoma

A

ablmost 100%

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34
Q

5 year survivial rate of Stage IV hodgkin lymphoma

A

50%

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35
Q

do RS cells alone mean that you’ve got Hodgkin lymphoma

A

No, need the appropriate histo background

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36
Q

what does term mean for hodgkin lymphoma

A

Amount of rumor burden

distribution in the body

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37
Q

what is low stage disease mean for hodgkin lymphoma

A

Localized
no systemic signs (fever, weight loss)
better prognosis

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38
Q

what is high stage disease for hodgkin lymphoma

A

widespread

worse prognosis

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39
Q

what does deviding staging up into A and B mean for for hodgkin lymphoma

A

A: Absensce of systemic symtoms
B: presence of systemic symtoms

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40
Q

how does the lymph node look in hodgkin Lymphomas

A

Enlarged, painless, superficial

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41
Q

what complications can arise from advanced Hodgkin lymphomas

A

Infections
Anemia
Thrombocytopenia

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42
Q

what are neoplastic lymphocytes originating in lymph nodes or extranodal lymphoid tissues (arise in lymph tissue)

A

Non-hodgkin lymphoma

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43
Q

how many types of Non-hodgkin lymphoma is there

A

2 dozen types

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44
Q

what is the origin of non-hodgkin lymphoma cells

A

85% B cell

15% T cell

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45
Q

what age does incidence of Non-hodgkin lymphoma rise

A

steadily after age of 40

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46
Q

cases of on-hodgkin lymphoma in 2017

A

72,000

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47
Q

Linical sings of non-hodgkin lymphoma

A

Painless lymph node englargement
Systemic symptoms in 30% of patients
Frequent immune abnormalities
Splenomegaly

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48
Q

what else may be invovled in non-hodgkin lymphomas

A

GI tract
Bones
CNS

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49
Q

What all is involved in the Classification of NHL

A

World Health Organization

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50
Q

what does Classification of NHL depend on

A

Morphologic
Clicial
Immunophenotypic
Molecular features

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51
Q

what growth patterns can NHL have

A

Nodule

Diffuse

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52
Q

what cell sizes can NHL have

A

Small

Large

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53
Q

what is better Nodular or diffuse NHL

A

Nodule is better

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54
Q

what is better, large or small cell NHL

A

Small better than large

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55
Q

what is low stage NHL

A

Localized

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56
Q

what is high stage NHL

A

numerous sites of involvement or bone marrow invovlement

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57
Q

what does PRognosis of NHL depend on

A

on the sub-type of lymphoma(not stage, this is an exception)

- also grading

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58
Q

how does one treat NHL

A

Chemo
Possible Radiation
Bone Marrow transplant

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59
Q

is there more morphologic diversity in Hodgekin or non-hodgkin lymphoma

A

More in non-hodgkin

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60
Q

Does Hodgkin or non-hodgkin lymphoma have multi node invovlement

A

non-hodgkin has multinode invovlement

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61
Q

what has more frequent extranodal spread and peripheral blood invovlement, hodgkin or non-hodgkin

A

Non-hodgkin

62
Q

what is needed to diagnoses non-hodgkin lymphoma

A

Histo examination

63
Q

do all lymphoid neoplasms arise from a signle cell

A

Yes

64
Q

when does a lymphoma develop cellularily

A

When a monoclonal expasion of lymphocytes are arrested at a particular stage in transformation

65
Q

why do immune abnormalities occur in lymphomas

A

Because they are tumors of the immune system

66
Q

How does NHL usually present itself

A

enlarged lymph noes
Evidence of extranodal spread
enlarged liver or spleen

67
Q

Does bone marrow get invovled more in hodgkin or non-hodgkin

A

Non-hodgkin more

68
Q

what represents the leukemic phase of non-hodgkin lymphone

A

Lymphoma cells circulating in the peripheral blood

69
Q

what complications of Hodkin lymphoma can occur

A

Infection
Anemia
thrombocytopenia

70
Q

what is Leukemia with a rapdi onset with balsts in the blood

A

Acute Leukemia

71
Q

what cells are affected in acute leukemia

A

Myeloid

Lymphoid cells

72
Q

what is leukemia with indolent onset

A

chronic Leukemia

73
Q

what cells are affected in chronic leukemia

A

Myeloid and lymphoid cells but more mature

74
Q

survival of acute leukemia

A

Fatal, living only months

75
Q

survivial of chronic leukemia

A

years or decades (indolent)

76
Q

wbc cound of acute and chronic leukemia

A

Both often increased

77
Q

how does bone marrow change in acute and chronic leukemia

A

Acute: great than 20% blasts
chronic:blasts typically not increased

78
Q

what is the cloncal growth of primitive lymphoid cell

A

Acute lymphoblastic leukemia

79
Q

what types of cell exist in Acute lymphoblastic leykemia

A

B and T cells

80
Q

what tends to accompany acute lymphoblastic leukemia

A

Increase WBC

thrombocytopenia

81
Q

what age tends to get acute lymphoblastic leukemia

A

Children

less than 15 years old

82
Q

what may come along with acute lymphoblastic leukemia

A

Lymphadenopathy

Splenomegaly

83
Q

what does Acute Lymphoblasti Leukemia prognosis relate to

A

Cytogenetics

84
Q

do chidlren or adults have better prognosis of acute lymphoblastic leukemia

A

Children have good prognosis

Adults have beed

85
Q

what is the treatment for acute lymphoblastic leukemia

A

Chemo is mainstay

bone marrow transplant at relapse

86
Q

Classification of Leukemia based on cell types

A

Myelogenous (myeloid and monocytic)

lymphoid

87
Q

Acute lymphoblastic Leukemia accounts for how much of acute leukemias

A

40%

88
Q

what are the subtypes of Acute lymphoblastic Leukemia

A

Early B precursor
Pre B
Matuer B
T cell

89
Q

doe Lymph node, Liver and Spleen enlargement often come with ALL or AML

A

more with Acute Lymphoblastic Leukemia

90
Q

what has the best prognosis of Acute lymphoblastic Lekemias

A

children 2-10

PRe b cell type

91
Q

what is Cloncal proliferation of primitive myeloid cell

A

Acute Myelogenous Leukemia

92
Q

what are the subtypes of Acute myelogenous Leukemia based on

A

Morphology
Cytochem
Immunophenotype
Cytogen

93
Q

what tends to happen negatively to acute myelogenous Leukemia

A

Increased WBC
anenia
Thrombocytopenia

94
Q

do children or adults get Acute myelogenous Leukemia

A

Adults

95
Q

what is often present in the cytoplasm of people with Acute Myelogenous Leukemia

A

Myeloperozidase

96
Q

what is the mainstay of treatment for Acute mYelogenous Leukemia

A

Chemo

97
Q

how well does treatment do for Acute Myelogenous Leukemia

A

70% remission

many relapse

98
Q

what influences Prognosis of Acute myelogenous Leukemia

A

Cytogenetics

99
Q

what is the proliferating cell in Acute myelogenous leukemia

A

Primitive myeloid cell

100
Q

what type of Leukemia has Auer rods

A

Acute Myelogenous Leukemia

101
Q

what is the most predictive Prognosis for Acute myelogenous Leukemia

A

Karyotype

102
Q

what is it called when Lesional cells from AML proliferate into soft tissue including the gingival

A

Granulocytic sarcoma

103
Q

what is Clonal proliferation of mature B lymphocytes, identical to small lymphocytic lymphoma

A

Chronic Lymphocytic leukemia

104
Q

how common is Chronic Lymphocytic leukemia

A

Most common adult leukemia in US

105
Q

what do cell affected by Chronic Lymphocytic elukemia express

A

surface IgM with kappa light chain restriction

High BCL2

106
Q

who tends to get Chronic Lymphocytic leukemia

A

over 60 years

men (2:1)

107
Q

what happens to White cell cound in Chronic Lymphocytic leukemia

A

Gradual increase in White cell count with lymphocytosis

108
Q

what happens to organs in Chronic Lymphocytic leukemia

A

Spelnomegaly

Lymphoadenopathy

109
Q

what disorders tend to develop as disease progresses

A

Anemia

Thrombocytopenia

110
Q

what do Tumor cells in Chronic Lymphocytic leukemia supress and lead to whaty

A

Supress normal B cell

leading to hypogammaglobulinemia

111
Q

how does Chronic Lymphocytic Leukemia progress

A

Eventually terminate into higher grade prcess

  • acute leukemia
  • high grade lympho
112
Q

what is the treatment base for Chronic Lymphocytic leukemia

A

Chemo

113
Q

what does the proliferating cell in Chronic Lymphocytic Leukemia look like

A

Mature appearing
Immunologically incompetent
lymphocyte

114
Q

does Chronic Lymphocytic Leukemia come from one cell

A

Monoclonal(yes)

115
Q

what are most the cell source for CHronic Lymphocytic Leukemia

A

95% B cell type

116
Q

How common I Chronic Lymphocytic Leukemia

A

2/3 of Chronic Leukemia

117
Q

what forms as marrow is overrun by leukemic cells during chronic lymphocytic leukemia

A

Cytopenias (anemia and thrombocytopenia)

118
Q

survival time for Chronic Lymphocytic Leukemia

A

4-6 years

119
Q

what is the A Clonal Proliferation of Immature Granulocytes

A

Chronic Myelogenous Leukemia

120
Q

what cells are affected in CHronic Myelogenous Leukemia

A

Stem cells

121
Q

what happens to cells affected by chronic Myelogenous Leukemia

A

Increase in WBC, Eosinophilia, basophilia

Left shifted Granulocytes

122
Q

what secondary disorder accompanies Chronic Myelogneous Leukemia

A

Thrombocytosis Anemia

123
Q

what organ is affected in CHronic Myelogenous Leukemia

A

Splenomegaly

124
Q

what kind fo Abnormality causes Chronic Myelogenous Leukemia

A 
Cytogenetic Abnormality (t(9;22)
Phiadelphia Chromosome
125
Q

what cuases Chronic Myelogenous Leukemia

A

Molecular fusion of bcr and abl genes

126
Q

what does targeted chemo do for Chronic Myelogenous Leukemia

A

Blacks the bcr-abl tyrosine Kinase to induce remission in most patients

127
Q

what is done for relapsed or resistance CHronic mYelogenous Leukemia

A

Bone marrow Transplant

128
Q

What does the Abnormal cells do to LEukemias

A

Suppress growth, maturation, and function of nromal cells

129
Q

what does Leukemia do to Body organs

A

Infiltrate

130
Q

what does leukemia do to the immune system

A

Dysfunction

131
Q

what does the Fusion of BCR and ABL genes do

A

Mimic effect of growth factor activation

132
Q

what marks the terminal phase of Chronic Myelogenous Leukemia

A
  • Increase in immature cell in peripheral blood and bone marrow
  • Decreased response to treatment (blast crisis)
133
Q

what is a clonal proliferation of Monoclonal plasma cells

A

Multiple Myeloma

134
Q

what is made during mutliple myeloma

A

Monoclonal heavy and or light chain production (IgG most common)

135
Q

when do people get multiple myeloma

A

late middle age (to elderly)

136
Q

how common is mutliple myeloma

A

30,000 cases in US for 2016

137
Q

what happens to bones in Multiple Myeloma

A

Multiple lytic bone lesion

Hypercalcemia

138
Q

what happens to bone marrow in multiple myeloma

A

Bone marrow infiltration by plasma cells

139
Q

what happens to serum in multiple myeloma

A

increased serum monoclonal protein

normal immunoglobulins suprress

140
Q

what complications come along with Mutliple Myeloma

A

Renal Failure
Infection
Bence-Jones proteinuria (light chains)

141
Q

are plasma cells in blood common in mutliple Myeloma

A

No

142
Q

what happens to RBC in multiple meloma

A

Rouleaux formation (stacking)

143
Q

how does Marrow plamsa cells infiltrate in multiple myeloma

A

Single cells and sheets

144
Q

prognosis of Multiple myeloma

A

variable, but usually porn

145
Q

suruvial for multiple myeloma

A

media (4-6 years)

indolent is even longer

146
Q

how do we try and treat multiple myeloma

A

Chemo
radio
bone marrow transplant

147
Q

success of chemo in multiple myeloma

A

Recent success with thalimomide analogs and anti-resorptives)

148
Q

why use radio for multiple myeloma

A

Palliation (bone pain)

149
Q

does Multiple Myeloma lead to an increase in all immunoglobins

A

No, just one type

150
Q

what immunoglobins tend to be increased from Multiple myeloma

A

60% IgG

20-25% igG

151
Q

what is Bence Jones Proteinuria

A

when only lifht chains are produced in multiple myeloma and it is pissed out

152
Q

why does Bone resorption occur in multiple myeloma

A

secretion of osteoclast activator factors by myeloma cells

general path (16 decks)

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