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WBC disorders Flashcards

1
Q

Causes of painless lymphadenopathy

A
  • Chronic inflammation
  • Metastatic carcinoma
  • Lymphoma
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2
Q

Treatment for follicular lymphoma

A

Rituximab (anti-CD20 antibody)

*Reserved for symptomatic patients

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3
Q

Which of the myeloproliferative disorders is not associated with increased risk for hyperuricemia or gout?

A

Essential thrombocythemia

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4
Q

Polycythemia vera is associated with a ________ mutation.

A

JAK2 kinase

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5
Q

What is the blood smear characteristic of mycosis fungoides?

A

Lymphocytes with cerebriform nuclei (Sezary cells)

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6
Q

Why is there an increased risk for infection in multiple myeloma?

A

monoclonal antibody lacks antigenic diversity; infection is the most common cause of death in multiple myeloma

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7
Q

Which neoplasm is associated with reactive polycythemia?

A

Renal cell carcinoma

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8
Q

most common age of patients with AML

A

50-60

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9
Q

Which markers are positive in Hodgkin lymphoma?

A

CD15 AND CD30

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10
Q

Which type of myeloproliferative disorder rarely progresses to marrow fibrosis or acute leukemia?

A

Essential thrombocythemia

*Platelets are just blebs of cytoplasm from megakaryocytes

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11
Q

What is the cause of marrow fibrosis in myelofibrosis?

A

Megakaryocytes produce excess platelet-derived growth factor (PDGF) cuasing marrow fibrosis

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12
Q

Causes of eosinophilia

A
  • Allergic reactions (type I hypersensitivity)
  • Parasitic infections
  • Hodgkins lymphoma
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13
Q

A negative monospot test suggests ______ as possible cause of mono.

A

CMV

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14
Q

T-ALL is characterized by which markers?

A

CD2 to CD8

*The blasts do NOT express CD10

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15
Q

Adult T- cell leukemia is associated with HTLV-1 and is most commonly seen in which countries?

A

Japan and the Caribbean

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16
Q
  • Lacunar cells
  • Enlarging cervical or mediastinal lymph node
A

Nodular sclerosis (Hodgkin lymphoma)

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17
Q

BCl2 expression in follicles. Follicular hyperplasia or follicular lymphoma.

A

Follicular lymphoma

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18
Q

The neoplastic cells of multiple myelome active the ________ receptor.

A

RANK receptor on osteoclasts

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19
Q

How is definitive diagnosis of mon made?

A

By serologic testing for the EBV viral capsid antigen

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20
Q

Characteristics of blasts

A

Large

Immature

punched out nucleoli

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21
Q

What sites are infected by EBV?

A

Oropharynx

Liver

B cells

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22
Q

Overexpression of cyclin D1 promotes _____ transition in the cell cycle, facilitating neoplastic proliferation.

A

G1/S

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23
Q

Gastric MALToma may regress with treatment of __________.

A

H.Pylori

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24
Q

Positive test for tartate-resistant acid phosphatase

A

Hairy cell leukemia

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25
Q

Subtypes of hodgkin lymphoma

A
  • Nodular sclerosis
  • Lymphocyte-rich
  • Mixed cellularity
  • Lymphocyte-depleted
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26
Q

Cytogenetic malfomation in Burkitt’s lymphoma

A

t(8,14), resulting in the translocation of c-myc on chromosome 8 to IgH on chromosome 14

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27
Q

Rouleaux formation of RBCs on blood smear

A

Multiple Myeloma

*Increased serum protein decreases charge betCween RBCs

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28
Q

All of the myeloproliferative disorders are associated with a JAK2 kinase mutation, except _________.

A

CML

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29
Q

Acute presentation of leukemia

A

Anemia (fatigue)

Thrombocytopenia (bleeding)

Neutropenia (infection)

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30
Q

In my cosis fungoides, aggregates of neoplastic cells in the epidermis are called _________.

A

Pautrier microabscesses

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31
Q

Clinical features of multiple myeloma

A
  • Increased risk of infection
  • Hypercalcemia
  • Lytic lesions
  • M Spike- Elevated serum protein
  • Rouleaux formation
  • Primary AL amyloidosis
  • Proteinuria
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32
Q

Types of Acute Leukemia

A

Acute lymphoblastic leukemia

Acute myelogenous leukemia

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33
Q

Complications of most myeloproliferative disorders

A
  • Increased risk for hyperuricemia and goat due to high turnover of cells
  • Progression to marrow fibrosis or transformation to acute leukemia
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34
Q

Acute leukemia is the neoplastic proliferation of _________.

A

Blasts

*Accumulation of >20% blasts in the bone marrow

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35
Q

Types of Chronic Leukemia

A
  • Chronic lymphocytic leukemia
  • Hairy cell leukemia
  • Adult cell leukemia/lymphoma
  • Mycosis Fungoides

*Chronic leukemia is the neoplastic proliferation of mature circulating lymphocytes; characterized by a high WBC count

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36
Q

Which type of hodgkin has the best prognosis of all types?

A

Lyphocyte rich

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37
Q

CD1a+

S-100

A

Langerhans cell histiocytosis

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38
Q

Causes of lymphopenia

A
  • Immunodeficiency
  • High cortisol stae
  • Autoimmune destruction
  • Whole body radiation
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39
Q
  • Bone pain with hypercalcemia
  • M spike
  • Anemia
  • Bone lytic lesions
  • Renal involvement
A

Multiple myelome

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40
Q

Where does T cell hyperplasia occur to cause splenomegaly in EBV infections?

A

T-cell hyperplasia in the periarterial lymphatic sheath (PALS), white pulp

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41
Q

What bacterial infection causes lymphocytic leukocytosis?

A

Bordetella pertussis

*Produce lymphocytosis-promoting factor, which blocks circulating lymphocytes from leaving the blood to enter the lymph node.

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42
Q

How do high cortisol states lead to neutrophilic leukocytosis?

A

Impairs leukocyte adhesion, leading to release of marginated pool of neutrophils

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43
Q

Clinical features of Adult T cell leukemia

A
  • Rash
  • Generalized lymphadenopathy with hepatosplenomegaly
  • Lytic bone lesions with hypercalcemia
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44
Q

Treatment for Waldenstrom macroglobulinemia

A

Acute complications are treated with plasmapheresis, which removes IgM from the serum

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45
Q

Disruption of normal lymph node architecture. Follicular hyperplasia or follicular lymphoma.

A

Follicular lymphoma

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46
Q

Neoplastic proliferation of reed-sternberg cells

A

Hodgkin lymphoma

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47
Q
  • blurry vission and headache
  • Budd-Chiari Syndrome
  • Flushed face
  • Itching
A

Polycythemia vera

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48
Q

What types of NHL lead to proliferation of intermediate-sized B cells?

A

Burkitt’s lymphoma

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49
Q

How is polycythemia vera distinguised from reactive polycythemia?

A
  • In PV, erythropoietin levels are decreased and SaO2 is normal
  • In reactive polycythemia , SaO2 is low and EPO is increased
  • In reactive polycythemia due to ectopic EPO production from renal cell carcinoma, EPO is high and SaO2 is normal.
50
Q

Chronic myeloid leukemia is driven by t(9,22) which generates a BCR-ABL fusion protein with increased ________ activity.

A

Tyrosine kinase

51
Q

Tingible body macrophages. Follicular hyperplasia or follicular lymphoma.

A

Follicular hyperplasia

*Cells undergo apoptosis in follicular hyperplasia. They do not in Follicular lymphoma

52
Q

What cytogenic traits determine the prognosis of ALL?

A
  • t (12,21)- good prognosis
  • t (9,22)- poor prognosis
53
Q

Viral infection will lead to what type of lymph node hyperplasia?

A

Paracortex

54
Q

ALL has positive staining for _________. AML has positive staining for _________.

A

TdT; myeloperoxidase (MPO)

*TdT is found when staining the nucleus. MPO is found when staining the cytoplasm

55
Q

Types of Acute myeloid leukemia

A
  • Acute promyelocytic leukemia
  • Acute monocytic leukemia
  • Acute megakaryoblastic leukemia
56
Q

What is the most definitive characteristics of lymphoblasts ?

A

TdT

*TdT absent in myeloid blasts and mature lymphoctes

57
Q

What are common symptoms of hodgkin lymphoma? What do these symptoms present?

A
  • Fevers, chills, weight loss, and night sweats
  • may lead to fibrosis
  • Reed- Sternburg cells secrete cytokines
58
Q

What is the CD8 T cell response to EBV?

A
  • Generalized lymphadenopathy
  • Splenomegaly
  • High WBC count with atypical lumphocytes in the blood
59
Q

Myelofibrosis blood smear

A

Leukoerythoblastic smear

  • Tear drop RBCs
  • Nucleated RBCs
  • Immature granulocytes
60
Q

Cuases of lymphocytic leukocytosis

A
  • Viral infections
  • Bordetella pertussis
61
Q

What types of NHL lead to proliferation of small B cells?

A

Follicular lymphoma

Mantle cell lymphoma

Marginal zone Lymphoma

Small lymphocytic lymphoma

62
Q

Cytogenetic abnormalities seen in acute promelocytic leukemia

A
  • t(15,17), which involves translocation of the retinioic acid receptor (RAR) on chromosome 17 to chromosome 15
    • RAR disruption blocks maturatuon and promyelocytes accumulate
63
Q

Which type of hodgkin is associated with abundant eosinophils?

A

mixed-cellularity

64
Q

Causes of monocytosis

A
  • Chronic inflammatory states
    • Autoimmune or infectious
  • Malignancy
65
Q

Neoplastic proliferation of mature CD4 T cells that infiltrate the skin, producing localized skin rash, plaques, and nodules

A

Mycosis fungoides

66
Q

Possible causes of reactive polycythemia

A
  • Lung disease
  • High altitude
  • Ectopic EPO production from renal cell carcinoma
67
Q

ALL presents in children with down syndrome ______ (before/after) age of five. AML presents in children with down syndrom ____ (before/after) age of five.

A

After; before

68
Q

Treatment for neutropenia

A

GM-CSF or G-CSF

*Boost granulocyte production

69
Q

Cytogenic marker for follicular lymphoma

A

t(14,18)

*BCL2 on chromosome 18 translocates to the Ig heavy chain locus on chromosome 14

70
Q

High serum _______ may be present in multiple myeloma.

A

IL-6

*Stimulates cell growth and immunoglobulin production

71
Q

What is the primary cause of symptoms seen in polycythemia vera?

A

Hyperviscocity of blood

72
Q

Monoclonality. Follicular hyperplasia or follicular lymphoma.

A

Follicular lymphoma

73
Q

Presentation of myelodysplastic syndromes

A
  • Cytopenias
  • Hypercellular bone marrow
  • Abnormal maturation of cells
  • Increased blast (<20%)

*Cells don’t get out into blood

74
Q

Crystal aggregates of MPO may be seen as _______.

75
Q

The african form of burkitt’s lymphoma involves the __________. The sporadic form involves the _________.

A

Jaw; abdomen

76
Q

Cytogenetic problem in mantle cell lymphoma

A

t(11,14) in which Cyclin D1 gene on chromosome 11 translocates with IgH on chromosome 14

77
Q

Complication of follicular lymphoma

A

Progression to diffuse large B-cell lymphoma

78
Q

Chronic lymphocytic leukemia is the neoplastic proliferation of _________ cells that express CD5 and CD20.

A

Naive B Cells

79
Q

How is CML distinguised from a leukemoid reaction?

A
  1. Negative leukocyte alkaline phosphaase stain
  2. Increased basophils
  3. t(9,22)
80
Q
  • Blasts infiltrate gums
    • Lack MPO
A

Acute monocytic leukemia

81
Q

_________ is used for screening for mono.

A

Monospot test

*Detects IgM antibodies that cross-react with horse or shep red blood cells (heterophile antibodies)

82
Q

list examples of chronic inflammatory states associated with marginal zone lymphoma

A
  • Hashimoto thyroiditis
  • Sjogren syndrome
  • H. pylori gastritis
83
Q

Rheumatoid arthritis and early stages of HIV infection will lead to what type of lymph node hyperplasia?

A

Follicular

84
Q

Complications of chronic lymphocytic leukemia

A
  • Hypogammaglobulinemia
  • Autoimmune hemolytic anemia
  • Transformation to diffuse large B-cell lymphoma (Richter transformation)
85
Q

Immature neutrophilic cells are characterized by decreased ______.

A

CD16 (Fc receptors)

*Results in decreased opsonization

86
Q

Most common primary malignancy of bone

A

Multiple myeloma

87
Q
  • Co expression of CD5 and CD20
  • Increased lymphocytes
  • Smudge cells
A

Chromic lymphocytic leukemia

88
Q

Causes of infectious mononucleosis

A

EBV

CMV *less common

89
Q
  • t(15, 17)
  • Increased risk for DIC
A

Acute promyelocytic leukemia

90
Q

Causes of neutrophilic leukocytosis

A
  • Bacterial infection or tissue necrosis
  • High cortisol state

*Induce release of marginated pool (both) and bone marrow neutrophils, including immature forms (infection/necrosis)

91
Q

Neoplastic proliferation of mature myeloid cells, especially RBCs

A

Polycythemia vera

92
Q

In chronic lymphocytic leukemia, involvement of lymph nodes leads to generalized lymphadenopathy and is called __________.

A

Small cell lymphoma

93
Q

In hairy cell leukemia, where are hair cells trapped in the spleen?

94
Q

Clinical features of Hairy Cell Leukemia

A
  • Splenomegaly
  • “Dry tap” on bone marrow aspiration

*Lymphadenopathy is usually absent

95
Q

Clinical feautures of Waldenstrom macroglobulinemia

A
  • Generalized lymphadenopathy
  • Increased serum protein with M spike (IgM)
  • Visual and neurologic deficits
  • Bleeding
96
Q

B-ALL is characteristized by lymphoblasts that express what markers?

A

CD10, CD19, CD20

97
Q

___________ is the earliest change to emerge after whole body radiation.

A

Lymphopenia

98
Q

Complications of mono

A
  • Increased risk for splenic rupture
  • Rash if exposed to ampicillin
  • Recurrence (due to dormancy) and B cell lymphoma (in immunodeficiency)
99
Q

First line of treatment for CML

A

Imatinib, which blocks tyrosine kinase activity

100
Q

How does T-ALL present in teenagers?

A

As a mediastinal thymic mass called a lymphoblastic lymphoma

101
Q

Which type of hodgkin is the most aggressive?

A

Lymphocyte-depleted

*Usually seen in the elderly and HIV-positive people

102
Q

Draining of tissues with cancer will lead to what type of lymph node hyperplasia?

A

Sinus histiocytes (medulla)

103
Q

ALL has an excellent response to chemotherapy but requires prophalaxis to _______ and ____.

A

Scrotum; CSF

104
Q

Treatment of polycythemia vera

A

Phlebotomy

Hydroxyurea (second line)

105
Q

Clinical features of myelofibrosis

A
  • Splenomegaly due to extramedullary hematopoiesis
  • Leukoerythroblastic smear
  • Increased risk of infection, thrombosis, and bleeding
106
Q

Hematopoiesis occurs via a stepwise maturation of _______ hematopoietic stem cells.

107
Q

Causes of painful lymphadenopathy

A

Lymph nodes draining a region of acute infection

108
Q

Adult T-cell leukemia is the neoplastic proliferation of ___________ .

A

Mature CD4 T cells

109
Q

Causes of neutropenia

A
  • Drug toxicity
    • Damage to stem cells results in decreased production of WBCs, especially neutrophils
  • Severe infection
110
Q

Essential thrombocythemia is assocated with ________ mutation.

A

JAK2 kinase

111
Q

Why does a high cortisol state lead to lymphopenia?

A

Induces apoptosis of lymphocytes

112
Q

In CML, _________ suggests progression to accelerated phase of disease.

A

Splenomegaly

*Transformation to acute leukemia usually follows shortly thereafter

113
Q

Primary effusion lymphoma associated with which virus

114
Q

Which form of MALToma is resistant to antibiotics?

115
Q

Which lymphoma is associated with a BRAF mutation?

A

Hairy cell leukemia

116
Q

Fried egg appearance in bone marrow

A

Hairy cell leukemia

117
Q

High Ki67

A

Diffuse large b cell lymphoma

118
Q

CD38

A

Plasma cells

119
Q

Stains for amyloid

A

Congo red stain

Apple green birefringence

120
Q

CD20+, CD30-, CD15-

A

Nodular lympocyte predominant hodgkin

121
Q

Conditions associated with a thymoma

A

Epithelial neoplasm of thymus

Myastenia gravis

Pure red cell aplasia

OS2 (10 decks)

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