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Pathology > WBC Path > Flashcards

WBC Path Flashcards

1
Q
  • an increase in total circulating white blood cells
A

Leukocytosis

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2
Q
  • an elevated white blood cell count that is a physiologic response to
    stress or infection
A

Leukemoid reaction

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3
Q

– a decrease in total circulating white blood cell count

A

Leukopenia

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4
Q

– all cell lines affected – anemia, thrombocytopenia,

neutropenia

A

Pancytopenia

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5
Q

Clinically relevant neutropenia –

Absolute Neutrophil Count (ANC) < _____/mm3

A

500

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6
Q

Causes of ______
 Decreased production of neutrophils
 Drugs
 Hematologic disease – cyclic neutropenia
 Nutritional deficiency – B12, Folate
 Myelophthisis
 Increased destruction - autoimmune reactions

A

Neutropenia

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7
Q 
 Regular, periodic reductions in neutrophils
 Symptoms greatest at nadir – fever, 
lymphadenopathy, malaise, pharyngitis, 
ulcerations, periodontitis
 Treatment - supportive care, cytokine 
therapy (G-CSF)
A

Cyclic Neutropenia

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8
Q
  • the neoplastic cells are in the bone

marrow and blood

A

Leukemias

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9
Q
  • the neoplastic cells are in the

lymph nodes – (also extranodal sites)

A

Lymphomas

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10
Q

Arises in bone marrow

Spreads to peripheral blood

A

Leukemia

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11
Q

Arises in peripheral lymphoid tissue, usually in lymph nodes
Forms a discrete tissue mass
May eventually spread to peripheral blood and bone marrow

A

Lymphoma

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12
Q 
\_\_\_\_\_ Leukemia
Abrupt, stormy onset
No maturation - precursor cells (blasts) 
proliferate
Kills rapidly without treatment
Cure is possible
A

Acute Leukemia

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13
Q 
\_\_\_\_\_ leukemia
Insidious course
Maturation - mature cells proliferate
Often not treated unless symptomatic
Cannot be cured
A

Chronic Leukemia

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14
Q

Clinical Symptoms of _____ ______
Cytopenias - depression of normal bone marrow function
Bleeding – petechiae, ecchymoses, epistaxis, gingival
hemorrhage due to thrombocytopenia
Fever - infections due to absence of mature granulocytes
Fatigue - anemia

A

Acute Leukemia

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15
Q

Lymphoblasts - immature precursor B or T lymphocytes
arrested at early stage of development
A disease of children
Good prognosis with aggressive chemotherapy

A

Acute Lymphoblastic Leukemia

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16
Q

Myeloblasts – immature myeloid precursors (granulocytic,
monocytic, erythroid, megakaryocytic) with no terminal
myeloid differentiation
Adults
Prognosis – chemotherapy, bone marrow transplantation.
More difficult to treat than ALL.
Gingival enlargement in monocytic types

A

Acute Myeloblastic Leukemia

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17
Q

Clinical Symptoms of _____ leukemia
Often clinically silent
Incidental leukocytosis on CBC

A

Chronic Leukemia

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18
Q 
Adults
Insidious onset, slow progression
Philadelphia chromosome – t(9:22) bcr-abl fusion gene
Splenomegaly, fever, fatigue
Blast crisis 
Bone marrow transplantation
A

Chronic Myelogenous Leukemia

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19
Q 
 Translocation t(9:22)
 Proto-oncogene abl on long arm chromosome 
9(q34)
 Transposed to bcr region (breakpoint cluster 
region) on chromosome 22(q11)
 Results in bcr-abl fusion gene
 Gene product is abnormal 
bcr-abl tyrosine kinase
 Induces cell proliferation
A

Philadelphia Chromosome

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20
Q

Most common type of leukemia
Adults, often asymptomatic
Hypogammaglobulinemia – infections
Anti red cell autoantibodies – autoimmune hemolytic anemia
Anti platelet autoantibodies – autoimmune thrombocytopenia
Richter syndrome – may transform to high grade lymphoma

A

Chronic Lymphocytic Leukemia

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21
Q
  • non-tender lymph node enlargement,

extra-nodal mass

A

Lymphoma

22
Q
  • cytopenias due to suppression of

hematopoiesis

A

Leukemia

23
Q

Are there such things as benign lymphomas?

A

All lymphomas are malignant

24
Q 
Clinical Presentation of \_\_\_\_
 Painless lymphadenopathy with firm, 
enlarged, rubbery, freely movable, 
non-tender lymph nodes
 Generally involves multiple lymph 
nodes in a non-contiguous pattern
 Frequently involves extranodal sites
A

NHL

25
Q

____ grade lymphoma - indolent, difficult to cure

A

Low grade

26
Q

____ grade lymphoma - aggressive, often curable

A

High grade

27
Q

_____ lymphoma
“African Jaw Lymphoma”
B-Cell NHL
EBV association

A

Burkitt Lymphoma

28
Q 
\_\_\_\_\_\_ Lymphoma– Low Grade
Arises from Mucosal-
Associated Lymphoid Tissue 
“MALT-oma” - mature B cells
Often indolent
Salivary glands, Sjogren
Syndrome
May transform to high grade 
lymphoma
A

MALT Lymphoma

29
Q

_____ Lymphoma
A sub-type of non-Hodgkin lymphoma (NHL)
A high grade B cell neoplasm, most rapidly-growing
human neoplasm
The endemic form has a predilection for jaws of children

A

Burkitt Lymphoma

30
Q

What are the 4 EBV associations?

A
  1. Infectious Mononucleosis
  2. Lymphomas – NHL and HL
    e. g. Burkitt lymphoma (NHL)
  3. Nasopharyngeal Carcinoma
  4. Oral Hairy Leukoplakia
31
Q 
Cytogenetics of \_\_\_\_\_\_
 Translocations, t(8:14) is the most 
common
 c-myc proto-oncogene on 
chromosome 8 has a role in cell 
cycle progression
 Immunoglobulin gene promoters 
cause overexpression of c-myc
 Overexpression of c-myc oncogene 
promotes inappropriate cellular 
proliferation
A

Burkitt Lymphoma

32
Q 
Oral Findings in \_\_\_\_\_\_
Rapidly growing painless 
swelling, producing 
paresthesia, loose teeth
Rapid demise if untreated
A

Burkitt Lymphoma

33
Q

What is the neoplastic cell present in Hodgkin Lymphoma?

A

Reed-Sternberg cell/ Owl-eye cell

34
Q 
General Characteristics of \_\_\_\_\_\_\_\_
Bimodal age distribution - young adults, older adults 
Painless lymphadenopathy
Constitutional symptoms variable
Fever – Pel-Ebstein fever
Night sweats
Weight loss
Generalized pruritus
Association with Epstein Barr virus
A

Hodgkin Lymphoma

35
Q

Spread of ______________

 Uniform, predictable pattern of spread from one lymph node region to the next

A

Hodgkin Lymphoma

36
Q

“B” Symptoms for Staging of ________
Recurrent, unexplained fevers
Night sweats
Unintended weight loss

A

Non-Hodgkin Lymphoma

37
Q

If Hodgkin lymphoma is stage 1, radiation or chemo?

A

radiation

38
Q

If Hodgkin lymphoma is stage 4, radiation or chemo?

A

Chemo

39
Q

Older adults
Disseminated neoplasm of terminally-differentiated B
lymphocytes (plasma cells)
Multifocal lytic bone lesions, hypercalcemia, bone pain
Myelophthisic anemia, predisposition to infections

A

Multiple Myeloma

40
Q

Oral Findings of _______:
Lytic lesions, loose teeth, pain, paresthesia,
pathologic fracture
Macroglossia - amyloidosis

A

Multiple Myeloma

41
Q

Laboratory Findings of _________
Elevated serum calcium, protein, immunoglobulins
Elevated erythrocyte sedimentation rate (ESR)
Rouleaux formation

A

Multiple Myeloma

42
Q

 Clinical assessment for adequate number and function of platelets.
 The bleeding time test represents the time taken for a standardized skin puncture to stop
bleeding
 The normal range depends on the actual method used and varies from 2 to 9 minutes
 It is abnormal when there are congenital or acquired platelet defects
 Drugs – ASA, NSAIDS
 Von Willebrand Disease

A

Bleeding Time Test

43
Q
  • decrease in platelets
A

Thrombocytopenia

44
Q
  • increase in platelets
A

Thrombocytosis

45
Q

 Aspirin - inhibits aggregation for lifetime of platelet (8-10d) (irreversible)
 NSAIDs - inhibits aggregation until drug eliminated (reversible)
 Von Willebrand Disease - compound defect involving platelet function and
coagulation pathway
 Normal platelet count with increased bleeding time

A

Thrombasthenia

46
Q

Platelet count < 100,000 /mm3

A

Thrombocytopenia

47
Q 
Causes of \_\_\_\_\_\_\_
Decreased production - aplastic anemia
Increased destruction – immunologic destruction
Sequestration in spleen – splenomegaly
Dilution - massive transfusion
A

Thrombocytopenia

48
Q

Autoimmune disease– antiplatelet autoantibodies
produce thrombocytopenia
Treatment with steroids, splenectomy

A

Immune Thrombocytopenic

Purpura (ITP)

49
Q

Primary: hematopoietic stem cell disorder
Increased numbers of megakaryocytes producing dysfunctional platelets
Reactive
Asplenia
Inflammatory disorders

A

Thrombocytosis

50
Q

What type of leukemia is most likely to infiltrate the gingiva?

A

AML

Pathology (26 decks)

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