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white blood cell disorder Flashcards

1
Q

what is the marker for hematopoietic stem cell

A

CD34

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2
Q

high cortisol state and neutopenia

A

due to lack of attachment and migration

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3
Q

mechanism of eosinophilia in Hodgkins

A

increased IL-5 production

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4
Q

basophilia

A

CML

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5
Q

what tissues are infected in EBV

A

oropharynx, liver and B cells

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6
Q

what is the presentation of EBV

A

paracortical expansion of the lymph node. splenomegaly (periarterial lymphatic sheath). high white count with atypical lymphocytes.

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7
Q

monospot test

A

detects IgM heterophile antibodies. these are usually sheep. if negative, think CMV

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8
Q

complications of EBV

A

splenic rupture, rash if penicillin exposure, dormancy in B cells (increased risk of recurrence and lymphoma).

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9
Q

acute leukemia

A

neoplastic proliferation off blasts. >20% in the bone marrow. they crowd out normal hematopoiesis. there will neutropenia, thrombocytopenia, anemia

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10
Q

what do blasts look like

A

immature, lack of cytoplasm. large. large nuclei and nucleoli

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11
Q

myeloidblast

A

AML myeloperoxidase present (auer rods

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12
Q

lymphoblast

A

ALL there is positive tDt

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13
Q

ALL

A

neoplastic accumulatio of lymphoblsats. positive for TdT (DNA polymerase in the nucleus). presents i children. associated with downs syndrome after 5. subdivided into B-ALL/T-ALL

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14
Q

B-ALL.

A

most common type. CD10, CD19, CD20. responds well to chemo.

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15
Q

what cytogenetic abnormalities affect the prognosis

A

T (12, 21) good prognosis.

t(9, 22) philadephia (this is the chromosome found in CML) poor prognosis

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16
Q

T-ALL

A

lymphoblastic markers ranging from CD2-CD8. NO CD10. TdT +

presents as a thymic mass in a teenager. this is acute lymphoblastic lymphoma.

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17
Q

AML

A

neoplastic myeloblasts. look for MPO or auer rods. punched out nucleus. common in older adults.

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18
Q

subclassification of AML

A

think t(15, 17) -APL

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19
Q

APL (type of AML)

A

t(15, 17) disrupts retanoic acid receptor. contain auer rods. there is a risk of DIC. ATRA treatment.

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20
Q

acute monocytic leukemia

A

proliferation of monoblast. usually lacks MPO. characteristically affects the gums

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21
Q

acute megakaryoblastic leukemia

A

megakaryoblasts, lack MPO. down syndrome before the age of 5

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22
Q

chronic leukemia

A

neoplastic proliferation of mature circulating lymphocytes. insidious onset, can live a long time with the disease. older patient.

23
Q

CLL

A

naive B-cell. CD5, CD20. smudge cells. generalized lymphadenopathy

24
Q

complications of CLL

A

hypogammaglobinemia, autoimmune hemolytic anemia. trasnformation into large B-cell lymphoma

25
Q

hairy cell leukemia

A

mature B cell proliferation. hairy cytoplasmic processes. TRAP positive. splenomegaly (red pulp expansion). LAD absent. cells are TRAPped in to the bone marrow and red pulp.

26
Q

what do we treat leukemia with

A

2-CDA -adenosine deaminase inhibitor

27
Q

ATLL

A

CD4+ t cells. associated with HTLV-1 (japan and Caribbean) presents with rash. LAD and splenomegaly lytic bone lesions with hypercalcemia.

28
Q

lytic bone lesions with a rash

A

ATLL

29
Q

mycosis fungiodes

A

CD4+ T cells. infiltrate the skin, rash, plaques and nodules. aggregates in the epidermis pautier microabscesses

30
Q

sezary syndrome

A

mycosis fungoides of the blood. cerebriform nuclei lymphocytes

31
Q

CML

A

myeloid cells, especially granulocytes. basophils are characteristic. driven by t(9, 22). increased tyrosine kinase activity. imatinib treatment. splenomegaly is common.

32
Q

CML with enlarging spleen

A

accelerated phase. heralds transformation phase.

33
Q

transformation of CML

A

when it transforms into an acute leukemia. can yield AML (2/3), ALL(1/3)

34
Q

how to distinguish CML from leukomoid reaction

A

granulocytes with LAP (-)
increased basophils
look for philadephia chromosome

35
Q

polycythemia vera

A

JAK2 kinase mutation. hyperviscosity. blurry vision and HA. budd-chiari syndrome. itching after bathing. flushing of the face

36
Q

reactive polycythemia

A

lung disease (O2 low, EPO high). renal cell carcinoma (EPO production, normal O2).

37
Q

essential thrombocytopenia

A

platelets. JAK2 kinase mutation. increased risk of bleeding or thrombosis. rarely progresses to fibrosis or leukemia. no significant gout

38
Q

myelofirbosis

A

megakaryocytes. JAK2 kinase mutation. excess PDGF. results in marrow fibrosis.

39
Q

clinical of myelofibrosis

A

splenomegaly, extramedullary hematopoiesis. increased infections, thrombosis and bleeding. leukoerythroblastic smear -release of immature cells into the blood stream.

40
Q

characteristic RBC of myelofibrosis

A

tear drop cells

41
Q

follicular expansion

A

rheumatoid arthritis

42
Q

paracortical expansion of the lymph node

A

viral disease

43
Q

three key lymphoma s

A

follicular, mantle, marginal

44
Q

follicular lymphoma

A

small B cells. CD20. nodules. late adulthood. painless LAD. overexpression of Bcl2

45
Q

what is the BCL2 translocation

A

t(14, 18) BCL translocates from 18 to the Ig heavy chain locus on 14
can progress to diffuse large B cell lymphoma
there are no macrophages present in the germinal center

46
Q

mantle cell lymphoma

A

small b cells CD20+ generalized painless LAD.

expands the region immediately adjacent to the follicle.

47
Q

translocation of mantle cell lymphoma

A

driven by 11, 14. cyclin D1 to the heavy chain locus on 14. from G1-S phase.

48
Q

marginal zone

A

expands the marginal zone CD20+
associated with chronic inflammatory states like sjrogens, hashimotos, h pylori.
MALToma is subtype

49
Q

burkitt lymphoma

A

intermediate B cells. extranodal mass in child or young adult. african form in the jaw. sporadic in the abdomen. 8, 14 C-MYC overexpression promotes cell growth. stary sky

50
Q

diffuse large cell b cell lymphoma

A

large b cells. CD20 that grow in diffuse sheets. most common form of NHL. clinically aggressive. presents in late adulthood.

51
Q

hodgkins lymphoma

A

rare neoplastic cells that secrete cytokines. reed-sternberg cell. CD15/CD30 +
multilobular nucleus. owl-eyed nucleus.

52
Q

reed sternberg cells

A

fever, chills, night sweats due to cytokines. reactive cells and fibrosis is common.

53
Q

subtype of reed-sternberg

A

nodular, lymphocyte-rish, mixed cellular, lymphocyte depleted.

54
Q

most common form of hodgkins

A

nodular sclerosis
enlarging cervical neck or mediastinal. young female. lymphnode divided by broad pink bands of fibrosis. reed-sternberg sits in the big open spaces and are called lacunar cells.

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