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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
hairy cell leukemia
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
what do we treat leukemia with
2-CDA -adenosine deaminase inhibitor
27
ATLL
CD4+ t cells. associated with HTLV-1 (japan and Caribbean) presents with rash. LAD and splenomegaly lytic bone lesions with hypercalcemia.
28
lytic bone lesions with a rash
ATLL
29
mycosis fungiodes
CD4+ T cells. infiltrate the skin, rash, plaques and nodules. aggregates in the epidermis pautier microabscesses
30
sezary syndrome
mycosis fungoides of the blood. cerebriform nuclei lymphocytes
31
CML
myeloid cells, especially granulocytes. basophils are characteristic. driven by t(9, 22). increased tyrosine kinase activity. imatinib treatment. splenomegaly is common.
32
CML with enlarging spleen
accelerated phase. heralds transformation phase.
33
transformation of CML
when it transforms into an acute leukemia. can yield AML (2/3), ALL(1/3)
34
how to distinguish CML from leukomoid reaction
granulocytes with LAP (-) increased basophils look for philadephia chromosome
35
polycythemia vera
JAK2 kinase mutation. hyperviscosity. blurry vision and HA. budd-chiari syndrome. itching after bathing. flushing of the face
36
reactive polycythemia
lung disease (O2 low, EPO high). renal cell carcinoma (EPO production, normal O2).
37
essential thrombocytopenia
platelets. JAK2 kinase mutation. increased risk of bleeding or thrombosis. rarely progresses to fibrosis or leukemia. no significant gout
38
myelofirbosis
megakaryocytes. JAK2 kinase mutation. excess PDGF. results in marrow fibrosis.
39
clinical of myelofibrosis
splenomegaly, extramedullary hematopoiesis. increased infections, thrombosis and bleeding. leukoerythroblastic smear -release of immature cells into the blood stream.
40
characteristic RBC of myelofibrosis
tear drop cells
41
follicular expansion
rheumatoid arthritis
42
paracortical expansion of the lymph node
viral disease
43
three key lymphoma s
follicular, mantle, marginal
44
follicular lymphoma
small B cells. CD20. nodules. late adulthood. painless LAD. overexpression of Bcl2
45
what is the BCL2 translocation
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
mantle cell lymphoma
small b cells CD20+ generalized painless LAD. | expands the region immediately adjacent to the follicle.
47
translocation of mantle cell lymphoma
driven by 11, 14. cyclin D1 to the heavy chain locus on 14. from G1-S phase.
48
marginal zone
expands the marginal zone CD20+ associated with chronic inflammatory states like sjrogens, hashimotos, h pylori. MALToma is subtype
49
burkitt lymphoma
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
diffuse large cell b cell lymphoma
large b cells. CD20 that grow in diffuse sheets. most common form of NHL. clinically aggressive. presents in late adulthood.
51
hodgkins lymphoma
rare neoplastic cells that secrete cytokines. reed-sternberg cell. CD15/CD30 + multilobular nucleus. owl-eyed nucleus.
52
reed sternberg cells
fever, chills, night sweats due to cytokines. reactive cells and fibrosis is common.
53
subtype of reed-sternberg
nodular, lymphocyte-rish, mixed cellular, lymphocyte depleted.
54
most common form of hodgkins
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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