White Blood Cell Disorders 1 Flashcards

1
Q

Leukocytes make up what percentage of the total blood volume?

A

1%

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2
Q

Where are leukocytes produced?

A

Bone marrow

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3
Q

What is the average lifespan of white blood cells?

A

4 days

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4
Q

What are the terms that mean increased or decreased WBCs?

A
Increased = leukocytosis
Decreased = leukopenia
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5
Q

What can cause leukocytosis?

A

Infection/inflammation, leukemia or lymphoma

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6
Q

What can cause leukopenia?

A

AIDS, corticosteroids

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7
Q

What is the most abundant granulocyte?

A

Neutrophils

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8
Q

Which leukocytes are granulocytes? Which are agranulocytes?

A
Granulocytes = neutrophils, eosinophils, basophils
Agranulocytes = monocytes and lymphocytes
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9
Q

Which type of WBC is associated with allergies and parasites?

A

Eosinophils

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10
Q

Which WBC is rare and prevents excessive clots?

A

Basophils

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11
Q

Which WBC turns into macrophages?

A

Monocytes

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12
Q

Which WBC is involved in adaptive immunity and has a nuclei that occupies most of the cell?

A

Lymphocyte

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13
Q

What are lymphocytes?

A

T cells, B cells, NK cells

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14
Q

What is the most common cause of reactive WBC disorders?

A

Microbial infections

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15
Q

What type of disorder makes up 40% of all childhood cancer related death?

A

Neoplastic WBC disorders (9% of adult)

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16
Q

What are the two types of WBC disorders?

A

Reactive (response to underlying disease) or neoplastic

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17
Q

What is the difference between neutropenia and agranulocytosis?

A

Neutropenia =

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18
Q

What things can cause neutropenia?

A

Metastasis to bone, infection like HIV, ADRs, autoimmune injury, granulomas, chemotherapy, corticosteroids

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19
Q

What pathogen is responsible for infectious mononucleosis?

A

Epstein-Barr virus (EBV) aka Human herpesvirus 4 (HHV-4)

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20
Q

What are the signs and symptoms of mono?

A

Pharyngitis, fever, generalized lymphadenitis, splenomegaly, hepatitis

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21
Q

How long does it take for mono to self-resolve?

A

4-6 weeks

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22
Q

How is mono diagnosed?

A

Monospot test for EBV antibodies

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23
Q

Mono is a risk for later issue?

A

Various B cell malignancies (immunosuppression can add to the risk)

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24
Q

What is reactive lymphocytosis?

A

Infected and atypical B cells (12,000-18,000 cells/microliter)

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25
Q

What is the shape of B cells under microscopy with mono?

A

Oval, large, irregular with folded/indented nuclei

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26
Q

When does mono usually infect people in developing countries? In already developed countries?

A
DevelopING = during childhood
DevelopED = adolescence
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27
Q

Is mono during childhood in developing countries usually symptomatic or is mono during adolescence in developed countries usually symptomatic?

A

During adolescence in developed countries (example = US)

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28
Q

What percent of those exposed to EBV succumb to infection?

A

50%

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29
Q

How is mono most commonly spread?

A

Saliva

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30
Q

What is the nickname for mono?

A

“Kissing disease”

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31
Q

What pathogen is responsible for cat-scratch disease?

A

Bartonella henselae

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32
Q

Cat-scratch disease affects 90% of which age group?

A

Children

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33
Q

What sign is sign 2 weeks after scratch with cat-scratch disease?

A

Cervical and axillary lymphadenopathy

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34
Q

How is cat-scratch fever diagnosed and treated?

A

Diagnosed by presence of Bartonella antibodies

No treatment because it’s self-limiting

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35
Q

Non-Hodgkin and Hodgkin lymphomas along with multiple myeloma are what kind of WBC conditions?

A

Lymphoid neoplasms

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36
Q

Acute myelogenous leukemia, myelodysplastic syndromes, and chronic myeloproliferative disorders are what kind of WBC conditions?

A

Myeloid neoplasms

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37
Q

Langerhans cell histiocytosis is what kind of WBC condition?

A

Histiocytic neoplasm

38
Q

Which involves the marrow or blood: leukemia or lymph? Which involves lymphatic tissues?

A
Marrow/Blood = leukemia
Lymphatics = lymphoma
39
Q

What is the most common feature of acute leukemias?

A

Anemia (fatigue)

40
Q

What are the two types of acute leukemias?

A

Acute lymphoblastic leukemia (ALL)

Acute myeloid leukemia (AML)

41
Q

Does acute lymphoblastic leukemia affect B or T cells?

A

BOTH!

42
Q

Which is the most common type of tumor associated with acute lymphoblastic leukemia: pre-B cell or pre-T cell tumors?

A

Pre-B cell tumors

43
Q

What type of leukemia makes up 80% of all pediatric leukemias?

A

Acute lymphoblastic leukemia

44
Q

When is acute lymphoblastic leukemia most commonly diagnosed?

A

Age 4

45
Q

Acute lymphoblastic leukemia is diagnosed later (ages 15-20) when which lymphocyte is involved?

A

T cells

46
Q

What type of ALL tumor is known as lymphoblastic lymphoma?

A

Pre-T cell tumors

47
Q

What is the location for pre-B cell tumors? Pre-T cell?

A

Pre-B cell tumors = marrow/peripheral blood

Pre-T cell tumors = thymus

48
Q

What is the efficacy rate of chemotherapy with acute lymphoblastic leukemia?

A

80% cured

49
Q

Chemotherapy works best on acute lymphoblastic leukemia with what population?

A

Females ages 2-10 years

50
Q

Chronic lymphocytic leukemia involves which lymphocytes?

A

B cells

51
Q

What is the most common leukemia of adulthood?

A

Chronic lymphocytic leukemia

52
Q

What is the most common leukemia of pediatrics?

A

Acute lymphoblastic leukemia

53
Q

What are the two types of chronic lymphocytic leukemia?

A

CLL = > 4,000 lymphocytes/microliter

Small lymphocytic lymphoma (SLL) =

54
Q

Which involves blood and which involves nodes: small lymphocytic lymphoma or CLL?

A
Blood = CLL
Nodes = SLL
55
Q

Which is more common: CLL or SLL?

A

CLL

56
Q

What is the normal level of lymphocytes per microliter?

A

1000/microliter

57
Q

What is the prognosis for chronic lymphocytic leukemia?

A

Variable (median = 4-6 years

58
Q

CLL can progress rapidly to an aggressive transformation leading to a prognosis of only 1 years survivability and then will resemble what other condition?

A

Diffuse large B cell lymphoma

59
Q

Follicular lymphoma involves which lymphocytes?

A

B cells

60
Q

What are centrocytes?

A

Lymphocytes with cleaved nuclei

61
Q

40% of adult non-Hodgkin’s lymphoma are what type of cancer?

A

Follicular lymphoma

62
Q

What is the age of onset for follicular lymphoma?

A

Over 50

63
Q

What is a unique feature of follicular lymphoma?

A

PAINLESS, generalized lymphadenopathy

64
Q

What is the prognosis for follicular lymphoma?

A
Range = 1-20 years
Average = 7-9 years
65
Q

85% of cases of which type of cancer have a translocation of t(14;18) of the BCL2 gene resulting in what?

A

Follicular lymphoma; decreased B cell apoptosis (inhibition of cancer death)

66
Q

Centrocytes and nodular aggregates of cancerous B cells are associated with what type of lymphoma?

A

Follicular lymphoma

67
Q

Approximately 40% of follicular lymphoma cases will progress into which aggressive condition?

A

Diffuse B cell lymphoma

68
Q

The majority of lymphomas are involved with which type of lymphocyte?

A

B cells

69
Q

Mantle cell lymphoma is involved with which type of lymphocyte?

A

B cells

70
Q

What specific structure is dysfunctional with mantle cell lymphoma?

A

Cyclins

71
Q

What is the function of cyclins?

A

Regulation of the cell cycle

72
Q

Where can mantle cell lymphoma be seen?

A

Marrow, spleen, liver, possibly GI looking like a polyp

73
Q

What is the gender bias associated with mantle cell lymphoma?

A

Males more likely to be affected

74
Q

What is the average age of diagnosis of mantle cell lymphoma?

A

Over 50

75
Q

What is the prognosis for mantle cell lymphoma?

A

POOR: 3-5 years average survival rate

76
Q

What is the most common lymphoma of adulthood?

A

Diffuse large B cell lymphoma

77
Q

What is the average age of diagnosis of diffuse large B cell lymphoma?

A

60 (but possible at any age: 15% of childhood lymphomas)

78
Q

What condition makes up 50% of all Non-Hodgkins lymphomas?

A

Diffuse large B cell lymphomas

79
Q

What is a huge risk factor for diffuse large B cell lymphoma/

A

Previous EBV infection

80
Q

In what extranodal locations can diffuse large B cell lymphoma manifest in the early stages? Late stages?

A
Early = GI tract, brain
Late = liver, spleen, marrow
81
Q

What is the treatment for diffuse large B cell lymphoma?

A

High dose chemotherapy

82
Q

What is the cure rate for diffuse large B cell lymphoma treated with chemo?

A

50% cured, but 80% enter remission with treatment

83
Q

Burkett lymphoma involves which lymphocytes?

A

B cells

84
Q

What type of lymphoma characteristically affects African children?

A

Burkitt lymphoma

85
Q

Which facial structures are affected with Burkitt lymphoma?

A

Mandible and maxilla

86
Q

A “starry sky” pattern produced by macrophages is associated with which lymphoma?

A

Burkitt

87
Q

What is a huge risk factor for the development of Burkitt lymphoma?

A

History of EBV infection

88
Q

What mutated gene is associated with Burkitt lymphoma?

A

MYC gene via t(8;14) which codes for transcription factors

89
Q

What is one of the fastest growing human neoplasms and is a lymphoma?

A

Burkitt lymphoma

90
Q

Is Burkitt lymphoma most commonly extranodal or intranodal?

A

Extranodal

91
Q

Where does Burkitt lymphoma manifest in those who get it in Africa? In the US?

A
Africa = maxilla and mandible
US = abdomen, GI, ovaries
92
Q

What is the prognosis for Burkitt lymphoma?

A

Great = aggressive chemotherapy cures most children