White Blood Cell Disorders 1

Question 1

drug induced neutropenia is often due to suppression of ________

Answer 1

suppression of committed myeloid precursors

Question 2

what are some causes for peripheral loss of neutrophils resulting in neutropenia

Answer 2

• immune related
• splenic sequestration
• increased consumption of neutrophils

Question 3

the most common cause of severe neutropenia is _____

Answer 3

drug induced (chemotherapy)

Question 4

for predictable neutropenia caused by chemotherapy, treating includes a _____ (drug: ____)

Answer 4

G-CSF (granulocyte colony stimulating factor)

drug: filgrastim

Question 5

what are some reactive changes in neutrophils in a patient with bacterial sepsis that you can see on histology?

Answer 5

Dohle bodies which are small blue cytoplasmic patches of dilated ER

Question 6

which lymphomas are often associated with eosinophilic leukocytosis

Answer 6

• Hodgkin’s

- T cell

Question 7

which skin diseases are associated with eosinophilic leukocytosis

Answer 7

• bulls pemphigus and pemphigoid

- dermatitis herpetiformis

Question 8

Dohle bodies, seen in ______ is indicative of _____

Answer 8

neutrophils (Dohle bodies are small cytoplasmic inclusions)

indicative of a patient with bacterial sepsis

Question 9

if you see basophilic leukocytosis on histology, it almost alway syndicates which myeloproliferative neoplasm?

Answer 9

CML

Question 10

viral infections from EBV, Hep A and CMV are causes for reactive monocytosis/lymphocytosis

Answer 10

reactive lymphocytosis

Question 11

inflammatory bowel diseases such as ulcerative colitis is a cause of reactive monocytosis/lymphocytosis

Answer 11

monocytosis

Question 12

infectious mononucleosis is the most common example of reactive ______

Answer 12

atypical lymphocytes

Question 13

in the lymph node, most of the B cell activity occurs in the _________

Answer 13

follicle (cortical region)

Question 14

paracortical hyperplasia of the lymph node is associated with _____

Answer 14

T cell response

Question 15

what do you see in the medulla of the lymph node?

Answer 15

mainly plasma cells

Question 16

it is hard to tell the difference from the peripheral blood between: reactive increase in granulocytes aka neutrophils (leukmoid reaction) vs _____

Answer 16

CML

Question 17

a child presents to the office with axillary lymphadenopathy, what should be done?

Answer 17

• because it is a child, lymphadenopathy is often due to meeting with pathogens (reactive)
• no need to rush for a biopsy. just have them come back after some time and see if it has gotten smaller

Question 18

general categories of causes of WBC malignancies

Answer 18

• pro growth mutations: tyrosine kinase mutations, MYC translocation
• ↑ self renewal: MLL translation, PML-RARA fusion gene
• ↓ apoptosis (pro survival): BCL2 tranlocation

Question 19

what is the difference between leukemia and lymphoma

Answer 19

• leukemia: neoplasia involves predominantly the bone marrow and peripheral blood at the time of presentation
• lymphoma: neoplasia from discreet tissue masses at the time of presentation

Question 20

almost all of ______ lymphomas present with ____ lymph node enlargement
(tender/nontender)

Answer 20

HODGKIN’S

NON TENDER

Question 21

lymphoid leukemias present with _____

Answer 21

cytopenias because symptoms and signs are related to bone marrow replacement

Question 22

in the lymphoid lineage, plasma cell neoplasms usually present with ______

Answer 22

bone destruction leading to bone pain due to pathological fractures

Question 23

extra nodal enlargement and thus GI symptoms and local symptoms are common in ______ lymphoma

Answer 23

NON HODGKINS

Question 24

B/T cell neoplasms show light chain restriction by expression either kappa or lambda chains

Answer 24

B cell neoplasms

Question 25

the _____ or ____ chains in B cell neoplasms can be detectable via ____ or _____

Answer 25

kappa or lambda;

flow cytometry or immunohistochemical stains

Question 26

what translocation is associated with follicular lymphoma?

Answer 26

t(14,18)

Question 27

what translocation is associated with mantle cell lymphoma

Answer 27

t(11,14)

Question 28

what translocation is associated with MALToma

Answer 28

t(11,18)

Question 29

t(8.14)

Answer 29

Burkitt’s lymphoma