White blood Cells Flashcards
What CD distinguishes a hematopoietic stem cell?
CD34
What type of cell is the most sensitive to radiation?
lymphocytes –> lymphopenia
What is the effect of cortisol on white blood cells?
leukocytosis - release of marginated pool
bats in a cave - no not boogers in your nose
In which type of cancer are eosinophils strangely very high?
hodkins lymphoma
Which neoplasm inc basophils?
CML
What is a type of bacteria that produces lymphocytosis?
bortadella pertussis
what are in mast cell granules?
histamine, heparin, eosinophil and neutrophil chemotactic factors
What are lymphoblasts specifically positive for that are not present in myeloid blasts, and mature lymphocytes?
Tdt - DNA polymerase
What is the most common type of ALL and what population is it frequent in?
B-ALL
-children younger than 6
Is CD10 present in cells of B-ALL or T-ALL?
B-ALL ONLY
What is the most common presentation in Tacute lymphoblastic lymphoma?
mediastinal thymic mass in a teenager
Myeloblasts are characteristic for staining for what?
MPO - auerer rods
What are some common myeloid antigens?
CD13, CD15, CD33, CD117 (Ckit)
What population is acute myeloid leukemia most common in ?
adults 50-60
APL:
- translocation
- treatment
T(15,17)
all trans retinoic acid
What two types of chemo inc the risk for AML?
- alkylating agents
- topo II inhibitors
B-CLL and SLL are indistinguishable phenotypically, genotypically, morphologically, so what the hell is the difference?
B-CLL - found in blood and BM
SLL - solid tumor mass of LNs
-malignant proliferation of naive B cells
What are some complications of B-CLL/SLL?
- hypogammaglobulinemia - infection = most common cause of death
- autoimmune hemolytic anemia
- transformation to DLBL (Richter)
Hairy cell leukemia is associated with activation of what ?
BRAF serine/threonine kinase
What does hairy cell leukemia stain positive for?
TRAP
What chemo drug is effective for hairy cell leukemia?
2 CDA - adenosine deaminase inhibitor
What leukemia is HTLV1 associated with?
ATL
How is ATL distinguished from multiple myeloma?
presence of a rash
lytic bone lesions are seen in both
What is mycoides fungoides?
neoplastic proliferation of mature CD4+ T cells - form pautrier microabscesses, which look like fungus
What is called with mycoides fungoides spreads to the blood?
sezary sydrome
What are five examples of myeloproliferative disorders?
- CML
- polycythemia vera
- essential thrombocythemia
- myelofibrosis
- mastocytosis
What are three complications of myeloproliferative disorders?
- hyperuricemia and gout
- progression to marrow fibrosis - spent phase
- transformation to acute leukemia
-except essential thrombocytopenia!w
What are the two most common acute leukemias that CML progresses to?
- AML -2/3
2. ALL - 1/3
How do you distinguish CML from a leukomoid reaction?
- CML granulocytes lack leukocyte analine phosphatase
- CML - inc basophils
- philadelphia chromosome in CML
What is mutated in polycythemia vera , essential thrombocytopenia, and myelofibrosis?
JAK2 Kinase
In PV are the SaO2 and EPO inc, dec, or neither?
SaO2 - normal
EPO - decreased (negative feedback)
In reactive polycythemia due to lung disease are the SaO2 and EPO inc, dec, or neither?
Sao2 - decreased
EPO - inc (positive feedback)
In reactive polycythemia due to Renal cell carcinoma are the SaO2 and EPO inc, dec, or neither?
sao2 = normal
EPO - high (lack of neg feedback)
What is the common visual appearance of mastocytosis?
urticaria pigmentosa - multiple tan brown nodules on skin of trunk
- most often in children
What is the usual diagnosis when the following lymph nodes are swollen:
- posterior auricular
- occipital
- posterior cervical
- axillary
- inguinal
- rubella
- scalp infection
- toxoplasmosis
- infection of chest wall
- legs or venereal infection
What is the usual cause of follicular hyperplasia?
rheumatoid arthritis
early stage HIV
What is the most common type of lymphoma?
Nonhodkins specifically - DLBCL
Nonhodkins lymphomas typically present in males, except for which type that is more common in women?
follicular lymphoma
What is the transformation in follicular lymphoma?
T(14, 18) - persistent activation of Bcl2
What type of lymphoma can follicular lymphoma progress to?
DLBCL
What is the translocation in mantle cell lymphoma?
T (11,14) - activation of cyclin D1 (bcl1)
-G1 –> S progression
What three conditions are marginal zone lymphomas associated with?
- hashimotos
- sjogren
- H pylori
How would you distinguish burkitt’s lymphoma from B-ALL?
burkitts - no expression of Tdt
What is the translocation in burkitts?
T(8,14) - activation of c-myc
What is the classic histological appearance of burkitts?
starry sky - lots of blue active cells with dead white cells
Where is the most common site of disease in DLBCL?
GI
What ages is hodkins lymphoma most common in?
between 10 and 30
What are the class cells of hodkins lymphoma and what markers are present on them?
-Reed sternberg cells - multilobed nuclei with prominent nucleoli
CD15+, CD30+
What is the most common subclass of hodkins lymphoma and describe it
nodular sclerosis
- cervical or mediastinal LN
- fibrosis forms nodules
- reed sternberg cells in wide open spaces - lacunar cells
Which subytype of hodkins lymphoma has the worst prognosis? best?
lymphocyte depleted - worst
lymphocyte rich - best
Which subtype of hodkins lymphoma has abundant eosinophils?
mixed cellularity
What is the most common primary malignancy in bone?
multiple myeloma
What are the clinical features of mult myeloma?
CRAB
- hypercalcemia
- renal - bence jones proteins - free light chain depositis
- anemia
- bone loss - lytic lesions
also:
- primary AL amiloidosis - free light chain
- inc risk of infection
- rouleaux formation
What is the classic finding on serum protein electrophoresis in mult myeloma?
M spike - usually IgG or IgA
What are two other causes of an M spike besides multiple myeloma?
- monoglonal gammopathy - old people
- waldenstrom macroglobulinemia - IgM
- no lytic bone lesions in either
What are the complications of waldenstrom macroglobulinemia?
Hyperviscosity—>retinal hemorrhage, stroke
What is the classic histiologic finding in langerhans histiocytosis?
birbeck granules
If an adolescent presents with an unlikely bone fracture with no apparent reason what should you expect -besides abuse obvi ?
eosinophilic granuloma
What are the classic findings in a spleen in RA and SLE
RA - germinal centers
SLE - fibrinoid necrosis of capsular and trabecular collagen
(onion thickening of central arterioles in white pulp)
What are gamna gandy bodies and when are they found?
foci of old hemorrhages
-spleen in sickle cell anemia
