Term
| what are the 2 leukopenias, which is most common, how many cells |
|
Definition
neutropenia/agranulocytosis <1000 cells/ul
lymphopenia (T/B cells) - less common |
|
|
Term
|
Definition
inadequate or ineffective granulopoiesis
increased grnulocytosis removal or destruction |
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|
Term
| what are 3 causes of neutropenia caused by inadequate or ineffective granulopoiesis |
|
Definition
aplastic anemia: marrow failure
leukemia: marrow replaced by tumor
chemotherapy drugs |
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|
Term
| what are 3 causes of neutropenia caused by increased granulocyte removal or destruction |
|
Definition
immune mediated injury: drug, autoimmune
splenic sequesteration: enlarged spleen, hypersplenism
infection: increased peropherial utilization pulls PMN into tissues |
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|
Term
| 3 signs of neutropenia in patient |
|
Definition
susceptibility to bacterial and fungal infection
malase, weakness, fatigue
chills, fever
agranulocytic angina: ulceration of mucosa of mouth and pharynx |
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|
Term
| what are 2 possible changes in the marrow in neutropenia and why |
|
Definition
marrow hypercellularity: when excess destruction or ineffective granulopoiesis
marrow hypocellularity: when drugs or autoimmune supressed granulocytopoesis |
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|
Term
| treatment of neutropenia, why |
|
Definition
GMCSF, GCSF
stimulates neutrophil production in marrow |
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|
Term
| what are 5 types of leukocytosis, how many cells |
|
Definition
WBC >10K
neutrophilic leukocytosis
reactive leukocytosis
monocytosis
eosinophilia
basophilia |
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|
Term
| why is normal leukocytosis confused with leukemia |
|
Definition
| when WBC get so high they look like leukemia (often in kids with acute viral infection) called leukemoid reaction |
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|
Term
| causes of neutrophilic leukocytosis 3, and some examples of each |
|
Definition
bacterial infection: esp pyogenic
tissue necrosis: MI, burns
high cortisol |
|
|
Term
| why does cortisol cause increase in neutrophils |
|
Definition
| cortisol disrupts adhesion of PMN increasing circulation of marginated pool |
|
|
Term
| 2 lab signs of neutrophilic leukocytosis |
|
Definition
immature neutrophils (shift left)
cells have fewer Fc (CD16) receptors (cannot recognize Ig as well) |
|
|
Term
| 2 causes of reactive leukocytosis |
|
Definition
viral infections
borditella pertussis |
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|
Term
| why does boretella pertussis cause leukocytosis and not neutrophilia |
|
Definition
| bordatella blocks lymphcotyes from leaving blood to enter node for further development |
|
|
Term
|
Definition
saliva
normally in teenagers |
|
|
Term
| what are the risk factors for mono 2 |
|
Definition
unable to control infected B cells...
marrow and organ transplant patients: post transplant lymphoproliferative disorder
x-linked lymphoproliferative disorder |
|
|
Term
| when EBV gets in the body where does it go 3 |
|
Definition
| oropharynx, liver, B cells |
|
|
Term
| when EBV invades B cells what does it do in there 2 |
|
Definition
lytic: replication and release of virons
latent: polyclonal activation and proliferation, Ab secretion (heterophil anti-sheep red cell Ab) |
|
|
Term
| when EBV affects T cells what does it do |
|
Definition
| causes circulating atypical lymphocytes (not the main infection point, response to infection) |
|
|
Term
| what is the body's response to EBV at the location of initial infection 5 |
|
Definition
oropharynx: sore throat
liver: hepatitis, rarley jaundice
B cells: fever, lymphadenopathy (post. cervical, axilla, groin) |
|
|
Term
| what do the atypical T cells in EBV look like 4 |
|
Definition
large nuclei
abundent cytoplasm
oval nuclei
few granules |
|
|
Term
| why do people with EBV have splenomeagly |
|
Definition
white pulp (lymphoid T cell area peri-lymphatic sheath) expansion due to atypical lymphocytes
spleen in fragile and prone to rupture |
|
|
Term
|
Definition
increased liver enzymes
monospot test: detect IgM heterophile antibodies (positive within 1wk)
definitive testing: EBV viral capsid antigen |
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|
Term
|
Definition
| none, normally self limiting in 2-6wk |
|
|
Term
|
Definition
hepatic dysfunction: jaundice, liver failure
splenic rupture: avoid sports to 1y
rash if exposed to penicillin
immune compormised allows uninhibited B cell proliferation that transforms into monoclonal B cell lymphoma |
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|
Term
| causes of monocytosis 3, and some examples of each |
|
Definition
chronic infection: TB, endocarditis, rickettsia, malaria
collagen vascular disease: SLE
inflammatory bowel disease: ulcerative colitis |
|
|
Term
| causes of eosinophilis causes 9 |
|
Definition
asthma
hay fever
vasculitis
allergic reaction
phemigus
dermatitis
herpatiforms
parasites
drug reactions
malignancies: hodgkin lymphoma (increased IL-5) |
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|
Term
|
Definition
|
|
Term
| what is the typical presentation of X-linked lymphoproliferative disorder, why is it a concern |
|
Definition
EBV can be fatal
usually young male |
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|
Term
| acute non-specific lymphadenitis: location, cause |
|
Definition
group of nodes or generalized nodes
infection (systemic or localized) |
|
|
Term
| acute non-specific lymphadenitis: node color, shape, internal changes, cells |
|
Definition
swollen red-gray TENDER engourged nodes
large germinal center
central follicle necrosis and abscess when infection severe (may cause overlying skin reaction)
neutrophils: when caused by pyogenic organism |
|
|
Term
| chronic non-specific lymphadenitis: 3 types |
|
Definition
follicular hyperplasia
paracortical hyperplasia
sinus histocytes |
|
|
Term
| cellular changes in chronic non-specific lymphadenitis |
|
Definition
B cell activation causes follicular/germinal center reaction
node archecture preserved
variable germinal center size
T cells, B cells, tangible body macrophages appear |
|
|
Term
| cause of chronic non-specific lymphadenitis 3 |
|
Definition
inflammation or infection...
RA, early HIB, toxoplasmosis |
|
|
Term
| cellular changes in paracortical hyperplasia |
|
Definition
| immune reaction causes T cell activation |
|
|
Term
| 3 causes of paracortical hyperplasia |
|
Definition
viral infection
post-vaccination
drugs |
|
|
Term
| cellular changes in sinus histocytes 3 |
|
Definition
distension and prominence of sinusoids
infiltrated by macrophages
hypertrophy of lining of endothelial cells |
|
|
Term
| cause of sinus histocytes |
|
Definition
|
|
Term
| cause of cat scratch disease |
|
Definition
bartonella henslae infection via feline scratch
usually <18yo |
|
|
Term
| common signs of cat scratch disease, timing of signs, location |
|
Definition
regional lymphadenopathy: usually neck of axilla
2wk after scratch, lasts 2-4wks |
|
|
Term
| 3 rare signs of cat scratch disease |
|
Definition
encephalitis
osteomyelitis
thrombocytopenia |
|
|
Term
| what would a bopisy show in cat scratch disease, how do we visualize it |
|
Definition
silver stain
irregular stellate necrotizing granulomas: sarcoid like granulomas with neutrophils and central necrosis |
|
|
Term
| why does cat scratch disease get sent for biopsy analyzation so often |
|
Definition
| lymphoma is common in kids so need to be cautious, biopsy will clearly distinguish |
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