-
AML
- adults
- failure to mature the myeloid cells
- Auer rods=aggregates of granules in cytoplasm of blasts/ diagnostic
- Tx=aggressive chemo/BMT
-
ALL
- Children
- No distinguishing morphologic features
- Dx=lymphoid surface antigens
- B or T cell precursors
- good prognosis
-
CML
- proliferation of granulocytes in blood and marrow
- adults 45-55
- initial chronic phase/acute leukemia (blast crisis)
- Philadelphia chromosome (9,22)
- Inc WBC#/hypercell marrow
- Tx=tyrosine kinase Inhib/Gleevec/Imatinib
-
CLL
- B lymphocytes
- Males>60
- Incurable but indolent
-
Lymphoma
- B or T cells
- node/solid lymphoid tissue
- Sx= lymphadenopathy/splenomegaly/B symptoms
- Dx=node biopsy for lrg/long 4-6 wks/inc size
-
Follicular cell Lymphoma
- low grade
- aggregates of lymphocytes
- marrow involvement
- middle/older age (can transform into higher grade)
-
Diffuse Large B cell Lymphoma
- localized disease
- any age
- large cells with prominant nuclei
-
Burkitt Lymphoma
- B cell
- (8,14) translocation
- fast double time (24 hrs)
- "starry sky"
- EBV associated
-
Hodgkin Lymphoma
- Reed-sternberg cells
- types: nodular sclerosis/mixed cellularity/ lymphocyte predominance
- Sx: enlarged nodes (neck/chest)/B signs
-
Plasma cell myeloma
- monoconal immunoglobulin may be detected in serum
- lytic lesons/hypercalcemia
- older people
- Sx: bone pain
- incurable/5 yr survival
-
Spleen disorders
- reactive (inflammation)
- congestive (cirrhosis/CHF)
- infiltrative
-
Thymus
- crucial in T cell development
- Tumor: benign/myasthenia gravis
-
Iron Deficiency Anemia
- Causes: dietary/blood loss/menses/pregnancy
- Smear: hypochromic/microcytic
- Marrow: dec Fe in macrophage or RBC precursor
- Lab: dec serum/inc TIBC/dec saturation
-
B12 deficiency
- Delayed division in all cells
- Marrow: hypercell
- Smear: large oval RBC/hypersegmented WBC
- Causes: poor absorb/Pernicious (AI)/cord degen
-
Folate Deficiency
- Delayed division in all cells
- Marrow: hypercell
- Smear: large oval RBC/hypersegmented WBC
- Causes: inc RBC destruction leads to inc folate use
-
Nephrotic syndrome
- heavy proteinuria (>3.5gr/24hrs)
- hypoproteinemia
- periferal edema
- hyperlipidemia
-
Nephritic syndrome
- hematuria
- proteinuria (<3.5gr/24hrs)
- oligouria
- Dec GFR (Inc BUN/CR)
- HTM (may have)
-
Glomerulonepritis
- primary: renal disease only
- secondary: systemic disease w/renal involve
- Lab: >1gr protein/24hrs/red cell casts/
- Dx: biopsy
-
Pyelonephritis
- Neutrophilic response leads to fibrotic lesions
- ascending infections
- Acute: fever/white cell casts/leukocytosis
- Chronic: polyuria/HTM/renal insufficiency
-
-
Vascular Kidney disease
(nephrosclerosis)
- Benign: from essential HTN
- Malignant: sudden onset of HTN/life-threatening
-
Cystitis
- Sx: burning/frequency/urgency
- Risk: remale/FB obstruction/instrumentation
-
vWD
- abnormal vWF (protected by Factor 8)
- Sx: easily bruise/nose bleeds/heavy periods
- Type I: quantitative/all fragments but too little #
- Type II: qualitative
- Type III: no vWF/severe sx
-
Hemophilia
- x-linked recessive
- Type A: factor 8 (common)
- Type B: factor 9
- Sx: bleeding into joints/muscles/organs
- Repete bleeds=damage/pain/deformities
- Tx: recombinant factors
-
Osteoarthritis
- One joint
- destruction of hyaline cartilage
- Normal wear&tear/heavy use/damage
- compensatory bone hypertrophy (inc SA of joints)
-
Rheumatoid arthritis
- AI rxn to synovial membrane in many joints
- chronic inflammation of synovial mem (pannus) dislocates bones
-
Sprain
tearning of ligaments/joint capsules
-
Strain
tearning of muscle/tendon
-
Meningocele
herniation of meninges
-
Meningomyelocele
herniation of nerve roots and spinal cord
-
Achondroplastic
- most common type of dwarfism
- fail normal bone/cartilage formation and growth
-
Osteomalacia
- adults (bones break)
- Rickets=kids (bones bend)
- Vit D deficiency
-
Paget's Disease
- >40 yrs
- resorb bone and replace w/poorly mineralized
- "mosaic tile" under microscope
- 10% develop osteosarcoma
-
Osteomyelitis
- Sequestrum: walled off dead bone
- Involucrum: new bone formed to wall off infection
-
Osteosarcoma
- Dx: cells making osteoid
- Lytic or blastic
- 10-25 yrs
- metaphysis, usually around knee
- Poor prognosis
-
Chondrosarcoma
- >35
- slow growth/trunk/upper extremities
-
Comminuted fracture
- fragmented
- multiple pieces
-
Green stick fracture
incomplete
-
Bone healing
- fibrin clot at site (cells of periosteum/endosteum organize)
- callus formed (granulation tissue/soft)
- calcification (bone callus)
- enchondral bone formation (cartilage turned to bone)
- lamellar bone replaces bone callus trabecular bone
-
Type I muscle
- antigravity
- slow twitch
- myoglobin/oxidative metabolism
- late to fatigue
-
Type II muscle
- bursts of great strength
- fast twitch
- lack myoglobin/anaerobic/lactic acid build up
- fatigues early
-
Duchenne muscle dystrophy
- most common
- sex-linked recessive (male)
- early onset
-
Myotonic dystrophy
- autosomal dominant
- onset later in life
- normal life expectancy
-
Hydrocephalus causes
- congenital malformations
- neoplasms
- meningial scaring
-
Glial cells
- Astrocyte: supporting cell/scar formation
- Oligodendrocyte: myelin (PNS=schwann cell)
- Ependymal: lines ventricular system
-
Epidural hematoma
- btw skull and dura
- rupture of artery/fracture skull
- rapid
-
Subdural hematoma
- btw dura and brain
- rupure of veins
- slow onset
-
Cerebral aneurysm
- localized dilation in vessel wall
- lack internal elastica
- occur at branch points (middle and ant cerebral branches)
-
Brain abscess
- infection of brain substance
- extensive necrosis
- bacteria/fungus
-
Encephalitis
- infection of brain substance
- minimal necrosis
- virus
-
Alzheimer's disease
- progress loss of intelectual/cognitive skills
- neuritic plaques/neurofibrillary tangles
-
Parkinson's disease
- Lewy bodies
- tremors
- loss spontaneous movements
- rigidity
- Substantia nigra looses pigment
-
meningitis
- confinded to arachnoid
- bacterial/fungal/viral
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