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Name two types of Hematologic Neoplasms??
- Myeloid Neoplasms
- Lymphoid Neoplasms
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What is the suspected Cause of Hematologic Neoplasms??
cause is unknown
suspected causes are viruses, radiation, carcinogens
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What is the most common treatement for Neoplasms?
Chemotherapy
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What can be some complications of treatment (chemotherapy) in Neoplasms??
- Anemia
- Infection and bleeding
- Hair loss
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What type of cancer is Leukiemia?
Lymphoid type cancer in the blood
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What type of cancer is Lymphoma??
lymphoma type cancer in tissue
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What is the common cause of death in immunocomprimised leukemia?
INFECTION!!
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Why do Leukemic pts have a lot of pain in the bones and joints??
B/c there leukemic cells are infiltrating in the joint capsules
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What do Leukemic pts experience at Night?
Night sweats to the extreme !! Soaking
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Leukemic pts have abdominal fullness due to What??
Spleenomeglia
- spleen can rupture if palpated to hard
- palpate under supervision
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Acute Leukemia affacts who??
All ages
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In Acute Leukemia cells are ...
dividing in large numbers
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In Acute Leukemia the clinical onset is
Sudden
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Acute Lekemia has anemia that is
Severe
Can be untreated for wks to months
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In Chronic Leukemia there is what kind of mitotic build up??
Slow and Insidious (sneaks up on you)
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Chronic Leukemia has anemia that is
Mild
untreated for months to yrs b/c asymptomatic
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What are the two types of Myeloid Neoplasms??
Chronic Myeloid Leukemia (CML)
Acute Myeloid Leukemia (AML)
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Which Myeloid Neoplasm carries the philadelphia chromosome??
Chronic Myeloid Neoplasm
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What cells are involved in CML??
neutrophils and macrophages
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CML exhibits a majority of what cell and carries what chromosome??
Majority exhibits malignant granulocytes that carry philadelphia chromosome
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The Philly Chromosome is a
gene mutation in gene translocation
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How does CML respond to Chemotherapy
Poorly
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CML is seen mostly in
Adults and is insidious
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AML presents itself at what year of life
64 yrs
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Why is there bone pain in AML
b/c marrow is being invaded
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Why is there anemia in AML and what is that pt at risk for??
b/c RBCs get pushed and crowded out and depleted leading to increased susceptibility to infection
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What are the Different kinds of Lymphoid Neoplasms??
- Chronic Lymphoid Leukemia (CLL)
- Acute Lymphoblastic Leukemia/Lymphoma (ALL)
- Hairy Cell Leukemia
- Plasma Cell Myeloma (multiple myeloma)
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Leukemia are what ??
Localized
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What happens in Chronic lymphoid leukemia (CLL)??
Malignant B-cells become plasma cells making antibodies
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What signs and symptoms are shown in Chronic lymphoid leukemia??
Often asymptomatic
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what is Chronic lymphoid leukemia treated with ??
Chemotherapy and stem cell replacement
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What cells are present in Lymphoid Neoplasms??
•NK Cell Leukemia / Lymphoma
•B cell Leukemia / Lymphoma / Myeloma
•T cell Leukemia / Lymphoma
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What cells are present in Myeloid Neoplasms??
•Neutrophils / Granulocytic Leukemia
•Monocyte / Monocytic Leukemia
•Red Blood Cells / Polycythemia Vera or Erythroid Leukemia
•Megakarocyte cells / Megakarocytic Leukemia
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What happens to WBCs in CLL
increased in WBC
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In CLL thrombocytopenia is what
Mild
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In ALL thrombocytopenia is what ??
mild to severe
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In ALL cell divide how??
cells divide very rapidly in large numbers
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Why does CLL have mild Anemia??
b/c your not slowing down erythropoesis
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What is the peak age for ALL
primarily in children around 3-7 yrs
second leading cause of death in children
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Why does ALL present with bone pain and infection
transformation of blasts in bone marrow
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What is a rare and chronic type of lymphoin neoplams??
Hairy cell leukemia
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What is the primary cell in Hairy cell Leukemia
primarily B cells with cilia looking like hair
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At what age does Hairy Cell Leukemia present itself??
around 35 yrs and more common in men
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What is Plasma Cell Myeloma (Multiple Myeloma)
Malignant disorder in mature plasma cells
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Plasma Cell Myeloma mostly occurs in who??
Adult men
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Where does Plasma Cell Myeloma often go to
Often goes to the Spine and Flat bones of head (calveria)
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What happens when Plasma Cell Myeloma goes into the spine or flat bones of the head??
When the cells invade it causes a lytic reaction ---> breakdown ----> decreased minerals ---> holes
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The lytic reaction in Plasma Cell Myeloma triggers what and are more prone for what ??
The reaction triggers osteoplastic reaction and are prone to pathologic fractures
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The osteoplactic reaction in Plasma Cell Myeloma is what to a disease
it is secondary to a disease
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How does a pathologic fracture happen
There is no trauma involved. a sneeze can cause the fracture
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In Plasma Cell Myeloma what do the malignant plasma cells secrete??
The plasma cells secrete antibodies called Bence-Jones protiens
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What are Bence- Jones proteins are what kind of antibody??
monoclonal antibodies
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Where can Bence-Jones proteins be detected in ??
in the blood or urine can aid in diagnosis.
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What are the two kinds of Lymphoma??
Hodgkin Disease
Non-Hodgkin Disease
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What is Hodgkin Disease
A malignant disorder in the lymph nodes
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What characterizes Hodgkin Disease??
Characterized by presence of Reed-Sternberg cells
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What cells are involved in Non-Hodgkin Disease??
B-cell, T-cell, and NK-cell Lymphomas
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What Cell is not present in Non-Hodgkin Disease??
No Reed-Sternberg cells
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Hodgkins disorder of the lymph nodes typically ...
stay in the nodes
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Non-Hodgkins lymphoma is very
Unpredictable in its spread and is often disseminated at diagnosis.
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HIV infects what cells
Infects Helper T cells (CD4+ Lymphocytes)
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The loss of Helper T cells causes what??
Immunodeficiency
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HIV The viruse has found to be present but not transmitted in what ??
- saliva and tears,
- amnitoic fluid,
- feces and aerisol,
- urine,
- cerebral spinal fluid
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HIV types 1 and 2 are
retroviruses that primarily infect CD4+ lymphocytes and macrophages
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HIV is acquired primarily through what?
- sexual transmission via semen and vaginal and cervical secretions;
- through parenteral transmission via blood,
- bloodproducts,
- contaminated needles/syringes;
- through perinatal transmission from an infected mother to her infant antepartum, intrapartum, and postpartum
- via breast milk.
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Who are at greatest risk of HIV infection include
- homosexual and bisexual men,
- IVDs who share needles or syringes,
- sexual partners of those in high-risk groups,
- infants born to infected mothers.
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Who is at the Highest risk for HIV??
Health Care workers
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After significant accidental exposure to HIV-infected blood or body fluids, it is recommended that health care workers take what???
- postexposure antiretroviral medication as soon as
- possible after exposure and as needed for 4 weeks after exposure
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HIV viruse consists of a core that contains what??
- RNA,
- proteins,
- enzymes
- which is protected by a spherical lipid bilayer viral
- envelope
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HIV is attracted to markers on surface of what cell??
CD4+ cells
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CD4+ cells hook up with what other cell
T helper cells
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What cell gathers up the HIV virus and sends it to the Helper T cell??
The Dendritic cell
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HIV infection leads to a decline in what cell
CD4+ cell
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What is the latency period of HIV infection
the establishment of the chronic infection
there is partial control and viral replication slows down
Latency period can last years to decades
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You are considered to have aid when you CD4+ count is what ??
When CD4+ count is less than 200/ul
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What is the seroconversion phase of the HIV infection??
Host begins to manufacture antibodies against the viral protein
formation of anti-HIV antibodies
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Viral Budding may cause excessive loss of what ??
excessive loss of cell membrane
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Flulike symptoms and the formation of anti-HIV antibodies (seroconversion) characterize the early stage of what??
Viral Seeding
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What body systems are affected by HIV
All body systems
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Early HIV infection is characterized by
fever, chills, headaches, nausea, vomiting, diarrhea, fatigue, weakness, arthralgia, sore throat, stiff neck, photophobia, irritability, and rash.
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The most significant systemic symptom of HIV is
Malnutrition or wasting,
due to a combination of factors, including an elevated metabolic rate, chronic inflammation, malabsorption, anorexia, and the effect of multiple opportunistic insults.
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Management of HIV and AIDS includes the use of
antiretroviral medications, including NRTIs, NNRTIs, and PIs.
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