Patho Test 2

These are found in the bone marrow & are parent cells of all blood cells.

This type of tissue is found in the bone marrow & supports the blood forming cells.

This is a stem cell that is committed to a specific line of blood cells (i.e. committed to forming red cells).

This is a general term for a substance released by a cell that has an effect on another cell.

In the bone marrow, cytokines act on the stem cells to cause the stem cell to make more of whatever it makes. In this instance, what are the cytokines called?

This is another name for the colony stimulating factors (CSF) for RBCs.

This helps WBCs recover faster after chemo, so the pt can get their next chemo sooner.

This is where lymphocytes proliferate, mature & interact w/ antigens.

1% of total blood volume is made of this, and although this is a small #, they're really important.

Normal range for WBCs:

This is a type of WBC that has subtypes including neutrophils, eosinophils & basophils.

These should be about 60% of total WBCs.

These are also called polymorphonuclear cells (PMNs).

These granulocytes are primarily responsible for fighting off infection.

In severe, overwhelming infections, the neutrophils will be __ b/c there are either too many in the tissues or the bone marrow isn't able to keep up. This is really bad!

These make up about 3% of total WBCs and are increased in allergic reactions & parasitic infections.

These granulocytes make up <1% of the total WBCs and are important in allergies, but not very.

These make up 30% of circulating WBCs and have 3 major subtypes including B cells, T cells & NK cells.

These are often called humoral or antibody based immunity. They respond to foreign invasion using antibodies. Some become plasma cells which produce antibodies.

These are responsible for the cellular immune response (response to foreign invasion mediated by cells).

These are also called helper cells.

These are also called effector cells or killer cells.

These make up about 8% of the total WBCs and are important in chronic inflammation & presenting antigens to T cells.

These are young, immature neutrophils.

If bands are > 1-3% of total WBCs, this is called what and is a sign of what?

This is a more expensive way to get the WBC count, but it's more accurate.

This is another name for elevated WBCs.

If absolute neutrophil count is <1500-1000, then what?

How do you calculate the absolute neutrophil count (ANC)?

This is the term for circulating neutrophils <1500.

This is the term for circulating neutrophils <200.

This is the most common cause of decreased WBCs.

Usual signs of inflammatory response may not be there when this is going on.

This type of cancer comes from hematopoietic precursors in the bone marrow
This other type of cancer arises from the peripheral lymph tissue.

This is the leading cause of death between ages 1-14.

This hematopoietic disease is increased in Down's syndrome.

This is the most common childhood cancer & is most often from __ cells.

This is most often an adult leukemia.

CBC will show what if acute leukemia?

Do lumbar puncture w/ this leukemia to see if in CNS.

This test will show you which type of leukemia.

A blood peripheral smear will show what in a pt w/ acute leukemia?

This is the mainstay of tx for acute leukemia.

This type of chronic leukemia is most from B cells & mostly in >50 yo.

This type of chronic leukemia mostly occurs in 30-50 yo.

This type of leukemia is associated w/ the Philadelphia chromosome.

This is the term for chronic leukemia becoming acute.

There is no specific tx for this type of leukemia unless there are sx's or WBC>150,000. In this instance, give what?

This leukemia can be cured w/ a bone marrow transplant.

This is a solid tumor derived from neoplastic lymphoid tissue and it's the 6th most common CA.

This type of lymphoma starts above the waist in the cervical or mediastinal nodes.

This type of lymphoma involves painless, progressive enlargement of lymph node or groups of lymph nodes. It starts in 1 & spreads to the rest around it.

This stage of this type of lymphoma has no constitutional symptoms.

This stage of this type of lymphoma involves constitutional symptoms such as fevers, night sweats, chills & weight loss.

When biopsy lymph node & find Reed-Sternberg cell, you know the pt has this type of lymphoma.

If just local Hodgkin Lymphoma, do this treatment.

This type of lymphoma has an 85% 5 year survival rate.

This type of Lymphoma can come from B cells (85%) or T cells (15%).

This type of lymphoma can occur in lymph nodes not next to each other & in liver, spleen & bone marrow.

This type of lymphoma can eventually involve the liver, lungs, GI & CNS.

Almost all pts w/ Burkitt's Lymphoma have evidence of this virus.

This bacteria is found frequently in MALT (Mucosal Associated Lymphoid Tissue) Lymphoma of the stomach.

Generally can get impaired humoral immunity w/ this type of lymphoma and get more bacterial infections.

Small/large lymphocyte tumors are low grade, progress slowly (>10 yrs or more) & eventually transform into aggressive lymphoma/leukemia b/c not as treatable.

Diffuse small/large B-cell lymphoma are aggressive, grow and metastasice & are rapidly fatal (but b/c aggressive, more responsive to tx).

Need this for diagnosis of lymphoma, then this for CD & surface antigens to determine exact subtype.

Will see an M spike w/ these diseases.

Will get a Bence Jones Protein with this disease.

This protein found in myeloma is toxic to the kidney and can cause renal failure.

Will only find the Bence Jones Protein in this test.

About 20% w/ this disease develop myeloma over 15 years.

This is a pre-malignant condition found in up to 3% of healthy people >50 yo. They only have M protein, but not Bence Jones or other symptoms.

In this disease, the bone marrow is replaced by plasma cells.

Can get pathologic bone fractures, more fractures in axial skeleton & long bones, and hypercalcemia (b/c of destruction of bone) with this disease.

Will get hyperviscosity, heart failure, neuropathy, and increased risk of infections with this disease.

This is the name given to islands of malignant cells, most often in bone, found in this disease.

This has a very poor prognosis and is found with this disease. It's an accumulation of proteins in the kidney and causes renal failure.

The classic triad for this disease is bone marrow plasmacytosis, lytic bone lesions, & either M protein spike or Bence Jones protein.

History of bleeding excessively after injury or trauma is consistent with this type of disorder.

Bleeding into skin (purpura or petechiae) & mucous membranes (GI & GU) are more common with this type of bleeding.

This is the term for increased platelet numbers.

Normal #s of platelets are 150,000-450,000. If >1 million, at risk for __.

Aspirin and NSAIDs are the most common cause of __ platelet function.

Can use desmopressin to treat this.

If severe bleeding & desmopression is no help, can try this to help decreased platelet function from any cause.

This is the term for decreased # of platelets (<100,000).

If platelets <50,000, at risk for __.

If platelets <20,000 @ risk for __.

This is a disease where the body is making an antibody to the platelets, but no other antibodies. It's relatively short term and benign in children and occurs after a virus. In adults, it's chronic, not after a virus, & doesn't necessarily get better w/ time.

This is a disease where the body is making antibodies to platelets as part of another disorder such as AIDS, SLE, antiphospholipid antibody, HCV, & heparin.

Will see platelet type bleeding and splenomegaly with these diseases.

Will need to give corcosteroids, IVIG, and schedule splenectomy to treat these diseases.

This disease involves platelets clotting in the microvasculature. Will see low platelets & bleeding, as well as hemolytic anemia.

Will need to do plasmapheresis & replace w/ fresh frozen plasma to treat this disease b/c the clinical symptoms are bad (HA, seizures, and change in mental status).

This is the most common type of blood cell.

This is the protein that gives flexibility to the RBCs & lets the cells squeeze through capillaries.

This allows the RBCs to carry oxygen & is found inside the cells.

80% of iron is stored in __, 20% stored in __ __, liver & spleen.

RBC production primarily occurs in the __ skeleton.

This is an early form of RBCs found in peripheral blood & they still have mitochondria & ribosomes. About 1% of RBCs are this type.

If this is increased, it's a sign of increased RBC production.

Making of RBCs influenced most by this, so anything that decreases this in the blood will increase RBC production.

Without this, there is no effect of oxygen on RBCs.

Rate of destruction of RBCs usually equals rate of production (about __% a day).

Old RBCs are destroyed by large phagocytic cells in this organ.

After old RBCs are destroyed, the iron and parts of the hemoglobin are used again. The rest of the hemoglobin is made into __.

Generally, these 3 things should be considered together on the CBC b/c they look at the same thing & generally go up and down together.

Patients who live at __ __ have a high level of RBC, Hct, and Hgb.

The lab needs to know __ and __ of the patient to give correct "normal" ranges for RBC, Hgb and Hct.

This is the % of red cell mass in 100mL of blood. The number on a CBC is a percentage. The lab will centrifuge the blood & get ratio of height of RBCs to total blood volume.

This will increase falsely w/ dehydration. It will decrease falsely w/ overexpansion of extracellular fluid (retaining fluid) or if RBCs are abnormally large or a really high WBC count. It's not always reliable after an acute hemorrhage.

Hematocrit is about __ times hemoglobin (if size of RBCs are normal & contain normal amount of hemoglobin).

If your patient has CVS disease, you aim for their Hgb to be >__ or Hct >__%.

In an otherwise healthy patient, transfuse if Hgb <__ or Hct <__%.

Use these if your patient is anemic to figure out size & shape of RBCs so can classify anemia.

This is a measure of average volume or size of RBC. It is high in macrocytic anemia & low in microcytic anemia.

This is a measure of average weight of hemoglobin in RBC, but isn't really used.

This is a measure of average concentration of hemoglobin in each cell. It is a measure of color of the RBC. If this is normal, it's called normochromic. If it's low, called hypochromic.

This tells how much the RBCs vary in size. It's a distribution of red cells on a bell curve. A normal value suggests all cells are about the same size. An elevated value means a wide bell curve & have some big cells & some small cells (meaning a mixed anemia or reticulocytes mixed w/ smaller RBCs).

This is a test that is checked primarily when a pt is anemia and should be increased in response to anemia. If it isn't, it's b/c the bone marrow can't or doesn't have what it needs to make RBCs. It's expressed as a % of total RBCs & should be about 1%.

This is a test that looks at blood under the microscope to identify size, shape, & color of RBCs; # and type of WBCs; and identify & estimate # of platelets. This test is more expensive, more time intensive, but more accurate than CBC.

This is a test where you can do special stains for iron stores & make sure the precursors of RBCs are intact. It is done to confirm megaloblastic anemia and diagnose leukemia or lymphoma. If a pt is anemic, you can use this test to determine if the bone marrow is the cause, document iron stores, document infiltration of bone marrow (neoplasm or fibrosis).

This is a disease manifested on labs by low Hgb, Hct or RBCs. Symptoms depend on how severe, how fast it develops, age and health of the pt.

This disease can have symptoms from tissue hypoxia (fatigue, weakness, dyspnea, angina, HA, or faintness) and compensation mechanisms (pale skin, nail beds, mucosa, tachycardia, palpitations, cardiac flow murmur b/c of increased flow & decreased viscosity of the blood).

This is an anemia due to premature destruction of RBCs.

This is an anemia when spectrin is not normal and RBCs lose their flexibility so they get destroyed in the spleen faster, so RBCs die young.

This disease involves mild anemia, jaundice, splenomegaly & bilirubin gallstones.

This is a chronic, severe hemolytic anemia w/ a hematocrit between 18 and 30%.

This hemolysis is so severe that pts get chronic anemia and jaundice. Vessel occlusion is the cause of most of the pathology with this illness. They get acute pain episodes that occur suddenly in almost any part of the body.

This is an atypical pneumonia that occurs from infarcting lung and can cause death in a sickle cell pt.

Children with this illness can get growth retardation and osteomyelitis. Adults can have more strokes. These pts have a spleen, but it doesn't work (called functional asplenia) & they can get life-threatening infections from encapsulated organisms such as strep pneumo, H flu and Klebsiella.

This is a disease in which there's a defective alpha or beta chain of hemoglobin resulting in hemolysis of RBCs.

Ferritin <10 is diagnostic of this condition.

This is a microcytic hypochromic anemia w/ iron in the serum, ferritin, transferrin are low, and TIBC is high.

This is the compulsion to eat ice and dirt seen in some pts with iron deficiency anemia.

This is seen in some pts w/ iron deficiency anemia and involves brittle hair & nails, smooth tongue, and sores in the corners of their mouths.

This is an indirect transferrin measure.

This is an oral treatment for iron deficiency anemia that is hard to tolerate b/c it causes significant GI upset & black stools.

This is an oral form of iron that's easier to tolerate, but not as much iron is absorbed as other methods.

If take PO iron w/ this, absorb more iron.

If can't absorb enough iron, give this which works better, but there's a risk of fatal anaphylaxis.

This is a megaloblastic anemia with neurologic symptoms including symmetric loss of vibratory and position sense in feet and eventually dementia.

This is an anemia that is most often from malnutrition.

This is an anemia where all cell lines are lost.

This is a moderate to severe anemia that looks like iron deficiency (microcytic hypochromic).

This is a disease where all lines are increased (increased RBCs, WBCs, and platelets) and symptoms are those of high viscosity in the blood, venous stasis and thromboembolism and hemorrhage.

These pts will have a dusky red appearance of lips, fingernails, and mucous membranes because of venous stasis.

Phlebotomy and chemo is the treatment for this condition.

This is a condition due to hypoxia and is treated w/ oxygen and by treating the underlying condition.

Pts with this disease can have HA, HTN, decreased thinking, hearing and vision, itching, night sweats and weight loss due to high viscosity of the blood.