Patho Test 2

  1. These are found in the bone marrow & are parent cells of all blood cells.
    Pluripotent stem cells
  2. This type of tissue is found in the bone marrow & supports the blood forming cells.
  3. This is a stem cell that is committed to a specific line of blood cells (i.e. committed to forming red cells).
    CFU (colony forming unit)
  4. This is a general term for a substance released by a cell that has an effect on another cell.
  5. 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?
    CSF (colony stimulating factors)
  6. This is another name for the colony stimulating factors (CSF) for RBCs.
  7. This helps WBCs recover faster after chemo, so the pt can get their next chemo sooner.
    Granuloycte-monocyte CSF (GM-CSF)
  8. This is where lymphocytes proliferate, mature & interact w/ antigens.
    Lymphoid tissue
  9. 1% of total blood volume is made of this, and although this is a small #, they're really important.
    WBCs or Leukocytes
  10. Normal range for WBCs:
  11. This is a type of WBC that has subtypes including neutrophils, eosinophils & basophils.
  12. These should be about 60% of total WBCs.
  13. These are also called polymorphonuclear cells (PMNs).
  14. These granulocytes are primarily responsible for fighting off infection.
  15. 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!
  16. These make up about 3% of total WBCs and are increased in allergic reactions & parasitic infections.
  17. These granulocytes make up <1% of the total WBCs and are important in allergies, but not very.
  18. These make up 30% of circulating WBCs and have 3 major subtypes including B cells, T cells & NK cells.
  19. These are often called humoral or antibody based immunity. They respond to foreign invasion using antibodies. Some become plasma cells which produce antibodies.
    B cells
  20. These are responsible for the cellular immune response (response to foreign invasion mediated by cells).
    T cells
  21. These are also called helper cells.
    CD4+ T cells
  22. These are also called effector cells or killer cells.
    CD8+ T cells
  23. These make up about 8% of the total WBCs and are important in chronic inflammation & presenting antigens to T cells.
    • Monocytes (circulation)
    • Macrophages (tissues)
  24. These are young, immature neutrophils.
  25. If bands are > 1-3% of total WBCs, this is called what and is a sign of what?
    • A shift to the left
    • Earliest sign of an acute bacterial infection
  26. This is a more expensive way to get the WBC count, but it's more accurate.
    Manual Differential
  27. This is another name for elevated WBCs.
  28. If absolute neutrophil count is <1500-1000, then what?
    At significant risk of severe infection
  29. How do you calculate the absolute neutrophil count (ANC)?
    ANC = WBC * (% neutrophils + % bands)
  30. This is the term for circulating neutrophils <1500.
  31. This is the term for circulating neutrophils <200.
    Absolute neutropenia
  32. This is the most common cause of decreased WBCs.
  33. Usual signs of inflammatory response may not be there when this is going on.
  34. This type of cancer comes from hematopoietic precursors in the bone marrow
    This other type of cancer arises from the peripheral lymph tissue.
    • Leukemia
    • Lymphoma
  35. This is the leading cause of death between ages 1-14.
  36. This hematopoietic disease is increased in Down's syndrome.
  37. This is the most common childhood cancer & is most often from __ cells.
    • Acute lymphocytic leukemia
    • B cells
  38. This is most often an adult leukemia.
    Acute myelogenous leukemia
  39. CBC will show what if acute leukemia?
    • Anemia
    • Thrombocytopenia
    • Increased WBCs
  40. Do lumbar puncture w/ this leukemia to see if in CNS.
    Acute lymphocytic leukemia
  41. This test will show you which type of leukemia.
    Bone marrow biopsy
  42. A blood peripheral smear will show what in a pt w/ acute leukemia?
    Immature forms of WBCs
  43. This is the mainstay of tx for acute leukemia.
  44. This type of chronic leukemia is most from B cells & mostly in >50 yo.
    Chronic leukocytic leukemia
  45. This type of chronic leukemia mostly occurs in 30-50 yo.
    Chronic myelogenous leukemia
  46. This type of leukemia is associated w/ the Philadelphia chromosome.
  47. This is the term for chronic leukemia becoming acute.
    Terminal blast crisis
  48. There is no specific tx for this type of leukemia unless there are sx's or WBC>150,000. In this instance, give what?
    • CLL
    • Chemo
  49. This leukemia can be cured w/ a bone marrow transplant.
  50. This is a solid tumor derived from neoplastic lymphoid tissue and it's the 6th most common CA.
  51. This type of lymphoma starts above the waist in the cervical or mediastinal nodes.
    Hodgkin Lymphoma
  52. 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.
    Hodgkin Lymphoma
  53. This stage of this type of lymphoma has no constitutional symptoms.
    • Stage A
    • Hodgkin Lymphoma
  54. This stage of this type of lymphoma involves constitutional symptoms such as fevers, night sweats, chills & weight loss.
    • Stage B
    • Hodgkin Lymphoma
  55. When biopsy lymph node & find Reed-Sternberg cell, you know the pt has this type of lymphoma.
    Hodgkin Lymphoma
  56. If just local Hodgkin Lymphoma, do this treatment.
  57. This type of lymphoma has an 85% 5 year survival rate.
    Hodgkin Lymphoma
  58. This type of Lymphoma can come from B cells (85%) or T cells (15%).
    Non-Hodgkin Lymphoma (NHL)
  59. This type of lymphoma can occur in lymph nodes not next to each other & in liver, spleen & bone marrow.
    Non-Hodgkin Lymphoma
  60. This type of lymphoma can eventually involve the liver, lungs, GI & CNS.
    Hodgkin Lymphoma
  61. Almost all pts w/ Burkitt's Lymphoma have evidence of this virus.
    Epstein-Barr Virus (EBV)
  62. This bacteria is found frequently in MALT (Mucosal Associated Lymphoid Tissue) Lymphoma of the stomach.
    H. pylori
  63. Generally can get impaired humoral immunity w/ this type of lymphoma and get more bacterial infections.
    Non-Hodgkin Lymphoma
  64. Small/large lymphocyte tumors are low grade, progress slowly (>10 yrs or more) & eventually transform into aggressive lymphoma/leukemia b/c not as treatable.
  65. Diffuse small/large B-cell lymphoma are aggressive, grow and metastasice & are rapidly fatal (but b/c aggressive, more responsive to tx).
  66. Need this for diagnosis of lymphoma, then this for CD & surface antigens to determine exact subtype.
    • Biopsy
    • Immunophenotyping
  67. Will see an M spike w/ these diseases.
    Plasma Cell Dyscrasias (MGUS & Myeloma)
  68. Will get a Bence Jones Protein with this disease.
  69. This protein found in myeloma is toxic to the kidney and can cause renal failure.
    Bence Jones Protein
  70. Will only find the Bence Jones Protein in this test.
    Urine protein electrophoresis (UPEP)
  71. About 20% w/ this disease develop myeloma over 15 years.
    Monoclonal Gammopathy of Undetermined Significance (MGUS)
  72. 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.
    Monoclonal Gammopathy of Undetermined Significance (MGUS)
  73. In this disease, the bone marrow is replaced by plasma cells.
    Multiple Myeloma (MM)
  74. Can get pathologic bone fractures, more fractures in axial skeleton & long bones, and hypercalcemia (b/c of destruction of bone) with this disease.
    Multiple Myeloma (MM)
  75. Will get hyperviscosity, heart failure, neuropathy, and increased risk of infections with this disease.
    Multiple Myeloma (MM)
  76. This is the name given to islands of malignant cells, most often in bone, found in this disease.
    • Plasmacytomas
    • Multiple Myeloma (MM)
  77. 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.
    • Myeloma Kidney
    • Multiple Myeloma (MM)
  78. The classic triad for this disease is bone marrow plasmacytosis, lytic bone lesions, & either M protein spike or Bence Jones protein.
    Multiple Myeloma (MM)
  79. History of bleeding excessively after injury or trauma is consistent with this type of disorder.
  80. Bleeding into skin (purpura or petechiae) & mucous membranes (GI & GU) are more common with this type of bleeding.
    Platelet Bleeding
  81. This is the term for increased platelet numbers.
  82. Normal #s of platelets are 150,000-450,000. If >1 million, at risk for __.
  83. Aspirin and NSAIDs are the most common cause of __ platelet function.
  84. Can use desmopressin to treat this.
    Decreased platelet function from any cause
  85. If severe bleeding & desmopression is no help, can try this to help decreased platelet function from any cause.
    Platelet transfusion
  86. This is the term for decreased # of platelets (<100,000).
  87. If platelets <50,000, at risk for __.
    Significant bleeding w/ trauma
  88. If platelets <20,000 @ risk for __.
    Spontaneous bleeding.
  89. 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.
    Primary Idiopathic Thrombocytopenia Purpura
  90. 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.
    Secondary Idiopathic Thrombocytopenia Purpura
  91. Will see platelet type bleeding and splenomegaly with these diseases.
    Idiopathic Thrombocytopenia Purpuras
  92. Will need to give corcosteroids, IVIG, and schedule splenectomy to treat these diseases.
    Idiopathic Thrombocytopenia Purpuras.
  93. This disease involves platelets clotting in the microvasculature. Will see low platelets & bleeding, as well as hemolytic anemia.
    Thrombotic Thrombocytopenia Purpura
  94. 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).
    Thrombotic Thrombocytopenia Purpura
  95. This is the most common type of blood cell.
    Red blood cells
  96. This is the protein that gives flexibility to the RBCs & lets the cells squeeze through capillaries.
  97. This allows the RBCs to carry oxygen & is found inside the cells.
    Hemoglobin (Hgb)
  98. 80% of iron is stored in __, 20% stored in __ __, liver & spleen.
    • Hemoglobin
    • Bone marrow
  99. RBC production primarily occurs in the __ skeleton.
    Axial skeleton
  100. This is an early form of RBCs found in peripheral blood & they still have mitochondria & ribosomes. About 1% of RBCs are this type.
    Reticulocyte (retic)
  101. If this is increased, it's a sign of increased RBC production.
    Reticulocyte count (retic count)
  102. Making of RBCs influenced most by this, so anything that decreases this in the blood will increase RBC production.
    • Oxygen needs
    • Oxygen
  103. Without this, there is no effect of oxygen on RBCs.
  104. Rate of destruction of RBCs usually equals rate of production (about __% a day).
  105. Old RBCs are destroyed by large phagocytic cells in this organ.
  106. After old RBCs are destroyed, the iron and parts of the hemoglobin are used again. The rest of the hemoglobin is made into __.
    Bilirubin (this is why increased RBC destruction increases bilirubin production and causes jaundice).
  107. 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.
    • Hgb
    • Hct
    • RBC
  108. Patients who live at __ __ have a high level of RBC, Hct, and Hgb.
    High altitudes
  109. The lab needs to know __ and __ of the patient to give correct "normal" ranges for RBC, Hgb and Hct.
    • Age
    • Gender
  110. 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.
    Hematocrit (Hct)
  111. 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 (Hct)
  112. Hematocrit is about __ times hemoglobin (if size of RBCs are normal & contain normal amount of hemoglobin).
  113. If your patient has CVS disease, you aim for their Hgb to be >__ or Hct >__%.
    • 10
    • 30
  114. In an otherwise healthy patient, transfuse if Hgb <__ or Hct <__%.
    • 8
    • 24
  115. Use these if your patient is anemic to figure out size & shape of RBCs so can classify anemia.
    Red cell indices (MCV, MCH, MCHC, RDW)
  116. This is a measure of average volume or size of RBC. It is high in macrocytic anemia & low in microcytic anemia.
    Mean corpuscular volume (MCV)
  117. This is a measure of average weight of hemoglobin in RBC, but isn't really used.
    Mean corpuscular hemoglobin (MCH)
  118. 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.
    Mean corpuscular hemoglobin concentration (MCHC)
  119. 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).
    Red cell distribution width (RDW)
  120. 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%.
    Reticulocyte count (retic count)
  121. 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.
    Peripheral blood smear
  122. 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).
    Bone marrow aspiration or biopsy
  123. 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.
  124. 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).
  125. This is an anemia due to premature destruction of RBCs.
    Anemia due to hemolysis
  126. 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.
    Hereditary Spherocytosis
  127. This disease involves mild anemia, jaundice, splenomegaly & bilirubin gallstones.
    Hereditary Spherocytosis
  128. This is a chronic, severe hemolytic anemia w/ a hematocrit between 18 and 30%.
    Sickle Cell Disease
  129. 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.
    Sickle Cell Disease
  130. This is an atypical pneumonia that occurs from infarcting lung and can cause death in a sickle cell pt.
    Acute Chest Syndrome
  131. 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.
    Sickle Cell Disease
  132. This is a disease in which there's a defective alpha or beta chain of hemoglobin resulting in hemolysis of RBCs.
  133. Ferritin <10 is diagnostic of this condition.
    Iron Deficiency Anemia
  134. This is a microcytic hypochromic anemia w/ iron in the serum, ferritin, transferrin are low, and TIBC is high.
    Iron Deficiency Anemia
  135. This is the compulsion to eat ice and dirt seen in some pts with iron deficiency anemia.
  136. 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.
    Epithelial Atrophy
  137. This is an indirect transferrin measure.
    TIBC (total iron binding capacity)
  138. This is an oral treatment for iron deficiency anemia that is hard to tolerate b/c it causes significant GI upset & black stools.
    Ferrous Sulfate
  139. This is an oral form of iron that's easier to tolerate, but not as much iron is absorbed as other methods.
    Ferrous Gluconate
  140. If take PO iron w/ this, absorb more iron.
    Vitamin C
  141. If can't absorb enough iron, give this which works better, but there's a risk of fatal anaphylaxis.
    IV iron (iron dextran)
  142. This is a megaloblastic anemia with neurologic symptoms including symmetric loss of vibratory and position sense in feet and eventually dementia.
    Vitamin B12 Anemia
  143. This is an anemia that is most often from malnutrition.
    Folic Acid Deficiency
  144. This is an anemia where all cell lines are lost.
    Aplastic Anemia
  145. This is a moderate to severe anemia that looks like iron deficiency (microcytic hypochromic).
    Chronic Disease Anemia (AOCD)
  146. 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.
    Polycythemia Vera
  147. These pts will have a dusky red appearance of lips, fingernails, and mucous membranes because of venous stasis.
    Polycythemia Vera
  148. Phlebotomy and chemo is the treatment for this condition.
    Polycythemia Vera
  149. This is a condition due to hypoxia and is treated w/ oxygen and by treating the underlying condition.
    Secondary Polycythemia
  150. 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.
    Polycythemia Vera
Card Set
Patho Test 2