Patho (chapter 11)

  1. granulocyes
    those containing granules

    • *neutrophils
    • *eosinophils
    • *basophils
  2. agranulocytes
    those that lack granules

    • *Lymphocytes
    • *Monocytes
  3. specific granules
    bind neural, basic, or acidic dye components
  4. azurophilic granules
    stain purple and are lysosomes
  5. neutrophils
    responsible for maintaining normal host defenses against invading bacteria and fungi, cell debris, and a variety of foreign substances
  6. eosinophils
    increase during allergic reactions and parasitic infections

    *During allergic reactions, they are thought to release enzymes or chemical mediators that detoxify agents associated with the reaction.

    *In parasitic infections, the eosinophils use surface markers to attach themselves to the parasite and then release hydrolytic enzymes that kill it
  7. Basophils
    specific granules of basophils stain blue with basic dye

    *granules contain heparin (anticoagulant), histamine (vasodilator), and other mediators of inflammation

    *involved in allergic and hypersensitivity reactions
  8. Lymphocytes
    most common of the agranulocytes; approx. 30% of the total blood leukocytes.
  9. 3 types of Lymphocytes
    • B lymphocytes
    • T lymphocytes
    • Natural killer cells
  10. B lymphocytes
    The differentiate to form antibody-producing plasma cells and are involved in humoral-mediated immunity
  11. T lymphocytes
    differentiate in the thymus

    *They activate other cells of the immune system (helper T cells) and are involved in cell-mediated immunity (cytotoxic T cells).
  12. Natural killer cells
    participate in innate or natural immunity and their function is to destroy foreign cells
  13. Monocytes/Macrophages
    largest of the WBCs

    distinguished by a large ammount of cytoplasm and a darkly stained kidney-shaped nucleus.

    They travel from the bone marrow to the body tissues, where they differentiate into various tissue phagocytes (histiocytes of loose connective tissue, microglial cells of the brain, Kupffer cells of the liver, and tissue macrophages.

    *play an important role in immune responses by activating lymphocytes and by presenting antigen to T cells
  14. leukopenia
    a decrease in the absolute number of leukocytes in the blood

    *this disorder may affect any of the specific types of WBCs but most often affect the neutophils
  15. Neutropenia
    an abnormally low number of neurtrophils and is commonly defined as a circulating neutrophil count of less than 1500
  16. Agranulocytosis
    denotes a virtual absence of neutrophils
  17. aplastic anemia
    all of the myeloid stem cells are affected, resulting in anemia, thrombocytopenia, and agranulocytosis
  18. Periodic or cyclic neutropenia
    an autosomal dominant disorder with variable expression that begins in infancy and persists for decades.
  19. Kostmann syndrome
    a rare inherited form of neutropenia

    Infants with the syndrome have almost no neutrophils present that develop beyond the promyelocyte stage.
  20. idiosyncratic
    used to describe drug reactions that are different from the effects observed in most persons and that cannot be explained in terms of allergy
  21. Infectious Mononucleosis
    a self-limiting lymphoproliferative disorder caused by the Epstein-Barr virus

    *can occur at any age, but principally in adolescents and young adults in developed countries.

  22. Incubation period of infectious mononucleosis
    incubation period lasts 4-8 weeks
  23. Leukemias
    they are malignant neoplasms of cells originally derived from precursor myeloid or lymphoid tissue cells.
  24. The leukemic cells may also infiltrate
    the liver, spleen, lymph nodes, and other tissues throughout the body, causing enlargement of these organs
  25. A rudimentary classification system divides leukemia into four types:
    • acute lymphocytic leukemia
    • chronic lymphocytic leukemia
    • acute myelocytic leukemia
    • chronic myelocytic leukemia
  26. lymphocytic leukemia
    involve immature lymphocytes and their progenitors that originate in the bone marrow but infiltrate the spleen, lymph nodes, CNS, and other tissues
  27. myelogenous leukemias
    involve the pluripotent myeloid stem cells in bone marrow, interfere with the maturation of all blood cells, including the granulocytes, erythrocytes, and thrombocytes
  28. breakpoint cluster
    the ABL gene is received at a specific site on 22q. The resulting BCR-ABL fusion gene codes for a novel protein that allows affected cells to bypass the regulated signals that control normal cell growth and differentiation, and instead undergo malignant transformation to become leukemic cells
  29. acute lymphocytic (lymphoblastic) leukemia

    *the most common cancer in children and adults

    *ALL encompasses a group of neoplasms composed of precursor B (pre-B) or T (pre-T) lymphocytes referred to as lymphoblasts
  30. Leukostasis
    a condition in which the circulating blast count is markedly elevated

    *requires immediate and effective treatment to lower the blast count rapidly
  31. Hyperuricemia
    occurs as the result of increased proliferation or increased breakdown of purine nucleotides secondary to the leukemic cell death that results from chemotherapy.
  32. Non-Hodgkin lymphomas
    represents a clinically diverse group of either B-cell or T-cell neoplasms

    *impairment of the immune system and infectious agents may play a role.

    *can originate from malignant transformation of either the T or B cells during their differentiation in the peripheral lymphoid tissues
  33. Mature B-Cell Lymphomas
    • Follicular lymphomas
    • Diffuse large B-cell lymphomas
    • Burkitt lymphoma
    • Mantle cell lymphomas
    • Marginal zone lymphomas
  34. Follicular lyphomas
    derived from germinal center B cells and consist of a mixture of centroblasts and centrocytes

    *affects lymph nodes, spleen, bone marrow, peripheral blood, head and neck region, gastrointestinal tract and skin
  35. Diffuse large B-cell lymphomas
    a heterogeneous group of aggressive germinal or postgerminal center neoplasms.

    • *may be involved with EBV or HIV infections
    • *it is a rapidly evolving, multifocal, nodal and extranodal tumor.
  36. Burkitt lymphoma
    one of the most rapidly growing tumors of the NHLs, is also a disorder of germinal center B cells

    *a destructive tumor in the jaw and other facial bones and the sporadic form typically presents with abdominal masses
  37. Mantle cell lymphomas
    • affect older people
    • rapid rate of progression
    • only one in five persons survives at least 5 years
  38. Marginal zone lymphomas
    *involves late-stage memory B cells that reside in the marginal zone or outermost compartment of the lymph node follicle.
  39. Hodgkin disease
    a specialized form of lymphoma that features the presence of an abnormal cell called a Reed-Sternber cell.
  40. Reed-Sternberg cells
    large, atypical, mononuclear tumor cells

    *these cells release factors that induce the accumulation of reactive lymphocytes, macrophages, and granulocytes, which typically make up greater than 90% of the tumor's cells
  41. Monoclonal gammopathy of undetermined significance (MGUS)
    characterized by the presence of the monoclonal immunoglobulin in the serum without other findings of multiple myeloma.

    *considered a premalignant condition
  42. Osteolytic bone lesions
    • bone pain
    • hypercalcemia
    • pathologic fractures
  43. Failure of antibody production
    Recurrent infections
  44. Plasma cell secretion of paraproteins
    • hyperviscosity of body fluids
    • amyloid deposits in heart and kidney
  45. Bone marrow infiltration
    Thrombocytopenia (purpura)
  46. Proteinuria
    Bence Jones protein
  47. Bone Marrow infiltration
    • Anemia (fatigue, pallor)
    • Neutropenia (decreased resistance to infection)
  48. Renal involvement
    myeloma nephrosis
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Patho (chapter 11)