PATH 370 - W2 Chp 10, 11, 13, 14, 15 (simplified kinda)

CML (Chronic myeloid leukemia): typical clinical presentation

-High granulocyte count on the CBC -splenomegaly

Type I hypersensitivity disorders occur w/in

15-30 mins

Type II hypersensitivity occurs w/in

15-30 mins

Type IV hypersensitivity occurs in

24-48 hrs

ALL (Acute Lymphoblastic Leukemia/Lymphoma) is the _____ leading cause of death in children

2nd

Peak incidence for ALL (Acute Lymphoblastic Leukemia/Lymphoma) is between which ages? 2nd peak?

3-7 years; middle age

Multiple myeloma or plasma cell myeloma ~occurs in adults; usually >__ years

40

CML (Chronic myeloid leukemia) average age of onset

40-50 years

Type III hypersensitivity occur in

6 hrs

Disseminated Intravascular Coagulation (DIC) definition

Acquired hemorrhagic syndrome in which clotting and bleeding occur simultaneously

ALL stands for

Acute Lymphoblastic Leukemia/Lymphoma

_____ can detect excessive red blood cell lysis

Bilirubin

Tx that can cause thrombocytopenia

Chemotherapy

CML stands for

Chronic myeloid leukemia

DIC stands for

Disseminated Intravascular Coagulation (DIC)

In Disseminated Intravascular Coagulation (DIC) _____ level and _____ count are decreased

Fibrinogen; platelet

_____ _____ _____ anemia occurs when exposed to certain drugs

Glucose-6-phosphate dehydrogenase deficiency

Type I hypersensitivity (Ab)

IgE

Type III hypersensitivity (Ab)

IgG

Type II hypersensitivity (Ab)

IgG or IgM

Type III hypersensitivity is also called (2)

Immune Complex-Mediated/Arthus Reaction

_____ is necessary for red blood cell production

Iron

_____ produce erythropoietin

Kidneys

Bence Jones protein can accumulate in the

Kidneys and damage them; at least 50% of patients develop kidney failure because large proteins start to damage the kidneys

Multiple myeloma or plasma cell myeloma Ab presentation

Large amount of one type of antibody = forms a characteristic spike = monoclonal Ab peak

Malignant plasma cells invade bone and form multiple tumor sites; may also target other tissues including (5)

Lymph nodes, liver, spleen, and kidneys, bone

Iron deficiency has low _____, _____, and _____

MCHC, MCH, and MCV

Bence Jones protein (definition)

Malignant plasma cells produce light chain antibody fragments that accumulate in blood/urine (helps confirm dx)

Bence Jones protein is found in which malignant disorder of white blood cells

Multiple myeloma or plasma cell myeloma

Vitamin K deficiency presents with increased

PT and INR

Blood Coagulation Assessment: (3)

PT/INR, aPTT, Bleeding time

DIC results in elevated

PT/INR/aPTT/D-dimer

In multiple myeloma or plasma cell myeloma, malignant plasma cells accumulate in the bone and cause what kind of fractures

Pathological fractures

CML (Chronic myeloid leukemia) is characterized by malignant granulocytes that carry the _____chromosome

Philadelphia chromosome (Ph+)

Multiple myeloma is also called

Plasma cell myeloma

Multiple myeloma or plasma cell myeloma is cancer of the

Plasma cells (plasma B cells)

Transfusion reactions involve _____ destruction caused by _____ _____

RBC; recipient antibodies

Type IV hypersensitivity (definition)

Sensitized T cells react with altered or foreign cells and initiate = dermal region inflammation

Common locations (4) for pathological fractures

Skull, spine, ribs, pelvis

Type IV hypersensitivity (cell type)

T-cell

asthma is which hypersensitivity disorder?

Type I

atopic eczema is which hypersensitivity disorder?

Type I

bee sting reactions are which hypersensitivity disorder?

Type I

drug reactions is which hypersensitivity disorder?

Type I

food allergies is which hypersensitivity disorder?

Type I

rhinitis is which hypersensitivity disorder?

Type I

Blood transfusion reactions are which hypersensitivity disorder?

Type II hypersensitivity

erythroblastosis fetalis is which hypersensitivity disorder?

Type II hypersensitivity

hyperacute graft rejection is which hypersensitivity disorder?

Type II hypersensitivity

myasthenia gravis is which hypersensitivity disorder?

Type II hypersensitivity

SLE (lupus) is which hypersensitivity disorder?

Type III hypersensitivity

farmer's lung arthritis is which hypersensitivity disorder?

Type III hypersensitivity

glomerulonephritis is which hypersensitivity disorder?

Type III hypersensitivity

vasculitis is which hypersensitivity disorder?

Type III hypersensitivity

Contact dermatitis is an example of which hypersensitivity disorder?

Type IV hypersensitivity

Guillain Barre disease is an example of which hypersensitivity disorder?

Type IV hypersensitivity

Multiple Sclerosis is an example of which hypersensitivity disorder?

Type IV hypersensitivity

Which hypersensitivity disorder is not mediated by immunoglobulins (Ab)?

Type IV hypersensitivity

graft-versus-host disease is an example of which hypersensitivity disorder?

Type IV hypersensitivity

transplant rejection is an example of which hypersensitivity disorder?

Type IV hypersensitivity

tuberculin reactions is an example of which hypersensitivity disorder?

Type IV hypersensitivity

Type II hypersensitivity occurs when

antibodies are formed against antigens on cell surfaces, usually resulting in lysis of target cells.

Common Rx that can prolong bleeding time

aspirin

Type I hypersensitivity disorders are also called (2)

atopic or anaphylactic

CML (Chronic myeloid leukemia) involve translocation of chromosomes 9 and 12 create a new fusion gene called

bcr/abl

Carbon dioxide is transported in the bloodstream as

bicarbonate ion

Vitamin K deficiency presents with normal

bleeding time and platelet count

Hemophilia presents with prolonged

bleeding time, aPTT

Multiple myeloma or plasma cell myeloma damages (2)

bone; renal system

CML (Chronic myeloid leukemia): protein product of the bcr/abl gene -> _____ _____ and reduces _____ _____ _____

cell proliferation; apoptotic cell death

ALL (Acute Lymphoblastic Leukemia/Lymphoma) occurs primarily in: children adults

children

Dysfunction of the liver can lead to

clotting factor deficiency

Red blood cells have no _____ _____

cytoplasmic organelles

Type II hypersensitivity are also called (2)

cytotoxic or cytolytic

Type IV hypersensitivity is also called

delayed-hypersensitivity (cell-mediated)

CML (Chronic myeloid leukemia) _____ respond well to chemotherapy does does not

does not

What is the most common type I hypersensitivity reaction? (i.e.,)

drug reactions

in Hairy cell leukemia all blood cells are

elevated

CML (Chronic myeloid leukemia) Sx

fatigue, weight loss, sweats, bleeding, abdominal discomfort (enlarged spleen)

Hairy cell leukemia clinical manifestation

hairy cells in peripheral blood; reduced numbers in granulocytes, platelets, RBCs

Type I hypersensitivity disorders: Mast cell degranulation releases chemicals that mediate the s/sx of anaphylaxis. Chemicals released are (5)

histamine, kinin, prostaglandins, interleukins, and leukotrienes

In DIC bleeding time is increased decreased

increased

Pernicious anemia is caused by lack of

intrinsic factor

50% of patients w/ multiple myeloma or plasma cell myeloma develop _____ failure

kidney

clinical manifestation of ALL (Acute Lymphoblastic Leukemia/Lymphoma)

long bone pain, bruising, fever, infection,

Type I hypersensitivity disorders are primarily mediated by sensitized _____ cells

mast

CML (Chronic myeloid leukemia) is a _____ cancer mature acute

mature

Vitamin K deficiency in newborns present with:

melena, bleeding from the umbilicus, and hematuria.

Type III hypersensitivity (definition)

occur when antigen-antibody complexes are deposited in tissues and result in the activation of complement = tissue inflammation and destruction.

Aplastic Anemia leads to

pancytopenia

Type II hypersensitivity (cell type involved)

phagocytic cells or IgM or IgG activated complement fragments (membrane attack complex)

Hemophilia presents with normal _____ count

platelet

Hemophilia (Presentation):

prolonged bleeding time, prolonged aPTT, normal platelet count

Is hairy cell leukemia acute or chronic?

rare, chronic

Treatment of DIC relies on

removal/correction of underlying cause

90% of a hairy cell leukemia cases present with

splenomegaly

autologous bone marrow transplant

the patient receives his own bone marrow cells which have been harvested, cleansed, treated, and then stored before the remaining bone marrow is destroyed

functions of the circulatory system (3)

transport O2, transport nutrients, remove waste

allogenic bone marrow transplant

uses healthy bone marrow cells from a compatible donor, often a sibling

Type I hypersensitivity disorders: chemicals released by mast cell degranulation cause (5)

vascular permeability, vasodilation, hypotension, urticaria, and bronchoconstriction.