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.
