Three main functions of blood
transportation, regulation, protection
Components of blood plasma
water, solutes, proteins
Formed elements of blood
rbcs, wbc, platelets
Phagocytes
neutrophils and monocytes
Major component of the immune system
lymphocytes
Granular WBC's
neutrophil, eosinophil, basophil
agranular WBC
lymphocyte, monocyte
Site of hematopoiesis after birth
Red bone marrow
cells that can develop into many different cell types
pluripotent stem cells
Site where lymphocytes complete their development
lymphoid tissue
hematopoiesis
blood cell formation
Type of WBCs elevated in an allergic reaction
eosinophils and basophils
anemia
decreased number of circulating RBCs
leukopenia
decreased number of circulating WBCs
leukocytosis
increased number of circulating WBCs
lymphoblast
early cell of the lymphocytic line usually found in the bone marrow
blood-brain barrier
capillary walls in the brain prevent harmful substances from entering the CNS
hypercellularity
increased number of cells in the bone marrow
meninges
three membranes that cover the brain and spinal cord
pneumonia
infection of one or both lungs
pus
accumulation of cells and fluid indicative of an infectious process
petechiae
red spots in the skin that result from blood leaking from capillaries
remission
return to a normal state after treatment
upper-lobe infiltrate
infectious material in the upper portion of the lung
transfusion
blood from a donor given through an IV line
hematocrit
The percentage of red blood cells to total blood volume
CBC
determines number and types of cellular components
throat culture
determines cause of an upper respiratory infection
bone marrow aspirate
analysis of blood-forming portion of the bone
lumbar puncture
check for cells, glucose, and protein in the spinal fluid
chest xray
useful in diagnosing pneumonia
gram stain
differentiates bacteria into two distinct classes
Which type of leukemia progresses slowly at first, affects cells of the myeloid line, and primarily affects adults?
chronic myelocytic leukemia (CML)
chemotherapy
systemic drugs that kill rapidly dividing cells
radiation
ionizing rays kill rapidly dividing cells
bone marrow transplant
transplant of healthy stem cells
hematology/oncology
provide diagnosis and treatment of neoplastic and hematologic disease
pathologist
doctor that analyzes biopsies and blood samples
pediatrics
doctor that is the first contact in diagnosing a child with leukemia
respiratory therapist
performs chest physiotherapy to expand and clear lungs
radiation oncology
doctor that oversees radiation treatment for cancer
clinical laboratory scientist
performs CBC, gram stain, and throat culture
nurse
monitors vital signs
radiology technician
takes chest xray
What symptoms did Noah exhibit?
pallor, bone tenderness, enlarged spleen and lymph nodes, bruising, bleeding (nosebleeds).
What abnormalities were present in the laboratory tests?
Elevated WBC count, decreased RBC, Hct, and platelet count. Decrease in normal White Blood Cells; elevated abnormal White Blood Cells (blasts).
leukemia
cancer of the blood, a large number of abnormal blood cells are produced which do not function properly
What is the difference between a chronic and acute leukemia? How do the symptoms differ?
In acute leukemia, the abnormal blood cells are blasts that remain very immature and cannot carry out their normal functions. The number of blasts increases rapidly, and the disease gets worse quickly. In chronic leukemia, some blast cells are present, but in general, these cells are more mature and can carry out some of their normal functions. Also, the number of blasts increases less rapidly than in acute leukemia. As a result, chronic leukemia gets worse gradually.
In acute leukemia, symptoms appear and get worse quickly. People with this disease go to their doctor because they feel sick. In chronic leukemia, symptoms may not appear for a long time; when symptoms do appear, they generally are mild at first and get worse gradually. Doctors often find chronic leukemia during a routine checkup--before there are any symptoms.
What are the four most common types of leukemia? In which age groups is each most predominantly found?
Acute lymphocytic leukemia (ALL) is the most common type of leukemia in young children. This disease also affects adults, especially those age 65 and older.
Acute myeloid leukemia (AML) occurs in both adults and children.
Chronic lymphocytic leukemia (CLL) most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children.
Chronic myeloid leukemia (CML) occurs mainly in adults. A very small number of children also develop this disease.
What are the common symptoms of leukemia?
Symptoms include: •Fever, chills, and other flu-like symptoms; •Weakness and fatigue; •Frequent infections; •Loss of appetite and/or weight; •Swollen or tender lymph nodes, liver, or spleen; •Easy bleeding or bruising; •Tiny red spots (called petechiae) under the skin; •Swollen or bleeding gums; •Sweating, especially at night; and/or •Bone or joint pain
What tests help a physician diagnose leukemia?
CBC, bone marrow smear
What abnormality in Noah's bone marrow smear was suggestive of a Leukemia?
A preponderance of one cell line, blasts.
Chemotherapy is the first line of treatment for ALL. What treatments would follow if chemotherapy fails?
Radiation therapy, biologic therapy, bone marrow transplant.
ALL is the most common cancer in young children. What is the approximate cure rate in children?
80%
Why is a lumbar puncture performed?
Diagnostic purposes: obtain a sample of spinal fluid for examination.
Therapeutic purposes: administer antibiotics, cancer drugs or anesthetic agents.
What is cerebral spinal fluid?
The CSF circulates around the brain and spinal cord (the central nervous system). This "water bath" acts as a support of buoyancy for the brain and spinal cord. The support of the CSF helps to protect the brain from injury.
What abnormalities can be detected from a chest x-ray?
Abnormalities of the lungs including: pneumonia, bronchitis, asthma, cysts, and cancers.
Abnormalities of the heart including: fluid around the heart, enlarged heart, heart failure, abnormal anatomy.
Broken chest bones.
Why would an immunocompromised patient be more susceptible to disease?
An immunocompromised patient has a depressed immune system, and is unable to mount a response to disease.
What evidence can be noted in the CBC and Bone Marrow results to indicate Noah is in remission?
Normal cell values and normal cell lines are present.
What is bone marrow and what is its purpose?
Spongy tissue inside some of the bones. It's purpose is to make blood cells.
How is bone marrow transplanted?
Blood stem cells (immature cells that can grow into red blood cells, white blood cells, and platelets) are transfused into the bloodstream.
What are possible sources for transplanted cells
a. iliac crest (hip bone)
b. blood stem cells
c. stem cells from their own blood if they're healthy enough to donate
d. umbilical cord blood
which cells fall within the lymphoid stem cell line?
T, B, NK lymphoblasts (natural killer)
percentage of neutrophils in blood
60-70%
percentage of lymphocytes in blood
20-25%
percentage of monocytes in blood
3-8%
percentage of eosinophils in blood
2-4%
percentage of basophils in blood
1%
hemoglobin
iron containing pigment of RBCs