Sect 7 - Benign Lymphatic Disorders

T cells

cellular immunity

- ID and destroys cells based on surface Ag/abnormal cells

B cells

humoral immunity

- produces antibodies

Thymus

Where does T cell maturation occur?

Bone marrow

Where does B cell maturation occur?

thymus

liver

spleen

tonsils

Peyer's patches (GI tract)

bone marrow

What organs are considered lymph tissue?

CD19, CD20

B-cell CD markers

CD3, CD4, CD8

T-cells CD markers

CD3

T-cell marker

CD4

T-helper cell

CD8

T-cytotoxic cell

CD4 and CD8 (monitor the decrease in CD4)

What CD markers are used to evaluate AIDS patients?

CD4+ cell count in AIDS

Infectious Mononucleosis

an acute, febrile infection of lymphoid tissue

Epstein-Barr and CMV

2 viruses that cause Infectious Mononucleosis

EBV

Which virus is the more common of Infectious Mononucleosis?

transmitted via exchange or oral secretions

How is infectious mono transmitted?

**hint: "Kissing disease"

teens and young adults

What population is most affected in infectious mono?

s/s of Infectious Mono

sore throat, cervical lymphadenopathy

fatigue, low grade fere and splenomegaly

rare features:

hepatomegaly, jaundice, rash, facial edema, anorexia, nausea and vomiting

Infectious Mono lab features

variable WBC count (12-25,000/ul)

relative lymphocytosis (usually >50%)

mild thrombocytopenia

PBS: >10% reactive lymphs

Monospot

rapid blood (whole blood or plasma/serum) test use to screen for infectious mono

heterophile antibodies (EBV only, CMV will be neg)

What antibody is being tested for in the Monospot test?

lymphs

Cell noted on PBS that would indicated the body's response to a virus

relative lymphocytosis (usually >50%)

Do pts with infectious mono have relative or absolute lymphocytosis? How much?

VCA-IgM rises 1st

VCA-IgG rises 2nd

Abs to EBNA rise during convalescent phase

What antibody to EBV rises first, second, and during the convalescent phase of infection?

abnormal liver function tests

What chemistry tests may be abnormal in an infectious mono patient?

treatment for Infectious Mono

- no specific therapy is employed

- bed rest

- corticosteroids used in lymphadenopahty is severe

approx 2-6 weeks

Infectious Mono is benign and uncomplicated 95% of time & infections last approx how long?

Bodetalla pertussis

acute, communicable bacterial disease characterized by a paroxysmal or spasmodic cough that usually ends in a prolonged high-pitched cough

Whooping cough

gram-neg cocci bacillus

Bordetalla pertussis is what kind of bacteria?

s/s of Bordetella pertusis

increased secretion of mucus

hacking cough, vomiting and anorexia

Bordetella pertussis lab features

increased WBC count (15,000-50,000/ul)

absolute and relative lymphocytosis

toxic granulation in neutrophil (bacterial infection)

absolute AND relative lymphocytosis

Do pts with Bordetella pertussis have relative or absolute lymphocytosis?

PCR

Fluorescent antibody tests are no longer performed for whooping cough diagnosis. What is the method of choice for Bordetella pertussis?

DTaP vaccine

What vaccine is recommended for Bordetella pertussis?

bacterial culture

What is the gold standard for Bordetella pertussis

con: longer turn around time

Toxoplasmosis gondii

a disseminated, opportunistic parasitic infection with a predilection for the CNS, heart and lungs

Transmitted trans placentally

Ingestion of raw/undercooked meat containing the tissue cysts

Exposure to oocytes in cat feces

3 routs of exposure for Toxoplasmosis gondii parasite

s/s of Toxoplasmosis gondii

fever, enlarged lymph nodes

hepatosplenomegaly

jaundice

convulsions

relative lymphocytosis

Pts with Toxoplasmosis gondii have relative or absolute lymphocytosis?

reactive lymphs

What cell is elevated in Toxoplasmosis gondii?

sulfonamides

treatment for Toxoplasmosis gondii

miscarriages and stillbirths

CNS lesion

What can happen if Toxoplasmosis gondii cause if it crosses the placental barrier?

disorders associated with Lymphocytopenia

Wiskott-Aldrich (causes a deficiency in IgM)

Chemo

Radiation

Lymphocytotoxin drugs

Aplastic Anemia

Hodgkin's Lymphoma

AIDS and SLE

HIV/AIDS

infection with Human Immunodeficiency Virus (HIV)

T-helper (CD4) and T-cytotoxic (CD8)

the two specific antigens associated with HIV/AIDS

CD4 T-helper cells

Which T cell is decreased in HIV/AIDS

(

clinical features in HIV/AIDS

immunodeficiency

neurological dysfunction

hairy leukoplasia of the tongue

disseminated Kaposi's sarcoma

thrush (oral candidiasis)

cytomegalovirus retinitis (blindness)

pneumocystis carinii

AIDS lab featurea

anemia

leukopenia

lymphocytopenia

pos HIV antibody, HIV-nucleic acid test, HIV cultures

anti-viral agents (AZT and protease inhibitors)

HAART (Highly Activate Anti-viral Therapy or Triple Cocktail)

2 therapy options for AIDS pts