Leukocyte Disorders Exam Three

What is a normal WBC count?

3,700- 11,000/mm^3

What percentage of the WBC does neutrophils make up?

55-65%

What percentage of the WBC count does eosinophils make up?

1-3%

What percentage of the WBC count does basophils make up?

.3-.5%

What percentage of the WBC count does monocytes make up?

3-8%

What percentage of the WBC count does lymphocytes make up?

20-30%

What are non-neoplastic WBC disorders?

leukopenia, neutropenia, leukocytosis, infectious mononucleosis

What is leukopenia?

a decrease in absolute of leukocytes in the blood

What does leukopenia primarily impact?

neutrophils

The risk for neutropenia is directly proportional to what?

absolute neutrophil count (ANC)

What is the normal value for ANC?

1000 microliters

What is neutropenia?

specific to low number of neutrophils (

What does agranulocytosis mean?

refers to a virtual absence of neutrophils

What can neutropenia result from?

decreased production, accelerated use or destruction, shift from blood to tissue

Neutropenia increases __________________ and _______________ of infection.

severity and risk

Neutropenia causes a reduced _______________________.

inflammatory response

What are the early signs of infection in neutropenia?

mild skin lesions, pharyngitis, diarrhea

What are the severe signs of infection in neutropenia?

fatigue, weakness, malaise, fever

With neutropenia infections must be treated ___________________.

immediately

When are patients put on neutropenic precautions?

if ANC < 500

What is leukocytosis?

increase in # of WBCs (mostly neutrophils) > 10,000/mm^3

Leukocytosis is often ___________, in response to ________________.

temporary, infection

Do people have chronic leukocytosis?

some people

Leukocytosis can be caused by what?

drug induced (steriods)

What is infectious mononucleosis?

A self-limiting lymphoproliferative disorder usually due to Epstein-Barr Virus

What is another less common cause of infectious mononucleosis?

CMV

How is infectious mononucleosis contracted?

via contaminated saliva, EBV infects the lymph tissue and B cells

Who is infectious mononucleosis most common in?

teenagers and young adults

What is the incubation period for mono?

4-6 weeks

How long does the prodromal period last for mono?

several days

What is prodrome?

an early vague symptoms of a disease

What are symptoms during the prodromal period of mono?

malaise, anorexia, and chills

The prodromal period symptoms ____________ overt symptoms.

precedes

What are the overt symptoms of mono?

fever, pharyngitis, lymphadenopathy

How long does the acute phase of mono last?

2-3 weeks

When do you make a full recovery from mono?

2-3 months

What are complications of infectious mono?

possible hepatitis, splenomegaly, myocarditis, upper airway obstruction

What are rare complications of mono?

ruptured spleen and CNS complications

What is the testing for mono?

specific antibodies or increased levels of IgM and IgG

What are lymphomas?

malignancies of the lymphatic system

What are the possible etiologies of lymphomas?

immunodeficiencies, toxins, viruses

Where is the initial tumors usually at in lymphomas?

secondary lymphatic organs

What types of lymphomas are there?

non-hodgkin lymphomas or hodgkin lymphoma

How many types of NHL are there?

40 different types

What are non-hodgkin lymphomas?

solid tumors arising from lymph tissue, often the lymph nodes

What cells can become malignant at any stage of differentiation?

B, T, or NK cells

How are NHL classified?

by cell type, level of maturation, and location

What lymphocytes are the most important?

B-cell

How is NHL diagnosed?

by lymph node biopsy

What are the symptoms of NHL?

indolent, aggressive, and increased infections

What does indolent mean in regards to NHL?

painless lymphadenopathy

What does aggressive mean in regards to NHL?

constitutional fear, sweating, weight loss

Many types of NHL are treatable with what?

radiation and chemotherapy

What is burkitt lymphoma?

an aggressive B-cell lymphoma

Where is burkitt lymphoma most common?

in certain areas of Africa

Almost all cases of burkitt lymphoma are linked to what?

viral infections

Where do tumors commonly grow in burkitt lymphoma?

tonsillar and submedibular lymph nodes

Where might burkitt lymphoma spread?

CNS

When must burkitt lymphoma get treatment?

urgently

What is hodgkin lymphoma?

a specialized lymphoma form featuring Reed-Sternburg cells

When do hodgkin lymphoma occur more frequently?

patients in early adulthood and older

Are the causes of hodgkin lymphoma known?

no, maybe be viruses, carcinogens, and genetic

What is hodgkin lymphoma classified into?

nodular lymphocyte predominant, and classic HL

What are the signs and symptoms of HL?

painless enlargement of a single or group of nodes, initial involvement above level of the diaphragm, mediastinal masses common, chest discomfort, cough or dyspnea, fatigue, anemia, pruritis, fevers, night sweats

What does a definitive diagnosis of HL require?

presence of reed-Sternberg cell through biopsy

How are people with HL staged?

according to lymph node involvement (number involved, one or both sides, disseminated?)

What is the treatment for HL?

radiation and chemotherapy

Where does HL usually develop?

in a single lymph node or chain above the diaphragm

Where does NHL originate?

at extranodal sites and spreads anatomically

What age groups does HL occur in?

early adulthood (15-40) and older adulthood (55+) (2 separate age groups)

What age groups does NHL occur in?

various age groups

what is NHL primarily caused by?

EBV

What is leukemia?

the proliferation of malignant hematopoietic cells, which replace normal bone marrow cells and get out to the blood

What are the classification systems for leukemia?

morphologic and based on timeline (acute or chronic)

What is the morphologic classification system based on?

predominant leukemic cells in marrow

What is the most common cause of cancer?

leukemias

Are the causes of leukemia clear?

no

What are possible causes of leukemia?

exposure to large amts of radiation, certain chemicals, toxins, previous chemotherapy for other cancers, and genetic predisposition for acute leukemias

How would you describe the onset of manifestations of acute leukemias?

sudden onset

Study table 24-1 for common s/sx of acute leukemias. Answer to this card is study.

study

How are acute leukemias diagnosed?

bone marrow and blood samples

What would you expect to see in a acute leukemia patient's bone marrow and blood sample?

increased lymphocytes, reduced erythrocytes and platelets

How is acute leukemia treated?

chemotherapy or bone marrow transplant

Who does Acute Lymphocytic leukemia (ALL) most often occur in?

children

Describe the onset of acute lymphocytic leukemia (ALL).

abrupt onset, rapidly fatal if untreated

What is acute lymphocytic leukemia (ALL) characterized by?

abnormal proliferation of lymphoblasts, low neutrophils count, very high WBC count, leukostasis

What does leukostasis do to blood viscosity?

increases

What does cells do acute myeloid leukemia affect?

the myeloblasts

In how many months in acute myeloid leukemia fatal?

3-6 months

Acute myeloid leukemia is more common in ______________ than Acute lymphocytic leukemia (ALL).

adults

Acute myeloid leukemia has similar manifestations as ___________________.

acute lymphocytic leukemias (ALL)

What would a WBC count look like for a patient with acute myeloid leukemia?

high WBC consisting of blast cells

What is chronic leukemia?

when a more mature lymphoid (CLL) or myeloid (CML) cell becomes malignant

Who is chronic leukemia most common in?

older adults (avg age= 72)

What happens to the malignant stem cell in chronic leukemias?

stem cell wildly over-replicates

What does survival of chronic leukemias depend on?

varies based on specific type

What system is affected by chronic leukemias?

immune system

What is the most common form of adult leukemia in the US?

chronic lymphocytic leukemia (CLL)

What are the different forms of chronic lymphocytic leukemia?

indolent and aggressive

What happens to the bone marrow in chronic lymphocytic leukemia?

bone marrow becomes congested by neoplastic lymphocytes crowding out other stem cells