Lymphatic System

Red Blood Cell Diseases

Anemia

Deficiency in erythrocytes or hemoglobin.

Iron deficiency, chronic disease

Fatigue, pallor, shortness of breath

Iron supplements, treat underlying cause

Aplastic Anemia

Bone marrow failure to produce blood cells.

Idiopathic, benzene, chloramphenicol

Pancytopenia, fatigue, infections

Transfusion, antibiotics, immunosuppressants, marrow transplant

Hemolytic Anemia

Excessive destruction of RBCs.

Hereditary (spherocytosis)

Spherocytes, jaundice, increased reticulocytes

Splenectomy

Sickle Cell Anemia

Abnormal hemoglobin (HbS) leading to sickled RBCs.

Genetic (African/Hispanic ancestry)

Pain crises, stroke, poor oxygenation

Pain management, transfusions, experimental gene therapy

Thalassemia

Defective hemoglobin production.

Genetic (Mediterranean, Asian ancestry)

Hypochromic, microcytic anemia

Transfusions, iron chelation, stem cell transplant

Pernicious Anemia

Inability to absorb vitamin B12 due to lack of intrinsic factor.

Autoimmune gastritis

Macrocytic anemia, neurologic symptoms

B12 injections/oral therapy for life

Hemochromatosis

Excess iron accumulation in body tissues.

Hereditary or frequent transfusions

Bronze skin, fatigue, diabetes, joint pain

Phlebotomy, iron chelation therapy

Polycythemia Vera

Increased RBC production leading to thickened blood.

Bone marrow abnormality

Ruddy complexion, headaches, thrombosis

Phlebotomy, myelotoxic drugs

Clotting Disorders

Hemophilia

Deficiency of clotting factors VIII or IX.

Genetic (X-linked)

Prolonged bleeding, joint hemorrhage

Factor replacement, gene therapy in trials

Purpura

Multiple small hemorrhages under the skin due to low platelets.

Autoimmune (ITP)

Petechiae, ecchymoses, bleeding gums

Splenectomy, immunosuppressive drugs

White Blood Cell Diseases

Leukemia

Malignant increase in white blood cells.

Unknown; some genetic links

Fatigue, fever, bleeding, bone pain, infections

Chemotherapy, targeted therapy, bone marrow transplant

- AML

Immature myeloblasts dominate.

Adults

Abrupt symptoms, low platelets/RBCs

Chemotherapy, possible transplant

- ALL

Immature lymphoblasts dominate.

Children, young adults

Sudden onset, bone pain, fatigue

Chemotherapy; high cure rate in children

- CML

Mixed immature/mature granulocytes.

Adults >55

Slow progression, fatigue

Gleevec and similar targeted therapies

- CLL

Mature lymphocytes dominate.

Elderly

Asymptomatic early, lymphadenopathy

Often no early treatment; monitored

Granulocytosis

Increased granulocytes due to infection/inflammation.

Infections, inflammation

Varies by type: eosinophilia, basophilia, neutrophilia

Treat underlying cause

Mononucleosis

Viral infection by Epstein-Barr virus.

EBV, saliva (kissing)

Fatigue, sore throat, swollen lymph nodes

Rest, supportive care

Bone Marrow Disease

Multiple Myeloma

Malignant plasma cells secrete abnormal antibodies (e.g., Bence Jones protein).

Unknown

Bone pain, fractures, anemia, renal failure, infections

Chemotherapy, pain control, bone marrow transplant

Antiglobulin (Coombs) Test

Detects antibodies coating RBCs

Used for Rh incompatibility, autoimmune hemolytic anemia, transfusion testing

Complete Blood Count (CBC)

Measures counts of RBCs, WBCs, platelets, Hgb, Hct, red cell indices

Fundamental screening test for many conditions

Erythrocyte Sedimentation Rate (ESR)

Measures rate of RBC settling

↑ in infections, inflammation, tumors; nonspecific

Hematocrit (Hct)

Percentage of blood volume that is RBCs

Performed via centrifugation

Hemoglobin (H, Hg, Hgb, HGB)

Measures total hemoglobin in blood

Assesses oxygen-carrying capacity

Platelet Count

Number of platelets per mm³ or µL

Normal: 150,000–450,000

Prothrombin Time (PT)

Measures clotting ability

Used to monitor warfarin; INR standardizes result across labs

Partial Thromboplastin Time (PTT)

Measures intrinsic clotting pathway

Often used alongside PT

Red Blood Cell Count (RBC)

Number of erythrocytes per mm³ or µL

Normal: ~4–6 million/mm³

Red Blood Cell Morphology

Microscopic exam of RBC shape

Identifies anisocytosis, poikilocytosis, micro/macrocytosis, sickle cells

White Blood Cell Count (WBC)

Number of leukocytes per mm³ or µL

Normal: 7,000–10,000/mm³

WBC Differential

Percentages of different WBC types

Includes neutrophils, lymphocytes, monocytes, eosinophils, basophils, bands

Shift to the Left

Increase in immature neutrophils

Suggests acute infection or inflammation

Apheresis

Separates and removes a component from blood

Includes leukapheresis, plasmapheresis, plateletpheresis

Blood Transfusion

Transfer of blood or components

Requires blood typing, infectious disease screening

Autologous Transfusion

Patient’s own blood is stored and reused

Avoids transfusion reactions

Packed Red Cells

RBCs separated from plasma for transfusion

Used to treat severe anemia

Bone Marrow Biopsy

Core sample of marrow for microscopic exam

Used to diagnose leukemia, anemia, pancytopenia

Bone Marrow Aspiration

Liquid marrow withdrawn via suction

Often combined with biopsy

Hematopoietic Stem Cell Transplantation

Infusion of stem cells after marrow ablation

For leukemia, lymphoma, myeloma, autoimmune diseases

Autologous Stem Cell Transplant

Uses patient’s own previously harvested stem cells

Less risk of GVHD

Allogeneic Stem Cell Transplant

Uses donor cells; requires HLA match

Risk of graft-versus-host disease (GVHD); requires immunosuppressants

GVHD (Graft-Versus-Host Disease)

Donor immune cells attack recipient tissue

Prevented with drugs like cyclosporine, methotrexate, sirolimus, mycophenolate

CBC

Complete blood count

diff

Differential count (white blood cells)

H and H

Hemoglobin and hematocrit

Hct

Hematocrit

Hgb, HGB

Hemoglobin

MCH

Mean corpuscular hemoglobin

MCHC

Mean corpuscular hemoglobin concentration

MCV

Mean corpuscular volume

RBC

Red blood cell; red blood cell count

WBC

White blood cell; white blood cell count

ESR / sed rate

Erythrocyte sedimentation rate

PT / pro time

Prothrombin time

PTT

Partial thromboplastin time

INR

International normalized ratio

SMAC

Sequential Multiple Analyzer Computer (automated chemistry analyzer)

Fe

Iron

g/dL

Grams per deciliter

μL

Microliter

mm³

Cubic millimeter

bands

Immature white blood cells (granulocytes)

baso

Basophils

eos

Eosinophils

lymphs

Lymphocytes

mono

Monocytes

segs

Segmented (mature) neutrophils

polys / PMNs / PMNLs

Polymorphonuclear leukocytes (neutrophils, eosinophils, basophils)

ALL

Acute lymphoid leukemia

AML

Acute myeloid leukemia

CLL

Chronic lymphoid leukemia

CML

Chronic myeloid leukemia

HCL

Hairy cell leukemia

MDS

Myelodysplastic syndrome (preleukemic condition)

ITP

Idiopathic thrombocytopenic purpura

DIC

Disseminated intravascular coagulation

GVHD

Graft-versus-host disease

EBV

Epstein-Barr virus (cause of mononucleosis)

ABMT

Autologous bone marrow transplantation

ASCT

Autologous stem cell transplantation

BMT

Bone marrow transplantation

HLA

Human leukocyte antigen (tissue typing marker)

Ab

Antibody

IgA, IgD, IgE, IgG, IgM

Classes of immunoglobulins (antibodies)

G-CSF

Granulocyte colony-stimulating factor

GM-CSF

Granulocyte-macrophage colony-stimulating factor

EPO

Erythropoietin (stimulates RBC production)

ANC

Absolute neutrophil count (WBC × % neutrophils)

ABO

Four main blood types: A, B, AB, O

WNL

Within normal limits

Adaptive Immunity

Ability to recognize and remember specific antigens and mount an attack on them; includes humoral (B cells) and cell-mediated (T cells) immunity.

Adenoids

Mass of lymphatic tissue in the nasopharynx.

Antibody

Protein produced by B cells to destroy antigens.

Antigen

Substance recognized as foreign by the body; triggers immune response. Mostly proteins on bacteria, viruses, or transplanted cells.

Axillary Nodes

Lymph nodes located in the armpit.

B Cell (B Lymphocyte)

Lymphocyte that matures into plasma cells to secrete antibodies; originates in bone marrow.

Cell-Mediated Immunity

T cells respond to and destroy antigens; a type of adaptive immunity.

Cervical Nodes

Lymph nodes in the neck region.

Complement System

Blood proteins that help antibodies destroy their targets.

Cytokines

Proteins secreted by cytotoxic T cells to aid antigen destruction (e.g., interferons, interleukins).

Cytotoxic T Cell

Lymphocyte (CD8+) that directly kills antigen-bearing cells.

Dendritic Cell

Antigen-presenting cell that shows T and B cells what to attack.

Helper T Cell

Lymphocyte (CD4+) that aids B cells and stimulates other T cells.

Humoral Immunity

B cells produce antibodies after exposure to specific antigens.

Immunity

Body’s ability to resist foreign organisms and toxins; includes natural and adaptive immunity.

Immunoglobulins

Antibodies (IgA, IgE, IgG, IgM, IgD) secreted by plasma cells.

Immunotherapy

Use of immune cells, antibodies, or vaccines to treat disease.

Inguinal Nodes

Lymph nodes in the groin region.

Interferons

Cytokines secreted by T cells and other cells to regulate immune response.

Interleukins

Cytokines that stimulate growth of B and T lymphocytes.

Interstitial Fluid

Fluid between cells; becomes lymph when it enters lymph capillaries.

Lymph

Clear fluid in lymphatic vessels, collected from tissues.

Lymph Capillaries

Smallest lymphatic vessels.

Lymphoid Organs

Lymph nodes, spleen, thymus gland, tonsils, and adenoids.

Lymph Node

Stationary lymphatic tissue clusters along lymph vessels; contains lymphocytes and macrophages.

Lymph Vessel

Tubes carrying lymph throughout the body; empty into veins in the upper chest.

Macrophage

Large phagocyte in lymph nodes and tissues that engulfs foreign substances.

Mediastinal Nodes

Lymph nodes in the chest between the lungs.

Mesenteric Nodes

Lymph nodes in the intestinal mesentery.

Monoclonal Antibody

Laboratory-produced antibody used to target and destroy cells; useful in immunotherapy.

Natural Immunity

Innate, nonspecific protection present at birth; involves neutrophils, monocytes, macrophages, NK cells.

Paraaortic Nodes

Lymph nodes near the aorta in the lumbar (waist) region.

Plasma Cell

Mature B lymphocyte that secretes antibodies.

Right Lymphatic Duct

Lymphatic vessel in the chest that drains lymph from the upper right body; empties into a large vein in the neck.

Spleen

Organ in the left upper abdomen that destroys old red blood cells, activates lymphocytes, and stores blood.

Suppressor T Cell

Lymphocyte that inhibits B and T cell activity; also called T regulatory cell (Treg).

T Cell (T Lymphocyte)

Lymphocyte that attacks antigens directly or secretes cytokines to destroy them.

Tolerance

Ability of T cells to recognize the body’s own antigens as "self" and not attack them; prevents autoimmune disease.

Thoracic Duct

Large lymphatic vessel draining lower and left side of the body; empties lymph into veins in the neck.

Thymus Gland

Lymphoid organ in the mediastinum that conditions T cells and aids immune response.

Tonsils

Masses of lymphatic tissue in the back of the oropharynx.

Toxin

Poison, typically a protein produced by certain bacteria, animals, or plants.

Vaccination

Exposure to a foreign protein (antigen) that provokes immune response, providing protection.

Vaccine

Weakened or dead antigen given to induce antibody production and adaptive immunity.

Immunodeficiency

Disorders where the immune system is deficient. Can be congenital (e.g., SCID) or acquired (e.g., AIDS).

SCID (Severe Combined Immunodeficiency Disease)

Congenital lack of B and T cells; thymus small; no immunity, leading to severe infections in infants.

AIDS (Acquired Immunodeficiency Syndrome)

Caused by HIV, which destroys CD4+ helper T cells; leads to opportunistic infections, secondary cancers, neurologic problems.

HIV (Human Immunodeficiency Virus)

Retrovirus that infects helper T cells (CD4+), disrupting immune response. Transmitted sexually, via blood, or mother-to-child.

Opportunistic Infections

Infections occurring in AIDS due to weakened immunity; include candidiasis, cryptococcal infection, PCP pneumonia, toxoplasmosis, etc.

Common Opportunistic Infections (Table 14-2)

- Candidiasis: fungal infection of mouth, skin, respiratory tract. - Cryptococcal infection: fungus from environment affecting lungs, brain. - Cryptosporidiosis: parasitic GI and CNS infection. - CMV infection: viral retinitis and enteritis. - Herpes simplex: viral blisters, encephalitis. - Histoplasmosis: fungal lung infection from bird/bat droppings. - MAI complex: bacterial systemic infection. - PCP pneumonia: fungal lung infection. - Toxoplasmosis: parasitic CNS infection. - Tuberculosis: bacterial lung and systemic infection.

Malignancies Associated with AIDS

Kaposi sarcoma (skin tumors) and lymphoma (lymph node cancer).

Wasting Syndrome

Weight loss, muscle weakness, decreased appetite and mental activity in AIDS patients.

HIV Transmission Routes (Table 14-3)

Sexual contact, blood exposure (needles, transfusion), and mother to newborn (in utero or breast feeding).

Treatment for AIDS

- Reverse Transcriptase Inhibitors (RTIs): block HIV replication enzyme (e.g., zidovudine). - Protease Inhibitors: block viral protease. - HAART: combination therapy including entry and integrase inhibitors.

Hypersensitivity (Allergy)

Abnormal immune response to allergens; can range from mild (hay fever) to severe (anaphylaxis).

Anaphylaxis

Severe systemic allergic reaction causing hypotension, shock, respiratory distress; requires immediate treatment (epinephrine).

Atopy

Inherited predisposition to allergic reactions (e.g., asthma, hives, atopic dermatitis).

Allergen Immunotherapy (Allergy Shots)

Gradual exposure to allergens to build tolerance and reduce symptoms.

Lymphoma

Malignant tumor of lymphoid tissue; includes Hodgkin and non-Hodgkin types.

Hodgkin Lymphoma

Malignant tumor with Reed-Sternberg cells; treated with radiation or chemotherapy; often curable.

Non-Hodgkin Lymphomas

Diverse group mostly involving B cells; treatment varies, often chemotherapy.

Multiple Myeloma

Malignant plasma cell tumor in bone marrow; produces large amounts of one antibody type (often IgG).

Waldenström Macroglobulinemia

B cell malignancy producing excess IgM causing blood thickening (hyperviscosity).

Thymoma

Tumor of thymus gland; associated with myasthenia gravis and autoimmune diseases; treated primarily by surgery.

Allergen

Substance causing a hypersensitivity reaction (type of antigen).

Anaphylaxis

Extreme allergic reaction.

Atopy

Inherited allergic predisposition.

CD4+ cells

Helper T cells infected by HIV.

Hodgkin lymphoma

Lymphoid malignancy with Reed-Sternberg cells.

HIV

Retrovirus causing AIDS.

Kaposi sarcoma

AIDS-related skin cancer from capillary cells, caused by human herpesvirus 8.

Non-Hodgkin lymphomas

Group of lymphoid cancers, mainly B cell types.

Opportunistic infections

Infections common in AIDS due to weakened immunity.

Protease inhibitor

Drug blocking viral protease to stop HIV replication.

Reverse transcriptase inhibitor (RTI)

Drug blocking reverse transcriptase enzyme in HIV replication.

Wasting syndrome

Weight loss and muscle weakness in AIDS patients.

CD4+ Cell Count

Measures number of helper T cells (CD4+ T cells) in blood.

Normal: 500–1500 cells/mm³If <250-200, start anti-HIV treatment

ELISA (Enzyme-linked Immunosorbent Assay)

Screening test for anti-HIV antibodies in blood.

Antibodies appear ~2 weeks post-infection.Positive test confirmed by Western blot.

Immunoelectrophoresis

Separates and measures types of immunoglobulins (IgM, IgG, IgE, IgA, IgD).

Detects abnormal antibody levels in diseases like multiple myeloma and Waldenström macroglobulinemia.

Viral Load Test

Measures amount of HIV virus in bloodstream.

Includes PCR assay and NASBA test to quantify viral RNA.

Computed Tomography (CT) Scan

X-ray imaging producing cross-sectional views of lymphoid organs (lymph nodes, spleen, thymus).

Used to detect abnormalities in lymphoid tissue and organs.

AIDS

Acquired immunodeficiency syndrome

CAR T-cells

Chimeric antigen receptors; lab-activated to fight cancer cells

CD4+ cell

Helper T cell

CD8+ cell

Cytotoxic T cell

CMV

Cytomegalovirus — causes opportunistic AIDS-related infection

Crypto

Cryptococcus — causes opportunistic AIDS-related infection

ELISA

Enzyme-linked immunosorbent assay — test to detect anti-HIV antibodies

G-CSF

Granulocyte colony-stimulating factor — cytokine promoting neutrophil production

GM-CSF

Granulocyte-macrophage colony-stimulating factor — promotes myeloid cell growth

HAART

Highly active antiretroviral therapy — combination drug treatment for AIDS

Histo

Histoplasmosis — fungal infection in AIDS patients

HIV

Human immunodeficiency virus — causes AIDS

HSV

Herpes simplex virus

IEC

Immunoeffector cells — activated cells defending the body in immune response

IgA, IgD, IgE, IgG, IgM

Immunoglobulins (types of antibodies)

IL1 to IL38

Interleukins (immune signaling molecules)

KS

Kaposi sarcoma

KSHV

Kaposi sarcoma herpesvirus (herpesvirus 8)

MAI

Mycobacterium avium-intracellulare complex — causes lung/systemic disease

MoAb

Monoclonal antibody

NHL

Non-Hodgkin lymphoma

PCP

Pneumocystis pneumonia — opportunistic AIDS infection

PI

Protease inhibitor

RTI

Reverse transcriptase inhibitor (e.g., zidovudine, lamivudine)

SCID

Severe combined immunodeficiency disease

Treg

Regulatory T cell (suppressor T cell)

Toxo

Toxoplasmosis — parasitic infection associated with AIDS