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47 terms

Disorders of White blood cells and lymphoid tissues

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non neoplastic disorders
neutropenia
infectious mononucleosis
neoplastic disorders
leukemias
lymphomas
multiple myeloma
leukocytes- wbc major function
to protect against foreign organisms
etiology of wbc disorders
deficiency- inadequate production and excessive destruction
proliferation
classifications of wbc's
granulocytes- neutrophils, basophils, eosinophils
monocytes and macrophages
lymphocytes- B and T.
myeloid stem cell
formed in bone marrow and circulate in blood- granulocytes, monocytes, and macrophages.
lymphoid stem cell
produced in bone marrow and circulate between blood and lymph: b-lymphocytes(humoral immunity) and t-lymphocytes(cell mediated immunity)
lymph system consists of
lymph vessels
lymph fluid
lymph nodes
spleen
thymus
lymph fluid
made from fluid derived from capillaries
filtered in lymph nodes
drains into vascular system
carried into ride side of heart
lymph nodes
important 2nd line of defense
WBC normal ranges
5,000-10,000 per microliter
leukopenia- below normal
neutrophils- most often decreased
neutropenia
<1500 per micro liter
<200 per micro liter- agranulocytosis
acquired or congenital
neutropenia etiology
decreased production and increased destruction
acquired neutropenia
most common etiology is DRUGS
neutropenia clinical manifestations
infections r/t normal flora
resp tract common site:
malaise
chills
fever
fatigue
infectious mononucleosis etiology
epstein barr virus(EBV)- herpes
self resolving lymphocyte proliferation
infectious mononucleosis prevalence
adolescents and young adults
upper socioeconomic groups
child hood occurrence often asymptomatic
provides complete immunity
infectious mononucleosis pathogenesis
virus transmitted by oral route- saliva
b-lymphocytes
infected individuals often asymptomatic and shed virus throughout life.
immunosuppressed individuals shed virus more often
mild contagion.
infectious mononucleosis clinical manifestations
incubation 4-8 wks
anorexia, malaise, chills, fever, sore throat, enlarged lymph nodes.
elevated wbc-mild
can cause hepatitis, splenomegaly
about 10% with fine red rash.
leukemia
malignant disorders with abnormal growth of wbc precursors( stem cells) in bone marrow
immature malignant cells replace normal bone marrow
mortality about 60%
#1 cause of death 1-14yrs
incidence high in adults
incidence and mortality rate decreasing
leukemia risk factors
possible complication of other cancers
environmental toxins-benzene
possible genetic tendency in some cases: highest blood disorder with down Sx and sometimes "runs in families"
spreading of leukemia
spread to lymph nodes, spleen, liver
organs enlarge
leukemia is classified by
course/duration of illness and abnormal type of cells and tissue involved
acute leukemia
rapid onset with lots of immature leukocytes and symptoms
chronic leukemia
gradual onset and leukocytes>mature occurs>in adults and elderly.
leukemias major categories of tissue/cell type
lymphocytic
myelogenous
what is used instead of cytic if majority of cells are immature?
blastic
lymphocytic leukemias
immature lymphocytes and precursors from bone marrow
lymph nodes
spleen
cns
various tissues
myelogenous leukemias
derived from pluripotent myeloid stem cells in bone marrow
depresses growth of all blood cells
leukemia-clinical manifestations
fatigue
fever
bleeding
cns-headache and seizures
infection
increased uric acid
bone pain
abdomen:pain and n/v
leukemia-WBC lab finding
total wbc count> 100,000 per micro liter.
leukemia RX
chemotherapy-acute forms
BMT: autologous-patients own bone marrow and allogenic-someone elses bone marrow
lymphoma
malignant lymphocytes
lymph nodes, spleen
more like solid tumor
may be slower to spread
among the most curable cancers
hodgkins lymphoma
reed-sternberg cell type
metastasis along lymph pathway
epstein barr virus sometimes present
hodgkins lymphoma incidence
bimodel age groups
age 10-20
after age 50
higher in males
hodgkins lymphoma etiology
unknown
possible inflammation r/t virus (epstein-Barr)
clinical manifestations hodgkins lymphoma
single node or group of nodes
painless and progressive enlargement
node usually above disphragm: cervical and mediastinal
earlier: anergy, fever/chills, night sweats, weight loss
later: fatigue, anemia, spread to liver, spleen, bone marrow.
hodgkins lymphoma Stage A
no symptoms other than enlarged node
Hodgkins Lymphoma stage B
fever
weight loss
itching
night sweats
non-hodgkins lymphoma
malignant lymphocyte other than reed sternbern
b-cells, macrophages
non-hodgkin's lymphoma incidence
older adults
HIV
6th most common adult malignancy
mortality about 50%
non hodgkins lymphoma etiology
most often unknown but r/t:
epstein barr virus
human t cell lymphoma virus
hiv
exposure to herbicides and chemical carcinogens
chronic peptic ulcer disease (helicobacter pylori infection)
clinical manifestations of non hodgkins lymphoma
r/t type and stage
b-cell lymphoma most aggressive: about 50% nhl cases
painless, superficial, enlarged lymph nodes
frequent infections
possible noncontigous spread: gi, testes, liver, lung, bone marrow.
lymphoma RX
radiation
chemotherapy
combination therapy
multiple myeloma
malignant proliferation of activated B cells (plasma cells)
invades bone tissue
unknown etiology
poor pronosis 1 1/2- 2 years
multiple myeloma clinical manifestations
similar to leukemia
bone destruction
pathological fractures
spinal compression
multiple myeloma Rx
chemotherapy
radiation
symptom management