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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)
made from fluid derived from capillaries
filtered in lymph nodes
drains into vascular system
carried into ride side of heart
WBC normal ranges
5,000-10,000 per microliter
leukopenia- below normal
neutrophils- most often decreased
neutropenia clinical manifestations
infections r/t normal flora
resp tract common site:
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
infected individuals often asymptomatic and shed virus throughout life.
immunosuppressed individuals shed virus more often
infectious mononucleosis clinical manifestations
incubation 4-8 wks
anorexia, malaise, chills, fever, sore throat, enlarged lymph nodes.
can cause hepatitis, splenomegaly
about 10% with fine red rash.
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
possible genetic tendency in some cases: highest blood disorder with down Sx and sometimes "runs in families"
immature lymphocytes and precursors from bone marrow
derived from pluripotent myeloid stem cells in bone marrow
depresses growth of all blood cells
cns-headache and seizures
increased uric acid
abdomen:pain and n/v
BMT: autologous-patients own bone marrow and allogenic-someone elses bone marrow
lymph nodes, spleen
more like solid tumor
may be slower to spread
among the most curable cancers
reed-sternberg cell type
metastasis along lymph pathway
epstein barr virus sometimes present
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.
non-hodgkin's lymphoma incidence
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
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
possible noncontigous spread: gi, testes, liver, lung, bone marrow.
malignant proliferation of activated B cells (plasma cells)
invades bone tissue
poor pronosis 1 1/2- 2 years
multiple myeloma clinical manifestations
similar to leukemia
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