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.
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
rapid onset with lots of immature leukocytes and symptoms
gradual onset and leukocytes>mature occurs>in adults and elderly.
leukemias major categories of tissue/cell type
what is used instead of cytic if majority of cells are immature?
immature lymphocytes and precursors from bone marrow lymph nodes spleen cns various tissues
derived from pluripotent myeloid stem cells in bone marrow depresses growth of all blood cells
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.
chemotherapy-acute forms BMT: autologous-patients own bone marrow and allogenic-someone elses bone marrow
malignant lymphocytes 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
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
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.
radiation chemotherapy combination therapy
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