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heme 201-2
68kilo heme 201
81
Medical
Not Applicable
02/01/2012

Additional Medical Flashcards

 


 

Cards

Term

type of granulocyte morphology:

toxic granulation

Definition
larger than normal basophilic granules in the cytoplasm
Term
hereditary wbc disorder: may hegglin
Definition

a hereditary autosomal dominant trait

Lab features:

inclusions will be in monocytes and lymphs

may hegglin inclusions in wbcs- resemble dohle bodies

thrombocytopenia with giant platelets

abnormal bizzare appearing platelets

Term
alder reillyanomaly
Definition

inherited as an autosomal reccessive trait

associated with disorders that prevent normal breakdown of mucopolysaccharides

 

 

Term
alder reilly anomaly lab findings
Definition

granulocytes, lymphs, and monocytes have heavy azurophilic granulation

characterized by presence of prominent, dark staining, coarse cytoplasmi granules that: are made of mucopolysacchrde deposits; may totally obscure the nucleus of cells

granules resemble toxic granulation except: larger, permanent feature of the cell,present even without infection

Term
hereditary wbc disorders: chediak higashi syndrome
Definition

autosomal recessive trait caused  by lysosomal defect

giant lysosomal granules produced in wbcs: cells cannnot release their contents after bacteria digestion

Term
chediak higashi syndrome lab findings
Definition

neutrophils shows giant grey-green cytoplasmic granules

lymphocytes and monocytes show single red granule in cytoplasm

Term
hereditary wbc disorders: pelger-huet anomaly
Definition

autosomal dominant trait

results  in abnormal maturation in neutrophils  neucleus

appears to function normally

 

Term
pelger huet anomaly lab findings
Definition

decreased segmentation of the nucleus

nucclear chromatin coarse and condensed

majority of the neutrophils have bilobed nucleus that is: dumbell shaped has pince-nez appearance ( two symetrical lobes)

Term
hereditary wbc disorders: chronic granulomatous disease
Definition

inherited primarily as a rare sex-linked recessive trait

seen primarily in males

generally fatal during early childhood due to recurring bacterial infections

wbc unable to kill catalase-positive organisms: catalase neutralizes hydrogen peroxide; hydorgen peroxide assists in oxygen- dependant bactericidal

 

Term
chronic granulomatous disease lab features
Definition

normal wbc morphology

number of wbcs increase during infection

granulomas ( granular tumor or growth) in many organs: site of chronic infection

Term
lipid storage disorder: gaucher's disease
Definition

results from deficiency of the enzyme beta-glucocerebrosidase

deficeincy leads to accumulation of glucocerebrosides mosty in monocytes/ macrophages; called gaucher cells

characterized by severe bone pain if bone is involved

Term
gauchers disease lab findings
Definition

cbc: leukopenia, thrombocytopenia

hepatosplenomegaly (simultaneous enlargement of both spleen and liver)

bone marrow shows gaucher cells: cells look like unfolded crumpled piece of pape

increased serum acid phosphatase

Term
niemann-pick syndrome
Definition

result of dificiency of the enzyme sphingomyelinase

leads to accumulation of sphingomyelinase in histocytes

Term
niemann pick syndrome lab findings
Definition

thrombocytopenia

presence of sea-blue histocytes in bone marrow: diagnostic of the syndrome

cel stain a striking intense blue using wright's stain or may-grunwald stain

macrophages have globular cytoplasm ( a cytoplasmic inclusion)

Term
Tay- sachs disease
Definition

reault of dificenciy of the enzyme hexaminosidase

enzyme dificency tested prenatally

leads to accumlation of sphingolipids in lymphocytes

Term
tay sach's diease lab findings
Definition

central nervous system affected mostly

vacuolated lymphocytes inperipheral blood

vacuolated histocytes (foam cells) in bone marrow

Term
infectious mononucleosis etiology
Definition

a bening illness caused by epstein barr virus (ebv)

virus enters body orally throught the lymphoid tissues in the pharnyx; infects b-lymphocytes; runs coarse and complete recovery usually occurs in 2 months; primarily in children young adults all races

Term
infectious mononucleosis symptoms
Definition

fatigue

sore throat

dysphagia: difficulty swallowing

general malaise

enlargement of the lymph nodes

splenomegaly and hepatomegaly

 

Term
infectious mononucleosis lab findings
Definition

diagnostic lab features include: presence of atypical lymph; positive monospot test

cbc: normal rbc and plt counts; slightly increased wbc count (can be up to 20,000/cu.mm

differential: absolute increase in lymphs (20-90% atypical lymph)

liver enzyme test may be abnormal

Term
leukemoid reactions etiology
Definition

a neutrophilic respose to bacterial infection marked by: accelerated relase of neutrophils; accompanied by shift to the left

 

Term
leukemoid reaction lab features
Definition

increased wbc count

neutrophillia with morphological sings of infection ( shift to the left): presence of metamyelocytes; increased number of bands

wbc anomalies: toxic granulation; dohle bodies; cytoplasmic vacuolization

Term
differenttiating btwn leukemoid reaction and cml
Definition

10-100 x 10/mm3

no esos, basos, or philidelphia chromosome

LAP increased

 

Term
dohle bodies
Definition

round oval light blue staining area found in the cytoplasm

remnanats of dna

seen with toxic granulation in infections and burns

Term
auer rods
Definition

slender rod-shaped bodies within the cytoplasm that are similar to azurophilic granules

seen within the cytoplasm of myeoblasts in acute myeoblastic leukemia

Term
toxic vacuolization
Definition

round clear spaces within granulocyte cytoplasm

seen in patients with severe bacterial infections

Term
malignant lymphocytes
Definition

usually  colonal

all abnormal cells and appear very similar to one another

seen in cancer

Term
reactive lymph
Definition

lymph with abundant cytoplasmm often indented by surrounding rbcs

often seen in infectious mononucleosis

Term
plasma cell
Definition

blue cytoplasm eccentric nucleus promininent nuclear clearing

rarely seen except in cases of severe inflammation or end stage of mutiple myeloma

Term
smudge cell
Definition

damaged fragile wbcs with a frayed nucleus and no cytoplasmic material

if many, mainly associated with chronic lymphoblastic leukemia

Term
malignancy
Definition
growth and proliferation of one or more clones of abnormal cells
Term
myeloid erythoid (me) ratio
Definition

ratio of the # of mature and immature granulocytes to # of mature and immature rbcs

normal range 2:1- 4:1

Term
neoplasm
Definition
new and abnormal formation of tissue such as a tumor or growth
Term
leukemia
Definition
malignant disease of hematopoietic tissue caused by the mutation of the bone marrow
Term
leukemia etiology
Definition

exposure to ionizing radiation

chemical agents assoc with leukemia include: benzene and cytotoxic alkylating agents; alkylating agents used to treat neoplasm

viruses: epstein-barr virus; human t-cell lymphotrophic virus

genetic factors: not inherited; clusters in families; increased in persons with congential chromosomal abnormalities as in down's syndrome

age: clinically important factor in diagnosis; different leukemias affect different age groups

race: usually more common in whites than blacks

Term
acute leukemia
Definition

leukemic cells: immature ( blast and pro stage)

thrombocytopenia: mild to severe

wbc count: usually elevated; some patients may have normal to decreased counts

affects all ages

if untreated less than  6mths course time

onset is sudden, rapidly

Term
chronic leukemia
Definition

leukemic cells- mature

thrombocytopenia: mild

wbc count: increased

affects adults

course 2-6 yrs

symptoms of long duration

Term
leukocyte alkaline phophatase stain (lap)
Definition

stains alkalike phosphatase present in the neutrophil

helpfil in differientaiting chronic myelogenous leukemia from leukemoid reaction or polycythemia vera

Term
myeloperoxidase stain (mps)
Definition

stains peroxidase present in primary granules of myeloid cells; demonstrates presence of auer rods

Positive- acute myelogenous or monocytic leukemias

negative- acute lymphocytic leukemia

Term
leukemia vs lymphoma
Definition

leukemia: abnormal cells are present in both bone marrow and peripheral blood

lymphoma: abnormal growth of cells is confined to the lymphatic tissue

Term
periodic acid-schiff reaction (pas)
Definition

stains high molecular weight carbohydrates normally present in most blood cells types except pronormoblasts

 

helps diagnosis erythroleukemia

Term
sudan black b (sbb)
Definition

stains phospholipids and lipoproteins present in granules of monocytes and granulocytes

Positive- acute myelogenous and myelomonocytic leukemias

negative- acute lyphocytic leukemia

Term
acid phosphatase
Definition

stains acid phosphatase present in lysosomes of all hematopoietic cells

identifies t-cell acute lymphocytic leukemia

Term
acid phosphatase (with tartrate resistance)
Definition

acid phophatase present in all hematopoietic cells

located in lysosomes 

helpful in diagnosing hairy cell leukemia

Term
nonspecific esterase stain
Definition

stains esterases in monocytes and macrophages

negative- granulocytic leukemias

positive- monocytic leukemias

Term
specific esterase (naphthol AS-D chloroacetate) stain CAE
Definition

stains esterases present in mature and immature neutrophils and mast cels

positive- neutrophilic cells

negative- monocytic cells

Term
acute myeloid leukemia etiology
Definition

malignant: clonal disease

characterized by the rapid proliferation of abnormal cells that: accumulate in the bone marrow; interfere with the production of normal blood cells

most common acute leukemia affecting adults

Term
lab findings for acute myeloid leukemia
Definition

cbc: blood count variables

blasts present in peripheral smear

auer rods present in: myeoblasts, monoblasts, promyelocytes

nrbcs may be seen

psuedo pelger-huet cells

increased m:e ration

Term
acute lymphoblastic leukemia
Definition

charaterized by replacement of normal hematopoietic elements in the bone marrow by abnormal lymphoid cells

results in decreased rbcs, phagocytes, and plts

 

most common malignant disease in children

Term
acute lymphoblastic leukemia
Definition

wbc count elevated in 60-70% of patients- blast forms predominate

close to 100% lymphoblasts and lymphocytes seen on peripheral smear

Term
chronic myelogenous leukemia (cml)
Definition

clonal stem cell disorder affecting the: monocytic, erythocytic, and megakaryocytic stem lines

most causes (95%) unknown

philidelphia chromosome formation underlying common finding : formation occurs when chromosome 9 and 22 conjoin; present in 70-90% of cml patients

accounts for 20-25% of all leukemia cases in western countries

Term
lab findings for chronic myelogeneous leukemia
Definition

disease marked by overwhelming accumulation of myeloid cells within the bone marrow and peripheral blood

cell counts marked by: extremely increased wbc counts

possible increase plt counts

peripheral smear shows: presence of neutrophils in all stages of development; increased basos and eos; increased plts; nrbcs

Term
lab findings for chronic myelogeneous leukemia: bone marrow
Definition

hypercellular

m:e ratio generally at least 10:1; normal is 3:1

low to absent lap

Term
chronic lympocytic leukemia
Definition

most cases clonal proliferation of b-lymph: 98% b-cell; 2% t-cell

causes: none; possibal viral cause

two times more common in men

most common type of leukemia in adults over 50

Term
chronic lymphocytic leukemia
Definition

normocytic/normochromic anemia with slight dec in plts

increased wbc ct: 20-200 x 10^9/L

peripheral smear: often see smudge cells; usually shows 60-95% lymphocytes

Term

myeloproliferative disorder:

chronic monocytic leukemia

Definition

cells negative for philidelphia chromosome: manifest with peripheral blood, bone marrow, and extramedullary tissues

usually the crisis is acute myeloid or acute lymphoblastic in nature

symptoms: severe anemia (usually n/n)

leukocytopenia

thrombocytopenia

Term

myeloproliferative disorder:

polycythemia vera

Definition

characterized by an accelerated production of rbcs

stimulates excess production of myeloids and megakaryocytes

definitive key to diagnosis: increase in absolute rbcs

usually seen in patients older than 60

 

Term
polycythemia vera lab findings
Definition

 increased hct, hgb, and red cell mass

increased wbc ct: 80% of the cases

increased plt ct: 50% of the cases

morph: nrbcs often present; poikilocytosis

Term

myeloproliferative disorder:

essential thrombocythemia

Definition

clonal proliferation of megakaryocytes in the bone marrow

megakaryocytes larger than normal and may be dysplastic in appearance

Term
essential thrombocythemia lab findings
Definition

plts:marked thrombocytosis; giant plts; microthrombocytes; plt aggregates; abnormally granulated plts; megakaryocytic cytoplasmic fragments; abnormal plt function

 

rbcs: n/n anemia

hjb, pappenheimer bodies, target cells, acantho

Term
myeloproliferative disorder: idiopathic myelofibrosis
Definition

stem cel defect resulting in an abnormal proliferation of granulocytes, rbcs, and megakaryocytes

may transform into acute leukemia

Term
idiopathic myelofibrosis lab findings
Definition

increased wbc ct in 50% of patients

morph: nrbcs, tear drop, immature neutrophils, dwarf megakaryocytes often present, along with large bizarre plts

Term
myelodysplastic syndromes
Definition
disorders that result  from clonal abnormalities of hematopoietic, pluripotent stem cells characterized by: hypercellular bone marrow; progressive reduction of blood cells in the peripheral blood;
Term
id the characteristics and lab findings of each classification of myelodysplastic syndrome
Definition
chart p. 128
Term
chronic lymphoproliferative disorders
Definition
comprise b and t lymphocyte disorders in which there is a clonal malignant proliferation of either subset
Term
hairy cell leukemia
Definition

medium sized lymphs (15-30 um in diameter)

nucleus:round to oval with fine chromatin; 1 to 5 distinct nucleoli

abundant cytoplasm with hair-like or ruffled projections 

Term
sezary syndrome
Definition

larger than normal lymphs

scant cytoplasm

cerebriform nucleus: with or without nucleoli; with fine chromatin

Term
hodgkins lymphoma
Definition

presence of reed-sternburg cells during lymph node biopsy

cells look like large, multinucleated cells resembling an owl's eye

cells react to the neoplasm rather than the neoplastic cells

Term
hogkins lymphoma lab findings
Definition

moderately increased wbc count with moncytosis neutrophilia and variable eosinophilia

toxic granulation

large bizzare plts

Term
non- hodgkins lymphoma
Definition

proliferation of malignant lymphocytes arrested at certain stages of maturation

abnormal lympocytes may be present on the peripheral smear

Term
plasma cell disorder
Definition
diverse group of diseases characterized by proliferation of a single clone of cells producing monoclonal immunoglobulin or immunoglobulin fragments
Term
multiple myeloma
Definition

result from abnormal proliferation of b-lymphocytes

plasma cells grow out of control and form a myeloma usually in the bone marrow

may lead to plasma cell leukemia

highest risk in black men over 80

Term
mutlple myeloma lab findings
Definition

increased esr

bence-jones protein present in urine

peripheral blood smear- marked rouleax

bone marrow estimation reveals abnormal plasma cells

see chart pg 135-136

Term
waldenstroms macro-albunemia
Definition

non-hodgkins lymphoma produces large amounts of an abnormal protein called macroglobulin

lymphoma cells grow mainly in teh bone marrow, where they crowd out the normal cells that make different blood cells

Term
macroglobulins
Definition
monoclonal IgM  immunoglobulins of high molecular weight
Term
waldsenstrom's macroglobulinemia lab findings
Definition

n/n anemia

marked rouleaux formation on peripheral blood smear

abnormal bleeding: prolonged bleeding time: PT, PTT; predominance of prolymphocytes in bone marrow

Term
polycythemia vera symptoms
Definition

headaches, dizziness, and visual impairment

increased blood pressure

splenomegaly- 75% of the cases

hepatomegaly- 35% of the cases

phlebitis

erythromelagia- painful red extremities

 

Term
multiple myeloma signs and symptoms
Definition

bone lesions

anemia

GI

Term
waldenstrom's macro-globulinemia signs and symptoms
Definition

fatigue/ weight loss

enlargement of lymph nodes, liver and spleen

neurobological changes

congestive heart failure

extensive bruising called cryoglobulinemic purpura

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