Term
|
Definition
| Malignant proliferations of WBC precursor cells within the bone marrow that spread to the blood and other organs |
|
|
Term
| Four Major Types of Leukemia |
|
Definition
| 1. acute lymphoblastic leukemia (ALL) 2. acute myelogenous leukemia (AML) 3. chronic lymphocytic leukemia (CLL) 4. chronic myelogenous leukemia (CML) |
|
|
Term
| Most Cases of Leukemia are? |
|
Definition
| AML Acute Myelogenous Leukemia |
|
|
Term
| Characteristics of Acute Leukemia |
|
Definition
| 1. Incidence: Most common leukemia in children; also occurs in adults Most common pediatric cancer; peak age 2-10 2.Prognosis: many cures (up to 70% children; 50% adults) |
|
|
Term
| Signs and Symptoms of Acute Leukemia |
|
Definition
| SIGN AND SYMPTOMS 1. Typically acute or abrupt onset 2. Both AML and ALL: a. Bone pain (due to replacement of bone marrow with blasts) b.Hepatosplenomegaly c. Signs of anemia: pallor; weakness d. Signs of thrombocytopenia: easy bruisability; epistaxis (nose bleed); gum bleeding |
|
|
Term
| KEY THING TO THINK WHEN BLASTS ARE REPORTED ON CBC |
|
Definition
| *** THINK OF ACUTE LEUKEMIA WHEN BLASTS ARE REPORTED ON CBC AND GET A HEMATOLOGY CONSULT RIGHT AWAY*** |
|
|
Term
| Clinical Aspect of Chronic Myelogenous Leukemia |
|
Definition
| INCIDENCE: median age at presentation- 50 years; can occur in children CLINICAL PRESENTATION 1. Easy fatiguability and weight loss; often asymptomatic 2. Splenomegaly in most patients; may be extreme Signs of splenomegaly: left upper quadrant pain; early satiety (feeling full upon eating) |
|
|
Term
| Which Chromosome is important in the pathogenesis of Chronic Myelogenous Leukemia? |
|
Definition
| Philadelphia chromosome present in up to 95% cases |
|
|
Term
| CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) |
|
Definition
| INCIDENCE: 1. Most common adult leukemia in US and Western Europe 2. Typically involves elderly patients SYMPTOMS: 1. Fatigue; anorexia (decreased appetite) 2. May be asymptomatic and discovered on routine CBC PHYSICAL SIGNS: Lymphadenopathy (often why patients present); splenomegaly |
|
|
Term
| HODGKIN'S DISEASE Incidence |
|
Definition
| Incidence 1. 2 peaks: young adults; other peak in adults > 50yrs 2. Male predominance 3. One of the most common cancers in young adults |
|
|
Term
| Presentation of Hodgkin's Disease |
|
Definition
| Presentation 1. Tends to present as localized lymphadenopathy 2. Many cases asymptomatic 3. 25-30% have "B symptoms": fever; night sweats; weight loss 4. **Reed Sternberg cells on peripheral smear** |
|
|
Term
| NON-HODGKIN'S LYMPHOMA (N-H-L) presents and is prevalent in? |
|
Definition
| Occur in all Ages Presents with: 1. Localized or generalized lymphadenopathy 2. May originate at extranodal site (e.g. spleen; liver; bone marrow; GI tract; tonsils; brain) |
|
|
Term
| Definition of Multiple Myeloma |
|
Definition
| Malignant proliferation of plasma cells which all secrete the same antibody (monoclonal antibody): monoclonal antibody is referred to as a paraprotein |
|
|
Term
| Clinical Features (Cases) for Multiple Myeloma |
|
Definition
| A. Punched out (destructive or lytic) bone lesions on XRAY: caused by accumulations of MM plasma cells in bone marrow B. Bone destruction results in hypercalcemia and bone pain (bone pain is most common presenting symptom) |
|
|
Term
|
Definition
| A. Lymphomas: Hodgkin's disease; non-Hodgkin's lymphomas B. Chronic leukemias: 1. chronic myelogenous leukemia (CML) 2. chronic lymphocytic leukemia (CLL) C. Acute leukemias D. Polycythemia vera: neoplastic proliferation of RBC in bone marrow (to be discussed in clinical med surg) E. Certain hemolytic anemias (e.g. thalassemia major) |
|
|
Term
| More Causes of Spenomegaly |
|
Definition
| A. Congestive states 1. portal hypertension secondary to chronic liver failure (cirrhosis) 2. right-sided heart failure B. Infectious conditions: e.g. infectious mononucleosis; malaria C. Storage diseases: Enzyme deficiencies result in accumulation of lipids and carbohydrates in spleen and other organs: e.g. Gaucher's disease; Niemann-Pick disease D. Connective tissue disorders: systemic lupus erythematosus; Felty’s syndrome (splenomegaly, lymphadenopathy, neutropenia and rheumatoid arthritis) |
|
|
Term
| Bacteria associated with Otitis Media in the newborn? |
|
Definition
| gram-negative enteric bacilli (E. coli), S. aureus |
|
|
Term
| Bacteria associated with Otitis Media in < 14 yr. ? |
|
Definition
| Strep pneumoniae, M. catarrhalis, H. influenzae, S. aureus |
|
|
Term
| Bacteria associated with Otitis Media in > 14 yr. ? |
|
Definition
| gp A β-hemolytic strep, S. aureus |
|
|
Term
| Chronic Otitis Media can result from: |
|
Definition
| AOM, eustachian tube obstruction, mechanical trauma, thermal or chemical burns, blast injuries, iatrogenic causes (eg, post tympanostomy tube placement). |
|
|
Term
| Tympanic Membrane Perforation is caused by and assoc. with? |
|
Definition
| Cause: trauma, barotrauma, infection S&S: pain, hearing loss |
|
|
Term
| Otitis Externa aka "swimmers ear" is caused by what Bacteria? |
|
Definition
|
|
Term
| DDX for Hearing Impairment |
|
Definition
| 1. outer ear: impacted cerumen, foreign bodies 2. middle ear: fluid effusion, OM, tumors, otosclerosis 3. repeated exposure to loud sounds 4. ototoxic meds (aminoglycosides)5.chemotherapy intrauterine infections(CMV, herpes simplex virus, HIV, Toxoplasma) |
|
|
Term
| 4 mechanisms responsible for Conductive Hearing Loss |
|
Definition
| obstruction, mass loading (middle ear infusion), stiffness (otosclerosis), discontinuity (ossicle disruption) |
|
|
Term
| Main causes of Sensorineural Hearing Loss |
|
Definition
long term exposure to loud noise, ototoxic meds, trauma, metabolic causes, aging
Usually irreversible |
|
|
Term
|
Definition
| An epithelial cell growth that forms in the middle ear, mastoid, or epitympanum after chronic otitis media. |
|
|
Term
| What is Mastoiditis and its symptoms |
|
Definition
| Mastoiditis is a bacterial infection of the mastoid air cells typically following acute otitis media. Symptoms begin days to weeks after onset of acute otitis media and include fever and persistent, throbbing otalgia. Nearly all patients have signs of otitis media and purulent otorrhea. |
|
|
Term
| What type of hearing loss does Acoustic Neuroma cause? |
|
Definition
|
|
Term
| What are the accompanying symptoms of Vertigo? |
|
Definition
| nausea, vomiting, pallor, diaphoresis, nystagmus frequently |
|
|
Term
| Main point tied in with the Vestibular System? |
|
Definition
| Changes in direction affect the motion & firing of the cilia within the canals, thereby affecting normal equilibrium. |
|
|
Term
| Which Disease is characterized by flucuating sensorineural hearing loss, and hearing intermittment roaring and excessive tinnitius? |
|
Definition
|
|
Term
| Which hearing disorder is characterized by profound sensorineural hearing loss, ear pain, and occurs due to a Acute Bacterial infection of inner ear? |
|
Definition
|
|
Term
| Epistaxis is secondary to? |
|
Definition
| Secondary to local trauma (nose blowing and picking) |
|
|
Term
| What is sometimes the first sign of Epistaxis? |
|
Definition
|
|
Term
| Seasonal Rhinitis is caused by what? |
|
Definition
| Tree Pollens, grass pollens, weed pollen, airborne fungal spores |
|
|
Term
| Perennial rhinitis is caused by what? |
|
Definition
| Dust mites, cockroach excreta, animal dander mold |
|
|
Term
| What are the most common pathogens of Sinusitis? |
|
Definition
| Strep Pneumococcus, H. Influenzae, Moraxella Catarrhalis |
|
|
Term
| Recurrent sinusitis is characterized by? |
|
Definition
| Multiple discrete acute episodes, each completely resovled in <30 days but recurring in cycles, with at least 10 days between complete resolution of symptoms. |
|
|
Term
| What are the most common contributing factors in Sinusitis? |
|
Definition
| Nasal Polyposis, and Air Pollution & Smoking |
|
|
Term
| Acute Sinusitis is usually charactized byt which Pathogens? |
|
Definition
| streptococci, pneumococci, Haemophilus influenzae, or staphylococci |
|
|
Term
| Chronic Sinusitis may be exacerbated by what? |
|
Definition
| Chronic sinusitis may be exacerbated by gram-negative bacilli or anaerobic microorganisms. |
|
|
Term
| What are some typical nosocomial organisms associated with Chronic Sinusitis? |
|
Definition
| Typical nosocomial organisms: S. aureus, K. pneumoniae, P. aeruginosa, P. mirabilis, and Enterobacter. |
|
|
Term
| Acute Pharyngitis is caused by what Pathogens? |
|
Definition
| viral gp A ß-hemolytic strep, M. pneumoniae, Chlamydia pneumoniae |
|
|
Term
| Acute Tonsillitis can be viral or due to what type of infection? |
|
Definition
|
|
Term
| What type of sores are disproportionately painful for their size, aka "Canker Sores"? |
|
Definition
| Apthous Ulcers Assoc. with trauma, most common "viral infections", stress, malnutrition. |
|
|
Term
| This rapidly progressive infection in the throat can lead to sudden respiratory obstruction and death? |
|
Definition
|
|
Term
| That pathogens cause Epiglottitis? |
|
Definition
| H. influenzae type B, S. pneumoniae, S. aureus, ß-hemolytic strep |
|
|
Term
| What is a acute infection between the tonsil and the superior pharyngeal constrictor muscle that is common in young adults? |
|
Definition
|
|
Term
| Peritonsilar Abscess are caused by what Pathogens? |
|
Definition
| Group A B-Hemolytic Strep, Bacteriodes |
|
|
Term
| The four types of Hypersenitivities Include? |
|
Definition
| Type I (Atopic, Anaphylactic), Type II (Cytotoxic, Cytolytic), Type III (Immune Complex), Type IV (delayed hypersensitivity) |
|
|
Term
| Type I Hypersenitivities are mediated by what? |
|
Definition
|
|
Term
| Type I (Atopic, Anaphylatic) is due to what, and Peaks when? |
|
Definition
| Type I is due to T-cell deficiency, abnormal mediator feedback, environment. Peaks in 15-30 minutes |
|
|
Term
| Examples of Atopic or Anaphylactic hypersenitivities include? |
|
Definition
| Rhinitis, Asthma, Atopic, Eczema, Bee sting rxn |
|
|
Term
| Type II hypersensitivities are mediated by what? |
|
Definition
|
|
Term
| Type II (Cytotoxis, Cytolytic) is due to what, and peaks when? |
|
Definition
| It is due to Antigen exposire, and Foreign cell/tissue/graft. Peaks in 15-30 minutes |
|
|
Term
| What are som examples of Type II hypersensitivities? |
|
Definition
| ABO transfusions, Hemolytic dx of newborns, Myasthenia gravis |
|
|
Term
| Type III is mediated by what? |
|
Definition
|
|
Term
| Type III or Immune complex is due to what, and peaks when? |
|
Definition
| Is to to: Persistent microbe antigen, self antigen, environmental antigens. Peaks in 6 hours |
|
|
Term
| What are some examples of Immune Complex (Type III)? |
|
Definition
| Glomerulonephritis, SLE, Arthritis |
|
|
Term
| What is Type IV mediated by? |
|
Definition
| Mediated by T-Lymphocytes |
|
|
Term
| What is Type IV (delayed hypersensitivity) due to, and when does it peak? |
|
Definition
| Due to intradermal antigens, epidermal antigens, and dermal antigens. Peaks within 24-48 hours |
|
|
Term
| Examples of Delayed hypersenitivities include? |
|
Definition
| TB Test, Contact Dermatitis, MS |
|
|
Term
| Which alteration in immune function causes the SELF DESTRUCTION of antigens? |
|
Definition
| Autoimmunity Ex. lupus erthematosis |
|
|
Term
| When the immune system of one person produces an immunologic reaction against tissues of antoher person this is called? |
|
Definition
| Alloimmune Disease ex. Transfusion rxn. |
|
|
Term
| What is the interruption of blood flow to an area called? |
|
Definition
|
|
Term
| Ischemis is the most common cause of what? |
|
Definition
| Heart Disease, Lung Disease, RBC disorders |
|
|
Term
| What occurs as a consequence of ischemia or toxic injury? |
|
Definition
|
|
Term
| What is the appropriate term for cell suicide when the cells are no longer needed? |
|
Definition
|
|
Term
| What is the lack of O2, and results in "power failure" within the cell? |
|
Definition
|
|
Term
| The AIDS virus has how many molecules of viral RNA in the middle |
|
Definition
|
|
Term
| What is the enzyme that transcibes viral RNA into DNA after virus enters the target cell? |
|
Definition
|
|
Term
| HIV binds to the surface of the target cell with what kind of receptor? |
|
Definition
|
|
Term
| What is the preferred "target" of viral attachment in HIV? |
|
Definition
|
|
Term
| What is the preferred "target" of viral attachment in HIV? |
|
Definition
|
|
Term
| A CD4+ count of less than _____ is diagnostic of AIDS whether symptomatic or asymptomatic? |
|
Definition
| Less than 200, with the normal count ranging from 600 to 1200 |
|
|
Term
| The median time from HIV infection to progression to AIDS is what? |
|
Definition
|
|
Term
| What are the three major means of transmission for HIV? |
|
Definition
| Blood, sexual, maternal-infant contact |
|
|
Term
| What test are used to detect HIV? |
|
Definition
| Enzyme-linked immunosorbent assey (ELISA), Western blot, Polymerase chain reaction |
|
|
Term
| Most antibodies of HIV occur within ____ months of exposure. |
|
Definition
|
|
