Patho lecture 3
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Name two types of Hematologic Neoplasms??
- Myeloid Neoplasms
- Lymphoid Neoplasms
What is the suspected Cause of Hematologic Neoplasms??
cause is unknown
suspected causes are viruses, radiation, carcinogens
What is the most common treatement for Neoplasms?
What can be some complications of treatment (chemotherapy) in Neoplasms??
- Infection and bleeding
- Hair loss
What type of cancer is Leukiemia?
Lymphoid type cancer in the blood
What type of cancer is Lymphoma??
lymphoma type cancer in tissue
What is the common cause of death in immunocomprimised leukemia?
Why do Leukemic pts have a lot of pain in the bones and joints??
B/c there leukemic cells are infiltrating in the joint capsules
What do Leukemic pts experience at Night?
Night sweats to the extreme !! Soaking
Leukemic pts have abdominal fullness due to What??
- spleen can rupture if palpated to hard
- palpate under supervision
Acute Leukemia affacts who??
In Acute Leukemia cells are ...
dividing in large numbers
In Acute Leukemia the clinical onset is
Acute Lekemia has anemia that is
Can be untreated for wks to months
In Chronic Leukemia there is what kind of mitotic build up??
Slow and Insidious (sneaks up on you)
Chronic Leukemia has anemia that is
untreated for months to yrs b/c asymptomatic
What are the two types of Myeloid Neoplasms??
Chronic Myeloid Leukemia (CML)
Acute Myeloid Leukemia (AML)
Which Myeloid Neoplasm carries the philadelphia chromosome??
Chronic Myeloid Neoplasm
What cells are involved in CML??
neutrophils and macrophages
CML exhibits a majority of what cell and carries what chromosome??
Majority exhibits malignant granulocytes that carry philadelphia chromosome
The Philly Chromosome is a
gene mutation in gene translocation
How does CML respond to Chemotherapy
CML is seen mostly in
Adults and is insidious
AML presents itself at what year of life
Why is there bone pain in AML
b/c marrow is being invaded
Why is there anemia in AML and what is that pt at risk for??
b/c RBCs get pushed and crowded out and depleted leading to increased susceptibility to infection
What are the Different kinds of Lymphoid Neoplasms??
- Chronic Lymphoid Leukemia (CLL)
- Acute Lymphoblastic Leukemia/Lymphoma (ALL)
- Hairy Cell Leukemia
- Plasma Cell Myeloma (multiple myeloma)
Leukemia are what ??
What happens in Chronic lymphoid leukemia (CLL)??
Malignant B-cells become plasma cells making antibodies
What signs and symptoms are shown in Chronic lymphoid leukemia??
what is Chronic lymphoid leukemia treated with ??
Chemotherapy and stem cell replacement
What cells are present in Lymphoid Neoplasms??
•NK Cell Leukemia / Lymphoma
•B cell Leukemia / Lymphoma / Myeloma
•T cell Leukemia / Lymphoma
What cells are present in Myeloid Neoplasms??
•Neutrophils / Granulocytic Leukemia
•Monocyte / Monocytic Leukemia
•Red Blood Cells / Polycythemia Vera or Erythroid Leukemia
•Megakarocyte cells / Megakarocytic Leukemia
What happens to WBCs in CLL
increased in WBC
In CLL thrombocytopenia is what
In ALL thrombocytopenia is what ??
mild to severe
In ALL cell divide how??
cells divide very rapidly in large numbers
Why does CLL have mild Anemia??
b/c your not slowing down erythropoesis
What is the peak age for ALL
primarily in children around 3-7 yrs
second leading cause of death in children
Why does ALL present with bone pain and infection
transformation of blasts in bone marrow
What is a rare and chronic type of lymphoin neoplams??
Hairy cell leukemia
What is the primary cell in Hairy cell Leukemia
primarily B cells with cilia looking like hair
At what age does Hairy Cell Leukemia present itself??
around 35 yrs and more common in men
What is Plasma Cell Myeloma (Multiple Myeloma)
Malignant disorder in mature plasma cells
Plasma Cell Myeloma mostly occurs in who??
Where does Plasma Cell Myeloma often go to
Often goes to the Spine and Flat bones of head (calveria)
What happens when Plasma Cell Myeloma goes into the spine or flat bones of the head??
When the cells invade it causes a lytic reaction ---> breakdown ----> decreased minerals ---> holes
The lytic reaction in Plasma Cell Myeloma triggers what and are more prone for what ??
The reaction triggers osteoplastic reaction and are prone to pathologic fractures
The osteoplactic reaction in Plasma Cell Myeloma is what to a disease
it is secondary to a disease
How does a pathologic fracture happen
There is no trauma involved. a sneeze can cause the fracture
In Plasma Cell Myeloma what do the malignant plasma cells secrete??
The plasma cells secrete antibodies called Bence-Jones protiens
What are Bence- Jones proteins are what kind of antibody??
Where can Bence-Jones proteins be detected in ??
in the blood or urine can aid in diagnosis.
What are the two kinds of Lymphoma??
What is Hodgkin Disease
A malignant disorder in the lymph nodes
What characterizes Hodgkin Disease??
Characterized by presence of Reed-Sternberg cells
What cells are involved in Non-Hodgkin Disease??
B-cell, T-cell, and NK-cell Lymphomas
What Cell is not present in Non-Hodgkin Disease??
No Reed-Sternberg cells
Hodgkins disorder of the lymph nodes typically ...
stay in the nodes
Non-Hodgkins lymphoma is very
Unpredictable in its spread and is often disseminated at diagnosis.
HIV infects what cells
Infects Helper T cells (CD4+ Lymphocytes)
The loss of Helper T cells causes what??
HIV The viruse has found to be present but not transmitted in what ??
- saliva and tears,
- amnitoic fluid,
- feces and aerisol,
- cerebral spinal fluid
HIV types 1 and 2 are
retroviruses that primarily infect CD4+ lymphocytes and macrophages
HIV is acquired primarily through what?
- sexual transmission via semen and vaginal and cervical secretions;
- through parenteral transmission via blood,
- contaminated needles/syringes;
- through perinatal transmission from an infected mother to her infant antepartum, intrapartum, and postpartum
- via breast milk.
Who are at greatest risk of HIV infection include
- homosexual and bisexual men,
- IVDs who share needles or syringes,
- sexual partners of those in high-risk groups,
- infants born to infected mothers.
Who is at the Highest risk for HIV??
Health Care workers
After significant accidental exposure to HIV-infected blood or body fluids, it is recommended that health care workers take what???
- postexposure antiretroviral medication as soon as
- possible after exposure and as needed for 4 weeks after exposure
HIV viruse consists of a core that contains what??
- which is protected by a spherical lipid bilayer viral
HIV is attracted to markers on surface of what cell??
CD4+ cells hook up with what other cell
T helper cells
What cell gathers up the HIV virus and sends it to the Helper T cell??
The Dendritic cell
HIV infection leads to a decline in what cell
What is the latency period of HIV infection
the establishment of the chronic infection
there is partial control and viral replication slows down
Latency period can last years to decades
You are considered to have aid when you CD4+ count is what ??
When CD4+ count is less than 200/ul
What is the seroconversion phase of the HIV infection??
Host begins to manufacture antibodies against the viral protein
formation of anti-HIV antibodies
Viral Budding may cause excessive loss of what ??
excessive loss of cell membrane
Flulike symptoms and the formation of anti-HIV antibodies (seroconversion) characterize the early stage of what??
What body systems are affected by HIV
All body systems
Early HIV infection is characterized by
fever, chills, headaches, nausea, vomiting, diarrhea, fatigue, weakness, arthralgia, sore throat, stiff neck, photophobia, irritability, and rash.
The most significant systemic symptom of HIV is
Malnutrition or wasting,
due to a combination of factors, including an elevated metabolic rate, chronic inflammation, malabsorption, anorexia, and the effect of multiple opportunistic insults.
Management of HIV and AIDS includes the use of
antiretroviral medications, including NRTIs, NNRTIs, and PIs.
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