HematologyTest2Lymphocytes

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victimsofadown
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271721
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HematologyTest2Lymphocytes
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2014-04-24 04:37:17
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HematologyTest2Lymphocytes
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HematologyTest2
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HematologyTest2Lymphocytes
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  1. What are the cell stages of Lymphocyte development and maturation?  Where do they occur?
    • Lymphoblast
    • Prolymphocyte
    • Lympocyte
    • Occurs in the lymph node
  2. What are the criteria for identifying Lymphocytes?
    • Morphological classification (small, medium/large)
    • Functional classification (T, B, NK)
    • Operational classification (response to mitogens, surface markers, rosette formation in sheep's blood)
  3. What are the surface markers found on various T and B lymphocytes?
    • T cells: CD3, CD4, CD8
    • B cells: CD19, CD20, CD22
  4. What are the basic functions of each type of lymphocyte? Name the subtypes w/ surface markers and give their basic function?
    • T cells: cell mediated response
    • Inflammatory- recruit macrophages and neutrophil
    • Cytotoxic (CD8)- kill pathogens (viruses)
    • Helper T cells (CD4)- TH1 participate in cell-mediated immunity
    • Helper T cells (CD4)- TH2 participate in antibody-mediated immunity by activated B cells
    • B cells: humoral response
    • plasma cells
    • memory cells
    • NK cells: single functioned, no subsets
  5. What are the elements of the lymphatic system?
    • Primary organs: hematopoetic blood islands
    • fetal liver
    • bone marrow
    • thymus
    • Secondary organs and tissues: Lymph nodes
    • spleen, tonsils
    • Peyer's patches
    • anal opening
  6. What is the function of the lymphatic system? Describe the "flow" of lymph throughout the body using specific names
    • drainage of interstitial fluid and transport of foreign substances
    • Vessels are blind-ended and fluid moves via peristalsis
    • thoracic duct: collects lymph from entire left side and bottom right side of body
    • delivers fluid to the left subclavian vein
    • right lymphatic duct: collects lymph from upper right side of body (head, chest, neck)
    • delivers lymph to the right subclavian vein
  7. What is the percentage breakdown of B and T cells in the peripheral blood?  The thoracic duct?
    • Peripheral blood: 60-80% T, 20-30% B
    • Thoracic duct: 85-90% T, 10-15%
  8. What specific location are B and T cells (different for each) found in the lymph nodes?  The spleen?
    • T cells in lymph nodes: paracortical regions, lymphoid follicles
    • B cells in lymph nodes: Germinal centers, subcapsular region, medullary cords
    • T cells in spleen: periarteriolar sheaths
    • B cells in spleen: germinal centers, periphery of periarteriolar sheath, red pulp
  9. Describe the difference in kinetic and circulatory patterns of B and T cells
    • B cells: mostly short lived
    • T cells: mostly long lived, rapid transmit time in blood, long G0 phase
  10. T cell education location?  Process of maturation?  Substances produced?
    • Educated in thymus (after creation in marrow)
    • Recognize antigen and dedifferentiate 
    • Become effector (helper or killer) cells as well as acting as inflammatory cells
    • Produce communicative substances (transfer factor, lymphotoxin, interferon, migration inhibiation factor, migration activation factor)
  11. B cell education location?  Process of maturation?  Substances produced?
    • Educated in bursa equivalent in marrow or peyer's patches
    • Dedifferenation stimulated by antigen OR T cells
    • Become plasma or memory cells
    • Produce humoral antibodies (A, D, E, G, M)
  12. What are the functions of each immunoglobulin?
    • A: cidal and found in secretions *dimer
    • D: function uncertain
    • E: binds to basophils and mast cells sensitizing them for certain allergic reactions
    • G: primary Ig, transferred across placenta
    • M: first antibodies to appear *pentamer
  13. Describe the evaluation of neutrophil function
    • Absolute neutrophil count: increased during infection
    • Neutrophil morphology: larger during infection
    • Evaluation of β-integrins (CD11, CD18): aids in diapedesis
    • Evaluation of neutrophil oxidative burst
  14. Describe evaluation of complement
    • Total hemolytic complement activity (CH50)
    • Specific component testing
    • Immunoassay for specific components
    • Functional testing for specific components
  15. Describe B, T, and NK cell screening and secondary tests
    • B cell screening: Quantitative immunoglobulins (via titers)
    • specific antibody
    • T cell screening: HIV testing
    • lymphocyte count
    • delayed-type hypersensitivity skin tests
    • B cell secondary: B cell enumeration (flow cytometry)
    • in vitro B cell function tests
    • T cell secondary: T cell enumeration (flow cytometry)
    • T cell proliferation (mitogen, antigen)
    • T cell cytokine production
    • T cell cytotoxicity
    • NK testing: NK cell enumeration (flow cytometry)
    • In vitro functional cytoxicity assay
  16. What are the three diseases of the Lymphocytes w/ VERY brief description of symptoms
    • DiGeorge Syndrome: little T cell function, hypocalcemia, and congenital heart disease
    • Burton's Agammaglobulinemia: failure to produce mature B cells and gamma globulin
    • Severe Combined Immunodeficiency Disease (SCID): Lack of function of both T and B cells
  17. DiGeorge Syndrome symptoms? cause? Notable information? Treatment? Outlook?
    • Little or no T cell function, hypocalcemia, and congenital heart disease
    • Immunodeficiency due to hypoplasia of the thyums
    • Hypocalcemia due to hypoplasia of the parathyroid glands
    • Genetic disorder (microdeletion in chromosome band 22q11.2)
    • Most common genetic cause of congenital heart disease next to Down syndrome
    • Treatment is thymus tissue transplant
    • Death by age 2 without treatment
  18. Burton's Agammaglobulinemia symptoms? cause? Notable information? Treatment? Outlook?
    • Failure to produce mature B cells and gamma globulin
    • Genetic disorder (X-linked recessive trait, mutation in tyrosine kinase gene Xq21.3-q22)
    • Prone to bacterial, but not viral, infections
    • Treatment is IV gamma globulin and antibiotics
    • Death within first 10 years without treatment
  19. Severe Combined Immunodeficiency Disease symptoms? cause? Notable information? Treatment? Outlook?
    • Little or no adaptive immune function (Both B and T cells affected)
    • Various genetic defects...
    • X-linked SCID
    • ADA deficiency
    • Purine nucleoside phosphorylase (PNP)
    • MHC class II or bare lymphocyte deficiency
    • "Boy in the bubble disease"
    • Very rare (1/500k births)
    • Death within first year of life if untreated

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