Chapter 11

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  1. Plasma makes up _____% of the blood.

    A. 55-58%
    B. 40-45%
    C. 39-45%
    D. <1%
    A. 55-58%
    (this multiple choice question has been scrambled)
  2. Collected at the bottom of the centrifuge, erythrocytes make up what percentage of the blood?

    A. <1%
    B. 55-58%
    C. 40-45%
    D. 39-45%
    D. 39-45%
    (this multiple choice question has been scrambled)
  3. In the middle buffy coat of the centrifuge, leukocytes and thrombocytes make up what percentage of the blood?

    A. 40-45%
    B. 39-45%
    C. 55-58%
    D. <1%
    D. <1%
    (this multiple choice question has been scrambled)
  4. In embryo, hematopoiesis occurs in the yolk, sac, liver, spleen, and bone marrow. Where does it occur after birth?
    ONLY in the Red Bone marrow
  5. ________ ________ stem cells in red bone marrow give rise to all blood cells.
    Pluropotent Hematopoietic Stem Cells
  6. The pluripotent hematopoietic stem cell gives rise to what two types of multi-potent stem cells?
    • Myloid Stem cells
    • Lymphoid Stem cells
  7. The stromal tissue found within bone marrow provides what function for blood-forming cells?
    Stromal tissue provides support
  8. What are the three committed progenitor cells that arise from the multipotent lymphoid stem cell?
    • T Lymphocytes
    • B Lymphocytes
    • Natural Killer (NK) cells
  9. What committed progeniter cells arise from the multipotent myloid stem cell?
    • Erythrocytes
    • Megakaryotes
    • Granulocytes (Neutro-,Baso-, Eosinophils)
    • Monocytes
  10. Megakaryotes develop into what type of cell?
  11. What do B-cells eventually become?
  12. Which of the following growth factors are used to treat bone marrow failure due to chemotherapy of aplastic anemia?

    a. Erythropoietin
    b. Granulocyte cology-stimulating factor
    c. Granulocyte-monocyte colony stimulating factor
    d. All the above
    d. all the above (NOT macrophage colony-stimulating factor or thrombopoietin)
  13. True/False: All granulocytes and agranulocytes are derived from myloid stem cells
    False. All granulocytes and agranular monocytes are derived from myloid stem cells. AGRANULAR LYMPHOCYTES NOT INCLUDED
  14. Granulocytes arise from ______ stem cells
    • Myloid stem cells
    • multo-lobar nucleus, spherical shape
  15. _____ have azurophilic granules that stain purple and are lysosomes
    • granulocytes
    • **ALL are phagocytic (neutro>eosin>baso)
  16. _____ is the most numerous Leukocyte (60-65%)
  17. This type of leukocyte is the earliest to arrive during acute inflammation.
  18. This leukocyte only accounts for 1-3% of WBC, and increase in number during allergic reactions (IgE) as well as during parasitic infections.
  19. This leukocyte is the most rare leukocyte. Its granules contain heparin and histamine, as well as other chemical mediators of inflammation. Typically increase in number only during hypersensitivity reactions. (May also be related to the mast cell)
  20. The group: Agranulocyte includes what two types of cells?
    • Lymphocytes (from Lymphoid)
    • Monocytes (from Myloid)
  21. This leukocyte is the largest of the WBC's, contains a kidney shapped nucleus, is considered to be an agranulocyte but contains azurophilic granules.
  22. This leukocyte is important in both innate immunity as well as adaptive immunity (activation of T-lymphocytes), and is also important LATE in acute inflammation.
    • Monocyte-Macrophage
  23. (B/T) lymphocytes make antibodies in antibody-mediated immune response, and (B/T) lymphocytes are involved in cell-mediated immune response. Both are part of adaptive immunity.
    • B-lymphocytes: antibodies
    • T-lymphocytes: cell-mediated
  24. Next to neutrophils, ____ are the next most numerous leukocyte in circulation (20%).
  25. The normal range of leukocytes in the peripheral circulation is:

    A. 15,000-20,000 cells/L
    B. 9,500-15,000 cells/L
    C. 1,500-5,000 cells/L
    D. 4,500-10,500 cells/L
    D. 4,500-10,500 cells/L
    (this multiple choice question has been scrambled)
  26. Lymphocytes are made in ______ lymphoid tissue, which includes the Thymus and Bone marrow.
    Central (primary) lymphoid tissue
  27. Where do lymphocytes encounter the specific antigen to which the will respond?
    Secondary lymphoid tissues: lymph nodes, spleen, mucosa-associated lymph tissue, cutaneous lymph tissues
  28. Between B lymphocytes and T lymphocytes, which matures in the bone marrow? In the thymus?
    • B Lymph: Bone Marrow
    • T Lymph: Thymus
  29. Within the lymph node, (B/T) lymph is found in the paracortex region, and (B/T) lymph is found in the follicles (secondary follicles are active).
    • T lymph: paracorTex
    • B lymph: follicles
  30. Both -philia, and -cytosis are two suffixes that mean?
    Reactive increase in number
  31. Pancytopenia:
    decreased RBC, WBC, and platlets
  32. Aplastic anemia:
    • all myloid stem cells are affected
    • Anemia: low RBC
    • Thrombocytopenia: low platlets
    • agranulocytosis: no granulocytes
  33. Agranulocytosis:
    Virtually no granulocytes (Neutrophils, Basophils, eosinophils)
  34. Neutropenia is commonly defined as a circulating neutrophil count of less than ____/microliter of blood
    Less than 1,500/microliter of blood
  35. Alloimmune neonatal neutropenia, cyclic neutropenia, and kostmann syndrome are the most common forms of ____ Neutropenia.
  36. Neutropenia can be acquired from:
    • Infection-mainly viruses
    • Drugs- drugs that act as haptens¬†(penicillin)
    • Radiation therapy
    • Cancer chemotherapy¬†
    • Felty Syndrome
    • Systemic Lupus
  37. _____ are the first line of defense against normal flora.
    Neutrophils. Neutropenia causes opportunistic disease.
  38. What causes Mononucleosis?
    Epstein-Barr virus (EBV); a herpevirus (HHV-4)
  39. This disease infects 90% of humans, persists for the lifetime of the individual, and is transmitted through several exposures to infected saliva.
  40. Mononucleosis penetrates the nasopharageal, oropharangeal and salivary epithelial cells. It then spreads to lymph tissue and attacks which lymphocytes?
    • B lymphocytes which have EBV receptors
    • Diagnosed by presence of heterophile antobodies (monostat)
  41. Mononucleosis has a incubation period of ____ days, a prodomal period for ____ days, and is characterized by ____, ____, and ____. Has an onset of ___, _____, and ____.
    • Incubation: 4-8 weeks
    • Prodomal: several days
    • Symptoms: malaise, anorexia, chills
    • Onset: fever, pharyngitis, lymphadenopathy
    • including (hpatitis and spleenomegaly)
    • Acute phase: 2-3 weeks
  42. True/False: There are no benign forms of leukemia
    True! Only malignant forms
  43. The cause of leukemia is unknown, but associated with:
    • high levels or radiation exposure
    • exposure to benzene and antitumor drugs
    • Increased incidence w/ Down Syndrome
    • Philadelphia Chromosome translocation found in 90% of persons w/ chronic myelogenous leukemia and in some acute leukemias
  44. This is the most common type of leukemia cancer in children and adults. 3/4 of all cases of childhood cancer.
    • Acute Lympocytic Leukemia (ALL)
    • Most cases (85%) are B-Cell origin
    • Presents w/ splenomegaly, lymphadenopathy, hepatomegaly
    • CNS signs
  45. This type of leukemia is most common in adults, and often has an infiltration of malignant cells in skin, gums, and other soft tissues
    Acute Myloid leukemia (AML)
  46. Which leukemia has the following symptoms: fatigue, anemia, night sweats, weight loss, bruising and nose bleeds, decreased platelet count, bone pain, neutropenia, lymphadenopathy, splenomegaly, and hepatomegaly?
    Both types of ACUTE leukemia
  47. _____ is a condition in which ciculating blast cell count is elevated (100,000 cells/microliter). Increased blood viscosity and emboli are common.
  48. A ____ ____ ____ is used to determine if a leukemia is lymphoid or myloid in origin.
    Bone marrow biopsy
  49. Which type of chronic leukemia affects pluripotent stem cells (usually granulocytes)
    Chronic Myloid Leukemia (CML)
  50. Which type of chronic leukemia targets plasma cells?
    Chronic Lymphocytic Leukemia (CLL)
  51. Which type of leukemia is the most common form of leukemia in the western world?
    Chronic Lymphocytic Leukemia
  52. Hypogammaglobulinemia (too many antibodies) is a symptom of which type of leukemia?
    Chronic Lymphocytic leukemia which affects B lymphocytes and plasma cells
  53. This type of leukemia accounts for only 10% of all leukemias, and is a disorder of the pluripotent hematopoietic progenitor cell.
    Chronic Myeloid Leukemia
  54. Which leukemia has the following symptoms: often asymptomatic, gradual increase in lymph node size, fever, abdominal pain, thrombocytopenia, WBC > 20,000/microliter
    • Chronic Lymphocytic Leukemia
    • Low risk: no treatment
    • Aggressive form: chemo
  55. Which leukemia has the following symptoms: chronic phase of variable length, asymptomatic, weakness, weight loss, leukocytosis w/ immature granulocyte cell types, anemia, thrombocytopenia, increased basophil count, increased number of blast cells in blood, leukostasis
    Chronic Myelogenous Leukemia
  56. Acute ____ leukemias primarily affect children, whereas acute ____ leukemias primarily affect adults.
    • Acute Lympocytic: children
    • Acute Myeloid: adults
  57. ____ leukemias have an insidious onset.
  58. Chronic ____ leukemia has the most favorable clinical course, most people living to die of another unrelated cause.
    Chronic Lymphocytic Leukemia
  59. (Hodgkin/Non-Hodgkin) lymphomas have Reed-Sternberg cells
    Hodgkin lymphomas have Reed Sternberg Cells
  60. (Hodgkin/Non-Hodgkin) lymphomas are cancerous T or B lymphocytes or NK cells.
    Non-Hodgkin lymphomas
  61. Reed-Sternberg cells
    • Multinucleated cancerous B lymphocytes seen in Hodgkin Lymphomas
    • Increased risk w/ Mono
  62. Pathognomic
    • presnece of a sign that means, beyond any doubt, a specific disease is present
    • Reed-Sternberg(CD30) cells mean Hodgkin Lymphoma
  63. The following as clinical manifestations of _____ lymphomas: Pruritus, fatigue, anemia, decrease in cell-mediated immunity, Anergy (failure to develop a positive response to skin tests such as TB tests)
    Hodgkin Lymphomas
  64. Plasma cell dyscrasias:
    Malignant plasma cell clones to produce huge numbers all producing same antibody, which leads to a huge increase in serum levels
  65. Multiple Myeloma
    • persons older than 60
    • malignant plasma cells in bone marrow
  66. The following risk factors can cause what disease? Chronic immune stimulation, ionizing radiation, exposure to pesticides and herbicides, exposure to agent orange, HIV infection
    Multiple Myeloma
  67. M proteins and Bence Jones Proteins are present in what disease?
    Multiple Myeloma
  68. Animia, neutropenia, thrombocytopenia w/ purpura, "moth eaten" bones, hypercalcemia, and plasmacytomas are all manifestations of ??
    Multiple Myloma
  69. True/False: normal antibodies are depressed in persons with multiple myeloma
  70. The triad for definitive diagnosis of Multiple Myloma includes:
    • 1. Bone Marrow plasmacytosis
    • 2. Lytic bone lesions
    • 3. Serum M protein spike/bence jones proteins in urine
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Chapter 11
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