Presentation on theme: "Chapter 11 Disorders of White Blood Cells and Lymphoid Tissues"— Presentation transcript:
1Chapter 11 Disorders of White Blood Cells and Lymphoid Tissues Essentials of PathophysiologyChapter 11 Disorders of White Blood Cells and Lymphoid Tissues
2PRE LECTURE QUIZ (TRUE/FALSE) White blood cells (granulocytes, monocytes, and lymphocytes) are formed in the bone marrow.The life span of white blood cells is relatively long, so constant renewal is not necessary to maintain normal blood levels.In neutropenia, all of the cell lines are affected, resulting in anemia, thrombocytopenia, and agranulocytosis.Infectious mononucleosis is a self-limiting disorder caused by the Epstein-Barr virus (EBV).Non-Hodgkin is a form of lymphoma that is associated with the presence of an abnormal cell called a Reed-Sternberg cell.
3PRE LECTURE QUIZAcuteCellLeukemiaPhiladelphia(Ph)thrombocyte/plateletClinical manifestations of acute leukemia include petechiae, ecchymosis, gingival bleeding, and epistaxis, as a result of a decreased ________________________________ level.More children are stricken with ____________________ than with any other form of cancer, and it is the leading cause of death in children between the ages of 1 and 14 years.The ________________ leukemias have a sudden and stormy onset with symptoms of depressed bone marrow function (anemia, fatigue, bleeding, and infections).The leukemias are classified according to their predominant ________________________ type.Chronic myelogenous leukemia is associated with the presence of the _________________________ chromosome, arising from a reciprocal translocation between the long arm of chromosome 22 and the long arm of chromosome 9.
6White Blood Cells or Leukocytes GranulocytesNeutrophils:primary pathogen-fighting cellsEosinophils:help control allergic responses; fight parasitesBasophils:release heparin, histamine, and other inflammatory mediators
8QuestionWhich type of leukocyte works the hardest when you receive a vaccination?EosinophilBasophilB-lymphocyteNeutrophil
9AnswerB-lymphocyteA vaccination introduces antigens, causing your body to create antibodies to fight the antigens. B-lymphocytes create those antibodies.Eosinophils and basophils are part of the allergic/immune response; neutrophils work to fight infections.
14QuestionWhich type of leukocyte is created in the bone marrow (myeloid)?EosinophilBasophilNeutrophilAll of the above
15AnswerAll of the aboveGranular leukocytes are created in the bone marrow; eosinophils, basophils, and neutrophils are all granular leukocytes.
16His doctor has prescribed several drugs: Scenario:A man has cancer and is being given radiation therapy…His doctor has prescribed several drugs:Question:Why have the following drugs been prescribed?ErythropoietinGranulocyte-monocyte colony-stimulating factorThrombopoietin
17White Blood Cell Count White blood cell counts vary between species The denser the population, the more neutrophilsThe more sexual partners, the more eosinophilsQuestion:What can you infer about diseases in these populations?
19QuestionPatients with HIV are immunocompromised. Which type of leukocyte is the best indicator of immune function?NeutrophilEosinophilT-lymphocyteMonocyte
20AnswerT-lymphocyteBecause T-lymphocytes direct the immune response, they are used to evaluate immune function. Patients with HIV are usually treated pharmacologically when their T-cell counts drop below 350 cells/mm3; they are considered to have AIDS when their T-cell counts drops to 200 cells/mm3.
22Acute myeloid leukemia (AML) LeukemiasMalignant neoplasms of hematopoietic stem cellsIn bone marrowCreate abnormal white blood cells: 2 types of leukemiaLymphocyticMyelogenousAcute myeloid leukemia (AML)
23AML Myeloid BlastsBone marrow aspirate showing acute myeloid leukemia. Several blasts have Auer rods.Auer rods are clumps of granular material that form elongated needles seen in the cytoplasm of leukemic blasts.
24Myelocytic Leukemias Mutation of myeloid cell line Overproduction of abnormal monocytes or granulocytesProduction of other cell types decreasesMultipotentstem cellscommonneoplasticmutationlymphoidin myeloidmyeloidstem cellsstem cellsstem cellsneoplastic committed precursor cellsabnormal monocytes or granular leukocytes
25Lymphocytic Leukemias Mutation of lymphoid cell lineOverproduction of abnormal immune cellsProduction of other cell types decreasesMultipotentstem cellscommonmutation inneoplasticmyeloid stemlymphoidlymphoidcellsstem cellsstem cellsneoplastic committed precursor cellsneoplastic B or T lymphocytes or naturalabnormal B or T lymphocytes or Naturalkiller cellsKiller cells
26Leukemias What is the difference between: Acute vs. chronic Lymphocytic vs. myelogenous
28Leukemias Affect Bone Marrow Activity Question:How would this cause:Bone pain and risk of fractures?Anemia?Thrombocytopenia?Immune suppression?
29QuestionWhat signs and symptoms will result when…?Abnormal WBCs are produced and they…Release inflammatory mediatorsInfiltrate peripheral lymphoid organsIncrease blood viscosityCreate waste products
30A child develops night sweats and nosebleeds… Scenario:A child develops night sweats and nosebleeds…He appears pale, weak, and fatiguedCervical lymph nodes are enlargedBlast count is elevatedAfter chemotherapy, he develops hyperkalemia.Question:Why did this happen?
31AnswerWhen there is a breakdown or destruction of cells, the electrolyte potassium moves from inside of the cell to outside of the cell wall. This shift of potassium outside of the cells causes hyperkalemia.
32Lymphoma vs. Leukemia or Dyscrasias They travel to the lymphoid organs to mature and developWBCs are formed and differentiate in the bone marrowLymph nodeNeoplasms arising here cause leukemias or plasma cell dyscrasiasNeoplasms arising here are lymphomas
34Myeloma Abnormal B cells Can form tumors Produce abnormal antibodies dyscrasias - a malfunction or abnormal condition, esp. an imbalance of the constituents of the blood.Abnormal B cellsCan form tumorsProduce abnormal antibodiesImmune depressionProteins increase blood viscosityInfiltrate organsProliferation of osteoclastsBreak down bone
35QuestionTrue or False: Hodgkin lymphoma has a better prognosis than non-Hodgkin lymphoma.
36AnswerTrue Non-Hodgkin lymphoma originates from malignancies in both T- and B-lymphocytes, where Hodgkin malignancies originate in B-cells (a specific type called the Reed-Sternberg cell). Therefore, more immune function is lost in non-Hodgkin lymphoma, and the prognosis is not as good.