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Questions and Answers
What is the main role of plasma in blood?
What is the main role of plasma in blood?
- To produce hormones and growth factors
- To provide structural support to cells
- To engage in immune responses
- To transport gases, nutrients, and waste (correct)
Which type of white blood cell is most abundant in the blood?
Which type of white blood cell is most abundant in the blood?
- Neutrophils (correct)
- Lymphocytes
- Monocytes
- Eosinophils
What is the lifespan of neutrophils?
What is the lifespan of neutrophils?
- 3-4 days
- 1-2 days (correct)
- Months to years
- Several weeks
Which of the following components is involved in the body's acquired immune response?
Which of the following components is involved in the body's acquired immune response?
What is the primary function of platelets in the blood?
What is the primary function of platelets in the blood?
How long is the lifespan of platelets in the blood?
How long is the lifespan of platelets in the blood?
Which white blood cell type is known for phagocytosing bacteria?
Which white blood cell type is known for phagocytosing bacteria?
What substance do basophils primarily release?
What substance do basophils primarily release?
Which type of white blood cell matures into macrophages?
Which type of white blood cell matures into macrophages?
What is a primary role of blood in the body?
What is a primary role of blood in the body?
What is the survival duration if Acute Leukaemia is untreated?
What is the survival duration if Acute Leukaemia is untreated?
Which presenting feature is common in Chronic Leukaemia?
Which presenting feature is common in Chronic Leukaemia?
What characterizes the pathological biology of Acute Leukaemia?
What characterizes the pathological biology of Acute Leukaemia?
Pancytopaenia in a patient indicates a deficiency in which elements?
Pancytopaenia in a patient indicates a deficiency in which elements?
What is a common symptom associated with neutropaenia?
What is a common symptom associated with neutropaenia?
Which of the following conditions is characterized by high blasts and low mature cells?
Which of the following conditions is characterized by high blasts and low mature cells?
What is the effect of excess malignant blood cells on blood viscosity?
What is the effect of excess malignant blood cells on blood viscosity?
Which feature is indicative of Acute Lymphoblastic Leukaemia (ALL)?
Which feature is indicative of Acute Lymphoblastic Leukaemia (ALL)?
What does the term 'neoplastic transformation' refer to in the context of leukaemia?
What does the term 'neoplastic transformation' refer to in the context of leukaemia?
In Chronic Leukaemia, compensation for symptoms is often possible due to what factor?
In Chronic Leukaemia, compensation for symptoms is often possible due to what factor?
What is the role of CD8+ T cells in the context of organ rejection?
What is the role of CD8+ T cells in the context of organ rejection?
Which of the following is NOT a signal required for T cell activation?
Which of the following is NOT a signal required for T cell activation?
How is the diversity of alpha-beta T cell receptors primarily generated?
How is the diversity of alpha-beta T cell receptors primarily generated?
What percentage of human peripheral blood T cells express the alpha-beta TCR complex?
What percentage of human peripheral blood T cells express the alpha-beta TCR complex?
What elements contribute to TCR diversity during the gene rearrangement process?
What elements contribute to TCR diversity during the gene rearrangement process?
What is the significance of N-region diversity in TCRs?
What is the significance of N-region diversity in TCRs?
What characterizes the third signal in T cell activation?
What characterizes the third signal in T cell activation?
Which molecules are primarily involved in the co-stimulatory signals necessary for T cell activation?
Which molecules are primarily involved in the co-stimulatory signals necessary for T cell activation?
What distinguishes between indolent and aggressive lymphomas based on histopathology?
What distinguishes between indolent and aggressive lymphomas based on histopathology?
Which stage of lymphoma is characterized by cancer spread beyond lymph nodes and involvement of one or more organs?
Which stage of lymphoma is characterized by cancer spread beyond lymph nodes and involvement of one or more organs?
What is the primary method used for the diagnosis of lymphoma?
What is the primary method used for the diagnosis of lymphoma?
What does the presence of abnormal blood findings generally indicate in comparison to lymphoma?
What does the presence of abnormal blood findings generally indicate in comparison to lymphoma?
Which treatment strategy is typically appropriate for indolent lymphomas?
Which treatment strategy is typically appropriate for indolent lymphomas?
What is a common feature of cutaneous T cell lymphoma expressed in mycosis fungoides?
What is a common feature of cutaneous T cell lymphoma expressed in mycosis fungoides?
Which marker is used for identifying B cells in lymphoma diagnosis?
Which marker is used for identifying B cells in lymphoma diagnosis?
What is indicated by a predominance of either kappa or lambda light chains in B cell malignancies?
What is indicated by a predominance of either kappa or lambda light chains in B cell malignancies?
Which of the following drugs is NOT commonly used in lymphoma treatment?
Which of the following drugs is NOT commonly used in lymphoma treatment?
Which imaging study is utilized for lymphoma staging?
Which imaging study is utilized for lymphoma staging?
What type of lymphoma is characterized by a 'nodular' histological appearance and is generally classified as indolent?
What type of lymphoma is characterized by a 'nodular' histological appearance and is generally classified as indolent?
Which of the following statements about lymphoma is correct?
Which of the following statements about lymphoma is correct?
What is the most common type of lymphoma that can be classified as diffuse?
What is the most common type of lymphoma that can be classified as diffuse?
What is the primary location of malignant cells in leukemias?
What is the primary location of malignant cells in leukemias?
Which cell type is most commonly associated with lymphomas?
Which cell type is most commonly associated with lymphomas?
What differentiates lymphoma from leukemia?
What differentiates lymphoma from leukemia?
Which type of lymphocyte is primarily responsible for humoral immunity?
Which type of lymphocyte is primarily responsible for humoral immunity?
Where do T cells mature in the body?
Where do T cells mature in the body?
What type of leukemia is characterized by an overproduction of abnormal lymphocytes?
What type of leukemia is characterized by an overproduction of abnormal lymphocytes?
Which statement is NOT true regarding lymphomas?
Which statement is NOT true regarding lymphomas?
Which immunological function is NOT associated with T cells?
Which immunological function is NOT associated with T cells?
Which of the following is a subtype of leukemia?
Which of the following is a subtype of leukemia?
What role do dendritic cells play in the immune response?
What role do dendritic cells play in the immune response?
What characterizes non-Hodgkin lymphoma?
What characterizes non-Hodgkin lymphoma?
Which of the following structures primarily contains B cells?
Which of the following structures primarily contains B cells?
What is the differentiation path of a long-term haematopoietic stem cell (LTHSC)?
What is the differentiation path of a long-term haematopoietic stem cell (LTHSC)?
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Study Notes
Blood Components and Haematopoiesis
- Blood is a connective tissue consisting of 2L cells and 3L plasma, totaling 5L of blood.
- Plasma acts as a buffer, making up approximately ¼ of the extracellular fluid (ECF).
Functions of Blood
- Transport: Carries gases, nutrients, waste, hormones, and growth factors.
- Regulation: Maintains body temperature, pH levels, and fluid balance.
- Protection: Aids in blood loss prevention and infection control.
Composition of Blood
- Key cell types include lymphocytes (20-35% of WBC), monocytes, neutrophils (50-70% of WBC), eosinophils, and basophils.
- Lymphocytes: Include T-cell, B-cell, and NK-cell subtypes, responsible for the acquired immune response.
- Monocytes: Mature into macrophages, capable of phagocytosis, with a lifespan of months to years.
- Neutrophils: Short lifespan (1-2 days) and primarily involved in phagocytosis of bacteria.
- Eosinophils: Combat allergic reactions and parasitic diseases; contain pink-stained granules.
- Basophils: Release inflammatory mediators like histamine and heparin.
Platelets
- Small, round, colorless cell fragments involved in clotting; life span of 7-10 days.
Lymphomas and Leukaemias
- Lymphomas: Predominantly affect lymph nodes; most common is B-cell lymphoma (80%).
- Leukaemias: Involve abnormal blood cell production in bone marrow, equally derived from B-cell and T-cell lineages.
Haematopoiesis
- Initiates from long-term haematopoietic stem cells (LTHSC), differentiating into short-term haematopoietic stem cells (STHSC).
- Common progenitors: Differentiate into lymphoid (T-cells, B-cells, NK-cells) and myeloid lineages (erythrocytes, granulocytes).
Types of Lymphocytes
- B-cells: Responsible for humoral immunity and antibody production.
- T-cells: Involved in cellular immunity, providing help to B-cells and cytotoxicity against pathogens.
Lymph Node Anatomy
- Follicle centers: Contain predominantly B-cells.
- Cortical regions: Mainly composed of T-cells.
Clinical Features of Lymphoma
- Symptoms include lymphadenopathy, potentially identified incidentally during exams.
- Abnormal blood findings are less common compared to leukaemia.
- Mycosis fungoides presents as a skin rash progressing to Sezary syndrome in blood.
Diagnosis of Lymphoma
- Requires a large tissue biopsy for histological assessment; flow cytometry assesses surface protein expression.
Histopathology of Lymphoma
- Classifies lymphomas as nodular (indolent) or diffuse (aggressive).
- 80% of lymphomas are classified into follicular (40% of HL) and diffuse large B-cell lymphoma (aggressive).
Gene Translocation in Lymphoma
- Changes in gene structure can lead to different types of lymphoma, requiring further investigation for diagnosis and treatment planning.
Staging of Lymphoma
- Stage I: Cancer in a single lymph node region or organ.
- Stage II: Cancer in multiple lymph nodes on one side of the diaphragm.
- Stage III: Lymph nodes above and below the diaphragm are affected.
- Stage IV: Widespread disease has spread beyond lymph nodes to organs like the liver or bone.
Treatment Strategies for Lymphoma
- Indolent lymphomas: Watchful waiting and local radiation, progressing to chemotherapy as needed.
- Aggressive lymphomas: Fast-track treatment with multi-agent chemotherapy and possibly stem cell transplantation.
Common Anti-Lymphoma Drugs
- Include Chlorambucil and combinations like CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone).
Outcomes of Therapy
- Indolent lymphoma: Median survival of 8 years; 25% alive after 10 years.
- Aggressive lymphoma: Cure rate of 30-40%; 50% mortality within 2 years.
Acute vs. Chronic Leukaemia
- Acute Leukaemia: Rapidly progressive; characterized by high blast count and primarily affects bone marrow.
- Chronic Leukaemia: Slower progression with more mature cells present.
Presenting Features of Leukaemia
- Acute Leukaemia: Bone marrow failure presents with severe symptoms, typically requiring treatment within weeks.
- Chronic Leukaemia: Often discovered during routine blood tests, symptoms related to splenomegaly and lymphadenopathy.
Pathobiology
- Acute Leukaemia: Characterized by abundance of immature 'blastic' cells.
- Chronic Leukaemia: Arises from a more mature haematopoietic stem cell.
T-Cell Activation Signals
- T-cell receptors recognize specific antigen-MHC complexes and require co-stimulatory signals for activation.
TCR Diversity
- Generated through genetic mechanisms during T-cell development, essential for effectively responding to various antigens, estimated to have around 25 million unique TCRs in humans.
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