Pathology Quiz: Tumors and Anemias

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Questions and Answers

What is the main purpose of apoptosis in hematopoiesis?

To remove aged and defective cells (correct)

To increase cell division

To produce new cells

To stimulate cell growth

Which type of leukemia affects B lymphocytes and typically occurs in adults over 50 years old?

Acute myelogenous leukemia

Chronic lymphocytic leukemia (correct)

Hairy cell leukemia

Acute monocytic leukemia

What is the function of growth factors in hematopoiesis?

To stimulate apoptosis

To reduce WBC count

To signal hematopoietic tissue to produce specific cell types (correct)

To inhibit cell growth

Which component of hemoglobin is responsible for carrying oxygen?

Heme groups Signup and view all the answers

What is a key factor in determining the prognosis of chronic myelogenous leukemia?

WBC count at diagnosis Signup and view all the answers

Where does hematopoiesis occur in adults?

Bones Signup and view all the answers

Which of the following is a characteristic of benign tumors?

Well-defined capsule Signup and view all the answers

What is the primary cause of pernicious anemia?

Lack of intrinsic factor Signup and view all the answers

What is the hallmark of sickle cell anemia?

Abnormal hemoglobin 'S' Signup and view all the answers

What is the primary difference between Hodgkin lymphoma and non-Hodgkin lymphoma?

Presence of Reed-Sternberg cells Signup and view all the answers

What is the most common type of leukemia in children?

Acute lymphocytic leukemia Signup and view all the answers

What is the treatment for pernicious anemia?

Injectable vitamin B12 Signup and view all the answers

What is the prognosis for chronic myeloid leukemia?

Responds poorly to chemotherapy, but improves with allogenic bone marrow transplant Signup and view all the answers

What is the primary manifestation of aplastic anemia?

Pancytopenia Signup and view all the answers

What is the primary difference between macrocytic anemia and megaloblastic anemia?

None, they are the same Signup and view all the answers

What is the treatment for sickle cell anemia?

Palliative care Signup and view all the answers

What type of hypersensitivity reaction is characterized by a delayed response and involvement of T cells?

Type 4, delayed hypersensitivity Signup and view all the answers

What is an example of tertiary prevention?

Management of chronic diseases and rehabilitation support services Signup and view all the answers

What is the main risk associated with uncontrolled hypertension?

Increased risk of heart disease, stroke, and kidney disease Signup and view all the answers

What is an example of a primary prevention strategy?

Health education on lifestyle changes Signup and view all the answers

What is the characteristic of Type 4 hypersensitivity reaction?

Delayed response and cell-mediated Signup and view all the answers

Why is it important to check blood pressure regularly?

Because people with high blood pressure may not feel symptoms Signup and view all the answers

Study Notes

Tumors

Benign tumors: slow-growing, well-defined capsule, non-invasive, well-differentiated, low mitotic index, no metastasis
Malignant tumors: fast-growing, not encapsulated, invasive, poorly differentiated, high mitotic index, able to metastasize

Anemias

Pernicious Anemia

Autoimmune disorder: anti-IF or anti-parietal cell antibodies
Manifestations: bleeding gums, diarrhea, impaired smell, loss of deep tendon reflexes, anorexia, personality or memory changes, positive Babinski's sign, stomatitis, paresthesia, and unsteady gait
Diagnosis: CBC, serum B12 levels, antibody presence, gastric analysis, folate (Schilling's test, bone marrow biopsy)
Treatment: injectable B12 (bypassing GI tract absorption)

Megaloblastic Anemia

Folate and VitB12 are required for DNA synthesis, leading to decreased maturation and cell division
Causes: decreased intake from diet, gastric dysfunction, celiac sprue, autoimmune (anti-IF or anti-parietal cell antibodies)
May see myelin breakdown and neurological complications

Macrocytic Anemia

Characterized by large red blood cells

Aplastic Anemia

Pancytopenia: bone marrow depression of all blood cells, damage to PSC
Causes: insidious, other anemias, autoimmune, medications, medical treatments, viruses, cancer, and genetic
Onset may be insidious or sudden and severe
Manifestations: anemia, leukocytopenia, thrombocytopenia
Diagnosis: complete blood count and bone marrow biopsy
Treatment: identify and manage underlying cause, oxygen therapy, infection control and treatment, bleeding precautions, blood transfusions, and bone marrow transplants

Sickle Cell Anemia

Autosomal recessive inheritance, abnormal hemoglobin "S" (one AA substitution)
HgbS causes RBC to become abnormally shaped/sickled under low oxygen conditions, leading to tissue hypoxia and ischemia
More common in people of African and Mediterranean descent
Manifestations: appear as early as 6 months of age, sickle cell crisis, painful episodes, tissue ischemia and necrosis, triggered by dehydration, stress, infection, high altitudes, and fever
Diagnosis: CBC, sickle solubility (screen), hemoglobin electrophoresis, CMP
Treatment: no cure, palliative, exceptions: stem cell or bone marrow transplant, gene therapy under research

Hemolytic Anemia

Excessive erythrocyte destruction, reticulocyte production index is high
Causes: idiopathic, autoimmune, genetics, infections, blood transfusion reactions, and blood incompatibility in the neonate
Several types: hemoglobinopathies (sickle cell anemia), thalassemia, RBC membrane or enzyme defects, immune (erythroblastosis fetalis) and non-immune hemolytic anemia

Lymphomas

Cancers originate in lymphatic system, affecting WBCs as well
Most common hematologic cancer in the US
Two main types:
- Hodgkin lymphoma: B cells
- Non-Hodgkin lymphoma: B cells, T cells, NK cells

Hodgkin Lymphoma

Lesser common of the two
Solid tumors with the presence of Reed-Sternberg cells
Typically originate in the lymph nodes of the upper body
Several subtypes
Amenable to cure
Manifestations: painless enlarged lymph nodes, weight loss, fever, night sweats, pruritus, coughing, difficulty breathing, chest pain, recurrent infections
Diagnosis: physical examination, presence of Reed-Sternberg cells in a lymph node biopsy, CBC, chest X-rays, CT-scan, MRI, PET scan, and bone marrow biopsy
Treatment: chemotherapy, radiation, and surgery

Non-Hodgkin Lymphoma

More common
Poor prognosis
Many different types
Similar to Hodgkin manifestations, staging, and treatment
Different in the spread and diagnosis
Can originate in the T or B cells
No Reed-Sternberg cells

Leukemia

Manifestations: leukopenia, leukocytosis, anemia, thrombocytopenia, lymphadenopathy, joint swelling, bone pain, weight loss, anorexia, hepatomegaly, splenomegaly, and central nervous system dysfunction
Diagnosis: H&P, CBC with peripheral blood smear, and bone marrow biopsy
Treatment: chemotherapy and bone marrow transplant

Chronic Myeloid Leukemia

Affects primarily adults
Responds poorly to chemotherapy, but prognosis is improved with allogenic bone marrow transplant

Acute Lymphocytic Leukemia

Affects young children
Best prognosis is found in children between 1 and 9 years of age; infants and adolescents respond less positively to chemotherapy

Acute Myelogenous Leukemia

Affects adults
Chemotherapy is less successful in adults with AML, although remissions may be achieved

Chronic Lymphocytic Leukemia

Affects adults >50 years
Prognosis is often related to the WBC count and the proportion of blast cells present at the time of diagnosis

Hairy Cell Leukemia

Affects males >50 years

Hemoglobin Structure

Globin group: surrounded by the four heme groups
Heme groups: ring-like organic compounds called porphyrins with an iron atom attached
Protein chains: two alpha chains and two beta chains, each with a heme group

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Description

A quiz covering the characteristics of benign and malignant tumors, as well as pernicious anemia, an autoimmune disorder.