Clinical Medicine II
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| show | protection from foreign substances, tumor surveillances, self recognition
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| What are tissue components to immune system | show 🗑
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| show | leukocytes, marcrophages, antigen presenting cells
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| show | immunoglobulins , complement proteins
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| show | humoral and cellular
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| Parts of humoral immunity | show 🗑
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| Types of celluar immunity | show 🗑
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| Types of congenital defects | show 🗑
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| show | Human immunodeficiency, malignancy(Cll, lymphoma, myeloma), chemo, radiation
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| show | Hematopoiesis, filtering, immune defense
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| Do we need the spleen | show 🗑
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| Major site of hematopoiesis during fetal life | show 🗑
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| show | Very acidic, ↓glucose, ↓ o2
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| show | w/ removal of spleen, RBC have reminents of its nucleus that the spleen normally removes
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| show | insoluble globin proteins within RBC’s d/t no spleen
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| show | 25% lymphoid mass, 50% total ab producing B cells-clear bacteria from circulation
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| show | removing encapsulated bacteria like S. peumo, H.flu, and N. meningitides
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| show | lymphoid organ, largest one being 25% lymphoid material
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| What is a spleen enlarged | show 🗑
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| show | liver dz, hematolgic malignancy, infx, congestion/inflammation, 1 splenic dz
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| show | CML myelofibrosis, gaucher dz, lymphoma, parasitic infx, thalassemia
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| show | clinical infxs, diagnostic, therapeutic
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| show | not usually good candidate, leaky jelly like supstance, will leak post biopsy
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| Consequences of splenectomy | show 🗑
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| Nuclear remnants in RBC | show 🗑
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| show | splenectomy sepsis w/I 3 years of splenectomy ~5% lifetime risk
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| What is PSS commonly caused by | show 🗑
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| How do we prevent PSS | show 🗑
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| show | kids until age 5 (pen or amoxicillin) or 3 years after, highly immunocomprimised adults, adult survivers of pneumococcal PSS
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| show | if no spleen, give abx for febrile illnesses 7-10days
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| 5 types of WBCs | show 🗑
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| Polymorphoncuclear cells (PMNs) | show 🗑
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| Fxns of Neutrophils | show 🗑
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| show | bacterial infx, physiologic stress, corticosteroids
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| show | viral infx, drugs/toxins, some bacterial infxns: brucella
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| show | CBC w/ diff, look at the percentage
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| ANC, levels that create risk | show 🗑
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| show | lymphocytes: B, T and NK cells 20-45% all white cells
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| What are signs for most viral infections | show 🗑
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| Where are lymphocytes | show 🗑
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| show | D: in bone marrow, M: in llymphoid tissues
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| show | synthesize immunoglobulins (abs)
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| show | T lymphocytes, Helper T (CD4) Cytotoxic suppressor (CD8) 60-85%
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| show | regulators of immune sys, influence production of abs by B cells
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| show | recognize kill virus, ↓ regulate ab production by B cells
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| What are natural killer cells (NK) | show 🗑
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| show | chronic infx: TB, lymphomas, granulomatous dz like sarcoid
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| show | phagocytize and kill microorganisms
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| show | secrete cytokines that induce fever and inflammation
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| What are 4 things that cause ↑ eosinophilic | show 🗑
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| Problem w/ eosinophils | show 🗑
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| show | in allergic d/o’s and myeloproliferative dz (CML, Polycythemia vera)
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| show | mast cells
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| show | IgE causes histamine release
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| Causes for leukopenia and leukocytosis | show 🗑
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| When would we call a hematologist or just recheck it | show 🗑
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| show | viral infx (usually ↓ neutorphils)
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| What is leukemia | show 🗑
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| What are the two types of leukemia | show 🗑
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| Initial presentation of non | show 🗑
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| Abno CBC examples | show 🗑
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| Leukemia classifications | show 🗑
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| show | chornic leukemia, still fxns nl but way more than there should be, ex CLL or CML
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| show | Acute leukemia, can’t make nl RBCs death fast
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| show | ALL CLL AML CML MC is CLL hight dealths AML
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| MC types is young kids, and Old ppl | show 🗑
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| show | acute: sxs fast, chronic slow and often diagnosis is mistaken CBC
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| Tx for leukemia | show 🗑
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| 3 phases of Acute leukemia | show 🗑
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| show | ALL
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| show | ALL
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| show | CML tx:
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| What is Gleevec | show 🗑
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| show | cervical, supraclavicular, axillary, inguinal nl: 1cm
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| show | often infx/inflammation
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| show | lymphoma
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| show | carcinoma
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| show | lymphoma
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| show | NHL
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| show | CBC renal and LFTs, coags, LDH, peripheral blood immunophenotyping, CT< MRI, PET, biopsy
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| Nodes on both sides of diaphragm | show 🗑
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| 1 node group | show 🗑
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| show | Stabe IV
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| >1node gropu, same side of diaphragm | show 🗑
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| What does A or B staging of lymphoma | show 🗑
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| show | eyes to thighs
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| Tx for lymphoma | show 🗑
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| Excess production of gamma globulin protein by a single clone of B cells/plasma cells | show 🗑
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| MGUS | show 🗑
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| Why is MGUS so important! | show 🗑
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| How dx MGUS | show 🗑
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| show | multiple myeloma
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| Where is MM seen more often | show 🗑
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| show | monoclonal protein (causein renal failure, hyperviscosity,amyloidosis, lytic bone lesions causing bone pain, pathologic frx, hypercalcemia, anemia and infections
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| Major criteria for MM | show 🗑
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| show | 10-29% plasma cells, smaller M-smike, lytic bone lesions, ↓ immunoglobulin levels
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| How do we dx MM | show 🗑
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| Tx MM | show 🗑
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