20 Approach to a Patient with WBC Disorders, Lymphadenopathy and Splenomegaly Flashcards

1
Q

May be a benign incidental finding or a presenting sign of an underlying disease

A

Lymphadenopathy

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2
Q

Clinical approach to patients with lymphadenopathy

A

History and physical exam
Age
Lymph nodes
Lab investigation

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3
Q

Removal of senescent RBCs
Antibody synthesis
Removal of antibody coated bacteria and antibody coated blood cells

A

Spleen

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4
Q

Space between the spleen can go to, not where the spleen is normally located

A

Traube’s space

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5
Q

Common s/s of splenomegaly

A

Heaviness/LUQ fullness

Early satiety

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6
Q

Form of mucopolyssacharidosis or accumulation of GAGs

A

Gaucher’s disease

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7
Q

Neoplastic transformation of WBC precursors

A

Maturation arrest
Uncontrolled proliferation
Evasion of apoptosis

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8
Q

Condensed granules that look like sticks in the cytoplasm

Differentiation of leukemia

A

Auer rods

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9
Q

Nonspecific signs and symptoms as a consequence of cytopenias

A

Leukemia

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10
Q

Diagnosis of leukemia

Reads how many of the cells express a particular signature

A

Flow cytometry

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11
Q

Definitive Ags for AML

A

Cytoplasmic MPO

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12
Q

Definitive Ags for ALL T-cells

A

Cytoplasmic CD3
Surface CD3
T cell receptor CD7-bright

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13
Q

Strongly associated Ags with AML

A

CD117

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14
Q

Strongly associated Ags with ALL-B cell

A

Cytoplasmic CD79a

Cytoplasmic CD22, CD19, CD-10 bright

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15
Q

Strongly associated Ags with ALL-T cell

A

CD7 bright

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16
Q

Moderately associated Ags with AML

A

CD13

CD33

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17
Q

Moderately associated Ags with ALL-B cell

A

TdT-moderate to bright

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18
Q

Moderately associated Ags with ALL-T cell

19
Q

Treatment modalities for leukemia

A

Transfusion (supportive)
Chemotherapy
Bone marrow transplant (curative)

20
Q

TKI inhibitors for CML

21
Q

Chromosomal aberration resulting in abnormal transcription factors that affect development of B and T cells

22
Q

Chromosomal deletion or possible somatic hypermutation of postgerminal or naive B cells

23
Q

Oncogenic mutations impede differentation, accumulating immature myeloid blasts in marrow

24
Q

Tyrosine kinase pathway related chromosomal translocation (Philadelphia chromosome)

25
Immature B or T cell (marrow)
ALL
26
Peripheral B or T cell (lymph nodes)
CLL
27
Immature myeloid lineage cells (marrow)
AML
28
Pluripotent hematopoietic stem cell (marrow)
CML
29
Condensed chromatin, scant cytoplasm, small nucleoli
ALL
30
Smudge cells, condensed chromatin, scant cytoplasm
CML
31
Auer rods (abnormal lysosomes), myeloblasts, monoblasts
AML
32
Hypercellular marrow, elevated eosinophils and basophils
CML
33
Stormy onset, symptoms related to depressed marrow function, bone pain, CNS manifestations
ALL
34
Asymptomatic or nonspecific, LAD, hepatosplenomegaly
CLL
35
Anemia symptoms, spontaneous bleeding, petechiae and eccymoses
AML
36
Insidious onset, mild anemic symptoms, splelenomegaly
CML
37
Anemia, thrombocytopenia, variable WBC's, >30% lymphoblasts
ALL
38
Sustained antibodies, lymphocytosis > 5000/uL, low platelets in 20-30%
CLL
39
Anemia, neutropenia, thrombocytopenia, >30% myeloblasts, auer rods
AML
40
Asymptomatic WBC > 50000 | Symptomatic WBC > 200000-1000000, some blast forms, increased eosinophils and basophils
CML
41
Most common leukemia among children
ALL
42
Most common leukemia among adults, twice as common in men
CLL
43
Most common leukemia among adults
AML
44
Most common leukemia among ages 20-50, and rare in children
CML