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

A

CD5

CD2

19
Q

Treatment modalities for leukemia

A

Transfusion (supportive)
Chemotherapy
Bone marrow transplant (curative)

20
Q

TKI inhibitors for CML

A

Imatinib

21
Q

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

A

ALL

22
Q

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

A

CLL

23
Q

Oncogenic mutations impede differentation, accumulating immature myeloid blasts in marrow

A

AML

24
Q

Tyrosine kinase pathway related chromosomal translocation (Philadelphia chromosome)

A

CML

25
Q

Immature B or T cell (marrow)

A

ALL

26
Q

Peripheral B or T cell (lymph nodes)

A

CLL

27
Q

Immature myeloid lineage cells (marrow)

A

AML

28
Q

Pluripotent hematopoietic stem cell (marrow)

A

CML

29
Q

Condensed chromatin, scant cytoplasm, small nucleoli

A

ALL

30
Q

Smudge cells, condensed chromatin, scant cytoplasm

A

CML

31
Q

Auer rods (abnormal lysosomes), myeloblasts, monoblasts

A

AML

32
Q

Hypercellular marrow, elevated eosinophils and basophils

A

CML

33
Q

Stormy onset, symptoms related to depressed marrow function, bone pain, CNS manifestations

A

ALL

34
Q

Asymptomatic or nonspecific, LAD, hepatosplenomegaly

A

CLL

35
Q

Anemia symptoms, spontaneous bleeding, petechiae and eccymoses

A

AML

36
Q

Insidious onset, mild anemic symptoms, splelenomegaly

A

CML

37
Q

Anemia, thrombocytopenia, variable WBC’s, >30% lymphoblasts

A

ALL

38
Q

Sustained antibodies, lymphocytosis > 5000/uL, low platelets in 20-30%

A

CLL

39
Q

Anemia, neutropenia, thrombocytopenia, >30% myeloblasts, auer rods

A

AML

40
Q

Asymptomatic WBC > 50000

Symptomatic WBC > 200000-1000000, some blast forms, increased eosinophils and basophils

A

CML

41
Q

Most common leukemia among children

A

ALL

42
Q

Most common leukemia among adults, twice as common in men

A

CLL

43
Q

Most common leukemia among adults

A

AML

44
Q

Most common leukemia among ages 20-50, and rare in children

A

CML