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Year 4 Block 3-Acute medicine > 307. Non hodgkin's lymphoma, myeloproliferative disorders and complications of leeakemia > Flashcards

307. Non hodgkin's lymphoma, myeloproliferative disorders and complications of leeakemia Flashcards

1
Q

What is a non hodgkins lymphoma?

A

Lymphoma that doesnt contain reed stenburg cells

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2
Q

What are the causes of non-hodgkins lymphoma?

A

Immunodeficiency

Drugs

HIV

H pylori

Toxins

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3
Q

What are the signs of non hodgkins lymphoma?

A

Superficial lymphadenopathy

Extranodal disease

Systemic symptoms- fevers, night sweats

Pancytopenia

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4
Q

What are common extra-nodal sites in non-hodgkins lymphoma?

A

Gut- commenest. Gastric MALT (h. pylori), Non malt gastric, small bowel

Skin

Ororpharynx

Bone, CNS and lung

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5
Q

What blood tests can be done for Non hodgkins lymphoma?

A

FBC, U&E’s, LFT’s increasde LDH

Marrow and node biopsy

Send cytology of any effusion

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6
Q

What is prognosis for Non hodgkins lymphoma?

A

Low grade lymphomas- Often causes little symptoms, hard to cure. e.g. follicular and MALT

High grade lymphomas- often curable, e.g. burkett’s

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7
Q

What is the treatment for non hodgkins lymphoma?

A

Low grade- radiotherapy, interferon alpha and rituximab

High grade- (b cell)- R- rituximab
C-yclophasmide
H-ydroxydaunorubicin
O-ncovin
P-rednisolone
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8
Q

Where are blood cells produced

What is meant by extramedullary haematopoiesis

A

Central skeleton and proximal long bones

In some anaemias (thalaseammia) increasde demand causes cells to made beyond the marrow in the liver and spleen.

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9
Q

What are the causes of pancytopenia?

A 
Aplastic anaemia,
 acute leukaemia, 
myelodysplasia,
myeloma, 
lymphoma,
 solid tumours,
 TB
, megaloblastic aneamia, 
Hypersplenism
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10
Q

What is agranulocytosis

A

Implies that granulatocytes (neutrophils, basophil, eosinophil granules) have stopped being made

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11
Q

What drugs induce agranulocytosis

A

Carbimazole,

procainamide

sulfonamides

gold

clozapine

dapsone

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12
Q

How do you carry out a bone marrow biopsy

A

Aspirate and trephine (fluid and bone marrow)

taken from posterior ilaic crest

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13
Q

What is aplastic anaemia?

A

Bone marrow stops making cells- pancytopeania

Presents with signs of anaemia

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14
Q

What are the causes of aplastic anaemia?

A

Autoimmune

Drugs

Viruses (parovirus and hepatitis)

Irradiation

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15
Q

What is the treatment of aplastic anaemia?

A

Supportive- transfuse blood products

Allogenic blood transfusion

Immunossuppresion

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16
Q

What are myeloproliferative disorders?

A

Proliferation of haemtopietic myeloid stem cells in the bone marrow

Polycythaemia vera- RBC
Chronic myeloid leukemia- CML
Essential thrombocytopeania
FIbroblasts- Myelofibrosis

17
Q

What is reactive polycythaemia?

A

Increased RBC, due to reduced plasma volume

Can be acute due to dehydration or chronic- obesity, hypertension and high alcohol intake

18
Q

What is absolute polycythaemia?

A

Increased RBC mass can be primary- polycythaemia vera

or secondary due to high altitude, chronic lung disease, cyanotic heart disease, heavy smoking, increased EPO secretion

19
Q

What is polycythaemia vera?

A

Malignant proliferation of plueripotent cells leading to them being resistant to apoptosis and causing excess RBC, WBC and platelets

20
Q

How does polycythaemia vera present?

A

Asymptomatic

Headaches, tinnitus, visual distrubance

Itching after hotbath, Burning sensation in finger and toes

21
Q

How is PCV investigated?

A

FBC, reticulocyte, hb, wbc, latelets, b12

Marrow biopsy

Cytogenics to differntiate from CML

Serum erythropoitein

22
Q

How is PCV treated

A

Keep heamatocrit <0.45 to reduce risk of thrombosis

Younger patients are given venesection

Hydroxycarbamide

23
Q

How does essential thrombocytopeania present and how is it treated?

A

Bleeding

Arterial and venous thromboembolism

Headache, atypical chest pain

24
Q

In essential thrombocytopeani it is important out causes of thrombocytosis. What are the causes of thrombocytosis

A

Bleeding

Infection

Chronic inflammation

Malignancy

Trauma

Iron deficiency

25
Q

What is the presention of myelofibrosis

A

Night sweats, fever, weight loss

splenomegaly

bone marrow failure

26
Q

What is the characterstic film seen in myelofibrosis

A

Leukoeryhtroblastic cells with tear drop RBC’s

27
Q

How is myelofibrosis treated?

A

Bone marrow support

Allogenic stem cells

Year 4 Block 3-Acute medicine (85 decks)

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