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clinical lab > ALL, CLL, HCL > Flashcards

ALL, CLL, HCL Flashcards

1
Q

differentiate between AML, ALL

A

1_AML: myeloblast, big people, big blasts, lots of nucleoli, lots of cytoplasm, lots of granules, aur rods, big toxicity, big mortality rate, MPO+, SBB+

2_ALL: lymphoblast, small people, small blasts, little cytoplasm, little nucleoli, no granules, little toxicity of treatment, little mortality rate, PAS+

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2
Q 
in cytochemistry, which cells exhibit: 
1_MPO, SBB
2_Non specific estrase
3_block positivity of PAS
4_Acid phosphatase
5_Acid estrase
A 
1_M1_M3
2_M4, M5
3_M6
4_M7,TALL, HCL
5_Histyocytic leukemia
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3
Q

in which cases immunophenotyping is diagnostic?

A

1_essential for diagnosis of M0&M7
2_define ALL lineage
3_Biphenotypic leukemia
4_charachterize a phenotype for MRD detection

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4
Q

Mention the basic panels of Abs

A 
1_T. lineage: CD3+_CD, 2,5,7.
(CD4,8 to exclude residual normal T cells). 
2_B. lineage:  CD22+-CD 19
CD 10 for CALL. 
3_Myeiloid markers: CD 13,33,MPO to exclude M0 and diagnose Biphenotypic.
CD 14,15 for M4,5.
CD 41,61:M7
4_
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5
Q

Mention the signs and symptoms of ALL

A 
1_Anemia
2_leukopenia
3_thrombocytopenia 
4_weight loss
5_LAP, HSM
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6
Q

What are the tecniques used to diagnose ALL

A

1_morphological features: Romanowsky stained BM
2_cytochemistrt
3_cytogenitics
4_immunophenotyping

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7
Q

Mention the morphological classifications of ALL

A

L1: small cell , homogenous population, common in childhood, most common type, best prognosis
L2:large cell, hetregenous population, common in adult, may be confused with blasts of AML
L3:Burkitts cell, large cell, homogenous population, poor prognosis, B cell mailignancies

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8
Q

what’s the eitology of ALL

A 
1_immun deficiency 
2_genitic factor 
3_ionizing radiation, electromagnetic field
4_chemicals 
5_infections
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9
Q

what is All

A

a malignancy of lymphopiotic cell manifested by slow but uncontrolled growth of abnormal poorly defferintiated lymphoid cells

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10
Q

Mention the immunological classification of ALL

A

1_T. cell: CD3,2,5,7.50%of pt have Mediastinal mass.
2_B. cell: +SIg,-TdT, usually L3
3_pre B cells:+HLA. DR, TdT, CD 19,20,24.
4_CALL(pro. B):+HLA, DR, CD10,19,24,20.
has the highst remission rate

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11
Q

mention the complications of ALL

A 
1_infection; most common cause of death. 
2_bleeding
3_meningeal leukemia 
4_testicular infiltration 
5_leukostasis
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12
Q

Mention the markers and thier results in different ALL subtypes.

A

type. Tdt.CAll.CD7.CD19.DR.M
1_CALL. + + - + + L1,2
2_PRE B. + + - + + L1
3_B CELL. - - - + + L3
4_T CELL. + - + - - L1,2

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13
Q

what are the main characters of CLL

A

1_most common leukemia in west
2_more common in whites, old men
3_lymphocytosis> 5000

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14
Q

Mention the signs and symptoms of CLL

A

1_symmetrical LN enlargement
2_hemolytic anemia
3_thrombocytopenia
4_HSM
5_Infections due to: impaired Ig production, Neutropenia, corticosteroids.
6_infiltration: skin, tonsill, CNS, bone, joint

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15
Q

What are tha lab findings in CLL

A

1_leukocytosis with lymphocytes 50000_200000
2_neutrophils: normal in early stage then reduced
3_HB normal early then decrease
4_normocytic normochromic anemia
5_spherocytosis, reticulocytosis,+coomb test
6_thrombocytopenia
7_hypoimmunoglobenimia
8_in blood film; monotonous cells, smear cells.
9_chromosomal abnormalities in 50% «trisomy 12»
10_CD 5 antigen

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16
Q

Write the Rai classification of CLL

A 
S0: lymphocytosis> 10000 in blood,> 30% in, BM.          «15 y» 
S1 0+LAP.   «5_9 y» 
S2 1+organomegaly.   «5_9»
S3 2+Anemia  «2»
S4 3+thrombocytopenia «2»

stage 0_ 2low risk
stage 3_4 high risk u

17
Q

Write the Bient classification of CLL

A

A.< 3 involved areas, Hb>10,platlete > 100
B.> 3,Hb same as A
C.any number of involved areas with Hb <10,plat <100

18
Q

What is the DDX of CLL

A 
1_prolymphocytic leukemia 
2_HCL
3_large granular lymphocytic leukemia 
4_leukemic phase of NHL (follicular, mantle) 
5_Waldenstroms macroglobulenimia
19
Q

Mention the lab findings in ALL

A

1_Leukocytosis in 75% of ptn, blast cells, the pb contain 100% lymphoblasts, lymphocytes, smudge cells.
2_BM: hypercellular, infiltration with lymphoid cells «more than 30 blasts», fibrosis may occur
3_Anemia, thrombocytopenia.

20
Q

explain some charecters of prolymphocytic leukemia.

A

rare form.
can arise or transform from CLL
lymphoid cells are larger and less mature.
in old males
leukocytosis> 100k
associated with splenomegaly but not particulary with LAP
poor prognosis

21
Q

explain some charecters of HCL

A 
median age, M> F. 
Pancytopenia. 
prominent splenomegaly. 
dry tap
very indolent. 
pb: mononuclear with hairy cytoplasmic projections.
22
Q

what will be the blood picture in HCL

A 
1_pancytopenia
2_normocytic normochromic anemia 
3_leukopenia
4_plat decrease 
5_most cases belong to the B cell lineage. 
6_HC  10_50%
23
Q

what is the result of cytochemistry and immunophenotyping in HCL

A

tartrate resistance and Acid phosphatase +

CD 11,25,103

24
Q

Mention the complications of CLL

A

1_hyperleukocytosis, Hypogammaglobulinemia
2_Anemia
3_thrombocytopenia
4_Autoimmunity
5_transformation to large cell lymphoma, pll, ALL, MM

25
Q

What is MDS

A

it is a hetreogenous group of clonal hematopoietic stem cell disorders charachterized by:
ineffective heamtopoisis
peripheral cytopenia

26
Q

what is the classification of MDS.

A

1_refractory anemia: dimorphic population,< 5%blast, AML in 10%
2_RA with sideroblasts: 15% sideroblasts,< 5%blasts
3_RAEB: 5_20% blasts, AML in, 35%.
4_RAEB. T: 21_30% blasts, AML in65%
5_CMML: anemia, thrombocytopenia, monocytosis, splenomegaly, AML in 30%

27
Q

what are the causes of leukemoid reactions?

A

myeloid:
1_infection
2_non hematological malignancy
3_acute hemolysis

lymphoid: 
1_cancer
2_TB
3_infectious mononucleosis
4_cytomegalovirus
5_pertussis, measles, chickenpox
28
Q

what are the lab findings in leukemoid reaction

A 
1_leukocytosis but not exceed 100k, blast<5%, toxic granulation, Doehle bodies
2_Anemia, plat N or H
3_BM WBC hyperplasia
4_ALP increase
5_Absent ph chromosome
29
Q

what do you know about leukoerythroblastic reaction?

A

1_it’s the presence of immature myloid cells and NRBCs in the PB
2_caused by: secondary carcinoma of bone, MM, myelofibrosis, marble bone syndrome, lymphoma, thalessimia major, hemolytic anemia, Gauchers and Niemann. pick Ds.
3_in blood film; anisopoikilocytosis, tear drop, NRBCs 10%, reticulocytosis, WBC shift to the left, plat normal or reduced.

clinical lab (5 decks)

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