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Hematology-Oncology > Assessment 1 > Flashcards

Assessment 1 Flashcards

1
Q

During the fetal period, definitive HPesis occurs in the?

A

LIVER AND SPLEEN

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2
Q

In adults HPesis confined to the?

A

Sternum
Vertebra
RIbs

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3
Q

List the hematopoiesis sites from development to adulthood hood

A

Derived from splanchnopleura (CD45+/CD34+) -> yolk sac (weeks 2-6 gestation; CD34+) -> liver and spleen (up until birth) -> long bones (tibia and femur) during childhood -> flat bones (ribs, sternum, vertebra) during adulthood

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4
Q

Most common precursor in hemopoietic tissue

A

Granulocyte/monocyte precursor

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5
Q

Describe how the major cell types are arranged relative to distance from sinusoids

A

principle - most migratory is furthest away from sinus

o Megakaryocytes – closest to sinuses

o Erythroid cells also close to the endothelium

o Leukocytes are farthest away from the sinus
-They have great migratory potential

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6
Q

What 2 progenitor cells does the common myeloid progenitor give rise to?

A
  1. Granulocyte/monocyte progenitor (CFU-GM)

2. Megakaryocyte/erythroid progenitor (MEP)

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7
Q

Granulocytosis

  • stage with no granules
  • last stage w/ nucleoli
  • appearance of primary granules
  • differentiating step
  • last stage to undergo mitosis
  • kidney bean shape
A
  • myeloblast
  • promyelocyte
  • promyelocyte -> azurophilic granules (lysosomes)
  • myelocyte -> 2ndary granules
  • myelocyte -> last mitotic cell
  • metamyelocyte
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8
Q

One bone marrow derived cell (CFU-GM) that undergoes mitosis in tissues?

A

monocyte: becomes a macrophage

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9
Q

JAK2 V617F mutation

  • what does it indicate?
  • what is it never seen with?
A
  • If we see this we know there is a neoplasia
  • But it’s not specific nor is it necessary to MPN

• Never seen with BCR/ABL

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10
Q

3 aspects of leukoerythroblastosis

-why/when does it occur with MPNs

A
  • teardrop RBCs
  • circulating nucleated red cells
  • left-shifted granulocytes

Fibrosis of the bone marrow. Seen in late stages of the disease

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11
Q

ALL immunophenotyping

B-ALL
T-ALL

which one presents as a mediastinal mass?

A

Both are TdT positive

B-ALL -> CD19 and CD10 (CALLA)
T-ALL -> CD2/3

T-ALL -> mediastinal mass

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12
Q 
APL
-translocation?
-cells filled with?
-increased risk of?
Treated with?
A

t(15;17)

Cells filled with auer rods (MPO+)

Inc risk of DIC -> auer rod/granule release

Txed with all-trans retinoic acid

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13
Q

Smudge cells are seen in which leukemia?

Immunophenotype for this cancer?

A

CLL/SLL

Immunophenotype

  • CD19, CD20 (b-cell antigens)
  • Abnormal CD5 (T cell antigen)
  • CD23
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14
Q

Which leukemia is positive for TRAP?

presentation of this cancer?

A

Hairy cell leukemia

  • ages 40 to 60
  • Splenomegaly
  • pancytopenia
  • absence of lymphadenopathy
  • B-cell leukemia
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15
Q

Target cells associated with?

A

HALT said the target cell

HbC disease
Asplenia
Liver disease
Thalassemia

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16
Q

Age distribution for HL vs NHL

prepubescent child?

A

HL
-bimodal: young adulthood and > 55 years

NHL
-peak for certain subtypes at 20-40

Prepubescent child more likely to have NHL

17
Q

5 categories for lymphadenopathy

A
  1. Increase in # of lymphocytes and macrophages in response to antigens
    – Infection or autoimmune
  2. Infiltration by inflammatory cells/ infection of
    LN “lymphadenitis”
  3. Proliferation of malignant lymphocytes or macrophage
  4. Infiltration by metastatic malignant cells
  5. Infiltration by metabolite-laden macrophage (lipid storage disease)
18
Q

Differentiate classical vs. non-classical HL by CD

-which HL in non-classical?

A

Classical -> CD30+, CD15+/-

Non-classical = nodular lymphocyte-predominant HL -> CD20+, CD45+

19
Q

Describe the staging of Hodkin’s lymphoma

A

Stage 1 and 2 - good prognosis

I - single lymph node

II - 2+ regions on same side of diaphragm (mediastinal LN)

III - both sides of diaphragm or spleen involvement

IV - disseminated involvement of lymphatic tissue

20
Q

Follicular lymphoma

  • chromosome abnormality -> leads to?
  • tx
A

t(14;18)

overexpression of bcl-2 = anti-apoptosis gene

Also CD10+

Chemotherapy

Rituximab -> anti-CD20 Ab

  • helps NK cells bind and kill cancer cells
  • used for maintenance tx
21
Q

Burkitt lymphoma

  • pathogenesis
  • types
  • histology
  • tx and associated problems
A

African type

  • EBV
  • jaw lesion

Non-endemic

  • t(8;14) -> B looks like 8
  • activation of c-myc -> rapid proliferation of B-cells
  • abdomen
  • fastest proliferating tumor

HISTOLOGY

  • starry night appearance
  • night = b-lymphocytes
  • stars = macrophages
  • indicates rapid cell turnover

Tx -> tumor lysis syndrome
-give allopurinol and urate oxidase

22
Q

Mantle cell lymphoma

  • translocation
  • CD
A

t(11;14)
-cyclin D1 -> increased cell cycle
poor prognosis

CD5+

23
Q

H. pylori associated with which lymphoma?

indolent or aggressive?

A

MALT lymphoma -> indolent (low grade)

24
Q

Most common form of aggressive lymphoma in adults?

A

DLBCL

-activated B-cell signature = worse prognosis

25
Q

Marker for Burkitt Lymphoma

A

Ki-67 proliferation marker > 98%

Also CD10+

26
Q

Nodular lymphocyte predominant HL

-histology/immunohistochem

A

CD20+ cells w/ rosettes of CD30+ T cells around the LP cell

“popcorn cells”

27
Q

HL vs NHL based on neoplastic cells

A

HL -> few neoplastic cells

NHL -> most cells neoplastic

28
Q

CRABBI for MM

A 
C - hypercalcemia
R - renal insufficiency 
A - anemia
B - bone lesions
B - bence jones proteinuria - Ig light chains in urine
29
Q

Rasburicase for MM - MoA

A

urate oxidase -> converts uric acid into a soluble form

30
Q

Paroxysmal nocturnal hemoglobinuira

A

Intravascular/intrinsic hemolytic normocytic anemia

Defect in GPI or DAF - protect RBC from complement

Neutrophils and platelets lysed too

triad - hemolytic anemia, pancytopenia, venous thrombosis

Labs: CD55/CD59 negative

tx w/ eculizumab

31
Q

Hereditary spherocytosis

A

Defect in proteins interacting w/ RBC membrane skeleton and plasma membrane
-ankyrin, band 3, protein 4.2, spectrin

  • inc MCHC -> concentrated Hb
  • inc RCDW

Positive osmotic fragility test

Tx w/ splenectomy

32
Q

Microangiopathic anemia

  • path
  • histo
A

path -> RBCs damaged when passing through obstructed or narrowed vessel lumina

-DIC, TTP-HUS, SLE

Histo -> shistocytes (helmet cells)

33
Q

Macroangiopathic anemia

-due to

A

Prothetic heart valve and aortic stenosis -> mechanical destruction of RBCs

Hematology-Oncology (3 decks)

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