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Blood Cancers 2 Flashcards

1
Q

describe leukemoid reaction

A

an elevated WBC count (leukocytosis)

a physiological response to stress or infection (as opposed to a priamry blood malignancy, such as leukemia)

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2
Q

neutrophilic leukemoid reaction characteristics

A

mimics CML (leukemia tests negative)
characterized by neutrophilia with a left shift
typically less than 50,000/cubic mm seen with severe bacterial infections
normal to elevated leukocyte alkaline phosphatase levels
abscense of philadelphia chromosome

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3
Q

WBC 38
segs (50-70) 50
bands (0-6) 30
lymphs (20-40) 20

A

38 WBCs (leukemoid reactions or possibly leukemia)
cell type implies neutrophils
mimics CML
evidence of severe infection

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4
Q

neutrophilic leukemoid reaction is due to?

A

severe bacterial infection

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5
Q

how do you tell the difference between CML and neutrophilic leukemoid reaction

A

CML has a philadelphia chromosome

neutrophilic leukemoid reaction does not

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6
Q

what are the types of myelocytic leukemoid reactions?

A

neutropilic leukemoid reaction
eosinophilic leukemoid reaction
basophilic leukemoid reaction
monocytic leukemoid reaction

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7
Q

lymphocytic leukemoid reaction is characterized by?

A

lymphocytosis (lymphs>segs)

mimicing CLL

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8
Q

what is the difference between lymphocytic leukemoid reaction and CLL

A

less than 50,000/cubic mm
absecne of lymphocytic leukemia cells in bone marrow
negative lymph node biopsy
evidence of primary infection

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9
Q 
30 year old
42 WBCs
35 segs
60 lymphs
5 monocytes
A

most likely lymphocytic leukemoid reaction (too young to be CLL)

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10
Q

lymphocytic leukemoid reaction is usually due to?

A

severe viral infection

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11
Q

lymphoma definition

A

group of malignant disorders that originate from unregulated lymphoid tissue growth
predominantly limited to lymph nodes (or bone, liver, spleen)

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12
Q

leukemia definition

A

neoplastic cells involve predominantely the blood and bone marrow

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13
Q

common early sign of Hodgkin’s or non-Hodgkin’s is?

A

painless enlargement of one or more lymph nodes

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14
Q

S/S of lymphoma

A 
painless swollen lymph nodes, in the neck, chest, armpit, groin or spleen
sweating/fever, at night
abnormla tiredness
weight loss
loss of appetite
persistent itching
perisstent cough
persistent breathlesness
pain in the lymph nodes after drinking alcohol
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15
Q

stage 1 lymphoma

A

disease is limited to one set of lymph nodes

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16
Q

stage 2 lymphoma

A

more than one site, only one side of the diaphragm

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17
Q

stage 3 lymphoma

A

lymph tissue or spleen on both sides of diaphragm

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18
Q

stage 4

A

other organ involvement, bone marrow and liver

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19
Q

what is the special kind of cells involved with Hodgkin lymphoma?

A

Reed-Sternberg cells

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20
Q

definition of Hodgkin lymphoma

A

malignancy derived from lymphoid tissue, primarily lymph node tissue and bone, especially involved B cells and the presence of Reed Sternberg cells

21
Q

Hodgkin lymphoma demographics

A

males

15-35, after 50

22
Q

how do you diagnose Hodgkin lymphoma?

A

lymph node biopsy

23
Q

S/S of Hodgkin lymphoma

A

painless, enlarged lymph node usually in the neck, night sweats, low grade fever and weight loss, itching
neutrophilia
monocytosis
associated with Epstein Barr virus

24
Q

when looking at a lateral chest, what are the spaces that should be dark?

A

retrosternal clear space
retrocardial clear space
possibly meganblas

25
DDX for ivory vertebra?
pagets, blastic mets, lymphoma
26
DDX for scalloping of the anterior bodies of the vertebra
aneuysm, lymphadenopathy, tumor, etc
27
Non-Hodgkin lymphoma definition
malignancy derived from lymphoid tissue including lymph node tissue, spleen, liver, GI tract, bone, may involve B and T cells
28
S/S of Non-Hodgkin lymphoma
``` males (all ages) non contiguous spread painless enlarged lymph nodes, espeically cervical extranodal GI, skin, lungs normal blood findings ```
29
if there is something in the retrosternal clear space, what is the DDX?
thymoma teratoma thyroid (goiter) terrible lymphoma (Hodgkin lymphoma)
30
what are the different labels for the chest view?
``` aorto-pulmonary window azygous fissure azygous vein right para-tracheal stripe right/left hilar point right/left main bronchus trachea aorta carina ```
31
on the right side of the sternum on a chest view, what do you see? left?
right atrium | left ventricle
32
how do you determine if a radiolucency is the nipple or not?
put BBs on their nipples and re-xray
33
ranke complex
seen in healed primary TB comprised of 2 parts: ghon lesion (calcified parenchymal tuberculoma) ipsilateral calcified hilar node
34
MC tumor of bone
osteochondroma
35
MC tumor of bone in spine
hemangioma
36
MC benign tumor of hand
enchondroma
37
MC malignant tumor of bone
lytic mets
38
MC primary malignancy of bone
multiple myeloma
39
top 4 primary malignant bone tumors
multiple myeloma osteosarcoma chrondrosarcoma Ewing's sarcoma
40
definition of multple myeloma
AKA Kahler's disease neoplastic proliferation of plasma cells primarily in the bone marrow monoclonal gammopathy
41
demogrpahics for multiple myeloma
twice as common in African Americans
42
S/S of multiple myeloma
``` bone pain (back, long bones, skull, ribs, pelvis) pathologic fractures fatigue weight loss multiple punched out lesions symptoms of hypercalcemia (anorexia, nausea, vomiting, somnolence, polydipsia recurrent infections normocytic normochromic anemia renal disease rouleax formation ```
43
lab significances for multiple myeloma
``` bone marrow has at least 10% plasma cells serum globulins are increased ESR elevated hypercalcemia M spike bence jones proteins CRAB ```
44
rouleax formation
RBCs stick together
45
CRAB
calcium (elevated) renal failure anemia bone lesions
46
if a child has a pathological fracture, what is the most likely diagnosis?
eosinophilic granuloma
47
what do you do to figure out if a ppatient has osteoporosis, lytic mets, or multiple myeloma?
history, clinical presentation old films, if not helpful labs (CBC, ESR, C-RP, BCP, UA)
48
what if labs lok like lytic mets?
bone scan MRI biopsy
49
what is labs look like multple myeloma?
PEP (urine and blood) skeletal survey MRI biopsy

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