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Vis Dis > Blood Cancers 2 > Flashcards

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
Q

DDX for ivory vertebra?

A

pagets, blastic mets, lymphoma

26
Q

DDX for scalloping of the anterior bodies of the vertebra

A

aneuysm, lymphadenopathy, tumor, etc

27
Q

Non-Hodgkin lymphoma definition

A

malignancy derived from lymphoid tissue including lymph node tissue, spleen, liver, GI tract, bone, may involve B and T cells

28
Q

S/S of Non-Hodgkin lymphoma

A 
males (all ages)
non contiguous spread
painless enlarged lymph nodes, espeically cervical
extranodal GI, skin, lungs
normal blood findings
29
Q

if there is something in the retrosternal clear space, what is the DDX?

A

thymoma
teratoma
thyroid (goiter)
terrible lymphoma (Hodgkin lymphoma)

30
Q

what are the different labels for the chest view?

A 
aorto-pulmonary window
azygous fissure
azygous vein
right para-tracheal stripe
right/left hilar point
right/left main bronchus
trachea
aorta
carina
31
Q

on the right side of the sternum on a chest view, what do you see? left?

A

right atrium

left ventricle

32
Q

how do you determine if a radiolucency is the nipple or not?

A

put BBs on their nipples and re-xray

33
Q

ranke complex

A

seen in healed primary TB comprised of 2 parts:
ghon lesion (calcified parenchymal tuberculoma)
ipsilateral calcified hilar node

34
Q

MC tumor of bone

A

osteochondroma

35
Q

MC tumor of bone in spine

A

hemangioma

36
Q

MC benign tumor of hand

A

enchondroma

37
Q

MC malignant tumor of bone

A

lytic mets

38
Q

MC primary malignancy of bone

A

multiple myeloma

39
Q

top 4 primary malignant bone tumors

A

multiple myeloma
osteosarcoma
chrondrosarcoma
Ewing’s sarcoma

40
Q

definition of multple myeloma

A

AKA Kahler’s disease
neoplastic proliferation of plasma cells primarily in the bone marrow
monoclonal gammopathy

41
Q

demogrpahics for multiple myeloma

A

twice as common in African Americans

42
Q

S/S of multiple myeloma

A 
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
Q

lab significances for multiple myeloma

A 
bone marrow has at least 10% plasma cells
serum globulins are increased
ESR elevated
hypercalcemia
M spike
bence jones proteins
CRAB
44
Q

rouleax formation

A

RBCs stick together

45
Q

CRAB

A

calcium (elevated)
renal failure
anemia
bone lesions

46
Q

if a child has a pathological fracture, what is the most likely diagnosis?

A

eosinophilic granuloma

47
Q

what do you do to figure out if a ppatient has osteoporosis, lytic mets, or multiple myeloma?

A

history, clinical presentation
old films, if not helpful
labs (CBC, ESR, C-RP, BCP, UA)

48
Q

what if labs lok like lytic mets?

A

bone scan
MRI
biopsy

49
Q

what is labs look like multple myeloma?

A

PEP (urine and blood)
skeletal survey
MRI
biopsy

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