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Year 3 - MedEd Lectures > Blood Cancers > Flashcards

Blood Cancers Flashcards

1
Q

How are Acute Leukaemias defined?

A

Neoplastic Conditions with rapid onset

Characterised by the presence of immature ‘blast’ cells in the blood and bone marrow.

Causes Bone Marrow Failure

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2
Q

How do Acute Leukaemias present?

A

Anaemia - Fatigue, Pallor, Breathlessness

Neutropenia - Recurrent Infections

Thrombocytopenia - Bleeding and easy bruising

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3
Q

What is Acute Myeloid Leukaemia?

A

Accumulation of Myeloblast cells

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4
Q

How is Acute Myeloid Leukaemia diagnosed?

A

Features of bone marrow failure

‘Auer Rods on Blood film’

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5
Q

What is Promyelocytic Leukaemia?

A

Subtype of AML

Very Aggressive

t(15;17)

DIC association

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6
Q

What is Acute Lymphoblastic Leukaemia?

A

Uncontrolled proliferation of lymphoblasts

3/4 B Cell ALL

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7
Q

How does ALL present?

A

Common in children (Under 6)

Bone Marrow Failure symptoms

Organ Infiltration - hepatosplenomegaly, enlarged lymph nodes, swollen testes.

T-Cell ALL can lead to stridor, wheeze and Superior Vena Cava obstruction.

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8
Q

How is ALL investigated?

A

Increased WCC

Anaemia and Thrombocytopenia

>20% Lymphoblasts on a blood film

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9
Q

What is Chronic Lymphocytic Leukaemia?

A

Accumulation of mature incompetent lymphocytes, which are unable to apoptose.

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10
Q

How does CLL present?

A

Asymptomatic in half of cases.

Symptoms of Bone Marrow Failure in other 50%

Associated with Autoimmune thrombocytopaenia + Anaemia (Evan’s Syndrome)

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11
Q

How would you investigate a possible case of CLL?

A

Increased Lymphocytes

Anaemia, Neutropenia, Thrombocytopenia

Smudge/Smear cells on blood film (Fragile lymphocytes).

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12
Q

What is Chronic Myeloid Leaukaemia?

A

Uncontrolled proliferation of granulocyte precursors in Bone Marrow.
Slower progression than in AML.

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13
Q

How does CML present?

A

50% Asymptomatic

FLAWS

BM Failure Symptoms

Hyperviscosity Symptoms (Visual Disturbance, headaches, thromobtic events)

Gout

Massive Splenomegaly

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14
Q

What causes CML?

A

Philadelphia Chromosome is associated.

t(9,22)

Froms BCR-ABL gene, coding for a constitutively active TK receptor.

This leads to continuous cell proliferation.

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15
Q

How would you investigate a possible case of CML?

A

WCC >100x109

Philadelphia Chromosome identified during Cytogenetics.

No excess blasts in Chronic stage

Can transform into Acute phase due to hyperproliferation of blast cells.

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16
Q

What is Hodgkin’s Lymphoma?

A

Malignant proliferation of Lymphocytes, which accumulate in Lymph Nodes causing Lymphadenopathy.

17
Q

How does Hodgkin’s Lymphoma present?

A

20-30yo

>50yo

Painless enlarging mass (commonly in neck, axilla and groin)

May be painful after drinking.

FLAWS

Firm non-tender rubbery Lymphadenopathy

Hepatosplenomegaly

18
Q

How would you investigate Hodgkin’s Lymphoma?

A

Lymph Node Biopsy - Reed Sternberg cells

Ann Arbour Staging

19
Q

What is non-Hodgkin’s Lymphoma?

A

Malignancy of Lymphoid Cells originating in lymph Nodes without Reed Sternberg Cells

85% B cell

15% T/NK Cells

20
Q

What are Reed-Sternberg Cells?

A

Giant Cells with B-cell signatures, but characteristically don’t express typical B-Cell proteins. Used to differentiate between Hodgkin’s and Non-Hodgkin’s Lymphoma

21
Q

What is associated with Non-Hodgkins Lymphoma?

A

EBV

HIV

SLE

Sjogren’s

22
Q

How does Non-Hodgkins Lymphoma Present?

A

Paniless enlarging mass in neck, axilla or groin.

FLAWS (Less common than in HL)

Organ Involvement: Skin rashes, headache, hepatosplenomegaly,sore throat, cough

Bone Marrow Failure

23
Q

What is Burkitt’s Lymphoma?

A

Subtype of Non-Hodgkins Lymphoma typically found in African children.

Large Lymph Node in the jaw.

‘Starry-Sky’ Appearance under microscopy.

24
Q

What is Multiple Myeloma?

A

Malignancy characterised by proliferation of plasma cells and the production of a monoclonal immunoglobulin (usually IgG or IgA).

25
Q

What are the risk factors for Multiple Myeloma?

A

Radiation

HIV

Agricultural Work

Occupational Chemical Exposure

>70 Years

Afrocaribbeans>Caucasian>Asian

26
Q

What are the presenting symptoms of Multiple Myeloma?

A

CRAB

Hypercalcaemia (stones, moans etc)

Renal Impairment

Anaemia

Bone Pain/Lesions

27
Q

What is MGUS?

A

Monoclonal Gammopathy of Unknown Significance

Pre-malignant condition with an accumulation of some monoclona plasma cells.

NO Crab features

28
Q

How would you investigate Multiple Myeloma?

A

Serum/Urine Electrophoresis (Bence-Jones Proteins)

Bloods - Raised ESR, CRP, Urea/Cr, Ca, NORMAL ALP

Rouleaux Formation on blood film

Serum monoclonal protein high

BM Aspirate = Raised Plasma Cells

Year 3 - MedEd Lectures (29 decks)

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