Blood Dyscrasias Flashcards
Acute lymphocytic leukemia (ALL) is the MC malignancy in?
Children under the age of 15 in the US
Is ALL responsive to therapy?
Yes, most responsive to therapy
What are some clinical features of ALL?
Bone and joint pain (invasion of periosteum)
splenomegaly, hepatomegaly, lymphadenopathy
Anterior mediastinal mass
Diagnostic lab findings for ALL and AML?
Variable WBC count
significant numbers of blast cells in peripheral blood
What complication is associated with ALL chemotherapy?
Tumor lysis syndrome
What is tumor lysis syndrome?
rapid cell death that releases intracellular contents
What does tumor lysis syndrome cause?
Hyperkalemia
Hyperphosphatemia
Hyperuricemia
Hypocalcemia
Acute myelogenous leukemia (AML) occurs mostly in?
Adults (80% of adult acute leukemias)
What risk is involved with AML?
Increased risk of bacterial infections (d/t neutropenia)
What unique clinical feature is seen in AML?
Skin nodules
What would you see in a bone marrow biopsy for diagnosing AML?
Auer Rods
What are Auer rods?
Granules and eosinophilic rods inside malignant cells
Present in AML, but not in ALL
Particularly noted if it is the APL phenotype
What is the best treatment option for AML?
Bone marrow transplantation gives the best change of remission or cure
Chronic lymphocytic leukemia (CLL) is most common in?
> 60 years of age
Leukemia occurring after age 50
Most common leukemia in the Western world
What is the cause of CLL?
B-type lymphocytes are mature, but functionally defective.
Is CLL considered the most or least aggressive type of leukemia?
Least aggressive
Clinical features of CLL?
Usually asymptomatic at the time of diagnosis
Generalized painless LAD (nontender lymph nodes)
Splenomegaly
Diagnostic findings for CLL?
Pancytopenia is common (anemia, thrombocytopenia, neutropenia)
Peripheral blood smear: smudge cells
What are smudge cells?
“fragile” leukemic cells that are broken when placed on the glass slide.
What are some general characteristics of chronic myelogenous leukemia (CML)?
Philadelphia chromosome (cheesesteak me likeee)
Treatment options for CML?
Target therapy: TKI Imatinib (Gleevec)
What are constitutional (B) sxs?
Fever, night sweats, anorexia, weight loss
What is Hodgkin lymphoma bimodal age distribution?
X1: 15-30 yrs old
X2: >50yrs of age
Lymph node bx lab finding for Hodgkin lymphoma?
Reed Sternberg Cells “owl eyes”
What is the MC clinical features of Hodgkin lymphoma?
Painless lymphadenopathy
What differentiates between Hodgkin lymphoma and non-Hodgkins lymphoma?
Presence of inflammatory cell infiltrates
How common is non-Hodgkins lymphoma compared to Hodgkins lymphoma?
Twice as common has Hodgkins lymphoma
Burkitt lymphoma a high-grade subtype of NHL is linked to?
African variety linked to EBV infection
Clinical features of NHL?
Lymphadenopathy
What is the definitive dx of NHL?
Lymph node bx- no Reed Sternberg Cells
What is multiple myeloma?
Neoplastic proliferation of a single plasma cell line that produces monoclonal immunoglobulin.
Age and race MC for multiple myeloma?
> 50 yrs
2x more common in AA compared to caucasian pts
What is a general characteristic of multiple myeloma?
Bone marrow elements are replaced by malignant plasma cells
What are skeletal manifestations of multiple myeloma?
Bone pain d/t osteolytic lesions, fractures, and vertebral collapse
Anemia manifestations of multiple myeloma?
Normocytic normochromic
Urine test finding for myeloma nephrosis caused by multiple myeloma
Bence Jones protein in urine - large amounts of free light chains
What is the MCC of death in pts with multiple myeloma?
Infections: pulmonary or urinary tract
Clinical feature of back/spine in pt with multiple myeloma?
Cord compression
What is a peripheral smear finding in pts with multiple myeloma?
Rouleaux formation
what are CRAB manifestations of multiple myeloma?
C = Calcium issues (hypercalcemia)
R = Renal insufficiency (elevated creatinine)
A = Anemia
B = bone lesions and pain
What is the preferred tx of multiple myeloma?
Autologous hematopoietic cell transplant (stem cell transplant)
What mutations are found in polycythemia vera?
Mutations of the JAK2 tyrosine kinase
S/Sxs of polycythemia vera?
Hyperviscosity: HA, dizziness, weakness, pruritus, visual impairment, dyspnea
In order to r/o polycythemia vera?
Rule out causes of secondary polycythemia (hypoxia, CO exposure)
DDx of polycythemia vera?
Smoking and Hypoxemia (secondary polycythemia)
Tx for polycythemia vera?
Repeated phlebotomy to lower the hematocrit
