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B&L Exam 2 > Case 4 > Flashcards

Case 4 Flashcards

1
Q

What is leukemia?

A
  • Lymphoid neoplasm
  • Originates in bone marrow.
  • Tumor cells in peripheral blood
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2
Q

Acute Leukemia

A
  • Increased risk in Down Syndrome, Bloom’s Syndrome, Fanconi’s anemia, twins, & exposure to radiation & chemicals
  • Labs: low platelets, blasts are large w/punched out nucleoli
  • Sx: anemia, thrombocytopenia, neutropenia
  • Testing: flow cytometry to confirm
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3
Q

Acute Lymphoid Leukemia (ALL)

A
  • Most common in children & minorities
  • Good prognosis
  • Associated w/Down Syndrome > age 5
  • Sx: abrupt onset, depression of marrow function (anemia, neutropenia and thrombocytopenia), CNS problems
  • Labs: normal WBC, but ↓ neutrophils (so WBC are relatively high), TdT+
  • Tx: induction chemotherapy, hyperCVAD
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4
Q

B-ALL

A
  • Most common
  • CD10, CD19, CD20
  • t9:22 Philadelphia chromosome is bad prognostic marker (more commonly seen in CML)
  • Tx: Imatinib
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5
Q

T-ALL

A
  • CD2-CD8

* Presents as thymic mass in teenagers

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6
Q

Chronic Lymphocytic Leukemia (CLL)

A
  • Neoplastic proliferation of naïve B-cells (CD5)
  • Most common leukemia in elderly (>50)
  • Rai staging (0-4)
  • Deletion 11q23 & alteration 17p → poor prognosis
  • Sx: asymptomatic or or fever, night sweats, weight loss, fatigue
  • Labs: ↑ WBC, small lymphocytes & smudge cells in smear
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7
Q

Hairy Cell Leukemia

A
  • Neoplastic proliferation of mature B cells
  • Sx: massive splenomegaly, no lymphadenopathy
  • Labs: TRAP +
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8
Q

Which mutations give rise acute leukemias?

A

Mutations that completely arrest maturation early in blood cell development

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9
Q

Which mutations give rise to myelodysplastic disorders?

A

Mutations that impair and slow blood cell maturation

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10
Q

Which mutation give rise of myeloproliferative disorders?

A

Mutations that cause autonomous overproduction of mature blood cells and their immediate precursors

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11
Q

What are some possible genetic etiologies for leukemia?

A

Down Syndrome, Bloom’s Syndrome, Fanconi’s anemia, Li-Fraumini Syndrome, Identical twins

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12
Q

What are some possible exposure etiologies for leukemia?

A

Radiation, industrial chemicals, alkylating agents, topoisomerase inhibitors, viruses (HTLV)

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13
Q

Multiple Myeloma

A
  • B-cell neoplasm commonly seen in older African Americans
  • Chromosome 13 deletion is bad prognostic marker
  • Sx: CRAB (Calcium, Renal insufficiency, Anemia, Bone pain/lysis)
  • Labs: ↑ globulin, ↑ creatinine, ↑ calcium, ↓ albumin Rouleaux formation on smear, lytic punchout lesions on x-ray, Bence-Jones protein + (in urine)
  • Tx: chemo, steroids
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14
Q

MGUS

A
  • Serum protein M spike (<10%
  • No end organ damage
  • Common in elderly
  • 1% chance/year that MGUS → smoldering or multiple myeloma
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15
Q

What is Durie-Salmon staging used for and what is it based on?

A

Staging for multiple myeloma and based on B-2 micro globulin & serum albumin levels

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16
Q

Which is the most aggressive type of Non-Hodgkin’s B-cell lymphoma?

A

Burkitt’s

17
Q

What are the 4 types of Hodgkin’s Lymphoma?

A
  1. Nodular sclerosing (women)
  2. Lymphocyte depleted (men, EBV & HIV)
  3. Lymphocyte predominant (CD20+, tx: rituximab)
  4. Mixed cellularity (associated w/EBV)
18
Q

What are the 3 types of B-Cell Non-Hodgkin’s Lymphoma?

A
  1. Aggressive (Burkitt’s)
  2. Intermediate (diffuse large B-cell, mantle)
  3. Indolent (follicular, small lymphocytic)
19
Q

What are the 2 types of B-Cell Non-Hodgkin’s Lymphoma?

A
  1. Peripheral T cell lymphoma

2. Cutaneous T cell lymphoma

20
Q

Describe Hodgkin’s Ann Arbor Staging

A

Stage I - 1 lymph node
Stage II - 2 nodes above the diaphragm
Stage III - 2 or more nodes w/at least 1 below the diaphragm
Stage IV - multiple nodes and at least one organ

21
Q

What two conditions are related to multiple myeloma?

A
  1. Waldenström Macroglobulinemia (Ab overproduced is IgM)

2. Monoclonal gammopathy of undetermined significance (MGUS)

22
Q

Hodgkin’s Lymphoma

A
  • Associated w/EBV
  • CD30/15+ & CD15-
  • Sx: constitutional sxs (fever, fatigue, night sweats)(B sxs)
  • Labs: Reed-Sternberg cells (owl’s eye appearance & multi-lobed nuclei), PET-CT scan
  • Tx: chemo w/ABVD
23
Q

Adult T-cell Leukemia Lymphoma (ATLL)

A
  • Associated w/HTLV-1

* Sx: rash, generalized lymphadenopathy

24
Q

What are the two types of Cutaneous T-cell Lymphomas?

A
  1. Mycosis fungiodes (infiltrate skin)

2. Sezary syndrome (skin lesions infiltrate peripheral blood)

B&L Exam 2 (8 decks)

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