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PATHOMA > Ch. 6 - MDS > Flashcards

Ch. 6 - MDS Flashcards

1
Q

MDS is characterized by one or more peripheral blood (blanks) and with (blank) in one or more myeloid lines

A

cytopenias; dysplasia

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2
Q

T/F: there is an inevitable risk of developing leukemia from MDS

A

false

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3
Q

what is the poster child for MDS?

A

older male; 70

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4
Q

In MDS, what is the state of the blood and cellular maturation?

A

cyotpenic with variable maturation

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5
Q

In MPD, what is the state of the blood and cellular maturation?

A

cythemic with distinct maturation

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6
Q

in Acute leukemia, what is the state of the blood and cellular maturation?

A

variable blood state with no maturation

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7
Q

What are the IPSS thresholds for Hemoglobin, ANC and platelets for MDS?

A

Hgb:

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8
Q

Are there blasts in the periph. blood in refractory anemia?

A

no

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9
Q
A

refractory anemia

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10
Q

GREATER THAN 15% ringed sideroblasts,

A

refractory anemia with ringed sideroblasts (RARS)

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11
Q

The red cell population in RARS can be described as;

A

dimorphic

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12
Q

(blank) bodies are seen in the peripheral blood of RARS

A

Pappenheimer

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13
Q

Which two types of MDS are the most stable?

A

RA and RARS

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14
Q

Refractory anemia with excess blasts has (blank)cytopenia

A

pancytopenia

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15
Q

Auer rods immediately classifies the disorder as RAEB (1/2)

A

2

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16
Q
A

1

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17
Q

5-19% blasts and/or Auer rods is RAEB (1/2)

A

2

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18
Q

No Auer rods,

A

5q- syndrome

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19
Q

Which has the best prognosis:RARARSRAEB 1RAEB 2 5q- syndrome

A

5q- syndrome

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20
Q

Clonal cytogenetic abnormalities are present in (blank) percent of MDS cases

A

50

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21
Q

Initiating stimuli for MDS invovles (blank) damage

A

genetic

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22
Q

benzene exposure, cigarettes, family Hx of heme neoplasms lead to de novo (blank)

A

MDS

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23
Q

What are the three heritble syndromes that lead to MDS?

A

Fanconi’s AnemiaSchwachman-Diamond syndromeDiamond-Blackfan syndromeFDS: fuck dysplastic syndromes

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24
Q

Describe the general clinical appearance of someone with MDS?

A

Fatigue and weaknessPalorEcchymosesHemorrhageInfection

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25
Q

Anisocytosis and poikilocytosis indicate what about RBC morphology?

A

Aniso=different in sizePoikilo= different in shape

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26
Q

RBCS in MDS have an MCV >110fL, indicating:

A

macrocytosis

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27
Q

MDS presents with anemia, meaning the Hgb will be below:

A

10

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28
Q

Basophilic stippling, Howell-Joly bodies, membrane abnormlities, and the presence of a nucleus (when there shouldn’t be one) are abnormalities found in what cell line in MDS?

A

RBCs

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29
Q

what shape do the macrocytes take in MDS?

A

oval

30
Q

MDS presents with a cytopenia of what RBC maturation stage?

A

reticulocytopenia

31
Q

Canon-ball nucleus is a finding of fucked up (blank) cells

A

nucleated RBCs that definitely should not be there

32
Q

T/F: left shifted granulocytes are always present in MDS

A

false; sometimes only

33
Q

Describe the granulation of neutrophils in MDS?

A

Agranular or hypogranular

34
Q

Pseudo-Pelgeroid, hypersegmented, or ringed nuclei are found in (blank) cells in MDS

A

granulocytes

35
Q

T/F: MDS can present with both leukopenia and neutropenia

A

true

36
Q

In MDS are platelets larger or smaller than their normal size?

A

FUCKING GIANT

37
Q

t/f: mds can lead to both thrombocytopenia and thrombocytosis

A

true

38
Q

When we say “FUCKING GIANT” platelets, how big are talkin’?

A

the size of a goddamned RBC

39
Q
A

MDS; myelogenous leukemia

40
Q

T/F: In MDS, the bone marrrow can be normal, hypo, or hyper cellular

A

true

41
Q

T/F: it is common to have dysplasia in all myeloid lines in MDS

A

true

42
Q

The fuck is karyorrhexis and when do you see it?

A

destructive fragmentation of the nucleus of a dying cell whereby its chromatin is distributed irregularly throughout the cytoplasm. See that shit in dyserythropoesis

43
Q

Describe the nuclear findings of dyserythropoesis?

A

Karyorrhexis, irregular staining, ringed sideroblasts, nuclear budding, nuclear fragmentation, multinucleation

44
Q

Describe the cytoplasmic findings of dyserythropoesis?

A

Vacuolization, basophilic stippling, ringed sideroblasts

45
Q

In the bone marrow during dyserythropoesis, describe the size of the erythroid precursors?

A

Giant, just like everything else

46
Q

Describe the bone marrow findings of dysgranulopoesis?

A

Basically everything in both directions from normal:hypo/hypersegmentation of nucluesHypo or agranularAbsent secondary granules

47
Q

T/F: megakaryocytes can be up, down, or normal in MDS

A

true

48
Q

The fuck is a micromegakaryocyte and where the fuck do you find it?

A

in the bone marrow in MDS; its a dysplastic finding

49
Q

Hyperchromatic nuclear staining happens in what cell lineage in MDS?

A

megakaryocytes

50
Q

T/F: reticulocytopenia is found in the peripheral blood of all types of MDS

A

true

51
Q

T/F: oval macrocytes are found in the peripheral blood of all types of MDS

A

true

52
Q

In what two types of MDS do you see nomral WBCs and platelets with blasts less than 1% of peripheral blood?

A

RA and RARS

53
Q

Describe the differences in blast percentages in both the peripheral blood and bone marrow for RAEB 1 and 2

A

RAEB1:peripheral: 5bone marrow: 10-19

54
Q

RAEB (1/2) correlates with a higher risk of leukemia

A

RAEB 2

55
Q

Which RAEB prognosis correlates with blast percentage?

A

RAEB 1

56
Q

In what forms of MDS do you see monoctyes

A

RAEB 1 and 2

57
Q

In which RAEB are ringed sideroblasts present?

A

RAEB 1

58
Q

MDS may follow what two types of treatment?

A

chemo or radiation

59
Q

T/F: therapy related MDS has a favorable prognosis and resolves after finishing treatment

A

false; UNFAVORABLE prognosis with high risk of leukemia

60
Q

which two chromosomes are involved in MDS?

A

5 and 7

61
Q

Complex karyotypes involving >(blank) csome abnormalities are associated with a worse MDS prognosis

A

3

62
Q

Median survival worsens with increasing (blank) percentage and (blank) dysplasia

A

increasing blast percentage; trilineage dysplasia

63
Q

What percent of MDS pts undergo transformation to leukemia?

A

10-40%

64
Q

What IPSS MDS category is this?5-10% marrow blasts.variable karyotype2-3 peripheral cytopenias

A

0.5

65
Q

What IPSS MDS category is this?

A

0

66
Q

What IPSS MDS category is this?Abnormal csome 7 or more than 3 karytype abnormalities

A

1

67
Q

What IPSS MDS category is this?11-20% marrow blasts

A

1.5

68
Q

What IPSS MDS category is this?21-30% marrow blasts

A

2

69
Q

What two growth factors are given to treat MDS?

A

GM-CSF, EPO

70
Q

Chemo is given as Tx for a (better/worse) prognosis of MDS

A

worse

71
Q

T/F: bone marrow transplant is an Tx for MDS

A

true

72
Q

What type of chemo drugs do you give for MDS?

A

hypomethylating agents like 5-azacytidine and decitabine

PATHOMA (11 decks)

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