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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
Anisocytosis and poikilocytosis indicate what about RBC morphology?
Aniso=different in sizePoikilo= different in shape
26
RBCS in MDS have an MCV >110fL, indicating:
macrocytosis
27
MDS presents with anemia, meaning the Hgb will be below:
10
28
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?
RBCs
29
what shape do the macrocytes take in MDS?
oval
30
MDS presents with a cytopenia of what RBC maturation stage?
reticulocytopenia
31
Canon-ball nucleus is a finding of fucked up (blank) cells
nucleated RBCs that definitely should not be there
32
T/F: left shifted granulocytes are always present in MDS
false; sometimes only
33
Describe the granulation of neutrophils in MDS?
Agranular or hypogranular
34
Pseudo-Pelgeroid, hypersegmented, or ringed nuclei are found in (blank) cells in MDS
granulocytes
35
T/F: MDS can present with both leukopenia and neutropenia
true
36
In MDS are platelets larger or smaller than their normal size?
FUCKING GIANT
37
t/f: mds can lead to both thrombocytopenia and thrombocytosis
true
38
When we say "FUCKING GIANT" platelets, how big are talkin'?
the size of a goddamned RBC
39
MDS; myelogenous leukemia
40
T/F: In MDS, the bone marrrow can be normal, hypo, or hyper cellular
true
41
T/F: it is common to have dysplasia in all myeloid lines in MDS
true
42
The fuck is karyorrhexis and when do you see it?
destructive fragmentation of the nucleus of a dying cell whereby its chromatin is distributed irregularly throughout the cytoplasm. See that shit in dyserythropoesis
43
Describe the nuclear findings of dyserythropoesis?
Karyorrhexis, irregular staining, ringed sideroblasts, nuclear budding, nuclear fragmentation, multinucleation
44
Describe the cytoplasmic findings of dyserythropoesis?
Vacuolization, basophilic stippling, ringed sideroblasts
45
In the bone marrow during dyserythropoesis, describe the size of the erythroid precursors?
Giant, just like everything else
46
Describe the bone marrow findings of dysgranulopoesis?
Basically everything in both directions from normal:hypo/hypersegmentation of nucluesHypo or agranularAbsent secondary granules
47
T/F: megakaryocytes can be up, down, or normal in MDS
true
48
The fuck is a micromegakaryocyte and where the fuck do you find it?
in the bone marrow in MDS; its a dysplastic finding
49
Hyperchromatic nuclear staining happens in what cell lineage in MDS?
megakaryocytes
50
T/F: reticulocytopenia is found in the peripheral blood of all types of MDS
true
51
T/F: oval macrocytes are found in the peripheral blood of all types of MDS
true
52
In what two types of MDS do you see nomral WBCs and platelets with blasts less than 1% of peripheral blood?
RA and RARS
53
Describe the differences in blast percentages in both the peripheral blood and bone marrow for RAEB 1 and 2
RAEB1:peripheral: 5bone marrow: 10-19
54
RAEB (1/2) correlates with a higher risk of leukemia
RAEB 2
55
Which RAEB prognosis correlates with blast percentage?
RAEB 1
56
In what forms of MDS do you see monoctyes
RAEB 1 and 2
57
In which RAEB are ringed sideroblasts present?
RAEB 1
58
MDS may follow what two types of treatment?
chemo or radiation
59
T/F: therapy related MDS has a favorable prognosis and resolves after finishing treatment
false; UNFAVORABLE prognosis with high risk of leukemia
60
which two chromosomes are involved in MDS?
5 and 7
61
Complex karyotypes involving >(blank) csome abnormalities are associated with a worse MDS prognosis
3
62
Median survival worsens with increasing (blank) percentage and (blank) dysplasia
increasing blast percentage; trilineage dysplasia
63
What percent of MDS pts undergo transformation to leukemia?
10-40%
64
What IPSS MDS category is this?5-10% marrow blasts.variable karyotype2-3 peripheral cytopenias
0.5
65
What IPSS MDS category is this?
0
66
What IPSS MDS category is this?Abnormal csome 7 or more than 3 karytype abnormalities
1
67
What IPSS MDS category is this?11-20% marrow blasts
1.5
68
What IPSS MDS category is this?21-30% marrow blasts
2
69
What two growth factors are given to treat MDS?
GM-CSF, EPO
70
Chemo is given as Tx for a (better/worse) prognosis of MDS
worse
71
T/F: bone marrow transplant is an Tx for MDS
true
72
What type of chemo drugs do you give for MDS?
hypomethylating agents like 5-azacytidine and decitabine

PATHOMA (11 decks)

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