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Heme and Lymph Final > CIS: Leukemias and Lymphomas and White Cell disorders > Flashcards

CIS: Leukemias and Lymphomas and White Cell disorders Flashcards

1
Q

Definition of Leukemia

A

autonomous clonal proliferation of malignant cells that proliferate in the bone marrow and usually are readily observable in the peripheral blood

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2
Q

Acute leukemia

A

the cells represent immature precursor cells

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3
Q

chronic leukemia

A

the cells are more mature appearing cells

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4
Q

What disease is Benzene associated with?

A

AML

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5
Q

What is the big risk factor for leukemias?

A

alkylators

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6
Q

What is radiation not associated with

A

CLL

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7
Q

To look like a rockstar, what should we offer as a diagnosis in older patients with mild pancytopenia and macrocytosis?

A

myelodysplasia or early AML

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8
Q

What does the 9-22 translocation give us?

A

the BCR-ABL proto-oncogene

-fusion gene with tryosine kinase activity

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9
Q

What is 9;22 associated with?

A

CML

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10
Q

What is 15;17 associated with

A

APL

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11
Q

How do acute leukemias present generally?

A

very rapid onset and clinical course

-if untreated the median duration of survival for adult acute leukemia is 3 months or less

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12
Q

How do chronic leukemias present generally?

A
  • slow onset and chronic course
  • half of all patients with chronic lymphocytic leukemia are still alive and have not required treatment 6 years after diagnosis
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13
Q

What do most patients with leukemia present with?

A
  • hx of fever, easy bruisability, fatigue, weight loss, or shortness of breath
  • in acute leukemias (ALL) patients often complain of bone pain
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14
Q

What labwork gives us the suspicious of chronic leukemia usually?

A

CBC done as part of a routine workup for another problem

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15
Q

At the time of diagnosis, how are most patients with chronic leukemias?

A

asymptomatic

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16
Q

What is Sweet’s syndrome?

A
  • acute febrile neutrophilic dermatosis (AFND)

- Cutaneous manifestation of AML…. bx demonstrates myelopblasts in the dermis (histiocytic variant of AFND)

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17
Q

What do we not want to confuse sweet’s syndrome with?

A

pyoderma gangrenosum

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18
Q

Tx of sweet’s syndrome?

A

management of AML

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19
Q

What are Auer Rods?

A

azurophilic rods in the cytoplasm of patients with AML

-may resemble a bundle of sticks in some cells of patients with APL

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20
Q

If the Auer rods look like a bundle of sticks in cells, what do we call those cells?

A

faggot cells

21
Q

If we see gingival hypertrophy, what should we think of?

A

most common in the M4 and M5 variants of AML

22
Q

What do we think of when we see smudge cells?

A

CLL

23
Q

What do we treat people with APL t(15;17) with?

A

ATRA

-all trans retinoic acid

24
Q

What can APL (acute promyelocytic leukemia) drive ?

A

DIC

-fibrinogen will be low

25
Q

What weird neuro finding is ALL associated with?

A

leptomeningeal carcinomatosis

26
Q

What nerve will get damaged in ALL?

A

CN6 because it is the longest nerve up there

27
Q

What translocation is ALL in that 18 year old girl?

A

t(4;11)

28
Q

What do we treat the leptomeningeal carcinomatosis from the ALL with?

A

intrathecal methotrexate

29
Q

What do we use to deliver intrathecal therapy?

A

ommaya reservoir

30
Q

What is intrathecal therapy?

A

injection of drugs into the spinal canal

31
Q

When I say TRAP test, you say

A

Hair Cell Leukemia

32
Q

name and describe the Rai stages?

A
  • 0: lymphocytosis only (>15,000)
  • 1: + LAD
  • 2: + splenomegaly
  • 3: + anemia
  • 4: + thrombocytopenia
33
Q

What is the Rai staging used for?

A

CLL

34
Q

How are lymph nodes in lymphomas?

A

typically non-tender and rubbery in consistency

35
Q

What happens after drinking beer with Hodgkin lymphoma?

A

pain in lymph nodes

36
Q

What can suggest retroperitoneal lymph node enlargement

A

Back pain and leg edema

37
Q

What is Richter’s syndrome?

A

when ppl with CLL develop DLBCL

-represents clonal evolution with additional cytogenetic abnormalities… tough to kill

38
Q

What are B symptoms?

A
  • important
  • fever, drenching night sweats, 10% weight loss in previous 6 months
  • likely paraneoplastic and associated with worse prognosis
39
Q

What are Immunosuppressed patients at increased risk for?

A

primary CNS lymphoma

40
Q

What infectious agents can lymphomas be linked to?

A

EBV- HD, Burkitt

H. pylori… gastric MALToma

41
Q

What should we consider if we see patients with cervical adenopathy?

A

infection
lymphoma
unusual disorders

42
Q

What is D-dimer?

A

a fibrin degradation product

43
Q

What is more common, benign causes of leukocytosis or malignant ones?

A

benign

-same goes for neutropenia

44
Q

What is a very general thing that can cause leukocytosis?

A

inflammation

45
Q

What is another thing that he had listed three times that can cause leukocytosis?

A

Drugs, drugs, DRUGS

-same for neutropenia

46
Q

In a smoker who has neutrophilia, what may be responsible for raising the count?

A

smoking….

47
Q

What’s a weird thing that might cause neturopenia?

A

infections

-and drugs too

48
Q

What should we suggest as being responsible for a patient with neutropenia?

A

medications, nutritional deficiencies, or sequestration

Heme and Lymph Final (14 decks)

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