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clin path > clinpath 2: polycythemia and lymphoproliferative disorders > Flashcards

clinpath 2: polycythemia and lymphoproliferative disorders Flashcards

1
Q

what is polycythemia?

A

increased PCV. A better term would have been erythrocytosis.

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2
Q

relative polycythemia

A

hemoconcentration: It looks like its increased, but really the fluids is decreased. Dehydration is the most common causeFluid shifts (this can happen fairly suickly eg. Colitis)RedistributionExcitement and exercise (splenic contration)

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3
Q

absolute polycythemia

A

increased Epo that is either appropriate or inappropriate

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4
Q

appropriate increase

A

Chronic hypoxia, lung disease, heart disease

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5
Q

inappropriate

A

EPO secretion renal cysts, tumors (this one is not very common)- fooling the cells into thinking that they are hypoxic.

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6
Q

primary polycythmia

A

is a myeloproliferative disorder where all cell lines are affected

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7
Q

what is leukemia

A

presence of neoplastic cells in peripheral blood and/or bone marrow or spleen.

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8
Q

aleukemic leukemia

A

no white cells

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9
Q

subleukemic leukemia

A

normal white cells

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10
Q

leukemic leukemia

A

drastically high white cells

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11
Q

what is the difference bt acute and chronic leukemia

A

acute tends to have a lower degree of maturation, and therefore the prognosis is very poor with survival times being low (20% more more blast cells in the marrow) chronic leukemia tends to be characterized by mature white cells and the survival time is longer

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12
Q

lymphoproliferative disorders are

A

lymphocytes and plasma cells

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13
Q

myeloproliferative disorders

A

are cells of the bone marrow stem cells: neutrophils, erythrocytes, rarely eosinophils and basophils

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14
Q

> 35000 is>15000 and erlichia negative

A

is leukemia!!!!!!

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15
Q

acute lymphoblastic leukemia (ALL)

A

Differentiate from stage V lymphomaLots of dogs presenting with multicentric lymphoma are leukemia50% of dogs with ALL will have lymphadenopathy

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16
Q

CBC associated with acute lymphoblastic leukemia

A
  • Thrombocytopenia - Lymphocytosis (usually) - lymphoblasts in the bloodPrognosis is poor, course is rapid and progressive and respond poorly to therapyCats are usually younger and FeLV positive.
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17
Q

Chronic lymphocytic leukemia

A

Cells are small and appear well differentiatedMost common in dogs, but can be in other species. Way more common in dogs than cats. Differentiate from other causes of lymphocytosisIf >35,000 its leukemia, but it can be lower and still be leukemia

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18
Q

two ddxs for chronic lymphocytic leukemia

A

stress/ excitement in cats; cat scratch fever

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19
Q

clinical signs of chronic lymphocytic leukemia

A

can either be asymptomatic, ill, lethargic, anorexia, pale mucosal membranes, lymphadenopathy, splenomegaly, hepatomegaly

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20
Q

lab findings chronic lymphocytic leukemia

A

Lymphocytosis(slightly greater to above 300,000Maybe anemia, thrombocytopeniaIncreased small lymphs in the bone marrowRarely monoclonal gammopathyCats are usually Fe-LV negative

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21
Q

CD 8

A

T cell

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22
Q

CD21

A

Bcell

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23
Q

CD 4-8-5

A

abberant T cells

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24
Q

CD34+

A

proginator cells

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25
Q

Multiple myeloma

A

Proliferation of plasma cells at various sites of the bone marrow and eventually other tissuesRelease into the peripheral blood happens, but its in small numbers. If a leukemia is lumped on, then survival time is very lowOn the left you see flame cells, they have an eccentric nucleus, and the immunoglobulin is not released. This accounts for the pink color

also a monoclonal gammopathy

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26
Q

signs of multiple myeloma

A

Depends on where the neoplastic plasma cells are.Also related to the immunoglobulins produced which result in hyperviscosisty of the blood. This can manifest as neurological signs. Also depends on the Ig. IgG there is not as much viscosity as IgM.

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27
Q

you seeMore than 20% plasma cells in the bone marrow, but this can also happen in antigenic stimulation, so you should differentiate from this.Monoclonal or biclonal gammopathy (igG and IgA) and this is referred to as a paraproteinBence jones proteins in the urine (the remanants of the light chains when Igs break up). These proteins cannot be picked up by dip sticks. Maybe send in fpr protein electrophoresis.Light chain disease (when the cells just produce the light chains). When this happens, you can miss a multiple myeloma because everything is going into the urine.Thrombocytopenia ( and the platelets will also fail to work), maybe. Depends on what is happeneing in the bone marrow

A

multiple myeloma

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28
Q

what is polycythemia?

A

increased PCV. A better term would have been erythrocytosis.

How well did you know this?
1
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2
3
4
5
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29
Q

relative polycythemia

A

hemoconcentration: It looks like its increased, but really the fluids is increased. Dehydration is the most common causeFluid shifts (this can happen fairly suickly eg. Colitis)RedistributionExcitement and exercise (splenic contration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

absolute polycythemia

A

increased Epo that is either appropriate or inappropriate

How well did you know this?
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31
Q

appropriate increase

A

Chronic hypoxia, lung disease, heart disease

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32
Q

inappropriate

A

EPO secretion renal cysts, tumors (this one is not very common)- fooling the cells into thinking that they are hypoxic.

How well did you know this?
1
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2
3
4
5
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33
Q

primary polycythmia

A

is a myeloproliferative disorder where all cell lines are affective

How well did you know this?
1
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2
3
4
5
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34
Q

what is leukemia

A

presence of neoplastic cells in peripheral blood and/or bone marrow or spleen.

How well did you know this?
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35
Q

aleukemic leukemia

A

no white cells

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36
Q

subleukemic leukemia

A

normal white cells

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37
Q

leukemic leukemia

A

drastically high white cells

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38
Q

what is the difference bt acute and chronic leukemia

A

acute tends to have a lower degree of maturation, and therefore the prognosis is very poor with survival times being low (20% more more blast cells in the marrow) chronic leukemia tends to be characterized by mature white cells and the survival time is longer

How well did you know this?
1
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39
Q

lymphoproliferative disorders are

A

lymphocytes and plasma cells

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40
Q

myeloproliferative disorders

A

are cells of the bone marrow stem cells: neutrophils, erythrocytes, rarely eosinophils and basophils

How well did you know this?
1
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2
3
4
5
Perfectly
41
Q

> 35000 is>15000 and erlichia negative

A

is leukemia!!!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

acute lymphoblastic leukemia (ALL)

A

Differentiate from stage V lymphomaLots of dogs presenting with multicentric lymphoma are leukemia50% of dogs with ALL will have lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

CBC associated with acute lymphoblastic leukemia

A
  • Thrombocytopenia - Lymphocytosis (usually) - lymphoblasts in the bloodPrognosis is poor, course is rapid and progressive and respond poorly to therapyCats are usually younger and FeLV positive.
44
Q

Chronic lymphocytic leukemia

A

Cells are small and appear well differentiatedMost common in dogs, but can be in other species. Way more common in dogs than cats. Differentiate from other causes of lymphocytosisIf >35,000 its leukemia, but it can be lower and still be leukemia

45
Q

two ddxs for chronic lymphocytic leukemia

A

stress in catscat scratch fever

46
Q

clinical signs of chronic lymphocytic leukemia

A

can either be asymptomatic, ill, lethargic, anorexia, pale mucosal membranes, lymphadenopathy, splenomegaly, hepatomegaly

47
Q

lab findings chronic lymphocytic leukemia

A

Lymphocytosis(slightly greater to above 300,000Maybe anemia, thrombocytopeniaIncreased small lymphs in the bone marrowRarely monoclonal gammopathyCats are usually Fe-LV negative

48
Q

CD 8

A

T cell

49
Q

CD21

A

Bcell

50
Q

CD 4-8-5

A

abberant T cells

51
Q

CD34+

A

proginator cells

52
Q

Multiple myeloma

A

Proliferation of plasma cells at various sites of the bone marrow and eventually other tissuesRelease into the peripheral blood happens, but its in small numbers. If a leukemia is lumped on, then survival time is very lowOn the left you see flame cells, they have an eccentric nucleus, and the immunoglobulin is not released. This accounts for the pink color

53
Q

signs of multiple myeloma

A

Depends on where the neoplastic plasma cells are.Also related to the immunoglobulins produced which result in hyperviscosisty of the blood. This can manifest as neurological signs. Also depends on the Ig. IgG there is not as much viscosity as IgM.

54
Q

you seeMore than 20% plasma cells in the bone marrow, but this can also happen in antigenic stimulation, so you should differentiate from this.Monoclonal or biclonal gammopathy (igG and IgA) and this is referred to as a paraproteinBence jones proteins in the urine (the remanants of the light chains when Igs break up). These proteins cannot be picked up by dip sticks. Maybe send in fpr protein electrophoresis.Light chain disease (when the cells just produce the light chains). When this happens, you can miss a multiple myeloma because everything is going into the urine.Thrombocytopenia ( and the platelets will also fail to work), maybe. Depends on what is happeneing in the bone marrow

A

multiple myeloma

55
Q

what is polycythemia?

A

increased PCV. A better term would have been erythrocytosis.

56
Q

relative polycythemia

A

hemoconcentration: It looks like its increased, but really the fluids is increased. Dehydration is the most common causeFluid shifts (this can happen fairly suickly eg. Colitis)RedistributionExcitement and exercise (splenic contration)

57
Q

absolute polycythemia

A

increased Epo that is either appropriate or inappropriate

58
Q

appropriate increase

A

Chronic hypoxia, lung disease, heart disease

59
Q

inappropriate

A

EPO secretion renal cysts, tumors (this one is not very common)- fooling the cells into thinking that they are hypoxic.

60
Q

primary polycythmia

A

is a myeloproliferative disorder where all cell lines are affective

61
Q

what is leukemia

A

presence of neoplastic cells in peripheral blood and/or bone marrow or spleen.

62
Q

aleukemic leukemia

A

no white cells

63
Q

subleukemic leukemia

A

normal white cells

64
Q

leukemic leukemia

A

drastically high white cells

65
Q

what is the difference bt acute and chronic leukemia

A

acute tends to have a lower degree of maturation, and therefore the prognosis is very poor with survival times being low (20% more more blast cells in the marrow) chronic leukemia tends to be characterized by mature white cells and the survival time is longer

66
Q

lymphoproliferative disorders are

A

lymphocytes and plasma cells

67
Q

myeloproliferative disorders

A

are cells of the bone marrow stem cells: neutrophils, erythrocytes, rarely eosinophils and basophils

68
Q

> 35000 is>15000 and erlichia negative

A

is leukemia!!!!!!

69
Q

acute lymphoblastic leukemia (ALL)

A

Differentiate from stage V lymphomaLots of dogs presenting with multicentric lymphoma are leukemia50% of dogs with ALL will have lymphadenopathy

70
Q

CBC associated with acute lymphoblastic leukemia

A
  • Thrombocytopenia - Lymphocytosis (usually) - lymphoblasts in the bloodPrognosis is poor, course is rapid and progressive and respond poorly to therapyCats are usually younger and FeLV positive.
71
Q

Chronic lymphocytic leukemia

A

Cells are small and appear well differentiatedMost common in dogs, but can be in other species. Way more common in dogs than cats. Differentiate from other causes of lymphocytosisIf >35,000 its leukemia, but it can be lower and still be leukemia

72
Q

two ddxs for chronic lymphocytic leukemia

A

stress in catscat scratch fever

73
Q

clinical signs of chronic lymphocytic leukemia

A

can either be asymptomatic, ill, lethargic, anorexia, pale mucosal membranes, lymphadenopathy, splenomegaly, hepatomegaly

74
Q

lab findings chronic lymphocytic leukemia

A

Lymphocytosis(slightly greater to above 300,000Maybe anemia, thrombocytopeniaIncreased small lymphs in the bone marrowRarely monoclonal gammopathyCats are usually Fe-LV negative

75
Q

CD 8

A

T cell

76
Q

CD21

A

Bcell

77
Q

CD 4-8-5

A

abberant T cells

78
Q

CD34+

A

proginator cells

79
Q

Multiple myeloma

A

Proliferation of plasma cells at various sites of the bone marrow and eventually other tissuesRelease into the peripheral blood happens, but its in small numbers. If a leukemia is lumped on, then survival time is very lowOn the left you see flame cells, they have an eccentric nucleus, and the immunoglobulin is not released. This accounts for the pink color

80
Q

signs of multiple myeloma

A

Depends on where the neoplastic plasma cells are.Also related to the immunoglobulins produced which result in hyperviscosisty of the blood. This can manifest as neurological signs. Also depends on the Ig. IgG there is not as much viscosity as IgM.

81
Q

you seeMore than 20% plasma cells in the bone marrow, but this can also happen in antigenic stimulation, so you should differentiate from this.Monoclonal or biclonal gammopathy (igG and IgA) and this is referred to as a paraproteinBence jones proteins in the urine (the remanants of the light chains when Igs break up). These proteins cannot be picked up by dip sticks. Maybe send in fpr protein electrophoresis.Light chain disease (when the cells just produce the light chains). When this happens, you can miss a multiple myeloma because everything is going into the urine.Thrombocytopenia ( and the platelets will also fail to work), maybe. Depends on what is happeneing in the bone marrow

A

multiple myeloma

82
Q

are lytic lesions of the bone probable with multiple myeloma

A

yes, they are. look for aspects like cord compression

83
Q

impaired platelet function is something else you may see with multiple myeloma

A

Yes

84
Q

signs of multple myeloma are

A

lethargy, anorexia, lameness, bleeding from the nares, PU/PD

fundoscopic changes

kidney: impaired tubular and glomerular function from excess protein;mineralization of kidneys secondary to hypercalcemia

neurological signs secondary to viscous blood

25% of dogs may have a bleeding disorder

85
Q

signs in cats of multiple myeloma

A

atypical plasma cell morphology

anemia

bone lesions

organ involvement

86
Q

definitions of myeloid neoplasms

A

lack of normal cell in the blood or the presence of neoplastic cels at the lvl of the bone marrow (dysplasia)

87
Q

T/F myelodysplastic syndromes and myeloproliferative neoplasms are both gradual in progression

A

true

88
Q

acute myeloid leukemias are rapid in progression

A

True

89
Q

myelodysplasic syndromes lab signs

A

RBCs and RBC precursors are abnormal is size leading to macrocytosis and anisocytosis

dudsynchrony of nuclear and cytoplasmic maturation

cytopenia in a singla or all lines

animals will be sick and have a bad prognosis

90
Q

T/F myelodysplastic syndromes are usually not preleukemic

A

False, they ARE preleukemic….usually

91
Q

to define an acute myloid leukemia, ___% or greater blast cells in the bone marrow must be present

A

20%

92
Q

is it possible for mylouid leukemia cells to be present in the peripheral blood

A

yes it is

93
Q

T/F undifferentiated leukemias have the most underdeveloped cells and cannot be classified

what species are undifferentiated leukemias present in

A

True

cats

94
Q

ultrastructural cytochemistry or immunochemistry can be used to classify ______

A

undifferentiated leukemia

95
Q

on bone marrow aspirate, if you see more than 90% blasts with less than 10% undifferentiated. What might you be looking at, but you can tell that they are granulocytic

A

myeloblastic leukemia

96
Q

20% blasts but 10% differentiated granulocytes

Often may promyelocytes

A

myeloblastic leukemia with differentiation

97
Q

True/ False. Immune mediated neutropenia can appear similar to granulocytic leukemia

A

False

98
Q

T/F. Myelomonocytic leukemia:

Myeloblasts and monoblasts are >20% in the BM

A

True

99
Q

Monocytic leukemmia (M5)

A

M5a Promonocytes and monoblasts >80% of non erythroid cells

M5b >20% to < 80% promonocytes and monoblasts

100
Q

erythroid leukemia

A

Erythroid >50%, myelobalsts and monoblasts and <20%

M6ER if most blasts are erythroid, called erythremic myelosis

101
Q

megakaryoblastic leukemia

A

> 20% megakaryoblasts and increased in the blood

102
Q

is it possible to see megakaryoblastic leukemia can include____ and ____

A

thrombocytopenia and thrombocytosis

neutropenia?

103
Q

T/F. Chronic granulocytic leukemia is more common in dogs than in cats

A

True

104
Q

maifests as a marked neutrophilia, left shift and often a monocytosis. You see hypersegmented nuclei and giant metamyelocytes, and bands

A

chronic granulocytic leukemia

105
Q

DDxs for chronic granulocytic leukemias

A

MDS, but CGL has marked leukocytosis

inflammatory or leukemoid reactions

106
Q

eosinophilc leukemia is rare, but when it is seen, it is usually in ___ with___

A

cats; FeLV

107
Q

DDx for eosinophilic leukemia

A

hypereosinophilic syndrome

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