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3 Haematology > Concepts in Malignant Haematology > Flashcards

Concepts in Malignant Haematology Flashcards

1
Q

how do you identify non-lymphoid cells from lymphoid cells?

A

morphology eg by blood count or film

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2
Q

how can you identify normal stem cells from other cells?

A

immunophenotyping

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3
Q

CD34 is an antigen often expressed on what cells…

A

stem cells

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4
Q

malignant haemopoiesis is characterised by 2 things, what are they?

A

inc numbers of abnormal + dysfunctional cells

loss of normal activity

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5
Q

what can cause blood cells to become dysfunctional or abnormal?

A

inc proliferation

lack of differentiation/maturation/apoptosis

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6
Q

what is the problem in acute leukaemia?

A

problem with differentiation/maturation of progenitor cells

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7
Q

describe levels of progenitor and differentiated cells in leukaemia

A

high progenitor cells (cant divide)

low differentiated cells

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8
Q

what kind of leukaemia DOES have normal differentiation of cells

A

chronic (only acute doesnt have differentiation of cells)

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9
Q

what is the problem in chronic leukaemia?

A

too many normal cells

differentiation/maturation is normal

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10
Q

what kind of mutation causes clonal expansion?

A

driver mutation

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11
Q

what is a “clone” in genetics

A

population of daughter cells derived from a single parent cells

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12
Q

how are clones helpful in cancer?

A

the parent cell has a genetic marker so you can trace the daughter cells back to their original parent cell because they will have the marker too

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13
Q

normal haemopoiesis is __clonal

A

poly

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14
Q

malignant haemopoiesis is __clonal

A

mono

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15
Q

monoclonal haemopoiesis…..

A

CANCER UNTIL PROVEN OTHERWISE

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16
Q

2 main branches of leukaemia

A

myeloid

lymphoid

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17
Q

if you have a cancer of your primitive lymphoid progenitor cells what is it called?

A

acute lymphoblastic leukaemia

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18
Q

if you have a cancer of your mature lymphoid cells what is it called?

A

CLL

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19
Q

what cancer can involve both blood and lymph nodes?

A

CLL

20
Q

what is a myeloma?

A

cancer of plasma cells in the marrow

21
Q

acute/chronic leukaemia is more severe

A

acute

22
Q

describe features of aggressive cancer on histology

A

large cells with a big nucleus and nucleolus

rapid proliferation

23
Q

how does bone marrow function differ between acute and chronic leukaemias?

A

acute has failure of BM function, chronic doesnt

24
Q

chronic myeloid leukaemias tend to affect what cells of the haemopoesis tree

A

stem cells

25
Q

acute myeloid leukaemias tend to affect what cells of the haemopoesis tree

A

primitive precursor cells

26
Q

lymphomas tend to occur when problems arise in the maturation of what cell?

A

B cells

27
Q

excess of blasts in the blood or bone marrow…

A

acute leukaemia

28
Q

what are lymphoid progenitor cells collectively called?

A

lymphoblasts

29
Q

most common childhood cancer?

A

acute lymphoblastic leukaemia?

30
Q

clinical presentation of ALL

A

outside involvement eg CNS/testis
bone pain
marrow failure symptoms

31
Q

what are symptoms of marrow failure

A

anaemia
infections
bleeding

32
Q

who gets ALL

A

children

33
Q

who gets AML

A

elderly >60

34
Q

presentation of AML

A 
outside involvement eg CNS/testis
bone pain
marrow failure symptoms
gum infiltration
DIC

NB VERY SIMILAR TO “ALL”

35
Q

Ix acute leukaemia

A
  1. blood count and film
  2. coag screen
  3. bone marrow aspirate for film and immunophenotyping
36
Q

describe a blood film of acute leukaemia

A

presence of auer rods
reduction in normal cells
presence of abnormal cells eg high nuclear:cytoplasmic ratio

37
Q

morphological characteristic of AML

A

auer rods

38
Q

what Ix provides a DEFINITIVE diagnosis

A

immunophenotyping

39
Q

if bone marrow aspiration is contra-indicated/not helpful what could you do?

A

take a trephine (piece of bone)

40
Q

Tx acute leukaemia

A

chemo

41
Q

chemo is inserted via what line in leukaemia?

A

hickman line

42
Q

complications of marrow suppression?

A

anaemia
neutropaenia
thrombocytopaenia

43
Q

neutropenic patients are at risk of sepsis from what organisms (state the most and 2nd most likely)

A
  1. gram NEGATIVE bacteria

2. fungi

44
Q

what drug used in leukaemia can cause cardiomyopathy?

A

anthracyclines

45
Q

what is defined as remission in leukaemia

A

<5% marrow blasts with recovery of normal haemopoiesis

46
Q

you are more likely to be cured of ALL in childhood/adulthood

A

childhood

3 Haematology (30 decks)

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