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DDX Blood Cancers Flashcards

1
Q

Polycythemia Vera would have which CBC findings?

A

Erythrocytosis, leukocytosis, thrombocytosis, with decreased EPO

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2
Q

Secondary Erythrocytosis has what EPO change?

A

Increased EPO

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3
Q

A Dx of Polycythemia Vera requires what next step?

A

Hematologist referral for bone marrow biopsy

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4
Q

A chem panel for polycythemia Vera would show?

A

Hyperuricemia, elevated LDH, and hypercholestremia

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5
Q

A patient presents with a history of gout and hypertension. Patient complains of significant pruritis. Physical exam shows splenomegaly. CBC leukocytosis, thrombocytosis and erythrocytosis. Dx?

A

Polycythemia Vera

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6
Q

Marked leukocytosis and thrombocytosis are hallmarks for which leukemia?

A

CML

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7
Q

Smudge cells and monotonous cells are characteristic of?

A

CLL

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8
Q

Leukocytosis, thrombocytopenia and anemia are all present in which leukemias

A

ALL, AML, CLL

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9
Q

Lymphocytosis is present in which 2 leukemias?

A

ALL, CLL

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10
Q

Most common leukemia adults?

A

CLL

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11
Q

What is the characteristic cell of AML?

A

Myeoblasts with auer rods

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12
Q

A Pel-Ebstein fever is characteristic of?

A

Hodgkin lymphoma

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13
Q

Which lymphoma is more likely to have distant spread and is also likely to convert to leukemia?

A

Non-Hodgkin

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14
Q

Which leukemia often converts to lymphoma?

A

CLL

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15
Q

Patient has lymph node px after drinking, most likely condition?

A

Hodgkins Lymphoma

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16
Q

What is the characteristic cell of Hodgkins Lymphoma

A

Reen Sternberg cells

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17
Q

What is the age distribution for Hodgkin lymphoma?

A

Bimodal
2 Peaks: 20-30 and 55+

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18
Q

T or F
Hodgkins lymphoma is painful.

A

False
Painless which increases malignancy risk

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19
Q

Frequency of lymph node involvement for lymphoma?

A

MC= Cervical
Then mediastinal, axillary, para-aortic
And usually unilateral

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20
Q

Alcohol induced pain is characteristic of…?

A

Hodgkin lymphoma

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21
Q

What is Pel-Ebstien fever and what is it characteristic of?

A

increased fever for 3-10 days with no known origin, then no fever for a few days, then repeats.
Hodgkin lymphoma

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22
Q

If you see this on a CBC what is the most likely Dx?
-May or may not have anemia
-Neutrophilia with leukocytosis
-Lymphocytopenia
-Eosinophilia
-increased ESR

A

Active Hodgkin lymphoma

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23
Q

What is the diagnostic triad for Hodgkins lymphoma

A
  1. Pel-Ebstein fever
  2. Pruitis
  3. Lymphadenopathy
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24
Q

Follow up managment for Hodgkins lymphoma?

A

Lymph node biopsy

25
What linage of cells are effected by Acute and Chronic forms of leukemia?
Acute- Blast cells Chronic- Resemble WBC "cytes" but not mature
26
What cells are effected by Myeloid or Lymphoid leukemia?
Myeloid- Monocytes, basophils, eosinophils, and neutrophils Lymphoid- B & T cells
27
Why do you typically see anemia and thrombocytopenia with leukemia?
Increase in WBC production in bone marrow takes up space and nutrients, causing a decrease in RBC and platelet production.
28
What additional tests can be done when suspecting leukemia?
comprehensive blood panel- will show increased LDH and increased uric acid ESR- will see a noticeable increase
29
Managment for leukemia?
Referral to hematologist or oncologist Bone marrow biopsy
30
What is the number one childhood cancer?
ALL Acute lymphoblastic leukemia
31
CBC shows: Leukocytosis (15K-50K) Anemia Thrombocytopenia Lymphoblasts (can be up to 25%) What is the most likely Dx?
ALL
32
What is the most common adult cancer?
CLL Chronic Lymphoblastic Leukemia
33
CBC shows: Leukocytosis Lymphocytosis (monotonous in shape) Anemia Thrombocytopenia Smudge cells What is the most likely Dx?
CLL
34
What would a chem panel show for CLL?
Hypogammaglobulinemia
35
If you have a patient over the age of 50, chronic fatigue with no known cause, lymphadenopathy and splenomegaly, CBC shows Lymphocytes over 50%, WBC over 15,000 What is the most likely Dx?
CLL
36
What is the SECOND most common adult cancer?
AML Acute Myeloid Leukemia
37
CBC shows: Leukocytosis Anemia Thrombocytopenia Myeloblast What is the most likely Dx?
AML
38
What type of leukemia has 3 clinical phases? And what phase are you most likely going to see in your office?
CML Chronic Myelogenous Leukemia Chronic phase. 85-90% of patients present in chronic phase and found accidentally during routine screenings. SSx; Insidious onset of nonspecific symptoms like fatigue, weakness, anorexia, weight loss, fever, night sweats, or abdominal fullness.
39
CBC shows: Leukocytosis (very high 200K-1Million) Anemia Thrombocytosis Possible Eosinophilia Possible Basophilia Myeloid cells in variable stages of development
CML
40
Philadelphia chromosome abnormality is a special test for what cancer?
CML
41
Pruitis can be found in what conditions/illness?
Lymphoma and Polycythemia vera
42
CBC shows: Erythrocytosis Leukocytosis Thrombocytosis (high potentially over 400K) And decreased EPO What is the most likely Dx?
Polycythemia Vera
43
CBC shows: Erythrocytosis WBC and platelets WNL EPO increased What is the most likely Dx?
Secondary Erythrocytosis
44
CBC shows: Erythrocytosis WBC and platelets WNL EPO WNL What is the most likely Dx?
Relative Erythrocytosis
45
What are some things that can cause Secondary Erythrocytosis?
Hypoxia (COPD, Emphysema, smoker, higher altitude, congestive heart failure) Renal tumor Testosterone injections
46
Dehydration causes what type of Erythrocytosis?
Relative Erythrocytosis
47
Gouty tophi or arthritis can be caused by what disorder and why?
Polycythemia Vera Because of increased RBC, as they break down the nuclei break down to give biproduct of uric acid.
48
On a Chem panel you see: Hyperuricemia Elevated LDH Hypercholesterolemia and EPO is decreased What is the most likely Dx?
Polycythemia vera
49
What is the management for Polycythemia Vera?
Hematologist for bone marrow biopsy. Then when confirmed phlebotomy, myelosuppressive therapy, maintain hydration, uric acid reducing therapy, diet avoiding iron supplements or organ meat.
50
Normal range for RBC?
Women 3.5-5.5 Mil/microL Men 4.3-5.9 Mil/microL
51
What is the normal hemoglobin ranges?
Women 14 g/dL +/- 2 (<11= anemia) Men 16 g/dL +/- 2 (<13= anemia)
52
What is the normal hematocrit range?
Women 37-47% Men 40-54%
53
Normal range for MCV?
80-100 FL
54
Anisocytosis is difference in size of RBC. <80 MCV=? >160 MCV=?
<80= microcytosis >160= macrocytosis
55
What is the normal RDW (variability in RBC)?
11-15%
56
What is the normal WBC count range?
4,500-11,000 /mL
57
Normal ranges for: Neutrophils Lymphocytes Monocytes Eosinophils Basophils
N= 50-70% L= 20-40% M= 2-10% E= 1-5% B= 0-1%
58
What is the normal range for platelets?
150,000-400,000 / microL
59
What is the range of platelets you would expect to see clinically evident bleeding like easily bruising or hemorrhage?
<70,000 / microL

Clinical Pathology (9 decks)

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