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Clinical Pathology > DDX Blood Cancers > Flashcards

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
Q

What linage of cells are effected by Acute and Chronic forms of leukemia?

A

Acute- Blast cells
Chronic- Resemble WBC “cytes” but not mature

26
Q

What cells are effected by Myeloid or Lymphoid leukemia?

A

Myeloid- Monocytes, basophils, eosinophils, and neutrophils
Lymphoid- B & T cells

27
Q

Why do you typically see anemia and thrombocytopenia with leukemia?

A

Increase in WBC production in bone marrow takes up space and nutrients, causing a decrease in RBC and platelet production.

28
Q

What additional tests can be done when suspecting leukemia?

A

comprehensive blood panel- will show increased LDH and increased uric acid
ESR- will see a noticeable increase

29
Q

Managment for leukemia?

A

Referral to hematologist or oncologist
Bone marrow biopsy

30
Q

What is the number one childhood cancer?

A

ALL Acute lymphoblastic leukemia

31
Q

CBC shows:
Leukocytosis (15K-50K)
Anemia
Thrombocytopenia
Lymphoblasts (can be up to 25%)
What is the most likely Dx?

32
Q

What is the most common adult cancer?

A

CLL Chronic Lymphoblastic Leukemia

33
Q

CBC shows:
Leukocytosis
Lymphocytosis (monotonous in shape)
Anemia
Thrombocytopenia
Smudge cells
What is the most likely Dx?

34
Q

What would a chem panel show for CLL?

A

Hypogammaglobulinemia

35
Q

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?

36
Q

What is the SECOND most common adult cancer?

A

AML Acute Myeloid Leukemia

37
Q

CBC shows:
Leukocytosis
Anemia
Thrombocytopenia
Myeloblast
What is the most likely Dx?

38
Q

What type of leukemia has 3 clinical phases? And what phase are you most likely going to see in your office?

A

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
Q

CBC shows:
Leukocytosis (very high 200K-1Million)
Anemia
Thrombocytosis
Possible Eosinophilia
Possible Basophilia
Myeloid cells in variable stages of development

40
Q

Philadelphia chromosome abnormality is a special test for what cancer?

41
Q

Pruitis can be found in what conditions/illness?

A

Lymphoma and Polycythemia vera

42
Q

CBC shows:
Erythrocytosis
Leukocytosis
Thrombocytosis (high potentially over 400K)

And decreased EPO

What is the most likely Dx?

A

Polycythemia Vera

43
Q

CBC shows:
Erythrocytosis
WBC and platelets WNL

EPO increased

What is the most likely Dx?

A

Secondary Erythrocytosis

44
Q

CBC shows:
Erythrocytosis
WBC and platelets WNL

EPO WNL

What is the most likely Dx?

A

Relative Erythrocytosis

45
Q

What are some things that can cause Secondary Erythrocytosis?

A

Hypoxia (COPD, Emphysema, smoker, higher altitude, congestive heart failure)
Renal tumor
Testosterone injections

46
Q

Dehydration causes what type of Erythrocytosis?

A

Relative Erythrocytosis

47
Q

Gouty tophi or arthritis can be caused by what disorder and why?

A

Polycythemia Vera
Because of increased RBC, as they break down the nuclei break down to give biproduct of uric acid.

48
Q

On a Chem panel you see:
Hyperuricemia
Elevated LDH
Hypercholesterolemia
and EPO is decreased
What is the most likely Dx?

A

Polycythemia vera

49
Q

What is the management for Polycythemia Vera?

A

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
Q

Normal range for RBC?

A

Women 3.5-5.5 Mil/microL
Men 4.3-5.9 Mil/microL

51
Q

What is the normal hemoglobin ranges?

A

Women 14 g/dL +/- 2 (<11= anemia)
Men 16 g/dL +/- 2 (<13= anemia)

52
Q

What is the normal hematocrit range?

A

Women 37-47%
Men 40-54%

53
Q

Normal range for MCV?

54
Q

Anisocytosis is difference in size of RBC.
<80 MCV=?
>160 MCV=?

A

<80= microcytosis
>160= macrocytosis

55
Q

What is the normal RDW (variability in RBC)?

56
Q

What is the normal WBC count range?

A

4,500-11,000 /mL

57
Q

Normal ranges for:
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils

A

N= 50-70%
L= 20-40%
M= 2-10%
E= 1-5%
B= 0-1%

58
Q

What is the normal range for platelets?

A

150,000-400,000 / microL

59
Q

What is the range of platelets you would expect to see clinically evident bleeding like easily bruising or hemorrhage?

A

<70,000 / microL

Clinical Pathology (9 decks)

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