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OPT 537 > Exam 2 -- Hematology #2 > Flashcards

Exam 2 -- Hematology #2 Flashcards

1
Q

What two types of leukocytes make up the majority of WBCs? Which WBCs are least abundant?

A

Neutrophils and lymphocytes (B cells, T cells, and NK cells) make up about 90% of WBCs; basophils make up only 0.5%.

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2
Q

How long do WBCs live for?

A

3-4 days

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3
Q

Neutrophils are also known as polymorphic leukocytes (PMNs). What is their function?

A

Ingest and kill bacteria and damaged cells

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4
Q

What are a couple of causes of neutrophilia?

A

Smoking*, inflammation (gout, RA)

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5
Q

What are a couple of causes of neutropenia?

A

Chemotherapy, radiation; nutritional deficiency

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6
Q

B cells, T cells, and NK cells make up the lymphocytes. What is their function?

A

They respond to viral and bacterial infections; B cells create antibodies.

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7
Q

What is a common cause of lymphocytosis?

A

Smoking*

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8
Q

Monocytes, if found in the tissue, are called macrophages. What is their function?

A

They engulf and kill bacteria, create pro-inflammatory response to the infection, and clear cellular debris.

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9
Q

What is the function of eosinophils and basophils?

A

They release histamine, cytokines, heparin, and prostaglandins as part of allergic and infectious response.

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10
Q

What is a common cause of eosinophilia?

A

Parasitic infections

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11
Q

True or false: all hematologic malignancies are more common in Caucasians

A

False; leukemias and lymphomas are more common in Caucasians, multiple myeloma is more common in African Americans

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12
Q

Leukemia is an overprodution of either immature “blast” cells or mature WBCs. This overproduction can suppress production of _________________ and _________________

A

RBCs (Anemia) and platelets (thrombocytopenia) – these two are specifically low in AML (part of testing)

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13
Q

What are some of the signs and symptoms of leukemia?

A

Fatigue, fever, retinal hemorrhages, CWS, anemia, thrombocytopenia, abdominal discomfort (splendomegaly), weight loss, night sweats, headaches, recurrent infections, lymphadenopathy, bone pain

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14
Q

In terms of leukemia, what does the term “acute” mean?

A

It means that the symptoms occur relatively suddenly; it also refers to “blast” cells (immature) cells being involved. Generally, acute forms of leukemia are more common in children.

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15
Q

In terms of leukemia, what does the term “chronic” mean?

A

It means that the symptoms last over a longer period of time; it also refers to mature cells being involved. Generally, chronic forms of leukemia are more common in adults.

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16
Q

In AML, what are the myeloid precurors unable to do?

A

Mature, leading to accumulation of those immature forms.

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17
Q

What is the median age of onset for AML?

A

65 years

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18
Q

Which gender has a higher prevalence for AML? What factors are associated with its development?

A

Male; development is thought to be associated with chemical exposure and genetics

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19
Q

A CBC count would show what in a patient with AML?

A

High WBC, low RBC and low platelets

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20
Q

A blood smear in a patient with AML would show what?

A

Increased myeloblasts and Auer rods

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21
Q

What is the remission rate for AML?

A

40% of patients under 60 experience remission, but prognosis is worse for elderly males

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22
Q

How would you treat AML?

A

Chemotherapy, radiation, stem cell replacement, leukapheresis, hydration, antibiotics

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23
Q

What is the most common form of leukemia in children?

A

ALL; it accounts for 1/3 of all childhood cancers

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24
Q

The Philadelphia chromosome is a modified form of chromosome 22. What types of leukemia is the Philadelphia chromosome associated with?

A

CML (97% of CML patients); ALL (30-40% of ALL patients)

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25
Q

Which gender and age group has a higher prevalence for ALL?

A

Males 2-5 years

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26
Q

What sort of testing can be done for ALL?

A

CBC (looking for increased lymphoblasts); genetic testing

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27
Q

How would you treat ALL?

A

Chemotherapy, radiation, stem cell replacement, leukapheresis, hydration, antibiotics; neutropenic diet; tyrosine kinase inhibitors for patients with Philadelphia chromosome (helps decrease lymphoblast production)

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28
Q

How does the remission rate for ALL in children compare to that in adults?

A

Complete remission occurs in 80% of children but only 25-30% of adults

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29
Q

CML is characterized by uncontrolled production of mature WBCs. What percentage of adult leukemias are CML?

A

About 15%

30
Q

What is the peak onset age of CML?

A

50-60 years

31
Q

What genetic abnormality is seen in most patients with CML?

A

Philadelphia chromosome

32
Q

What is a blast crisis in CML?

A

It’s when blast cells can start showing up and causing problems. It occurs in a patient with CML if they go untreated for a long time. You’d want to treat a blast crisis as if this were an acute leukemia.

33
Q

What testing can be done for CML?

A

CBC looking for elevated WBC, and genetic testing for Philadelphia chromosome

34
Q

What are the treatment options for CML?

A

Tyrosine kinase inhibitors (Imatinib) results in a 95% response rate, chemotherapy, stem cell transplant

35
Q

What is the 5-year survival rate for CML?

A

90%

36
Q

True or false: CLL is the least common adult form of leukemia.

A

False; it is the most common adult form of leukemia, making up 1/3 of adult leukemias

37
Q

What is the median age of onset for CLL?

A

70 years

38
Q

What percentage of CLL arises from B cell proliferation?

A

95%

39
Q

Which gender is more affected by CLL?

A

Males

40
Q

What testing can be done for CLL?

A

CBC looking for elevated lymphocytes; blood smear (showing no blasts with normal-looking lymphocytes

41
Q

What are the treatment options for CLL?

A

Chemotherapy (Chlorambucil), stem cell transplant, radiation

42
Q

Although some patients with CLL die within 2-3 years, what is the median survival rate?

A

10 years

43
Q

Lymphomas are the ___________ most common malignancy in the Western world

A

5th

44
Q

True or false: lymphoma is the most common form of blood cancer

A

True.

45
Q

The lymphatic system is composed of what structures?

A

Lymph nodes, bone marrow, thymus, spleen, tonsils, GI tract

46
Q

The lymphatic system consists of B cells and T cells. What is the function of this system?

A

Fight infection, remove fluid from tissue

47
Q

Hodgkin’s lymphoma is slightly more common in _________________ (males/females)

A

Males

48
Q

Hodgkin’s lymphoma is associated with what virus?

A

Epstein-Barr Virus

49
Q

What is the peak age of onset for Hodgkin’s lymphoma?

A

It shows a bimodal distribution – about age 20 and age 65

50
Q

What are some of the symptoms that a patient with Hodgkin’s lymphoma might present with?

A

Painless enlargement of a lymph node, fever, night sweats, weight loss, pruritus (itching)

51
Q

What are some tests that can be done for Hodgkin’s lymphoma?

A

Lymph node biopsy showing Reed-Sternberg cells (“owl eyes”), PET scan, chest X-ray

52
Q

How would you treat Hodgkin’s lymphoma?

A

Chemotherapy and radiation

53
Q

What is the prognosis for a treated patient with Hodgkin’s lymphoma?

A

About 80% cured

54
Q

Which is more common, Hodgkin’s or non-Hodgkin’s lymphoma?

A

Non-Hodgkin’s lymphoma

55
Q

True or false: non-Hodgkin’s lymphoma has the same symptoms as Hodgkin’s lymphoma but can also progress to involve the CNS

A

True.

56
Q

True or false: non-Hodgkin’s lymphoma does not metastasize

A

False; it can metastasize

57
Q

The testing and treatment for non-Hodgkin’s lymphoma is the same as for Hodgkin’s lymphoma, with one exception. What is that exception?

A

Lymph node biopsy in non-Hodgkin’s lymphoma would not show Reed-Sternberg cells (no “owl eyes”)

58
Q

True or false: most patients with non-Hodgkin’s lymphoma survive 6-10 years from diagnosis

A

True.

59
Q

Burkitt’s lymphoma is a subtype of non-Hodgkin’s lymphoma and is the fastest growing human tumor. It is the most rapidly prolierating type of lymphoma, involving what type of lymphocyte?

A

B cells

60
Q

Which gender is more commonly affected by Burkitt’s lymphoma?

A

Male

61
Q

True or false: Burkitt’s lymphoma is associated with Epstein-Barr Virus

A

True.

62
Q

What is a typical presentation of a patient with Burkitt’s lymphoma?

A

Jaw or belly tumor, in a child

63
Q

Multiple myeloma is characterized by overproduction of what type of cells?

A

Plasma cells from bone marrow (secrete IgG, IgA, sometimes IgM)

64
Q

True or false: the median age of onset for multiple myeloma is below 50

A

False; it is over 60 years

65
Q

Which gender and ethnic group have a higher prevalence for multiple myeloma?

A

Males; African Americans

66
Q

True or false: multiple myeloma is the most common hematologic malignancy.

A

False; it is the second most common hematologic malignancy

67
Q

What are some of the signs and symptoms of multiple myeloma?

A

Bone pain (70%), spinal cord compression, increase in osteoclasts, hypercalcemia, real failure, anemia (73%), neutropenia, thrombocytopenia, recurrent infections

68
Q

What testing can be done for multiple myeloma?

A

Urine testing (looking for increased protein), X-ray (looking for decreased bone mass and “peper pot” defects in skull), bone marrow biopsy

69
Q

Though multiple myeloma is not curable, there are a few treatment options. What are they?

A

Chemotherapy, radiation therapy, bisphosphonates, stem cell transplant

70
Q

How long might you expect an individual with multiple myeloma to live, if they are treated?

A

5 years

OPT 537 (21 decks)

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