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Hematology And Oncology > FA + MTB 3 > Flashcards

FA + MTB 3 Flashcards

1
Q

T cell ALL can present as

A

Mediastinal mass (presenting as SVC-like syndrome)

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2
Q

Acute lymphoblastic leukemia/lymphoma (ALL)-better prognosis if

A

t(12;21)

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3
Q

Acute lymphoblastic leukemia/lymphoma (ALL) may spread to

A

CNS and testes

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4
Q

Acute lymphoblastic leukemia/lymphoma (ALL) markers

A
  1. TdT+ (pre-T and pre-B cells)

2. CD10+ (pre-B cells only)

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5
Q

CLL markers

A

CD20 and CD5 and CD23 B cell neoplasm

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6
Q

Smudge cells in the peripheral smear leukemia

A

CLL

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7
Q

Richter transformation

A

CLL/SLL transformation into aggressive large B cell lymphoma

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8
Q

Hairy cell leukemia

Age and type of cells

A

Adults males

Mature B cells (with hair-like cells projections) –> fuzzy appearing on LM

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9
Q

Hair cell leukemia cells morphology/presentation

A

Cells with filamentous, hair-like cells projections (fuzzy appearing on LM)
presents with massive splenomegaly
peripheral lymphadenopathy is very uncommon

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10
Q

Hair cell leukemia - aspiration?

A

dry because of Marrow fibrosis

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11
Q

Hair cell leukemia cells detection

A
  1. Stains TRAP (Tatrate-resistant acid phosphate)

2. Flow cytometry (largely replaced TRAP)

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12
Q

Hair cell leukemia treatment

A
  1. Cladribine

2. Pentostatin

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13
Q

Auer robs

A

Perioxidase + cytoplasmic inclusions seen mostly in M3 AML

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14
Q

AML risk factors

A
  1. Prior exposure to alkylating chemotherapy
  2. Radiation
  3. Myeloroliferative disorders
  4. Myelodysplastic
  5. Down syndrome
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15
Q

AML common presentation

A

DIC

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16
Q

AML M3 treatment

A

If t(15;17).. M3 subtype respond to all trans retinoic acid (vit A), inducing differentiation of meyloblasts

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17
Q

Philadelphia ch

A

t(9;22)

BCR-ABL

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18
Q

CML cells

A

Mature and Maturing granoulocytes
Neutrophils
Metamyelocytes
Basophils

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19
Q

Blast crisis

A

CML transform to AML or ALL

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20
Q

CML vs leukemoid reaction

A

CML has very low LAP as a result of low activity in malignant neutrophils (vs benign neutrophilia)

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21
Q

t8;14

A

Burkitt lymphoma (c-myc)

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22
Q

t9;22

A

Philadelphia (BCR-ABL)

  • CML
  • rarely ALL
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23
Q

t11;14

A

Mantle (cyclin d1)

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24
Q

t14;18

A

Follicular lymphoma (BCL-2)

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25
Q

t12;21

A

Better prognosis ALL

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26
Q

t15;17

A

M3 AML subtype respond to vit A

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27
Q

Langerhans cell histiocytosis present in a child as

A
  1. Lytic bone lesions
  2. Skin rash
  3. Recurrent otitis with a mass involving the mastoid
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28
Q

Langerhans cell histiocytosis - T cells activation

A

Cells are functionally immature and do not effectively stimulate primary T cells via antigen presentation

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29
Q

Langerhans cell histiocytosis markers

A

S-100 (mesodermal origin)

CD1a

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30
Q

Histological feature of Langerhans cell histiocytosis

A

Birdeck granules (tennis racket or rob shape on EM) are characteristic

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31
Q

Polycythemia vera definition/symptoms

A

A form of 1ry polycythemia –> disorder oh high Hct

  1. Intense itching after hot shower (due to increased basophils)
  2. Erythromelalgia (rare, severe, burning pain and red blue discoloration) due to blood clots in vessel
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32
Q

Polycythemia vera respond to

A

phlebotomy, hydroxyuream ruxolitinib (JAK1/2 inhibitor)

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33
Q

types of polyceythemia

A
  1. relative
  2. Appropriate absolute
  3. inappropriate absolute
  4. Polycythemia vera
34
Q

types of polyceythemia and O2 saturation

A
  1. relative: normal
  2. Appropriate absolute: decreased
  3. inappropriate absolute: normal
  4. Polycythemia vera: normal
35
Q

Relative polycythemia - associations

A
  1. dehydration

2. burns

36
Q

Appropriate absolute polycythemia - associations

A
  1. lung disease
  2. congenital heart disease
  3. high altitude
37
Q

Inappropriate absolute polycythemia - associations

A
  1. malignancy: renal, hepatocellular etc
  2. hydronephrosis
    (ECTOPIC EPO secretions)
38
Q

Essential thrombocytosis definition / symptoms

A

massive proliferation of megakaryocytes and platelets

symptoms: 1. Bleeding 2. Thrombosis
3. Erythromelalgia may occur

39
Q

Myelofibrosis - definition

A

Obliteration of bone marrow due to increased fibroblast activity in response to proliferation of monoclonal cell lines
(pathoma: neoplastic prolif of mature myeloid cells, esp megak –> PDGF –> marrow fibrosis)

40
Q

Chronic myeloproliferative disorders - JAK2

A

Polycythemia vera: +
Essential thromb: + (30-50%)
Myelofibrosis: + (30-50%)
CML: -

41
Q

Chronic myeloproliferative disorders - PHILDELFIA

A

CML

42
Q

Polycythemia vera - cells

A

increased RBC, WBC, platelets

43
Q

Essential thromb - cells

A

increased platelets

44
Q

myelofibrosis - cells

A

decreased RBCs

variable WBCs and platelets

45
Q

CML

A

decreased RBCs

increased WBCs and platelets

46
Q

lung cancer - who should be treated with surgery

A
  • the size is not the most important factor
  • if the lesions is large but is surrounded by normal lung and there is enough remaining lung function post resection, the surgery is still possible
47
Q

lung cancer - the surgery is not possible if

A
  1. bilateral disease or lymph nodes involved on opposite size
  2. malignant pleural effusion
  3. heart, carina, aorta, or cena cava is involved
48
Q

lung cancer screen

A

annually with low-dose chest cancer in those with:

adults 55-80 who with 30 pack year smoking history

49
Q

ovarian cancer - most accurate test

ovarian cancer - initial test

A

most accurate: biopsy

initial: U/S

50
Q

ovarian cancer - treatment

A

the only cancer in which removing large amounts of locally metastatic disease will benefit the patient. Remove all visible tumor and pelvic organs and give chemotherapy

51
Q

Azathioprine, 6-mercaptopurine, 6-thioguanine side effects

A
  1. Myelosuppresion 2. GI. 3. Liver
52
Q

Cladribine (2-CDA) clinical use / toxicity

A

Hairy cell leukemia

  1. Myelosupression
  2. Nephrotoxicity
  3. Neurotoxicity
53
Q

Cytarabine (arabinofuranosyl cytidine) clinical use / toxicity

A 
AML
LYMPHOMAS 
1. Leukopenia 
2. Thrombocytopenia 
3. Megaloblastic anemia
54
Q

Methotrexate (MTX) toxicity

A
  1. Myelosupression (REVERSIBLE WITH LEUCOVORIN)
  2. Hepatotoxicity
  3. Mucositis (mount ulcers)
  4. Pulmonary fibrosis
55
Q

5-fluorouracil toxicity

A

Myelosupression (NOT REVERSIBLE WITH LEUCOVORIN)

56
Q

Antitumor antibiotics

A
  1. Bleomycin
  2. Dactinomycin (actinomycin D)
  3. Doxorubicin, daunorubicin
57
Q

Bleomycin side effects

A
  1. Pulmonary fibrosis
  2. MINIMAL myelosupression
  3. Skin hyperpigmentation
58
Q

Dactinomycin (actinomycin D) side effects

A

Myelosuppression

59
Q

Doxorubicin,

Daunorubicin side effects

A

Toxic to tissues following extravasation

  1. Dilated cardiomyopathy
  2. Alopecia
  3. Myelosuppression
60
Q

How to prevent dilated cardiomyopathy with doxorubicin or daunorubicin administration

A

Dexrazoxane, an iron chelatin agent

61
Q

Alkylating agents

A

Busulfan
Cyclophosphamide, isosfamide
Nitrosoureas (carmustine, iomustine, semustine, streptozocin)

62
Q

Busulfan side effects

A
  1. Severe myelosuppression (almost always)
  2. Pulmonary fibrosis
  3. Hyperpigmentation
63
Q

Nitrosoureas toxicity

A

Cns: 1. Dizziness 2. Ataxia 3. Convulsion

64
Q

Cyclophosphamide, ifosfamide toxicity

A
  1. Myelosuppresion

2. Hemorrhagic cystitis

65
Q

Partially Prevent hemorrhagic cystitis in Cyclophosphamide, ifosfamide by:

A

Mesna (thiol group of mesna binds toxic metabolitis)

66
Q

Microtubule inhibitors

A
  1. Paclitaxel, and others taxols
  2. Vincristine
  3. Vinblastine
67
Q

Paclitaxel toxicity

A
  1. Myelosuppression
  2. Alopecia
  3. Hypersensitivity
  4. Neuropathy
68
Q

Vinblastin toxicity

A

Myelossupression

69
Q

Vincristine toxicity

A
  1. Neurotoxicity: (areflexia, peripheral neuritis)

2. Paralytic ileus

70
Q

Hydroxyurea clinical use

A
  1. Melanoma
  2. CML
  3. Sickle cell anemia (increases HbF)
71
Q

Hydroxyurea toxicity

A
  1. SEVERE myelosuppression

2. GI upset

72
Q

Imatinib clinical use

A
  1. CML (BCR-ABL)

2. GI stromal tumors (c kit)

73
Q

Imatinib toxicity

A

Fluid retention

74
Q

Rituximab toxicity

A

Increased risk of progressive multifocal leukoencephalopathy

75
Q

Cisplatin carboplatin toxicity

A
  1. Nephrotoxicity
  2. Ototoxicity
  3. peripheral neuropathy
76
Q

How to prevent cisplatin or carboplatin associated nephrotoxicity

A

Amifostine (free radical scavenger) chloride (saline) diuresis

77
Q

Etoposide, tenoposide - mechanism of action

A

Inhibits topoisomerase 2–> dna degradation

78
Q

Etoposide tenoposide toxicity

A
  1. Myelosuppression
  2. Gi upset
  3. Alopecia
79
Q

Irinotecan, topotecan mechanism of action

A

Inhibit topoisomerase 1 and prevent DNA unwinding and replication

80
Q

Irinotecan, topotecan toxicity

A
  1. Severe myelosuppression

2. Diarrhea

81
Q

Trastuzumab (herceptin) toxicity / clinical use

A

Cardiotoxicity

Her2 + breast cancer and gastric cancer

82
Q

SERMs (tamoxifen, raloxifene) clinical

A

Tamoxifen: breast cancer treatment
Raloxifene: prevent osteoporosis
Both: breast cancer prevention

Hematology And Oncology (21 decks)

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