haem Flashcards
key aspects of acute lymphoblastic leukaemia?
most common in children 2-4 yrs or 45+ associated with down’s syndrome blood film = blast cells bruising philadelphiachromosome
key aspects of chronic lymphocytic leukaemia?
older adults
associated with warm haemolytic anaemia - autoimmune disorder characterized by the premature destruction of healthy rbc (haemolysis)
richter transformation into high grade lymphoma
blood film = smear or smudge
key aspects of chronic myeloid leukaemia?
3 phases: 5 year asymptomatic chronic phase, immunocompromised accelerated phase, blast phase (severe symptoms and pancytopenia)
associated with philadelphia chromosome
key aspects of acute myeloid leukaemia?
most common ACUTE leukaemia in adults
result of transformation from a myeloproliferative disorders (stem cell disorder)
blood film = raised blast cells (rods inside cytoplasm called auer rods)
what are the age ranges for different types of leukaemia?
ALL CeLLmates have CoMmon AMbitions
ALL = 2-4 or 45+ CLL = 55+ CM = 65+ AM = 75+
symptoms of leukaemia?
fatigue, fever, failure to thrive pallor, petechia abnormal bleeding, abnormal bruising hepatosplenomegaly (liver and spleen go massive) lymphadenopathy (swollen nodes)
investigations for leukaemia?
FBC, blood film, LDH (may be raised), bone marrow biopsy (definitive diagnosis), chest x-ray (infection or swollen nodes), lymph node biopsy, CT (look at tumours)
what is pancytopenia?
combo of anaemia, leukopenia and thrombocytopenia (reduced rbc, wbc, platelets)
wtf is leukaemia ?
genetic mutation in precursor cell of bone marrow = excessive production of 1 type of abnormal wbc = suppression of other cells = pancytopenia
bone marrow biopsy? plus bone marrow aspiration vs bone marrow trephine?
biopsy = taken from iliac crest using specialist needle, local anaesthetic
aspiration = taking liquid sample of cells from bone marrow (faster) trephine = taking solid core of bone marrow (better assessment of cells/structure but longer wait time)
management of leukaemia?
primary = chemotherapy and steroids other = radiotherapy, bone marrow transplant, surgery
complications of chemo?
failure, stunted growth/development in children, infections due to immunodeficiency, neurotoxicity, infertility, secondary malignancy, cardio toxicity, tumour lysis syndrome
what is tumour lysis syndrome? how is it treated?
release of uric acid from cells being destroyed by chemo = uric acid forms crystals in interstitial tissue and tubules of kidneys = causes acute kidney injury
allopurinol or rasburicase = reduce uric acid
potassium and phosphate released so must be monitored (plus calcium)
wtf is micocytic anaemia ?
small RBC, usually hypochromic (less colour) due to lack of pigment which carries oxygen
wtf is normocytic anaemia ?
normal sized rbc but low in number (if anaemia and MCV normal = normocytic)