Haem: Interactive Leukaemia Cases Flashcards

1
Q

What is a mediastinal mass in a child with a high WBC likely to be?

A

Thymoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which type of leukaemia can cause thymoma?

A

Acute lymphoblastic leukaemia of T cell lineage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the main technique used to identify the type of acute leukaemia?

A

Immunophenotyping

NOTE: cytochemistry is not very good at predicting whether it is an acute lymphoblastic leukaemia or a primitive myeloid leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a bad prognostic feature in leukaemia?

A

Very high WCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What feature seen on blood film would suggest that a leukaemia is myeloid in lineage?

A
  • Granules
  • Auer rods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which techniques are used to determine whether cells are lymphoid or myeloid?

A
  • Cytochemistry
  • Immunophenotyping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is a diagnosis of acute promyelocytic leukaemia confirmed?

A
  • Cytogenetic/FISH/molecular genetic analysis
  • 15;17 translocation forming the PML:RARA fusion gene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is acute promyelocytic leukaemia treated?

A
  • Platelets
  • Chemotherapy
  • All-trans-retinoic acid (ATRA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the prognosis of acute promyelocytic leukaemia?

A

Complete remission can be achieved

90% 5-year survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why might APML cause a short APTT?

A

There is so much activation of coagulation factors that it accelerates the clotting of the plasma once calcium is added when APTT is being measured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Aside from chronic leukaemia, which other condition must you consider in an elderly patient with anaemia?

A

Myelodysplastic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a dimorphic blood film?

A

Presence of hypochromic microcytes and macrocytic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the main difference between polycythaemia vera and essential thrombocythaemia?

A
  • PV - increase in RBC and platelet count
  • ET - isolated raised platelet count
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the best investigation for diagnosing polycythaemia vera?

A

Molecular analysis for JAK2 mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is polycythaemia vera treated?

A

Venesection + hydroxycarbamide

NOTE: venesection alone is NOT sufficient if the patient also has a high platelet count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly