Haem- malignancy

Question 1

leukaemia

Answer 1

a group of blood cancers with an increase in white blood cells

Question 2

chronic myeloid leukaemia

Answer 2

Proliferation of myeloid cells - granulocytes and their precursors, other lineages (platelets)

Question 3

cytogenetic change that is characteristic of CML

Answer 3

Philadelphia chromosome- t(9:22)

Question 4

Philadelphia chromosome results in a new gene-

Answer 4

BCR-ABL1

Question 5

three phases of CML

Answer 5

chronic phase
accelerated phase
blast phase

Question 6

CML chronic phase

Answer 6

can last around 5 years
often asymptomatic

Question 7

CML accelerated phase

Answer 7

high proportion of the cells in the bone marrow and blood (10-20%)
patients become more symptomatic, develop anaemia, thrombocytopenia, and become more immunocompromised

Question 8

CML blast phase

Answer 8

high proportion of blast cells (>30%)
This phase has severe symptoms and pancytopenia
It is often fatal

Question 9

CF of CML

Answer 9

asymptomatic
splenomegaly
hyper metabolic symptoms
gout

Question 10

treatment of CML

Answer 10

tyrosine kinase inhibitors e.g. imatinib

Question 11

MOA of tyrosine kinase inhibitors e.g. imatinib

Answer 11

Prevents the action of theBCR-ABL fusion protein i.e.this is the abnormal protein produced by the Ph mutation

Question 12

acute myeloid leukaemia

Answer 12

malignant disease of primitive myeloid cells (excess of myeloblasts)

Question 13

acute myeloid leukaemia common age range

Answer 13

> 60 years

Question 14

acute lymphoblastic leukaemia

Answer 14

Malignant disease of primitive lymphoid cells (lymphoblasts)

Question 15

Most common childhood cancer

Answer 15

acute lymphoblastic leukaemia

Question 16

ALL often associated with?

Answer 16

Down syndrome

Question 17

CF of ALL

Answer 17

marrow failure- anaemia, infections, bleeding
leukaemic effects
bone pain

Question 18

abnormal cells ‘blasts’ features

Answer 18

large size
high nuclear:cytoplasmic ratio
prominent nucleolus

Question 19

blood film specific to AML

Answer 19

Auer rod- Blast cells have rods inside their cytoplasm

Question 20

diagnostic tool required for definite diagnosis of AML/ALL

Answer 20

immunophenotyping

Question 21

multi-agent chemotherapy in AML

Answer 21

intensive chemo (3-4 cycles)
prolonged hospitalisation

Question 22

multi-agent chemotherapy in ALL

Answer 22

can last up to 2-3 years
different phases of treatment at varying intensity

Question 23

Hickman line

Answer 23

used to provide long-term central venous access

Question 24

complications of acute leukaemia

Answer 24

anaemia
neutropenia
thrombocytopenia

Question 25

neutropenia complication

Answer 25

infections- increased severity and duration
gram negative bacteria can cause life threatening sepsis in neutropenic patients
prolonged neutropenia makes patients susceptible to fungal infections

Question 26

thrombocytopenia complication

Answer 26

bleeding- purport, petechiae

Question 27

complications of anti-leukaemic treatment

Answer 27

nausea and vomitting
hair loss
liver, renal dysfunction
tumour lysis syndrome
infection
late affects (eg infertility, cardiomyopathy)

Question 28

single most important prognostic factor in AML

Answer 28

cytogenic type

Question 29

females/males have better prognosis in ALL?

Answer 29

females

Question 30

chronic lymphocytic leukaemia

Answer 30

chronic proliferation of a single type of well differentiated lymphocyte, usuallymature B-lymphocytes

Question 31

common age range for CLL

Answer 31

> 55 years

Question 32

CF of CLL

Answer 32

asymptomatic
non-specific (night sweats etc)
lymph node/spleen enlargement
infections
bleeding
warm autoimmune haemolytic anaemia

Question 33

blood film findings in CLL

Answer 33

> lymphocytes
smear cells