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Haematology > Haematological Malignancies > Flashcards

Haematological Malignancies Flashcards

1
Q

Most common childhood cancer

A

Acute lymphoblastic leukaemia

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2
Q

Epidemiology of acute myeloid leukaemia

A

more common in elderly

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3
Q

Difference between “acute” and “chronic” leukaemiad

A

both are proliferation of abnormal blood cell progenitors
in acute types there is also a block to maturation/differentiation
This does not occur in the chronic types.

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4
Q

characteristics of a ‘blast’

A

high nuclear to cytoplasmic ration

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5
Q

Auer rod

A

seen in acute myeloid leukaemia

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6
Q

how are leukaemias investigated

A 
Blood count and film
Coag screen
Marrow aspirate
Immunophenotype - definitive diagnosis
Cytogenetics - prognostic significance
Trephine biopsy (piece of bone) better assessment and helpful is aspirate sub optimal
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7
Q

what is immunophenotyping

A

uses flow cytometry to look at what proteins (antigens) are present on the cell surface using antibodies

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8
Q

Describe the curative treatment of ALL

A

chemotherapy lasting up to 2-3 years

induction, consolidation, intensification and maintenance

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9
Q

Decribe the curative treatment of AML

A

intensive
2-4 cycles of chemo (5-10 days of chemo followed by t-4 weeks recoveraly)
prolonged hospitalisation

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10
Q

how is chemo administered

A

via a hickman line (central venous catheter)

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11
Q

what type of bacteria usually causes neutropenic sepsis

A

gram negatives

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12
Q

name the complications associated with marrow supression in leukaemias

A

anaemia
neutropenia
thrombocytopenia - bleeding, purpura, petechia

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13
Q

complications of chemotherapy

A 
nausea and vomiting
hair loss
liver, renal dysfunction
tumour lysis syndrome
loss of fertility
cardiomyopathy with antracyclines
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14
Q

what is tumour lysis syndrome

A

a group of metabolic abnormalities that can occur as a complication during the treatment of cancer,[1] where large amounts of tumor cells are killed off (lysed) at the same time by the treatment, releasing their contents into the bloodstream

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15
Q

what is APML

A

acute promyelocytic leukaemia- associated with specific translocation and DIC

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16
Q

how does chemo/radiothearpy work

A

damages cells as they are dividing

cell recognises damaged beyond repair so undergoes apoptosis

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17
Q

which genetic conditions have an increased risk of haematoligcal malignancies (leukaemia)

A

downs

klinefleters

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18
Q

what type of cells does chronic lymphocytic leukaemia usually affect

A

b cells

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19
Q

what is seen on blood film of CLL and is pathoneumonic

A

smear cells

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20
Q

treatment of CLL

A

watchful waiting
supportive
chemo
rituximab

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21
Q

what is ricter syndrome

A

transformation of CLL to high grade B cell lymphoma

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22
Q

name the myeloproliferative disorders

A

polycythaemia rubra vera
Essential thrombocythemia
Myelofibrosis
CML

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23
Q

symptoms of polycythaemia

A

headaches, visual distrubances, vascular events, erythromylagia, gout, itching classically after shower or bath - due to increased histamine release

24
Q

treatment of polycythaemia

A

venesection
aspirin
hydroxyurea

25
Q

what is polycythaemia

A

myeloproliferative disorder in which there is increase roduction of red blood cells

26
Q

what is ET

A

increased megakaryocytes - increased platelets

27
Q

how is ET treated

A

antiplatelets

hydroxyurea

28
Q

what is myelofibrosis

A

also increased megakaryocity production but leads to bone marrow fibrosis and inefective erythropoesis
no increased platelets like in ET

29
Q

“tear drop poikilocytes”

A

myelofirosis

30
Q

treatment of myelofibrossi

A

bone marrow transplant

31
Q

philidelphia chromosome

A

CML

translocation of BCR - ABL chromosomes 22 and 9.

32
Q

specific treatment of CML

A

tyrosine kinase inhibitor - imatinib

33
Q

most common type of lymphoma

A

non hodgkins (80 percent) - usually b cell

34
Q

name types of t cell lymphoma

A

cutaneous (mycosis fungoides)

enteropathy (in coeliac)

35
Q

reed sternberg cells

A

hodgkins lymphoma

36
Q

most common type of hodgkins

A

nodular sclerosing

37
Q

staging of lymphoma

A

1 - one site of lymphadenopaty e.g. neck
2 - two sites on same side of diapgragm e.g. neck and axilla
3. - two or more sites on different sides of diaphragm e.g. neck and groin
4. - widespread extra nodal involvement multiple sites

38
Q

what is myeloma

A

cancer affecting plasma cells - disease characterised by abnormal monoclonal antibody formation (para proteins)

39
Q

what type of antibodies affected in myeloma

A

IgG

40
Q

bence jones proteins

A

myeloma

41
Q

myeloma symptoms

A

lytic bone lesions due to increased osteoclast activity
hypercalcaemia
renal failure
bone marrow faillure - anaemia and neutropenia

42
Q

blood film in myeloma

A

rouleux

43
Q

raised ESR + osteoporosis

A

myeloma until proven otherwise

44
Q

treatment of myeloma

A

supportive - hydrate, bisphosphates, local radiotherrapy, EPO and transfusions
life prolonging - prednisilone and bone marrow transplant

45
Q

typical sites of bone lesions in myeloma

A

vertebrae
skull
ribs

46
Q

investigation of leukaemia

A

FBC and blood film
marrow aspirate/biopsy
immunophenotyping
cytogenetics - prognosis

47
Q

investigation of lymphoma

A

FBC and blood film
ultrasound and excisional biopsy
immunohistochemistry - to subclassify e.g. CD 20 positice in NHL and CD30 positive reed sternberg cells in hodgkins
immunophenotyping

48
Q

what is seen on electrophoresis of serum protein in myeloma

A

a large narrow spinke in gamma region - - due to increased monoclonal antibodies - IgG

49
Q

investigation of myeloma

A 
serum protein electrophoresis
serum light chain assay
bone marrow examination 
urin protein eletrophoresis
xrays of the bones
50
Q

describe the process of b cell maturation

A

b cell identifies antigen in circulation and moves to lymph node (naive b cell)
enters mantle zone (mantle cell)
enters germinal centre (centroblast –> centrocyte)
enters marginal zone (marginal)
enters circulation (plasma cell)

51
Q

give the types of lymphoma arising from each stage of b cell

A 
naive - small lymphcytic
mantle - mantle
centroblast - diffuse large b cell
centrocyte - follicular 
marginal - marginal
52
Q

give the high grade lymphomas

A

burkitts
diffuse large b cell
mantle

more curable

53
Q

give the low grade lymphomas

A

small lymphocytlc
follicular
marginal

less curable

54
Q

which lymphoma is associated with EBV

A

burkitts

55
Q

type types of non hodgkins

A

classical

nodular sclerosing

56
Q

most common type of NHL

A

nodular sclerosing

Haematology (21 decks)

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