Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

5. Senior Block- Cancer Care > Haematological Malignancies and BM Failure > Flashcards

Haematological Malignancies and BM Failure Flashcards

1
Q

What is a hematopoietic stem cell?

A

A cell isolated from the blood or bone marrow that can renew itself and is able to differentiate into a variety of specialised cells.

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

What 3 cellular mechanisms contribute to a haematological malignancy developing?

A

Too many cells proliferating
Cells do not apoptose
Cells do not differentiate (maturation arrest)

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

Give 3 risk factors for Acute Lymphoblastic Leukaemia

A 
Prenatal x-rays 
Radiation exposure
Down's syndrome 
Neurofibromatosis type 1
Smoking 
Previous chemotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the pathophysiology of ALL

A

Proliferation of lymphoblasts (B or T cells). he excess cells do not work correctly so are unable to fight infection. The bone marrow also cannot produce enough platelets and red cells due to the excess of white cells which results in anaemia.

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

Where does ALL commonly metastasise to?

A 
Lymph nodes 
Liver 
Spleen
Brain 
CNS
Testicles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give 5 clinical features of ALL

A 
Fever
Weakness
Increased risk of infections 
Fatigue 
Easy bleeding and bruising 
Bone pain 
Weight loss 
SOB
Lymphadenopathy 
Hepatosplenomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give 4 investigations done when ALL is suspected

A 
FBC with differential 
LFTs
U+Es
DNA Analysis (Philadelphia + FISH) 
Cytogenic analysis
Lumbar puncture
Bone marrow aspiration and biopsy
Immunophenotyping 
Chest x-ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 3 phases of treating ALL?

A
  1. Remission induction
  2. Consolidation/intensification
  3. Maintenance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the main management techniques of ALL?

A

Chemotherapy –> started immediately
Radiotherapy
Stem cell transplant
Targeted therapy –> tyrosine kinase inhibitor, monoclonal antibodies

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

Give 4 risk factors for Chronic Lymphocytic Leukaemia

A 
>60 years old
Male 
White 
Hx of CLL in family 
Russian-Jew heritage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the pathophysiology of CLL?

A

Excess production of lymphocytes with a slow disease progression

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

Give 4 clinical features of CLL

A 
*Asymptomatic* 
Increased risk of infections 
Lymphadenopathy 
Night sweats
Fatigue
Weight loss
Hepatosplenomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is CLL investigated?

A 
FBC + differential 
Immunophenotyping 
Bone marrow aspiration + biopsy 
CT Scan 
FISH 
Flow cytometry 
Chest x-ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is CLL managed?

A 
Monitor if caught early and no symptoms 
Chemotherapy 
Targeted therapy 
Radiotherapy 
Splenectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give 4 risk factors for AML

A 
Smoking 
Obesity 
Previous childhood ALL
Male
Hx of chemotherapy 
Myelodysplastic syndromes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Explain the pathophysiology of AML

A

Myeloid stem cells become abnormal myeloblasts which cannot become healthy white cells. The cells produce too many non-functioning monocytes or granulocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does AML commonly metastasise to?

A

CNS
Skin
Gums

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give 4 clinical features of AML

A 
Fever
Easy bleeding/bruising
Weight loss
Bone pain 
Hepatosplenomegaly 
SOB 
Weakness
Increased risk of infections 
Lymphadenopathy 
Pale skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is AML investigated?

A 
FBC + differential 
Cytogenic analysis
Immunophenotyping 
Peripheral blood smear
Bone marrow aspiration and biopsy 
LP 
RT-PCR
Chest x-ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is AML managed?

A

Chemotherapy
Radiotherapy

Stem cell transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Give 2 risk factors for CML

A

> 60 years old

Philadelphia gene mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the pathophysiology of CML?

A

The Philadelphia gene mutation results in excess tyrosine kinase production which causes too many stem cells to become underdeveloped white blood cells (granulocytes). Cancer progresses slowly over many years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Give 4 clinical features of CML

A 
Tiredness
Weight loss
Increased bleeding and bruising 
Bone pain 
Night sweats
Fever 
Hepatospenomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is CML investigated?

A 
FBC + differential 
U+Es
LFTs
Bone marrow aspiration and biopsy 
Cytogenetic analysis
FISH
RT-PCR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How is CML managed?

A

Tyrosine kinase inhibitors

Chemotherapy
Biological therapy
Stem cell transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Essential Thrombocytopenia?

A

Excess proliferation of the precursors to platelets so bone marrow makes too many platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Give 2 risk factors for Essential Thrombocytopenia

A

> 50 years old
Female
Abnormal JAK2 gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Give 4 clinical features of Essential Thrombocytopenia

A 
Headache
Thrombosis
Lightheaded 
Peripheral neuropathy 
Splenomegaly 
Fatigue 
Weakness
Haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How is Essential Thrombocytopenia investigated?

A

FBC
JAK2 mutation testing
Bone marrow biopsy (rule out other causes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How is Essential Thrombocytopenia treated?

A

Low dose aspirin
Cytoreductive therapies
Interferon alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Why is it important to monitor Essential Thrombocytopenia?

A

Can transform to myelofibrosis or leukaemia

32
Q

Give 2 risk factors for Polycythemia Vera

A

> 60 years
Male
JAK2 mutation

33
Q

Describe the pathophysiology of Polycythemia Vera

A

Body makes too many red cells so blood becomes thicker and slower.

34
Q

Give 4 clinical features of Polycythemia Vera

A 
Thrombosis
Headache
Blurred vision 
Weakness
Sweating
Fatigue
Dizziness
Splenomegaly 
Gout
Pruritus
Peptic ulcers
35
Q

How is Polycythemia Vera investigated?

A

FBC
JAK2 mutation testing
Bone marrow biopsy

36
Q

How is Polycythemia Vera treated?

A

Aspirin
Phlebotomy
Cytoreductive therapies

37
Q

Why is it important to monitor Polycythemia Vera?

A

Can transform to myelofibrosis or leukaemia

38
Q

What is myelofibrosis?

A

Clonal disorder of hematopoietic stem cells. Abnormal cells produce cytokines which cause bone marrow fibrosis. Can occur spontaneously or after a previous bone marrow disorder

39
Q

Give 2 risk factors for myelofibrosis

A

> 50 years old
JAK2 mutation
Previous myeloproliferative disorder

40
Q

Give 4 clinical features of myelofibrosis

A 
Splenomegaly 
Fatigue
Fever
Increased infections
Hepatomegaly 
Weakness
41
Q

How is myelofibrosis investigated?

A

FBC, US, MRI, Genetic testing, Bone Marrow biopsy

42
Q

How is myelofibrosis managed?

A 
Supportive Care
Cytoreduction 
JAK2 inhibitors
Splenomegaly
Bone marrow transplant
43
Q

What are the two main subtypes of Lymphoma?

A

Hodgkin

Non-Hodgkin

44
Q

Give 4 risk factors for Hodgkin Lymphoma

A 
Male 
Immunodeficient 
Obesity 
Smoking
Epstein Barr virus
FHx
Aged around 25 and around 80
45
Q

What is the pathophysiology of Hodgkin Lymphoma?

A

Malignant proliferation of lymphocytes causing lymphadenopathy and organ infiltration.

46
Q

What cells characterise Hodgkin Lymphoma?

A

Reed-Sternberg cells

Popcorn cells

47
Q

Give 4 clinical features of Hodgkin Lymphoma

A 
Lymphadenopathy --> enlarged, painless, non-tender lymph node, ache after drinking alcohol
Night sweats
Fevers
Weight loss
Itching, worse after drinking alcohol 
Cough 
SOB
Increased risk of infections 
Increased risk of bleeding 
Hepatosplenomegaly
48
Q

What is the gold standard test for diagnosing Hodgkin Lymphoma?

A

Lymph node excision biopsy

49
Q

What tests can be done to investigate Hodgkin Lymphoma?

A 
Lymph node excision biopsy 
CT CAP
Chest x-ray 
Bloods --> FBC, U+Es, LFTs, CRP, LDH, urate, Ca2+
Bone marrow aspirate and biopsy
50
Q

Describe the Lugano classification system

A

Stage 1 –> lymphoma in single group of LNs
Stage 2 –> lymphoma in >2 sites of LNs but same side of the diaphragm
Stage 3 –> lymphoma in LNs on both sides of the diaphragm
Stage 4 –> lymphoma spread to an extranodal site eg. liver, bones, lungs

51
Q

What are B symptoms in regard to lymphoma?

A

Night sweats
Fever
Unexplained weight loss

52
Q

When is a lymphoma described as ‘bulky disease’?

A

LN >10 cm or large tumour in mediastinum

53
Q

How is Hodgkin Lymphoma managed?

A

Chemotherapy
Radiotherapy to affected lymph nodes
+/- Steroids

Preservation of fertility –> egg/sperm collection

54
Q

Give 4 risk factors for Non-Hodgkin Lymphoma

A 
Immunodeficiency
Epstein Barr virus
Hepatitis C
H. pylori
Coeliac disease
FHx
HIV
HTLV1
55
Q

What is the pathophysiology of Non-Hodgkin Lymphoma?

A

Malignant proliferation of lymphocytes. Can be classified into whether B cells or T cells are affected.
Low grade –> better prognosis
High grade –> aggressive

56
Q

Give 4 clinical features of Non-Hodgkin Lymphoma

A 
Painless swellings in neck, armpit or groin 
Night sweats
Fevers
Weight loss
Itching 
SOB 
Increased risk of infections 
Hepatosplenomegaly 
Enlarged tonsils 
Increased bleeding
57
Q

How is Non-Hodgkin Lymphoma investigated?

A

Lymph node biopsy
Chest x-ray
Bloods –> FBC, U+Es, LFTs, LDH, viral screen
CT CAP

58
Q

How is Non-Hodgkin Lymphoma treated?

A

Chemotherapy
Radiotherapy
Immunotherapy- Rituximab
Watch and wait

59
Q

What is Monoclonal Gammopathy of Undetermined Significance (MGUS)?

A

Paraprotein (abnormal protein) found in urine or blood by incidental finding. Do not need treatment but need follow up due to risk of transition into myeloma

60
Q

Give 3 risk factors for myeloma?

A 
> 40 years old
FHx
Immunodeficiency 
Pernicious anaemia
SLE
Ank. spond
Obesity 
MGUS
61
Q

What is the pathophysiology of myeloma?

A

Atypical proliferation of plasma cells in the bone marrow which produces paraproteins (mAb). Production of excess immunoglobulins, usually IgG

62
Q

What is light chain myeloma?

A

Only the light chain of the immunoglobulins is produced and not the whole thing. Can be detected in the urine

63
Q

Give 4 clinical features of myeloma

A 
CRAB
Calcium increase
Renal failure --> IgG damages kidneys
Anaemia 
Bony lesions

Increased bleeding and bruising
Bone pain and fractures
Increased risk of infections

64
Q

How is myeloma investigated?

A 
Bloods --> FBC, U+Es, LFTs, ESR, serum protein electrophoresis, serum free light chain assay, Ca2+, albumin, beta-2 microglobulin
Urine sample
Bone marrow biopsy
Chest x-ray 
CT CAP
MRI
65
Q

How is myeloma managed?

A

Chemotherapy
Biological therapy- Thalidomide
Steroids- dexamethasone, prednisolone
Stem cell transplant

66
Q

What is a low level of red cells called?

A

Anaemia

67
Q

What is a low level of platelets called?

A

Thrombocytopenia

68
Q

What is a low level of white cells called?

A

Neutropenia

69
Q

Give 3 symptoms of anaemia

A

Tachycardia
Tachypnoea
Reduced exercise tolerance
SOB

70
Q

Give a sign of thrombocytopenia

A

Increased bruising and bleeding

71
Q

Give a sign of neutropenia

A

Increased infections

72
Q

What is the condition where all 3 cell lines from the bone marrow are depleted?

A

Aplastic anaemia

73
Q

Give 3 risk factors for aplastic anaemia

A 
FHx
HIV
Immunodeficiency
Illegal drug use
Exposure to radiation
74
Q

Give 3 symptoms of aplastic anaemia

A

SOB
Increased bleeding
Increased infections
Reduced exercise tolerance

75
Q

How is aplastic anaemia treated?

A

Immunotherapy
Platelet and red cell transplant
Aggressive infection treatment
Reduce infection risk

76
Q

How is aplastic anaemia investigated?

A 
FBC
Reticulocyte count
B12 and folate levels 
Infection screen
LFT
U+Es
TFT
Bone marrow aspirate and biopsy
77
Q

Give 3 potential causes of bone marrow failure

A 
Congenital 
Infections --> HIV, Hep C, EBV, parvovirus
Drug induced --> NSAIDs, phenytoin, carbamazepine
Immune related 
Radiation exposure
Vitamin deficiency --> B12/folate
Infiltration --> myeloma, myelofibrosis
Idiopathic

5. Senior Block- Cancer Care (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions