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Julia PCP2 > Haematology > Flashcards

Haematology Flashcards

1
Q

What is myeloma?

A

Monoclonal expansion of an antibody M-protein or Bence-Jones protein

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2
Q

What is myeloma?

A

Monoclonal expansion of an antibody M-protein or Bence-Jones protein

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3
Q

What is the normal % of plasma cells in the bone marrow?

A
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4
Q

What can be detected in the urine if the clonal proliferation occurs in the light chain component of the immunoglobulin?

A

Bence-Jones protein

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5
Q

What is the paraprotein found in the serum or urine when a clonal immunoglobulin is present?

A

M-protein

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6
Q

MGUS: what are the values of serum M-protein (g/L) and marrow clonal plasma cells (%)?

A

Serum M-protein

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7
Q

What is the only difference between smouldering myeloma & multiple myeloma

A

Presence of CRAB features

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8
Q

What are the CRAB features of myeloma?

A

C - hypercalcaemia
R - renal insufficiency
A - anaemia
B - bone lesions (lytic)

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9
Q

What is the normal % of plasma cells in the bone marrow?

A
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10
Q

What can be detected in the urine if the clonal proliferation occurs in the light chain component of the immunoglobulin?

A

Bence-Jones protein

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11
Q

What is the paraprotein found in the serum or urine when a clonal immunoglobulin is present?

A

M-protein

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12
Q

MGUS: what are the values of serum M-protein (g/L) and marrow clonal plasma cells (%)?

A

Serum M-protein

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13
Q

What is the only difference between smouldering myeloma & multiple myeloma

A

Presence of CRAB features

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14
Q

What are the CRAB features of myeloma?

A

C - hypercalcaemia
R - renal insufficiency
A - anaemia
B - bone lesions (lytic)

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15
Q

Besides the CRAB features, what are some of the clinical consequences of myeloma?

A

Hyperviscosity, amyloidosis, recurrent infections

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16
Q

What are the clinical manifestations of hypercalcaemia?

A

Abdominal pain, renal stones, delirium, osteopenia

17
Q

What test is diagnostic for multiple myeloma & what bodily secretions can it be performed on?

A

Protein electrophoresis - on serum or urine

18
Q

What markers are used for prognostic estimations in multiple myeloma?

A

LDH, B-2 microglobulin, serum albumin

19
Q

What are the treatments for multiple myeloma?

A

Chemotherapy (thalidomide based + alkylator + steroids), autologous transplants

+ symptom control: renal support, bone supplements, blood transfusions

20
Q

What medications are used for symptoms relief in multiple myeloma?

A
  • Transfusions for anaemia
  • Vitamin D supplements ± bisphosphonates for fractures
  • Fluids for renal insufficiency
21
Q

What are the 3 broad lineages of lymphoma classification according to the WHO?

A
  • Hodgkin lymphoma
  • B-cell non-Hodgkin lymphoma
  • T-cell non-Hodgkin lymphoma
22
Q

In terms of aggressiveness, name 1 low, 1 intermediate and 1 high type of B cell non-Hodgkin lymphoma.

A

Low: follicular lymphoma
Intermediate: diffuse large B-cell non-Hodgkin lymphoma
High: Burkitt lymphoma

23
Q

What are 4 clinical presentations of lymphoma?

A
  • SOB & cough
  • Abdominal discomfort
  • Lymphadenopathy
  • PUO & night sweats
24
Q

What cells found in the lymph nodes are pathognomic of Hodgkin lymphoma?

A

Reed-Sternberg cells

25
Q

Which immunohistochemical stains confirm a diagnosis of Hodgkin lymphoma?

A

CD15 and CD30

26
Q

How is Hodgkin lymphoma staged?

A

Ann-Arbor staging: according to extent of disease - ie. one or multiple nodes involved, one or both sides of the diaphragm

27
Q

What sort of lymphoma is diffuse large B-cell lymphoma?

A

An intermediately aggressive non-Hodgkin lymphoma

28
Q

What serum markers indicate aggressive disease in diffuse large B-cell lymphoma?

A

Serum uric acid and LDH

29
Q

Chemotherapy targets which receptor on B cells in diffuse large B-cell lymphoma?

A

CD20

30
Q

Which clinical syndrome might be seen in tumour lysis syndrome?

A

Hyperuricaemia, hypercalcaemia, hyperphosphataemia, hyperkalaemia & acute renal failure

31
Q

What prophylactic treatment can be provided for tumour lysis treatment?

A

Uric acid lowering agents, hydration

32
Q

What are some risk factors for the development of leukaemia?

A
  • Previous cytotoxic therapy
  • Exposure to ionizing radiation
  • Chemical exposure
  • Infections, eg/ EBV
  • Genetics
  • Rare familial syndromes
33
Q

What are some clinical features of acute leukaemia (name 4)?

A
  • Petechiae
  • Lethargy
  • Infection
  • SOB
  • B symptoms - fevers, sweats, weight loss
34
Q

What bone marrow feature is diagnostic of an acute leukaemia?

A

Blast cells accounting for >20% of nucleated cells in the bone marrow

35
Q

Which feature found in bone marrow aspirates is pathognomic of acute myeloid leukaemia?

A

Auer rods

36
Q

What does immunophenotyping (flow cytometry) show?

A

Specific surface proteins that the malignant cells possess, eg/ CD15 and CD30 in Hodgkin lymphoma

37
Q

What is the use of cytogenetics in leukaemia?

A

Cytogenetics can be used diagnostically & prognostically in leukaemia. They provide information about the particular genetic abnormalities possessed by the malignant cells.

Julia PCP2 (21 decks)

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