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Year 3- Specialties > Haematology- Lymphoproliferative Disorders > Flashcards

Haematology- Lymphoproliferative Disorders Flashcards

1
Q

Leukaemia?

A

Any type of cancer seen in the blood

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2
Q

Lymphoma?

A

Cancer of lymphoid origin

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3
Q

What are some of the symptoms of lymphoma?

A

Enlarged lymph nodes

Can be extranodal involvement

Can be bone marrow involvement

Weight loss, fever, night sweats, fatigue, pruitis

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4
Q

How are lymphomas/leukemia’s diagnosed?

A

Biopsies from either lymph node or bone marrow

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5
Q

How are lymphoma/leukemia’s staged?

A

Some sort of imaging, usually CT

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6
Q

What are the four most common lymphoproliferative disorders?

A

Acute lymphoblastic leukemia
Chronic lymphoblastic leukemia
Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma

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7
Q

What are the two divisions of non-Hodgkin’s lymphoma?

A

High grade
Low grade

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8
Q

What is the most common type of lymphoms?

A

Non-Hodgkin’s High-grade lymphoma

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9
Q

What happens in Acute lymphoblastic leukaemia?

A

Rapid, uncontrolled growth of lymphoid progenitor cells

Usually in bone marrow but they can go anywhere

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10
Q

Which age group is acute lymphoblastic leukaemia most common in?

A

Children

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11
Q

How does acute lymphoblastic leukaemia present?

A

2-3wk history of bone marrow failure or joint/bone pain

->typical history: young/young adult, impaired vision, weight loss, fatigue.

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12
Q

What is the treatment for acute lymphoblastic leukaemia?

A

Multi-agent intensive chemotherapy +/- allogeneic stem cell transplant
T-cell immunotherapy

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13
Q

What are some of side effects of T-cell immunotherapy?

A

Cytokine release syndrome- fever, hypotension, dyspnea

Neurotoxicity- confusion, headaches, focal neurology, coma

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14
Q

What are some of the factors which mean there is a poorer risk of recovery?

A

Increased age
Increased white cell count
Slow/poor response to treatment

->still 40% remission rate, but usually 90% approx.

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15
Q

Typical presentation of acute lymphoblastic leukaemia?

A

Bone marrow failure +/- raised white cell count
Bone pain, infection, sweats

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16
Q

What is the difference between acute lymphoblastic leukaemia and chronic lymphoblastic leukaemia?

A

Chronic lymphoblastic leukaemia grow a lot ore slowly, if at all.
Rarely needs treatment.

->requires a lymphocyte count >5 for diagnosis

17
Q

How does chronic lymphoblastic leukaemia present?

A

Usually asymptomatic.

Frequent findings:
bone marrow failure, lymphadenopathy, splenomegaly, fever and sweats

Less common findings:
hepatomegaly, infections, weight loss

18
Q

How is chronic lymphoblastic leukaemia usually found?

A

Incidentally, usually when looking at blood results

19
Q

What are some of the associated findings in patients with chronic lymphoblastic leukaemia?

A

Immune paresis (loss of normal immunoglobulin production)
Haemolytic anaemia

20
Q

Treatment for chronic lymphoblastic leukaemia
is not usually required.

What are some of the indications for treatment of chronic lymphoblastic leukaemia?

A

-Progressive bone marrow failure
-Massive lymphadenopathy
-Progressive splenomegaly
-Lymphocyte doubling time <6 months or >50% increase over 2 months
-Systemic symptoms
-Autoimmune cytopenias

21
Q

Treatment, if required, for chronic lymphoblastic leukaemia?

A

Targeted treatments: ibruinib, idelalisib, venetoclax

22
Q

What are the poor prognostic factors for chronic lymphoblastic leukaemia?

A

Genetic profile: p53 loss/mutation

23
Q

Presentation of lymphoma?

A

Lymphadenopathy/ Hepatosplenomegaly
Extranodal disease
Weight loss, fatigue, fever (B symptoms)
Bone marrow involvement

24
Q

How are lymphomas staged?

A

Lymph node biopsy
CT scan
Bone marrow aspirate

25
Q

Which type of cell are the majority of Hon-Hodgkin lymphomas derived from?

A

B cells

26
Q

What is the difference between low-grade and high-grade non-Hodgkin lymphomas?

A

Low grade lymphoma:
-Often asymptomatic
-Responds to chemotherapy but incurable

High grade lymphoma:
-Aggressive, fast-growing
-Require combination chemotherapy
-Can be cured

27
Q

What is the most common high grade lymphoma?

A

Diffuse large B-cell lymphoma

28
Q

Treatment of high-grade non-Hodgkin’s lymphoma?

A

Combination chemotherapy

29
Q

At which ages are Hodgkin’s lymphoma most common?

A

1st peak at 15-35yrs
2nd peak later life

30
Q

What are some of the associations of Hodgkin’s lymphoma?

A

Epstein Barr virus
Familiar link
Geographical clustering

31
Q

Treatment of Hodgkin’s lymphoma?

A

Combination chemotherapy +/- radiotherapy
Monoclonal antibodies
Immunotherapy

->all of these apply to almost all lymphoproliferative disorders he said :)

32
Q

Which investigation is important in the role of assessment to response to treatment in Hodgkin lymphoma?

A

PET scan

33
Q
A

Year 3- Specialties (26 decks)

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