Hematologic System Flashcards

0
Q

Lymphoma and staging

A
  • RFs: EBV, H. pylori, HIV, organ/stem cell transplant, autoimmune disease
  • Imaging/tests: CT, PET, bone marrow bx
  • Dx: cervical or axillary node excisional bx
  • *Burkitt lymphoma**
  • translocation of c-myc on chrom 8 to chrom 14 which leads to overexpression of c-myc and excess B cell proliferation
  • *Follicular lymphoma**
  • 14:18 translocation which leads to over expression of bcl-2 which prevents apoptosis
  • *CLL**
  • B-cell lineage
  • Sx: fatigue, frequent infections, lymphadenopathy, splenomegaly, thrombocytopenia, increase in circulating mature lymphpcytes
  • Tx: chemo, stem cell transplant
  • *Hairy cell leukemia**
  • B cell lymphoma in middle aged men
  • Sx: pancytopenia, massive splenomegaly
  • Hairy cells detected by TRAP stain (hairy monster in a trap)
  • Flow cytometry
  • *Non-Hodgkin Lymphoma**
  • Sx: painless lymphadenopathy
  • Dx: NEED TISSUE BX, flow cytometry, FNA bx
  • Labs: CBC, LFTs, uric acid, Ca, serum protein electrophoresis, CXR, CT, bone marrow bx, LP, PET scan
  • Tx: rituximab, chemo
  • GI lymphoma: most commonly seen in stomach
    • RF= H. pylori
    • Sx: abdominal pain, obstruction, GI hemorrhage, GI tract perforation, fatigue
    • Tx: surgical resection with removal of draining LNs, chemo
  • *Hodgkin Lymphoma**
  • 20-30yo and >50yo
  • Sx: nontender lymphadenopathy, fever, night sweats, wt loss
  • Dx: LN bx (will see Reed-Sternberg cells)
  • Tx: Low stage= radiotherapy. Advanced stage= chemotherapy.
  • Good prognosis
  • *Ann Arbor Staging**
  • Stage 1: single LN region
  • Stage 2: 2 or more LN regions on the same side of the diaphragm
  • Stage 3: Both sides of the diaphragm are involved
  • Stage 4: Involvement of extra-nodal sites (liver, bone marrow)
  • A: asymtomatic
  • B: Symptoms (wt loss, fever, night sweats)
  • E: extralymphatic involvmement
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1
Q

Anemia

A
  • All women of childbearing age should have CBC done before any surgical procedure
  • IDA in an elderly pt is colorectal carcinoma until proven otherwise
  • anisocytosis=variation in size of RBCs
  • poikilocytosis= variation in shape of RBCs
  • Target cells: Thalassemia
  • Howell Jolly bodies: sickle cell, hemolytic anemia
  • Iron def is the most common cause of anemia
  • Microcytic: iron def, anemia of chronic disease, sideroblastic anemia, thalassemia
  • Macrocytic: Vit B12 def, Folate def
  • Normocytic: hemolysis, acute blood loss
  • Sx:HA, dyspnea, palpitations, dizziness, fatigue, dark urine, pallor, icterus, glossitis, koilonychia, angular cheilitis, tachypnea, tachycardia, pica (with IDA)
  • Dx: gold standard is bone marrow bx, but this is rarely done.
  • Labs: CBC, peripheral blood smear, reticulocyte count, UA, stool for occult blood, serum Fe(decreased in IDA), TIBC(increased in IDA), serum ferritin(decreased in IDA)
  • Tx IDA: oral iron (ferrous sulfate), parenteral iron, blood transfusion if Hgb <6g/dL (generally if 6-7, possible if 7-8),
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