HEME Flashcards
What is Burkitt’s lymphoma? What is the characteristic translocation and what is the demographics of this? ( young boys sub-Saharan Africa, starry starry sky pattern from van Gogh)
A high grade malignant tumor of lymphoid stem cells, that divides rapidly. (responds to chemotherapy) Neoplastic lymphoid cells that originate from the LN or BM may infiltrate other tissues, and so extranodal sites, such as the mandible and facial soft tissue is more prominent in this disease.
· Common in sub-Saharan Africa where it is endemic among children infected with EBV
What is waterhouse fredricksons syndrome?
In Meningococcemia, massive adrenal hemorrhages (Waterhouse-Friderichsen Syndrome) are related to fibrin thrombi within the microcirculation of the adrenal cortex, causing bilateral adrenal hemorrhages, shock and death.
What is the characteristic Reed-Sternberg cell? Where would it be found in, what condition?
All histologic sub types of hodgkins lymphoma contain the characteristic Reed-Sternberg Cell/Common to all of these subtypes are the pathogneumonic “Reed-Sternberg” cells, cells with a bilobed, mirror-image nucleus with prominent nucleoli, surrounded by a clear halo that is reminiscent of an owl’s eye.
General features of Hodgkins lymphoma?
· most common of the malignant lymphomas that is pathologically distinct from other lymphoid malignancies.
· affects males more than females
· more common in whites than in blacks
· affects all age groups, the age distribution is bimodal, with one peak at 20 years and another after 50 years of age
What is monoclonal spike?
· The monoclonal spike on Serum Electrophoresis supports of diagnosis of Myeloma, followed by Serum Protein Immunoelectrophoresis which concentrates on the gamma region for the determinations of both the heavy and light chains
How do you diagnose multiple myeloma? What is multiple myeloma? What are Bence-Jones Proteins?
· The immunoglobulins secreted by the plasma cells are also excreted in the kidneys, where it damages the tubules and contributes to deterioration of renal function. The light chains of the immunoglobulins are secreted in the urine as “Bence-Jones Proteins”.
· The presence of Bence-Jones Proteins in a 24 hour urine electrophoresis is present in over 90% of cases
Which type of leukemia has an association with the Philadelphia chromosome and what is the Philadelphia chromosome? (in other words whats the translocation)
-Chronic Myelogenous Leukemia; 95% of pt’s with CML have the Philadelphia Chromosome (Ph1).
· The result of this translocation t(9:22) is the Philadelphia Chromosome, a shortened 22 but with two genes not normally together encoding and producing a uncontrolled protein (tyrosine kinase) causing CML.
Remember the physiology of pernicious anemia having to do with intrinsic factor.
· A chronic condition caused by malabsorption of Vitamin B12, usually due to a lack of gastric intrinsic factor, needed for absorption.
· Because of a reduced number of gastric parietal cells, they do not produce sufficient amounts of Intrinsic Factor.
What is the schlling test?
Cobalamine absorption is measured indirectly by administering radioactive cobalamine and measuring its excretion in the urine. Patients with Pernicious Anemia have an inability to absorb the orally-given cobalamine.
